{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:37:34Z","timestamp":1791571054496,"version":"4.3.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Background: Bedside exploratory laparotomy is a heroic intervention for unstable patients who cannot be transported to the operating room. Given a previously documented high mortality rate, some argue against the procedure on assumption of non-beneficence. This study aims to evaluate procedural mortality rate and identify physiologic factors associated with death after bedside exploration. Methods: A single-center, retrospective review of consecutive patients who underwent bedside exploratory laparotomy between 2019 and 2024 was conducted. Patients were stratified into cohorts based on a composite outcome of in-hospital or 30-day survival, and an analysis was conducted to identify factors associated with mortality. Results: A total of 51 patients underwent bedside exploratory laparotomy, with a mortality rate of 82.4% (42\/51) within 30 days or during index hospitalization. The median postoperative time to death was 18.1 hours. Mortality rates were 73.9% in SICU, 90.0% in MICU, and 88.2% in CTICU. Survivors were younger than non-survivors (46.5 vs. 60.8 years; p = 0.025) and had lower Charlson Comorbidity Index scores (2 vs. 4; p = 0.0011). Preoperative lactate was lower (4.12 vs. 10.16 mmol\/L; p = 0.0012) and pH higher (7.30 vs. 7.20; p = 0.042) in survivors. Significant intraoperative findings were more frequent in non-survivors (95% vs. 33%; p &lt; 0.001). Conclusion: Bedside exploratory laparotomy is a last-resort intervention with exceedingly high mortality. We observed older patients with significant acidosis or identifiable intraoperative findings have worse prognoses. Preoperative goals-of-care discussions should be prioritized in elderly patients before proceeding with bedside exploration to ensure ethical delivery of surgical care.<\/jats:p>","DOI":"10.1177\/00031348261443341","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:33:40Z","timestamp":1776263620000},"page":"2700-2706","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Bedside Exploratory Laparotomy: Factors Associated With Mortality and Clinical Implications in Critically - Ill Patients"],"prefix":"10.1177","volume":"92","author":[{"given":"Jason M.","family":"Aubrey","sequence":"first","affiliation":[{"name":"Corewell Health West, Michigan State University"},{"name":"Michigan State University, College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apoorva","family":"Ojha","sequence":"additional","affiliation":[{"name":"Michigan State University, College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4308-4776","authenticated-orcid":false,"given":"Matthew J.","family":"Morris","sequence":"additional","affiliation":[{"name":"Corewell Health West, Michigan State University"},{"name":"Michigan State University, College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah R.","family":"Liefeld","sequence":"additional","affiliation":[{"name":"Corewell Health West, Michigan State University"},{"name":"Michigan State University, College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aryana M.","family":"Sharrak-Sitto","sequence":"additional","affiliation":[{"name":"Corewell Health West, Michigan State University"},{"name":"Michigan State University, College of Human Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay E.","family":"Burdett","sequence":"additional","affiliation":[{"name":"Priority Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathryn L.","family":"Chadwick","sequence":"additional","affiliation":[{"name":"Corewell Health West, Michigan State University"},{"name":"Corewell Health West"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Chung","sequence":"additional","affiliation":[{"name":"Corewell Health West, Michigan State University"},{"name":"Michigan State University, College of Human Medicine"},{"name":"Corewell Health West"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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