Patterns and factors associated with complications of laparotomy for firearm and blast injuries in the Emergency Management Centre in Erbil city

Background and objective: Laparotomy is the surgical opening of the abdomen and the important way to control and treat any problem and complication along pathway site of penetrating by a bullet or shell. This study aimed to identify the patterns and the factors associated with complications of laparotomy for firearm and blast injuries in Erbil City. Methods: This retrospective study was carried out on 125 injured patients at the Emergency Management Centre in Erbil city. Data was collected from the Statistics Department of Emergency Management Centre from 1st January 2014 to 31st December 2016. Results: The mean age of the included patients was 26.2 ± 11.0. The majority of patients were young (54.4%), male (80%), lived in the Erbil center (45.6%), and the injured place was mostly in the center of Erbil (45.6%). The mean and standard deviation time needed to arrive at the hospital was 8.7 ± 39.2 hours. Most of them had a medium condition (53.6%), arrived within the first hour to the hospital (57.6%), had the first operation at the Emergency Management Centre (89.6%), did not have any other injury (64%) and had bullet injuries (88%). The post operative complications from laparotomy were significantly higher in those with poor condition at admission (P <0.001), not having the first operation at Emergency Management Centre (P = 0.003) and higher number of internal organs injured (P = 0.010). There was a significant association between postoperative complications from laparotomy with the time needed to arrive at the hospital (P = 0.028) and having associated injuries (P = 0.028). Conclusion: Bullet injury was the most common penetrating abdominal trauma leading to one or more intra-abdominal organ injury and needing emergency laparotomy for treatment and prevention of complications. Postoperative complications from laparotomy were significantly associated with the condition of admission, the first operation of the Emergency Management Centre, the number of internal organs injured, the time needed to arrive at the hospital and presence of associated injuries.