Outcomes of damage control laparotomy after trauma in low andmiddle-income countries: A systematic review and meta-analysis.
Pooled mortality after damage control laparotomy in low- and middle-income countries reaches 37.77%.
Outcomes of damage control laparotomy after trauma in low andmiddle-income countries: A systematic review and meta-analysis.
Damage control laparotomy (damage control laparotomy) is an established life-saving strategy for critically injured patients presenting with the lethal triad of hypothermia, acidosis, and coagulopathy.
The protocol was prospectively registered on PROSPERO (CRD42025639498).
over a third of patients died after this emergency surgery in these settings
Ten retrospective studies comprising 914 patients from five countries (South Africa, Pakistan, India, Oman, and Brazil) met the inclusion criteria.
Six of the ten studies (n = 704, 77.0%) were from South Africa.
Subgroup analysis showed a pooled mortality of 31.61% (95% CI: 28.27%-35.15%, I² = 0.00%) in South African studies and 53.62% (95% CI: 44.47%-62.54%, I² = 31.65%) in non-South African low- and middle-income countries studies (Cochran Q-test for subgroup differences: Q = 14.23, df = 1, p < 0.001).
Damage control laparotomy mortality in low- and middle-income countries appears higher than mortality rates reported in high-income countries series, though direct comparison is limited by differences in study populations, injury profiles, case-mix, and the predominance of South African data in the available literature.
The pooled estimate should be interpreted cautiously given the small number of studies, high heterogeneity, and retrospective study designs.