Evidence map›Paper›PMID 34649583›Full record

ArticleWorld journal of emergency surgery : WJES2021

Variation in use of damage control laparotomy for trauma by trauma centers in the United States, Canada, and Australasia.

Derek J Roberts, Peter D Faris, Chad G Ball, Andrew W Kirkpatrick, Ernest E Moore, David V Feliciano, Peter Rhee, Scott D'Amours, Henry T Stelfox

Open access · goldAbstract read
In one paragraph

Article in World journal of emergency surgery : WJES, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Increased use of damage control laparotomy for emergency small bowel or colon surgery: does it affect patient outcomes?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  3. Article
  4. Physiology dictated treatment after severe trauma: timing is everything.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 3 countries.

Derek J RobertsDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, Room A-280, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada. Derek.Roberts01@gmail.com.ORCID 0000-0001-6111-6291
Peter D FarisThe O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Chad G BallThe O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Andrew W KirkpatrickDepartment of Surgery, University of Calgary and the Foothills Medical Centre, Calgary, AB, Canada.
Ernest E MooreDepartment of Surgery, School of Medicine and the Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado, Denver, CO, USA.
David V FelicianoDepartment of Surgery and Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.
Peter RheeDepartment of Surgery, Westchester Medical Center, Section of Trauma and Acute Care Surgery, New York Medical College, Valhalla, NY, USA.
Scott D'AmoursSouth Western Sydney Clinical School, UNSW, Sydney, NSW, Australia.
Henry T StelfoxThe O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Alberta Health Services · CAUniversity of Calgary · CADenver Health Medical Center · USLiverpool Hospital · AUUniversity of Maryland, Baltimore · USUniversity of Ottawa · CAWestchester Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy.

methodsA self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted. The survey collected information about trauma center and program characteristics. It also asked how often the trauma program director estimated DC laparotomy was performed on injured patients at that center on average over the last year. Multivariable logistic regression was used to identify predictors of a higher reported frequency of use of DC laparotomy.

resultsOf the 366 potentially eligible trauma centers sent the survey, 199 (51.8%) trauma program directors or leaders responded [United States = 156 (78.4%), Canada = 26 (13.1%), and Australasia = 17 (8.5%)]. The reported frequency of use of DC laparotomy was highly variable across trauma centers. DC laparotomy was used more frequently in level-1 than level-2 or -3 trauma centers. Further, high-volume level-1 centers used DC laparotomy significantly more often than lower volume level-1 centers (p = 0.02). Nearly half (48.4%) of high-volume volume level-1 trauma centers reported using the procedure at least once weekly. Significant adjusted predictors of more frequent use of DC laparotomy included country of origin [odds ratio (OR) for the United States vs. Canada = 7.49; 95% confidence interval (CI) 1.39-40.27], level-1 verification status (OR = 6.02; 95% CI 2.01-18.06), and the assessment of a higher number of severely injured (Injury Severity Scale score > 15) patients (OR per-100 patients = 1.62; 95% CI 1.20-2.18) and patients with penetrating injuries (OR per-5% increase = 1.27; 95% CI 1.01-1.58) in the last year.

conclusionsThe reported frequency of use of DC laparotomy was highly variable across trauma centers. Those centers that most need to evaluate the benefit-to-risk ratio of using DC laparotomy in different scenarios may include high-volume, level-1 trauma centers, particularly those that often manage penetrating injuries.

Indexed as

LaparotomyTrauma CentersAustralasiaCross-Sectional StudiesHumansInjury Severity ScoreUnited StatesCross-sectional studyDamage control laparotomySurgical variationWounds and injuries

Identifiers

PMID34649583
PMCPMC8515656
OpenAlexW3183206351

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.