Indications, mortality, and long-term outcomes of 50 consecutive patients undergoing damage control laparotomy for abdominal gunshot wounds

Outcomes of patients undergoing damage control laparotomy (DCL) for abdominal gunshot wounds (GSWs) remains relatively unknown. The purpose of this study was to evaluate the impact of DCL on long term morbidity and survival.

This retrospective study was conducted on patients undergoing a damage control laparotomy for abdominal GSWs. The data were collected using 50 consecutive trauma patients over a 4.5-year-period between August 1st, 2004 and September 30th, 2009. The patients were classified regarding the characteristics, such as age, perioperative physiological parameters, trauma indices, number of abdominal GSWs, critical care unit stay, hospital length of stay, morbidity, and mortality. Univariate and multivariate logistic regression was employed to compute the odds of survival and estimate the unadjusted and adjusted association between these factors.

According to the results, the majority of the patients were male (96%) with a mean age of 29.7 years who had a single abdominal gunshot wound (60%). Liver injuries (58%) followed by small bowel (44%), majors venous (40%), and colonic (38%) trauma were observed in the patients. The overall mortality rate was obtained at 54%. The mean length of intensive care unit stay and mean hospital length of stay were 7 and 13 days, respectively. Factors associated with a decreased odds of survival included Penetrating Abdominal Trauma Index (PATI) > 25, intra-operative blood lactate level > 8 mmol/L, and massive transfusion >10 units packed red blood cells.

After controlling the confounding factors, a PATI score of > 25 was associated with a decreased odds of survival (OR: 0.20, P=0.04).