Abstract
Hypothesis: Awareness of guidelines for damage control can improve patient outcomes after postraumatic open abdomen. Design: Retrospective (November 1992 to December 1998), prospective (January 1999 to July 2001), 104-month study. Setting: Los Angeles County and University of Southern California Medical Center, Los Angeles. Patients: All patients undergoing damage control resulting in posttraumatic open abdomen. Main Outcome Measures: The main outcome measure was survival. Data were also collected on surgical findings and indications for damage control, including organs injured, intraoperative estimated blood loss, and intraoperative fluids, blood, and blood products administered. Postoperative complications, length of time patients had an open abdomen, and surgical intensive care unit and hospital length of stay were also recorded. Results: No difference in mortality existed between patients admitted before awareness of guidelines (group 1; 21 [24%] of 86 patients died) and patients who underwent damage control following these suggested guidelines (group 2; 13 [24%] of 53 patients died) (P=.85). Of the 139 patients, 100 had penetrating injuries and 39 had blunt injuries. Estimated blood loss was 4764±5349 mL. Mean intraoperative fluid replacement was 22034 mL. One hundred one patients (73%) experienced 228 complications, for a mean of 2.26 complications per patient. Group 1 patients spent a longer time in the operating room (mean, 4.09±1.99 hours; range, 0.4-9.5 hours) vs group 2 patients (mean, 2.34±1.50 hours; range, 0.3-6.2 hours; P
| Original language | English |
|---|---|
| Pages (from-to) | 209-215 |
| Number of pages | 7 |
| Journal | Archives of Surgery |
| Volume | 139 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2004 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Surgery
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Has Evolution in Awareness of Guidelines for Institution of Damage Control Improved Outcome in the Management of the Posttraumatic Open Abdomen? / Asensio, Juan A.; Petrone, Patrizio; Roldán, Gustavo; Kuncir, Eric; Ramicone, Emily; Chan, Linda; Cheadle, William G.; Franklin, Glen A.
In: Archives of Surgery, Vol. 139, No. 2, 02.2004, p. 209-215.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Has Evolution in Awareness of Guidelines for Institution of Damage Control Improved Outcome in the Management of the Posttraumatic Open Abdomen?
AU - Asensio, Juan A.
AU - Petrone, Patrizio
AU - Roldán, Gustavo
AU - Kuncir, Eric
AU - Ramicone, Emily
AU - Chan, Linda
AU - Cheadle, William G.
AU - Franklin, Glen A.
PY - 2004/2
Y1 - 2004/2
N2 - Hypothesis: Awareness of guidelines for damage control can improve patient outcomes after postraumatic open abdomen. Design: Retrospective (November 1992 to December 1998), prospective (January 1999 to July 2001), 104-month study. Setting: Los Angeles County and University of Southern California Medical Center, Los Angeles. Patients: All patients undergoing damage control resulting in posttraumatic open abdomen. Main Outcome Measures: The main outcome measure was survival. Data were also collected on surgical findings and indications for damage control, including organs injured, intraoperative estimated blood loss, and intraoperative fluids, blood, and blood products administered. Postoperative complications, length of time patients had an open abdomen, and surgical intensive care unit and hospital length of stay were also recorded. Results: No difference in mortality existed between patients admitted before awareness of guidelines (group 1; 21 [24%] of 86 patients died) and patients who underwent damage control following these suggested guidelines (group 2; 13 [24%] of 53 patients died) (P=.85). Of the 139 patients, 100 had penetrating injuries and 39 had blunt injuries. Estimated blood loss was 4764±5349 mL. Mean intraoperative fluid replacement was 22034 mL. One hundred one patients (73%) experienced 228 complications, for a mean of 2.26 complications per patient. Group 1 patients spent a longer time in the operating room (mean, 4.09±1.99 hours; range, 0.4-9.5 hours) vs group 2 patients (mean, 2.34±1.50 hours; range, 0.3-6.2 hours; P
AB - Hypothesis: Awareness of guidelines for damage control can improve patient outcomes after postraumatic open abdomen. Design: Retrospective (November 1992 to December 1998), prospective (January 1999 to July 2001), 104-month study. Setting: Los Angeles County and University of Southern California Medical Center, Los Angeles. Patients: All patients undergoing damage control resulting in posttraumatic open abdomen. Main Outcome Measures: The main outcome measure was survival. Data were also collected on surgical findings and indications for damage control, including organs injured, intraoperative estimated blood loss, and intraoperative fluids, blood, and blood products administered. Postoperative complications, length of time patients had an open abdomen, and surgical intensive care unit and hospital length of stay were also recorded. Results: No difference in mortality existed between patients admitted before awareness of guidelines (group 1; 21 [24%] of 86 patients died) and patients who underwent damage control following these suggested guidelines (group 2; 13 [24%] of 53 patients died) (P=.85). Of the 139 patients, 100 had penetrating injuries and 39 had blunt injuries. Estimated blood loss was 4764±5349 mL. Mean intraoperative fluid replacement was 22034 mL. One hundred one patients (73%) experienced 228 complications, for a mean of 2.26 complications per patient. Group 1 patients spent a longer time in the operating room (mean, 4.09±1.99 hours; range, 0.4-9.5 hours) vs group 2 patients (mean, 2.34±1.50 hours; range, 0.3-6.2 hours; P
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U2 - 10.1001/archsurg.139.2.209
DO - 10.1001/archsurg.139.2.209
M3 - Article
VL - 139
SP - 209
EP - 215
JO - JAMA Surgery
JF - JAMA Surgery
SN - 2168-6254
IS - 2
ER -