Introduction: The trauma room at Oslo University Hospital- Ulleval is fully equipped for major damage control\r\nprocedures, in order to minimize delay to surgery. Since 2006, patients in need of immediate laparotomy have\r\nincreasingly been transferred to a dedicated trauma operating room (OR). We wanted to determine the decrease in\r\nnumber of procedures performed in the emergency department (ED), the effect on time from admission to\r\nlaparotomy, the effect on non-therapeutic laparotomies, and finally to determine whether such a change could be\r\nundertaken without an increase in mortality.\r\nMethods: Retrospective evaluation of haemodynamically unstable trauma patients undergoing laparotomy during\r\nthe period 2002ââ?¬â??2009. Based on time for protocol change Period 1 was defined as 2002ââ?¬â??2006 and Period 2 as\r\n2007ââ?¬â??2009. Significance was set at p < 0.05.\r\nResults: A total of 167 consecutive patients were included; 103 patients from Period 1 and 64 from Period 2. We found\r\na 42% decrease in ED laparotomies (p < 0.001). Median time to laparotomy increased from 24.0 to 34.0 minutes from\r\nPeriod 1 to Period 2 (p = 0.029). Crude mortality fell from 57% to 39%. The proportion of non-therapeutic laparotomies\r\nin the OR tended to be lower over the whole study period.\r\nConclusion: Moving this cohort of haemodynamically compromised trauma patients in need of emergency\r\nlaparotomy out of the ED to a dedicated OR resulted in longer median time to laparotomy, but did not increase\r\nmortality.
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