Year: 2024
Type: article
Study design: Observational Study
Abstract: Introduction Trauma laparotomy outcomes are influenced by both patient and system factors. Out of hours (OOH) is associated with reduced staffing and on-site seniority which may impact patient outcomes. We aimed to establish if OOH laparotomy is associated with poorer outcomes. Methods A retrospective analysis was performed on all patients that underwent a trauma laparotomy at a major trauma centre between 2019 and 2023. Groups were divided into in-hour admission (IH) (08:00 - 20:00) and OOH (20:00– 08:00). The primary outcome was mortality and secondary outcomes included intensive care and total length of stay. Statistical analysis was performed to determine differences between groups. Results 176 patients were included. The majority (62.5%) were OOH and penetrating the commonest mechanism of injury in both OOH (63.6%) and IH (57.5%). Comparing those admitted OOH and IH there was no difference inactivation of code red protocols (42.7% vs 39.4% p=0.663). ITU admissions (36.3% vs 43.9% p=0.318), length of ITU stay (mean days 9.1 ± 11.1 vs 15.7 ±17.4 p=0.068), total hospital stay (mean days 14.4 ± 25.3 vs 19 ± 25.4 p=0.204) or mortality (7.3% vs 4.5% p=0.469). Conclusion Although a larger proportion of trauma laparotomies occur in the OOH period, no statistical difference was found in any patient outcomes. This is likely due to established processes in our mature trauma model.
Source: British journal of surgery
Authors: James Green, Lachlan Dick
Institutions: Imperial College Healthcare NHS Trust, NHS Lothian
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402373028