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Objective: Compare outcomes of diagnostic laparoscopy (DL) for trauma patients among community and university hospital centers.
Design: Retrospective review of the National Trauma Databank for the years 2002-2010.
Setting: University and community teaching hospitals.
PATIENTS: Trauma patients admitted to university or community centers that underwent a DL procedure from 2002 to 2010.
Main Outcome Measures: Demographics, systolic blood pressure, respiratory rate, and GCS in the emergency department. Hospital length of stay (LOS), ICU LOS, ventilator days, number of hours to laparoscopy, and hospital disposition were compared. Complication rates were noted and compared to reported literature.
RESULTS- We identified 7697 cases (5188 performed in 361 university centers and 2509 in 349 community centers averaging 14 and 7 cases per center respectively). Male to female ratio was 4:1 in both groups. ICU admissions in university centers were 44% and 55% in community centers. The remaining results are summarized in tables below.
CONCLUSION- University centers are utilizing laparoscopy in their management of trauma patients more frequently. The differences in LOS, ICU admissions, and ventilator days may be due to the limitations of in-hospital rehabilitative services in community trauma centers. Our data point to the relative feasibility of DL in trauma patients in both settings. However, more prospective studies are required to evaluate the relative safety and cost-benefit of DL for trauma.

Mean	University	Community	P value
Age	30	31	0.00
GCS	14	13	0.04
SBP	132	132	0.50
RR	26	28	0.16
Hours to procedure	26	32	0.06
Resource utilization	University	Community	P value
Length of stay	8	9	0.00
ICU Days	6	7	0.20
Ventilator Days	5	6	0.01
Complication	University (%)	Community (%)	Trauma Literature (%)
Mortality	1.8	2	NA
DVT	0.9	2.5	5-63
PE	0.3	0.5	1-24
Pneumonia	0.9	1	33
Wound infection	1.3	1	2-11
Abdominal abscess	0.5	0.2	2-11

Hospital Disposition	University	Community
Home	82	75.3
Home care	1.9	2.4
Acute care facility	2.4	2.5
Extended care facility	8.6	12.6
Discharge to another facility	11	15.1
Against medical advice	0.4	0.8
Other	4.7	6.4