BACKGROUND: Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European trauma patients, with focus on triage. METHODS: We prospectively registered all trauma patients in Eastern Denmark over 12 consecutive months. We analysed the flow of trauma patients through the system, the time spent at different locations, and we assessed the risk factors of mortality. RESULTS: We included 2875 trauma patients, of whom 158 (5.5%) died before arrival at the hospital. Most patients (75.3%) were brought to local hospitals and patients primarily (n=82) or secondarily triaged (n=203) to the level I trauma centre were the most severely injured. Secondarily transferred patients spent a median of 150 min in the local hospital before transfer to the level I trauma centre and 48 min on transportation. Severe injury with an injury severity score >15 was seen in 345 patients, of whom 118 stayed at the local hospital. They had a significantly higher mortality than 116 of those secondarily transferred [45/118, 38.1% vs. 11/116, 9.7% (P<0.0001)]. Mortality within 30 days was 4.3% in admitted patients, and significant risk factors of death were violence [odds ratio (OR)=5.72], unconsciousness (OR=4.87), hypotension (OR=4.96), injury severity score >15 (OR=27.42), and age. CONCLUSIONS: Around 50% of all trauma deaths occurred at the scene. Increased survival of severely injured patients may be achieved by early transfer to highly specialised care.
BACKGROUND: Most studies on trauma and trauma systems have been conducted in the United States. We aimed to describe the factors predicting mortality in European traumapatients, with focus on triage. METHODS: We prospectively registered all traumapatients in Eastern Denmark over 12 consecutive months. We analysed the flow of traumapatients through the system, the time spent at different locations, and we assessed the risk factors of mortality. RESULTS: We included 2875 traumapatients, of whom 158 (5.5%) died before arrival at the hospital. Most patients (75.3%) were brought to local hospitals and patients primarily (n=82) or secondarily triaged (n=203) to the level I trauma centre were the most severely injured. Secondarily transferred patients spent a median of 150 min in the local hospital before transfer to the level I trauma centre and 48 min on transportation. Severe injury with an injury severity score >15 was seen in 345 patients, of whom 118 stayed at the local hospital. They had a significantly higher mortality than 116 of those secondarily transferred [45/118, 38.1% vs. 11/116, 9.7% (P<0.0001)]. Mortality within 30 days was 4.3% in admitted patients, and significant risk factors of death were violence [odds ratio (OR)=5.72], unconsciousness (OR=4.87), hypotension (OR=4.96), injury severity score >15 (OR=27.42), and age. CONCLUSIONS: Around 50% of all trauma deaths occurred at the scene. Increased survival of severely injured patients may be achieved by early transfer to highly specialised care.
Authors: Eveline A J van Rein; Rogier van der Sluijs; Frank J Voskens; Koen W W Lansink; R Marijn Houwert; Rob A Lichtveld; Mariska A de Jongh; Marcel G W Dijkgraaf; Howard R Champion; Frank J P Beeres; Luke P H Leenen; Mark van Heijl Journal: JAMA Surg Date: 2019-05-01 Impact factor: 14.766
Authors: Thomas Kristiansen; Hans M Lossius; Kjetil Søreide; Petter A Steen; Christine Gaarder; Pål A Næss Journal: J Trauma Manag Outcomes Date: 2011-06-16
Authors: Marcus Fredriksson Sundbom; Amalia Sangfelt; Emma Lindgren; Helena Nyström; Göran Johansson; Helge Brändström; Michael Haney Journal: BMJ Open Date: 2022-02-15 Impact factor: 2.692
Authors: R Hesselfeldt; J Steinmetz; H Jans; M-L B Jacobsson; D L Andersen; K Buggeskov; M Kowalski; M Praest; L Øllgaard; P Höiby; L S Rasmussen Journal: Acta Anaesthesiol Scand Date: 2013-01-07 Impact factor: 2.105