Andrea M Gochi, Cynthia J Susai, Alberto Jarrin-Lopez, Chade A Aribo, Anna Huang Perez, Henry Olivera Perez, Madeline Ryu, Savinnie Ho, Gregory P Victorino, Adam Gutierrez, Genna Beattie, April E Mendoza
Routine preoperative imaging was not associated with documented changes in surgical management among trauma patients undergoing ostomy reversal.
INTRODUCTION: Preoperative imaging before ostomy reversal in trauma patients is understudied. We hypothesized that imaging would infrequently identify clinically actionable findings and that routine imaging would represent a less cost-effective strategy.
METHODS: Trauma patients with ostomy creation at a Level 1 trauma center (2017-2024) were identified. Associations between injury patterns, imaging, intraoperative factors, and surgical outcomes were analyzed using univariable and multivariable methods. A decision analytic model was developed to evaluate the cost-effectiveness of routine imaging before ostomy reversal.
RESULTS: Of 280 patients with intestinal injuries, 70 required ostomies, and 55 underwent reversal. Preoperative imaging was performed in 36 (65%) patients, identifying rectal narrowing in two (3.6%). Loop ostomy (odds ratio 5.7, P = 0.02) was associated with rectal contrast studies. Increasing age (odds ratio 1.2, P = 0.008) was associated with colonoscopy.
CONCLUSIONS: Routine preoperative imaging was not associated with documented changes in surgical management among trauma patients undergoing ostomy reversal.