• Connor P Littlefield, Maosong Ye, Linder Wendt, Colette Galet, Kevin Huang, and Dionne A Skeete.
• Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
• Eur J Trauma Emerg Surg. 2025 Jan 24; 51 (1): 5959.

PurposeEvidence to guide the application of damage control laparotomy (DCL) in emergency surgery patients is limited. We assessed whether DCL use for emergent small bowel or colon surgery increased over time and its impact on outcomes. We hypothesized that DCL would be utilized more often in patients with significant comorbidities or septic shock with improved outcomes.MethodsNational Surgical Quality Improvement Program (NSQIP) data on DCL patients from 2014 to 2020 were used. Endpoints were incidence of DCL, in-hospital mortality, hospital length of stay (LOS), complications, and 30-day readmission over time. P-values < 0.05 were considered statistically significant.ResultsDCL incidence increased over time (OR = 1.07 [1.05-1.08], p < 0.001). Presence of pre-operative septic shock increased over the years (OR = 1.04 [1.01-1.07], p = 0.007). Mortality, readmission, and post-operative septic complications did not change over the study period. Average LOS significantly decreased over time (OR = 0.93 [0.92-0.95], p < 0.001).ConclusionThe odds of a surgeon using DCL increased by 7% each year. Although pre-operative septic shock incidence increased, LOS decreased over time while mortality remained unchanged.© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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