An observational study assessing the global variation in patient characteristics, management, and outcomes in those undergoing trauma laparotomy

Trauma accounts for approximately 9% of all global deaths  and contributes the greatest loss of disability-adjusted life-years for adolescents and young adults worldwide . In the context of global abdominal trauma, both blunt and penetrating, the trauma laparotomy is the most commonly performed operation; it can be used both as a means to access identified injuries to organs within the abdomen and pelvis, such as life-threatening bleeding (from vessels or solid organs) or contamination (from hollow viscus injuries), or for exploratory diagnostic reasons, where cross-sectional imaging may not be easily feasible or available. Whilst mortality rates following a trauma laparotomy are substantial, ranging between 8-40% (3–8), in recent years the role of damage control resuscitation has transformed trauma care, with significant reduction in mortality and morbidity to trauma patients being observed .However, the standard of care and variation in practice occurring globally for patients undergoing a trauma laparotomy remain relatively unknown.Variation likely exists worldwide in the management and outcomes of patients following trauma laparotomy however at present its limited data exists. Hence, this study is to evaluate both patient and injury factors for those undergoing trauma laparotomy, their clinical management, and post-operative outcomes.Data will be collected through access to patient records only at each centre, performed by members of the local study team. The patient will not be contacted directly in any during their inpatient stay or after the study. The study is observational and no direct involvement in patient care will occur. Data will be collected either directly onto the REDCap cloud (see Data Management) or recorded temporarily onto a hard copy Data Collection Form, which will then be stored securely before the data then is uploaded to the REDCap cloud (with the forms subsequently being destroyed safely).The mean and standard deviation will be reported for all normally distributed variables and the median and interquartile range for non-normally distributed variables. Participating centres will be stratified based on their country into groups based on their Human Development Index (HDI) rank, with 30-day mortality then reported for each HDI group and compared using the Pearson chi squared test.