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• W4306179017 abstract "INTRODUCTION: Emergent operative exploration is the standard of care for penetrating thoracoabdominal trauma. With advanced CT imaging, preoperative scans may be obtained efficiently for operative planning. This study aims to determine if CT imaging before operative exploration for hemodynamically stable thoracoabdominal gunshot wound injuries adversely affects patient outcomes. METHODS: This was a retrospective chart review was performed between 2014 and 2019 at an urban trauma center to identify hemodynamically stable patients who suffered penetrating thoracoabdominal gunshot wound and had operative intervention. Patients were then stratified into 2 groups: (1) those who received CT imaging before operative intervention, and (2) those who went straight to the operating room (OR). RESULTS: A total of 113 patients were identified. A total of 64 (56.6%) received CT imaging, and 49 (43.4%) went straight to the OR (Table). There were no differences in mortality (p = 0.25), hospital length of stay (p = 0.17), ICU length of stay (p = 0.14), ventilator days (p = 0.37), and postoperative complications (p > 0.05). Time spent in the OR and time from emergency department to end of operation were similar between groups (p = 0.051). Multivariable analysis demonstrated risk factors for time greater than 150 minutes includes Injury Severity Score, age, sex, and blood product administration. Multivariate regression displayed that for each unit of PRBC given, OR time were more likely to increase (p < 0.001). Table. - Patient Demographics and Outcome Data Demographics Overall Sample (N = 113) Group A: CT Scan before Going to the Operating Room (N = 64) Group B: Straight to the Operating Room (N = 49) p Value Age, y, mean (SD) 25.57 (7.60) 24.30 (6.74) 27.22 (8.38) 0.042 Race, % (White, Black, other, unknown) 8.0, 86.7, 1.8, 3.5 3.1, 92.2, 1.6, 3.1 14.3, 79.6, 2.0, 4.1 0.175 Sex, % (male, female) 92, 8 90.6, 9.4 93.9, 6.1 0.530 Injury Severity Score, mean (SD) 16.95 (9.42) 16.34 (8.76) 17.73 (10.26) 0.220 Hospital days, mean (SD) 11.06 (8.12) 10.42 (7.87) 11.90 (8.44) 0.142 Ventilator days, mean (SD) 2.07 (4.15) 1.95 (4.65) 2.22 (3.43) 0.370 MTP activation, n (%) 31.9% 17.2% 51% <0.0001 Total number of blood products, mean (SD) 4.00 (6.24) 2.09 (3.26) 6.49 (8.11) <0.0001 Mortality, n (%) 0.9% 0% 2.0% 0.251 CONCLUSION: Obtaining a CT scan before operative intervention in hemodynamically stable patients with thoracoabdominal gunshot wound did not affect mortality, hospital length of stay, or ventilator days, indicating that obtaining CT scans before operative intervention may be safe in select patients. This pilot serves as the basis for an ongoing regional multi-institutional study." @default.
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• W4306179017 date "2022-10-17" @default.
• W4306179017 modified "2023-09-27" @default.
• W4306179017 title "Preoperative CT Scanning in Hemodynamically Stable Thoracoabdominal Gunshot Wounds: Outcomes from a Long-Term Single-Institution Pilot Study" @default.
• W4306179017 doi "https://doi.org/10.1097/01.xcs.0000895308.58336.d6" @default.
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