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Complications after laparotomy for trauma: a retrospective analysis in a level I trauma centre

Langenbeck's Archives of Surgery volume 400, pages 83–90 (2015)Cite this article

Abstract

Purpose

Laparotomy is a potential life-saving procedure after traumatic abdominal injury. There is limited literature about morbidity and mortality rates after trauma laparotomy. The primary aim of this study is to describe the complications which may occur due to laparotomy for trauma.

Methods

Retrospective evaluated single-centre study with data registry up to 1 year after initial laparotomy for trauma was performed in a level 1 trauma centre in The Netherlands. Between January 2000 and January 2011, a total of 2390 severely injured trauma patients (ISS ≥ 16) were transported to the VUMC. Patient demographics; mechanism of injury; injury patterns defined by Abbreviated Injury Scale (AIS), Injury Severity Score (ISS) and Revised Trauma Score (RTS); surgical interventions and findings; and morbidity and mortality were documented.

Results

A total of 92 trauma patients who underwent a trauma laparotomy met the inclusion criteria. Of these patients, 71 % were male. Median age was 37 years. Median ISS was 27. Mechanisms of injury comprised of car accidents (20 %), fall from height (17 %), motorcycle accidents (12 %), pedestrian/cyclist hit by a vehicle (9 %) and other in three patients (5 %). Penetrating injuries accounted for 37 % of the injuries, consisting of stab wounds (21 %) and gunshot wounds (16 %). Complications classified by the Clavien-Dindo Classification of Surgical Complications showed grade I complications in 21 patients (23 %), grade II in 36 patients (39 %), grade III in 21 patients (23 %), grade IV in 2 patients (2 %) and grade V in 16 patients (17 %).

Conclusion

Laparotomy for trauma has a high complication rate resulting in significant morbidity and mortality. Most events occur in the early postoperative period. Further prospective research needs to be conducted in order to identify possibilities to improve care in the future.

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Conflicts of interest

None.

Authors’ contributions

All authors have made substantial contributions to all of the following: (1) study conception and design, acquisition of data, analysis and interpretation of data, drafting of manuscript and critical revision of manuscript. They have given final approval of the version to be submitted.

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Affiliations

  1. Department of Trauma Surgery, VU University Medical Centre, De Boelelaan 1117, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands

    Matthijs H. van Gool, Georgios F. Giannakopoulos, Leo M. G. Geeraedts Jr. & Wietse P. Zuidema

  2. Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands

    Elly S. M. de Lange-de Klerk

Authors
  1. Matthijs H. van Gool
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  2. Georgios F. Giannakopoulos
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  3. Leo M. G. Geeraedts Jr.
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  5. Wietse P. Zuidema
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Correspondence to Matthijs H. van Gool.

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van Gool, M.H., Giannakopoulos, G.F., Geeraedts, L.M.G. et al. Complications after laparotomy for trauma: a retrospective analysis in a level I trauma centre. Langenbecks Arch Surg 400, 83–90 (2015). https://doi.org/10.1007/s00423-014-1260-0

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Keywords

  • Trauma
  • Abdominal injury
  • Laparotomy
  • Complications