Efficacy of direct-to-operating room trauma resuscitation: a systematic review
Abstract Background Hemorrhage control is a time-critical task, and recent studies have demonstrated that a shorter time to definitive care is positively associated with patient survival and functional outcomes. The concept of direct transport to the operating room was proposed in the 1960s to reduc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13017-023-00532-5 |
| _version_ | 1797350078588911616 |
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| author | Dongmin Seo Inhae Heo Donghwan Choi Kyoungwon Jung Hohyung Jung |
| author_facet | Dongmin Seo Inhae Heo Donghwan Choi Kyoungwon Jung Hohyung Jung |
| author_sort | Dongmin Seo |
| collection | DOAJ |
| description | Abstract Background Hemorrhage control is a time-critical task, and recent studies have demonstrated that a shorter time to definitive care is positively associated with patient survival and functional outcomes. The concept of direct transport to the operating room was proposed in the 1960s to reduce treatment time. Some trauma centers have developed protocols for direct-to-operating room resuscitation (DOR) programs. Moreover, few studies have reported the clinical outcomes of DOR in patients with trauma; however, their clinical effect in improving the efficiency and quality of care remains unclear. In this systematic review, we aimed to consolidate all published studies reporting the effect of DOR on severe trauma and evaluate its utility. Methods The PubMed, EMBASE, and Cochrane databases were searched from inception to April 2023, to identify all articles published in English that reported the effect of direct-to-operating room trauma resuscitation for severe trauma. The articles were reviewed as references of interest. Results We reviewed six studies reporting the clinical effect of operating room trauma resuscitation. A total of 3232 patients were identified. Five studies compared the actual mortality with the predicted mortality using the trauma score and injury severity score, while one study compared mortality using propensity matching. Four studies reported that the actual survival rate for overall injuries was better than the predicted survival rate, whereas two studies reported no difference. Some studies performed subgroup analyses. Two studies showed that the survival rate for penetrating injuries was better than the predicted survival rate, and one showed that the survival rate for blunt injuries was better than the predicted survival rate. Five studies reported the time to surgical intervention, which was within 30 min. Two studies time-compared surgical intervention, which was shorter in patients who underwent DOR. Conclusion Implementing DOR is likely to have a beneficial effect on mortality and can facilitate rapid intervention in patients with severe shock. Future studies, possibly clinical trials, are needed to ensure a proper comparison of the efficiency. |
| first_indexed | 2024-03-08T12:39:39Z |
| format | Article |
| id | doaj.art-a2e6863821f84250a3594fbce65c224e |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-03-08T12:39:39Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-a2e6863821f84250a3594fbce65c224e2024-01-21T12:14:44ZengBMCWorld Journal of Emergency Surgery1749-79222024-01-011911910.1186/s13017-023-00532-5Efficacy of direct-to-operating room trauma resuscitation: a systematic reviewDongmin Seo0Inhae Heo1Donghwan Choi2Kyoungwon Jung3Hohyung Jung4Division of Trauma Surgery, Department of Surgery, Ajou University School of MedicineDivision of Trauma Surgery, Department of Surgery, Ajou University School of MedicineDivision of Trauma Surgery, Department of Surgery, Ajou University School of MedicineDivision of Trauma Surgery, Department of Surgery, Ajou University School of MedicineDivision of Trauma Surgery, Department of Surgery, Ajou University School of MedicineAbstract Background Hemorrhage control is a time-critical task, and recent studies have demonstrated that a shorter time to definitive care is positively associated with patient survival and functional outcomes. The concept of direct transport to the operating room was proposed in the 1960s to reduce treatment time. Some trauma centers have developed protocols for direct-to-operating room resuscitation (DOR) programs. Moreover, few studies have reported the clinical outcomes of DOR in patients with trauma; however, their clinical effect in improving the efficiency and quality of care remains unclear. In this systematic review, we aimed to consolidate all published studies reporting the effect of DOR on severe trauma and evaluate its utility. Methods The PubMed, EMBASE, and Cochrane databases were searched from inception to April 2023, to identify all articles published in English that reported the effect of direct-to-operating room trauma resuscitation for severe trauma. The articles were reviewed as references of interest. Results We reviewed six studies reporting the clinical effect of operating room trauma resuscitation. A total of 3232 patients were identified. Five studies compared the actual mortality with the predicted mortality using the trauma score and injury severity score, while one study compared mortality using propensity matching. Four studies reported that the actual survival rate for overall injuries was better than the predicted survival rate, whereas two studies reported no difference. Some studies performed subgroup analyses. Two studies showed that the survival rate for penetrating injuries was better than the predicted survival rate, and one showed that the survival rate for blunt injuries was better than the predicted survival rate. Five studies reported the time to surgical intervention, which was within 30 min. Two studies time-compared surgical intervention, which was shorter in patients who underwent DOR. Conclusion Implementing DOR is likely to have a beneficial effect on mortality and can facilitate rapid intervention in patients with severe shock. Future studies, possibly clinical trials, are needed to ensure a proper comparison of the efficiency.https://doi.org/10.1186/s13017-023-00532-5Direct-to-operating roomTraumaMortalityTreatment outcome |
| spellingShingle | Dongmin Seo Inhae Heo Donghwan Choi Kyoungwon Jung Hohyung Jung Efficacy of direct-to-operating room trauma resuscitation: a systematic review World Journal of Emergency Surgery Direct-to-operating room Trauma Mortality Treatment outcome |
| title | Efficacy of direct-to-operating room trauma resuscitation: a systematic review |
| title_full | Efficacy of direct-to-operating room trauma resuscitation: a systematic review |
| title_fullStr | Efficacy of direct-to-operating room trauma resuscitation: a systematic review |
| title_full_unstemmed | Efficacy of direct-to-operating room trauma resuscitation: a systematic review |
| title_short | Efficacy of direct-to-operating room trauma resuscitation: a systematic review |
| title_sort | efficacy of direct to operating room trauma resuscitation a systematic review |
| topic | Direct-to-operating room Trauma Mortality Treatment outcome |
| url | https://doi.org/10.1186/s13017-023-00532-5 |
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