SRS83 Patey Prize Entrant - Textbook outcomes from trauma laparotomy in the South Wales Major Trauma Network—an observational cohort study

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Abstract Aims Report the outcomes of patients undergoing trauma laparotomy (TL) at the Major Trauma Centre, including 30 day mortality, Adapted Clavien-Dindo in Trauma (ACDiT) and Textbook Outcome. Analyse factors associated with patient death after injury. Methods An observational cohort study, from 1/9/20 to 31/12/24. Any adult patient undergoing TL at the Major Trauma Centre was included. Data were collected using a standardised Microsoft Form and analysed using SPSS. Chi square test was used to compare categorical values and Kruskal-Wallis to compare continuous variables. Results Of 102 eligible patients, 93 were included, the median age was 32 (IQR 21–46) and 74% of patients were male. The median time pre-hospital was 118 mins (67–177). Blunt mechanisms (66%) were more frequent than penetrating (34%), the frequency of TLs increased over time to 3 per month in 2024. Tranexamic acid was received pre-theatre by 81% (75) of patients, however 43% (40) received a crystalloid infusion. Overall 30-day mortality was 11% (10) rising to 16% (10) in the blunt trauma cohort. A Textbook Outcome was recorded in 53% (49) of patients. Blunt mechanism of injury and lower GCS on arrival were significantly associated with mortality. Diastolic BP, base deficit, lactate and haemoglobin were significantly associated with mortality. Conclusions Blunt mechanism, admission GCS, diastolic BP, base deficit, lactate and Hb were associated with mortality, this can be used to help identify patients at high risk of mortality. Future work will look at longer term follow up including patient reported outcomes.

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