{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T04:29:20Z","timestamp":1777091360847,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T00:00:00Z","timestamp":1562803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Damage control laparotomy (DCL) is a lifesaving technique to minimize the lethal triad of coagulopathy, hypothermia, and acidosis. The government has nominated and supported our center as one of the regional trauma centers of South Korea since 2014. This study aimed to investigate the improving outcomes of patients undergoing DCL before and after the establishment of the trauma center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The period from January 2011 to December 2017 was divided into pre\u2010trauma center (pre\u2010TC) (2011\u20132013) and trauma center (TC) (2014\u20132017) periods. Multivariable logistic regression was performed to identify the risk factors and risk\u2010adjusted cumulative sum (RA\u2010CUSUM), and graphs were used to monitor the change in mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>Of the 485 patients who underwent trauma laparotomy, DCL was performed for 119 patients (24.5%). The operation time (99 vs. 80\u00a0min, <jats:italic>p<\/jats:italic>\u2009=\u20090.022), time from admission to operation (125 vs. 112\u00a0min, <jats:italic>p<\/jats:italic>\u2009=\u20090.010), time from admission to first treatment (119 vs. 99\u00a0min, <jats:italic>p<\/jats:italic>\u2009=\u20090.004), and time from admission to first transfusion (70 vs. 52\u00a0min, <jats:italic>p<\/jats:italic>\u2009=\u20090.009) were significantly shortened in the TC period. The ratio of plasma to packed red blood cells in massive transfusions (\u2265PRBCs 10 units within the first 24 h) was significantly increased in the TC period (0.56 vs. 0.72, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). RA\u2010CUSUM curves revealed that the risk\u2010adjusted 30\u2010day mortality improved and then plateaued in the TC period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>After the implementation of a trauma center, more prompt intervention and damage control resuscitation could be achieved. Moreover, risk\u2010adjusted mortality of DCL was improved.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05083-y","type":"journal-article","created":{"date-parts":[[2019,7,11]],"date-time":"2019-07-11T16:02:33Z","timestamp":1562860953000},"page":"2814-2821","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Quality Improvement of Damage Control Laparotomy: Impact of the Establishment of a Single Korean Regional Trauma Center"],"prefix":"10.1002","volume":"43","author":[{"given":"Wu Seong","family":"Kang","sequence":"first","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery Chonnam National University Hospital and Medical School 42, Jebong\u2010ro, Dong\u2010gu Gwangju Korea"},{"name":"Department of Trauma Surgery Wonkwang University Hospital Iksan Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4418-2729","authenticated-orcid":false,"given":"Young Goun","family":"Jo","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery Chonnam National University Hospital and Medical School 42, Jebong\u2010ro, Dong\u2010gu Gwangju Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun Chul","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Trauma Surgery, Department of Surgery Chonnam National University Hospital and Medical School 42, Jebong\u2010ro, Dong\u2010gu Gwangju 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