Improving Trauma Patient Management: Predisposing Factors for Trauma-induced Physiological Disorders and the Importance of Damage Control Surgery

Introduction Several studies have shown that correcting physiological disorders takes precedence performing definitive surgery in trauma patients, so damage control surgery (DCS) has become a widely accepted approach. This study aims to identify the predisposing factors for trauma-induced physiological disorders as a potential and proven factor for performing DCS. Method A retrospective study was conducted on trauma patients (2017- 2019). Physiological and clinical changes during the first 24 hours after emergency surgery in included patients were recorded. Patients were classified into three groups: Group 1 underwent DCS and damage control resuscitation (DCR) due to hemodynamic or physiological failure. Patients who received definitive treatment were divided in two groups, those who had physiological deterioration after surgery (Group 2), and those who remained stable based on physiological condition (Group 3). Result Out of 3,157 patients, 475 cases met the inclusion criteria. Among them, 151 (31.8%) cases had severe brain trauma as the most common severe injury. Despite group 2 having clinical and physiological stability upon arrival, they had similar mortality and more severe head injuries compared to group 1 (p=0.00). In group 1, 78.94% of patients with severe head injuries showed physiological improvement after DCS, compared to group 2, where all patients had physiological regression after definitive surgery, primarily characterized by coagulopathy and acidosis. Conclusion Severe head injury patients are at risk of physiological disorders. DCR should be prioritized with neurosurgeons and DCS considered as a preventive measure along with other injuries. This approach can prevent physiological disorders and improve patient outcomes.