SRS22 - Traumatic bowel and mesenteric injury in England, wales and Ireland: a retrospective analysis of the trauma audit and research network data registry, 2012–2021

Abstract Background Traumatic bowel and mesenteric injury (TBMI) confer significant morbidity and mortality. This study aimed to characterise the epidemiology and clinical outcomes of TBMI in England, Wales and Ireland after the inception of a national major trauma network. Methods A retrospective observational analysis of the Trauma Audit and Research Network national data registry was performed. Demographics, injury descriptors, patient management and outcomes were extracted for all patients enrolled between 2012 and 2021. Results From 2012–2021, 4124 patients met the inclusion criteria. Annual case volume increased from 249 to 510 over the observation period. Median age at presentation was 34 years (IQR 23–50) and males comprised 77% of cases (n = 3175). Blunt trauma accounted for 54% of injuries (n = 2222) and almost half of the cohort had ISS 15 (48%, n = 1983). Haemorrhagic shock occurred in 8% of cases (n = 360) and 67% (n = 2777) presented outside of normal working hours (17:00–08:00). CT imaging was performed in 77% (n = 3177). Operative management occurred in 84% of cases (n = 3469): laparotomy 74% (n = 3037) and laparoscopy 10% (n = 413). Thirty-day and 24-hour mortality were 9.1% (n = 377) and 5.3% (n = 219), respectively, with a decline in 30-day mortality from 11.4% in 2013 to 7.3% in 2021. Median hospital stay was 9 days (IQR 6–18). Conclusions Following the implementation of major trauma networks, TBMI incidence increased while mortality decreased. Rapid access to diagnostics and operative intervention seem integral to improved healthcare outcomes. Ongoing improvements to the granularity of registry data will support ongoing quality improvement efforts across the system.