{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T08:58:05Z","timestamp":1784883485587,"version":"3.55.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Marshfield Clinic Health System Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with liver cirrhosis (LC) demonstrate significantly elevated mortality rates following a traumatic event. This study aims to examine and compare the clinical outcomes in adult trauma patients with pre-existing LC undergoing laparotomy or non-operative management (NOM). Additionally, the study aims to investigate various patient outcomes, including mortality rate based on transfusion needs and timing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study utilized the American College of Surgeons Trauma Quality Program Participant Use File (ACS-TQIP-PUF) 2017-21 to compare laparotomy vs NOM in adults (\u226518\u00a0years) with pre-existing LC who presented to trauma facilities with isolated blunt solid organ abdominal injuries (Injury Severity Score \u226516, Abbreviated Injury Scale solid organ abdomen \u22653).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 929 patients, 38.2% underwent laparotomy, while 61.7% received NOM. The in-hospital mortality rate was lower for patients who received NOM (52.3% vs 20.0%, P &lt; .01). The risk of in-hospital mortality was significantly associated with laparotomy (OR 5.22, 95% CI: 2.06-13.18, P &lt; .01) and sepsis (OR 99.50, 95% CI: 6.99-1415.28, P &lt; .01). On average an increase in blood units in 4 hours was observed among those who experienced an in-hospital mortality (OR 5.65, 95% CI: 3.05-8.24, P &lt; .01) and those who underwent laparotomy (OR 3.85, 95% CI: 1.36-6.34, P &lt; .01)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Trauma patients with moderate to severe isolated organ injury and Liver cirrhosis had significantly higher mortality rates, acute renal failure, whole blood units received, as well as longer ICU-LOS when undergoing laparotomy compared to non-operative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348241230087","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T19:38:05Z","timestamp":1706211485000},"page":"1347-1356","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluating Mortality Outcomes, Transfusion Characteristics, and Risk Factors Associated With Cirrhotic Trauma Patients Undergoing Emergency Laparotomy Versus Non-Operative Management: A National Analysis"],"prefix":"10.1177","volume":"90","author":[{"given":"Adel","family":"Elkbuli","sequence":"first","affiliation":[{"name":"Division of Trauma and Surgical Critical Care, Department of Surgery, Orlando Regional Medical Center, Orlando, FL, USA"},{"name":"Department of Surgical Education, Orlando Regional Medical Center, Orlando, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Breeding","sequence":"additional","affiliation":[{"name":"Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Martinez","sequence":"additional","affiliation":[{"name":"Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heli","family":"Patel","sequence":"additional","affiliation":[{"name":"Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Chin","sequence":"additional","affiliation":[{"name":"John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D-Dre","family":"Wright","sequence":"additional","affiliation":[{"name":"John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Marshfield Clinic Health System, Marshfield, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Trauma, Marshfield Clinic Health System, Marshfield, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Public Health, Marshfield Clinic Research Institute, Marshfield, WI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"bibr1-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.07.051"},{"key":"bibr2-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.140.7.650"},{"key":"bibr3-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-9923-7"},{"key":"bibr4-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1177\/0003134821998673"},{"key":"bibr6-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2004.06.017"},{"key":"bibr5-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1177\/000313480006601120"},{"key":"bibr7-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.07.002"},{"key":"bibr8-00031348241230087","volume-title":"Hepatic Injury, Blunt, Selective Nonoperative Management Of","author":"Eastern Association for the Surgery of Trauma (EAST)","year":"2023"},{"key":"bibr9-00031348241230087","volume-title":"Trauma Quality Programs Participant Use File","author":"ACS","year":"2022"},{"key":"bibr10-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000244"},{"key":"bibr11-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002464"},{"key":"bibr12-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318220b192"},{"key":"bibr13-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.03.057"},{"key":"bibr14-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31829a2c19"},{"key":"bibr15-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181ba361f"},{"key":"bibr16-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-020-00302-7"},{"key":"bibr17-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318270160d"},{"key":"bibr18-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182702afc"},{"key":"bibr19-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30489"},{"key":"bibr20-00031348241230087","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.05.004"}],"updated-by":[{"DOI":"10.1177\/00031348241305412","type":"expression_of_concern","label":"Expression of concern","source":"publisher","updated":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000}}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241230087","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348241230087","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348241230087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:39:05Z","timestamp":1777379945000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348241230087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,25]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1177\/00031348241230087"],"URL":"https:\/\/doi.org\/10.1177\/00031348241230087","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,25]]}}}