Evaluating patient factors, operative management and postoperative outcomes in trauma laparotomy patients worldwide: a protocol for a global observational multicentre trauma study
Michael F Bath,
Justin Davies,
Andy J M Leather,
Tom Bashford,
Ramani Moonesinghe,
Kokila Lakhoo,
Katharina Kohler,
Ross Davenport,
Arthur Kwizera,
Andrew Conway Morris,
Max Marsden,
Joachim Amoako,
Brandon George Smith,
Peter John Hutchinson,
David J Clark,
Thomas Weiser,
Timothy Hardcastle,
Zane Perkins,
Laura Hobbs,
Ravi Naidoo,
Yannick Nördin
Affiliations
Michael F Bath
International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
Justin Davies
Cambridge Colorectal Unit, Addenbrooke`s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Andy J M Leather
2 School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King`s College London, London, UK
Tom Bashford
International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
Ramani Moonesinghe
National Clinical Director for Critical and Perioperative Care, NHS England, London, UK
Kokila Lakhoo
Department of Paediatric Surgery, University of Oxford, Oxford, UK
Katharina Kohler
International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
Ross Davenport
Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK
Arthur Kwizera
Department of Anesthesia, Makerere University, Kampala, Uganda
Andrew Conway Morris
Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK
Max Marsden
Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK
Joachim Amoako
Department of Surgery, Korle Bu Teaching Hospital, Accra, Ghana
Brandon George Smith
International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
Peter John Hutchinson
Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
David J Clark
Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
Thomas Weiser
Department of Surgery, Stanford University, Palo Alto, California, USA
Timothy Hardcastle
Department of Surgical Sciences, Mandela School of Medicine (NRMSM), University of KwaZulu-Natal, Durban, South Africa
Zane Perkins
Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK
Laura Hobbs
International Health Systems Group, Department of Engineering, University of Cambridge, Cambridge, UK
Ravi Naidoo
Department of Surgery, Ngwelezana Hospital, Empangeni, South Africa
Yannick Nördin
Emergency Medical Care System (SAMU), Jalisco State, Mexico
Introduction Trauma contributes to the greatest loss of disability-adjusted life-years for adolescents and young adults worldwide. In the context of global abdominal trauma, the trauma laparotomy is the most commonly performed operation. Variation likely exists in how these patients are managed and their subsequent outcomes, yet very little global data on the topic currently exists. The objective of the GOAL-Trauma study is to evaluate both patient and injury factors for those undergoing trauma laparotomy, their clinical management and postoperative outcomes.Methods We describe a planned prospective multicentre observational cohort study of patients undergoing trauma laparotomy. We will include patients of all ages who present to hospital with a blunt or penetrating injury and undergo a trauma laparotomy within 5 days of presentation to the treating centre. The study will collect system, patient, process and outcome data, following patients up until 30 days postoperatively (or until discharge or death, whichever is first). Our sample size calculation suggests we will need to recruit 552 patients from approximately 150 recruiting centres.Discussion The GOAL-Trauma study will provide a global snapshot of the current management and outcomes for patients undergoing a trauma laparotomy. It will also provide insight into the variation seen in the time delays for receiving care, the disease and patient factors present, and patient outcomes. For current standards of trauma care to be improved worldwide, a greater understanding of the current state of trauma laparotomy care is paramount if appropriate interventions and targets are to be identified and implemented.
