[Epidemiology of the severely injured patient. A prospective assessment of preclinical and clinical management. AG Polytrauma of DGU].

The severe multiple trauma is of extraordinary medical and social and economical importance. Nevertheless there exist only a few german data to describe these patients. The aim of the study was an epidemiological analysis of 2069 patients of the Trauma Registry of the German Society of Trauma Surgery, recorded from 1993-1997. A descriptive kind of analysis of the incidence of injuries and complications of this collective was done and the amount of therapeutic means examined. Most patients (56.7%) were traffic victims, almost all patients suffered from blunt trauma. The relation male to female was 2.6:1, the average Injury Severity Score 22.2 +/- 13.1 points, the average age was 38.5 +/- 18.7 years. Chest trauma was the most frequent significant injury (AIS > or = 3 points, 44.5%), followed by severe head injury (39.2%) which was the most important reason for early lethality (death < or = 24 h after trauma, 51.7% of all deceased) and the total hospital lethality (18.6%). 68.9% of the patients showed injuries of the extremities. Patients were admitted to hospital in 71.7% in times of stand-by service (between 4 p.m. and 8 a.m., weekends, holidays) and required (median) 4 days ventilation, 6 days ICU treatment and stayed in hospital 19 days. Complications recorded were organ failure (lung 22.0%, circulation 18.7%, liver 9.6%, kidney 3.1%) and sepsis (11.6%). The presented epidemiological analysis is a comprehensive description of a large collective of multiple traumatized patients. The current data of the Trauma Registry of the German Trauma Society can be used to answer scientific, clinical and economical questions and for quality management.