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dc.contributor.authorRoberts, Derek J
dc.contributor.authorFaris, Peter D
dc.contributor.authorBall, Chad G
dc.contributor.authorKirkpatrick, Andrew W
dc.contributor.authorMoore, Ernest E
dc.contributor.authorFeliciano, David V
dc.contributor.authorRhee, Peter
dc.contributor.authorD'Amours, Scott
dc.contributor.authorStelfox, Henry T
dc.date.accessioned2021-10-21T14:40:12Z
dc.date.available2021-10-21T14:40:12Z
dc.date.issued2021-10-14
dc.identifier.urihttp://hdl.handle.net/10713/16904
dc.description.abstractBackground: It is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy. Methods: A self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted. The survey collected information about trauma center and program characteristics. It also asked how often the trauma program director estimated DC laparotomy was performed on injured patients at that center on average over the last year. Multivariable logistic regression was used to identify predictors of a higher reported frequency of use of DC laparotomy. Results: Of the 366 potentially eligible trauma centers sent the survey, 199 (51.8%) trauma program directors or leaders responded [United States = 156 (78.4%), Canada = 26 (13.1%), and Australasia = 17 (8.5%)]. The reported frequency of use of DC laparotomy was highly variable across trauma centers. DC laparotomy was used more frequently in level-1 than level-2 or -3 trauma centers. Further, high-volume level-1 centers used DC laparotomy significantly more often than lower volume level-1 centers (p = 0.02). Nearly half (48.4%) of high-volume volume level-1 trauma centers reported using the procedure at least once weekly. Significant adjusted predictors of more frequent use of DC laparotomy included country of origin [odds ratio (OR) for the United States vs. Canada = 7.49; 95% confidence interval (CI) 1.39-40.27], level-1 verification status (OR = 6.02; 95% CI 2.01-18.06), and the assessment of a higher number of severely injured (Injury Severity Scale score > 15) patients (OR per-100 patients = 1.62; 95% CI 1.20-2.18) and patients with penetrating injuries (OR per-5% increase = 1.27; 95% CI 1.01-1.58) in the last year. Conclusions: The reported frequency of use of DC laparotomy was highly variable across trauma centers. Those centers that most need to evaluate the benefit-to-risk ratio of using DC laparotomy in different scenarios may include high-volume, level-1 trauma centers, particularly those that often manage penetrating injuries.en_US
dc.description.urihttps://doi.org/10.1186/s13017-021-00396-7en_US
dc.language.isoenen_US
dc.publisherSpringer Natureen_US
dc.relation.ispartofWorld Journal of Emergency Surgery : WJESen_US
dc.rights© 2021. The Author(s).en_US
dc.subjectCross-sectional studyen_US
dc.subjectDamage control laparotomyen_US
dc.subjectSurgical variationen_US
dc.subjectWounds and injuriesen_US
dc.titleVariation in use of damage control laparotomy for trauma by trauma centers in the United States, Canada, and Australasiaen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s13017-021-00396-7
dc.identifier.pmid34649583
dc.source.volume16
dc.source.issue1
dc.source.beginpage53
dc.source.endpage
dc.source.countryEngland


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