Timmermans et al reported predictors of mortality associated with damage control surgery for major abdominal trauma. The authors are from the University of Maastricht, Groote Schuur Hospital and the University of Cape Town.

Patient selection: damage control surgery for major abdominal trauma


Preoperative predictors of mortality:

(1) older age (> 30 years)

(2) acidosis (more negative base excess, lower arterial pH)

(3) hypothermia


Postoperative predictors of mortality:

(1) moderate or severe thrombocytopenia (DIC, other)

(2) prolonged INR (> 2)

(3) massive blood transfusion in the first 24 hours



Hypothermia, coagulopathy and acidosis are referred to as the deadly triad.


Other factors:

(1) need for inotropes

(2) septic shock

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