Kenneth W Bueltmann1, Marek Rudnicki2. 1Advocate Illinois Masonic Medical Center, Chicago, Il, 2University of Illinois
Introduction: The incidence of trauma and its heavy burden upon the healthcare system remain strong. Paradigm shifts in the management of these cases has, however, improved the mortality in such cases. It can be expected that improvements in management, when combined with the benefits of laparoscopy, will demonstrate positive impacts upon treatment outcomes.
Methods: The Nationwide Inpatient Sample was referenced for inpatient stays for the years 2004 to 2014. Abdominal trauma cases were selected and identified as hollow (HO) or solid organ (SO) type, and as blunt or penetrating. The trauma subset was then scanned for the presence of discrete laparoscopic procedures, laparotomy, and converted cases, and flagged accordingly. The rates of laparoscopic (LC), open (OC), and converted cases (CC) were calculated at statistically evaluated using SAS 9.2.
Results: From 2004 to 2014, 117,158 cases presented as abdominally located blunt trauma. The majority of cases involved SO injury (85%). The LC use in these patients increased 196% from 2004 to 2014 (0.48 +/- 0.06% to 1.42 +/- 0.14% , p<.0001), whereas in HO the rate of LC increased 149% (3.75 +- 0.4% to 8.1 +/- 0.76% , p<.0001). OC remained stable over the study period with no significant difference in utilization, currently at 2.1 +/- 0.2% and 5.3 +/- 0.6%, for SO and HO, respectively. The number of CC increased 180% for SO (from 0.41 +/- 0.06% to 1.2 +/- 0.1%, p<.0346) and 83% for HO (2.45 +/- 0.35% to 4.5 +/- 0.57%, p<.0001). Details of utilization of different surgical approaches in patients with HO and SO injuries are presented in tables below
Conclusion: Utilization of laparoscopy in treatment of intraabdominal solid and hollow organs injury increases over time. Although current analysis based on available HCUP NIS data include any procedures done during post-traumatic hospitalization, its results can lead to conclusion that minimally invasive technique is being utilized in increased fashion.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88424
Program Number: P702
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster