Snapshot of trauma laparotomy deaths in Queensland

ANZ J Surg. 2018 Jun;88(6):569-572. doi: 10.1111/ans.14431. Epub 2018 Mar 6.

Abstract

Background: Trauma remains the most frequent cause of death for patients under 35 years of age. Head injury and catastrophic haemorrhage account for the majority of early deaths. A trauma laparotomy is often necessary to arrest haemorrhage.

Methods: All patients who died in Queensland hospitals between 2011 and 2016 having had a trauma laparotomy were identified from the Queensland Audit of Surgical Mortality.

Results: About 69.0% of the 84 deaths were male with a median age of 47.6 years. About 64.3% of deaths occurred within the first 2 days following trauma. Mechanism of injury was typically road traffic accident (77.4%). Sixteen patients underwent a non-therapeutic laparotomy. Following peer-review, different management was recommended for only three patients.

Conclusion: This group of patients who died in the setting of a trauma laparotomy received high quality trauma care. Ongoing education is needed as some non-therapeutic laparotomies may be avoidable.

Keywords: laparotomy; mortality; quality assurance; trauma.

MeSH terms

  • Abdominal Injuries / mortality*
  • Abdominal Injuries / surgery
  • Adult
  • Age Factors
  • Aged
  • Cause of Death*
  • Cohort Studies
  • Female
  • Hospital Mortality / trends*
  • Humans
  • Incidence
  • Injury Severity Score
  • Laparotomy / methods
  • Laparotomy / mortality*
  • Male
  • Middle Aged
  • Quality Assurance, Health Care*
  • Queensland / epidemiology
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors
  • Wounds and Injuries / mortality
  • Wounds and Injuries / surgery