Abstract
IntroductionWe aimed to assess the effect of time to hepatic resection on the outcomes of patients with high-grade liver injuries who underwent damage control laparotomy (DCL). MethodsThis is a 4-year (2017–2020) analysis of the ACS-TQIP. Adult trauma patients with severe liver injuries (AAST-OIS grade ≥ III) who underwent DCL and hepatic resection were included. We excluded patients with early mortality (<24 h). Patients were stratified into those who received hepatic resection within the initial operation (Early) and take-back operation (Delayed). ResultsOf 914 patients identified, 29% had a delayed hepatic resection. On multivariable regression analyses, although delayed resection was not associated with mortality (aOR:1.060,95%CI[0.57–1.97],p = 0.854), it was associated with higher complications (aOR:1.842,95%CI[1.38–2.46],p < 0.001), and longer hospital (β: +0.129, 95%CI[0.04–0.22],p = 0.005) and ICU (β:+0.198,95%CI[0.14–0.25],p < 0.001) LOS, compared to the early resection. ConclusionDelayed hepatic resection was associated with higher adjusted odds of major complications and longer hospital and ICU LOS, however, no difference in mortality, compared to early resection.
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