Der Kostenschätzer im TraumaRegister DGU®

Lefering, Rolf; Mahlke, L.; Franz, D.

doi:10.1007/s00113-016-0266-1

Cited by 7 publications

(14 citation statements)

References 7 publications

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“…Even though both cohorts did not differ much in terms of overall trauma severity (ISS) and ICU period, the average length of total hospital stay was profoundly different in both populations (30,6 days PNI group; 24,2 days control group). Longer hospitalisation in case of accompanying PNI compared to upper limb trauma without nerve affection resulted in more than 5000 Euro higher calculated treatment costs per patient utilizing the cost estimator which was established for the TR-DGU recently [ 10 ]. Table 4 adresses injury severity and treatment variables in depth.…”

Section: Resultsmentioning

confidence: 99%

“…Like prior series already stated we also observed a striking coincidence of PNI and vascular lesions which may be caused by the close anatomical proximity of arterial, venous and neural structures in the extremities [ 11 , 13 , 19 – 21 ]. Despite of equivalent average trauma load in both groups in terms of ISS and mean ICU period we noticed a distinctively increased length of mean hospital stay for PNI compared to control patients which caused considerable additional direct treatment expenditures measured with the cost estimator which has been implemented for the TR-DGU by Lefering et al [ 10 ]. Many studies confirm the high financial burden and resource consumption induced by PNI which seems to be even more significant in upper compared to lower extremity nerve involvement [ 7 , 17 , 22 ].…”

Section: Discussionmentioning

confidence: 96%

“…Those patients with nerve lesions were compared to the upper limb trauma cohort without associated peripheral neurological deficit. Additionally we utilized the recently established TR-DGU cost estimator to calculate mean treatment expenditures for both groups [ 10 ]. Meeting the TR-DGU coding principles represented by the reduced version of the AIS 2005 nerve trauma of the upper limb (arm and hand) can be categorized as minor lesion (AIS 2005 code: 730699.1) or major injury (AIS 2005 code: 730604.2).…”

Section: Methodsmentioning

confidence: 99%

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Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

Huckhagel

Nüchtern

Regelsberger

et al. 2018

Scand J Trauma Resusc Emerg Med

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BackgroundPeripheral nerve injury (PNI) as an adjunct lesion in patients with upper extremity trauma has not been investigated in a Central European setting so far, despite of its devastating long-term consequences. This study evaluates a large multinational trauma registry for prevalence, mechanisms, injury severity and outcome characteristics of upper limb nerve lesions.MethodsAfter formal approval the TraumaRegister DGU® (TR-DGU) was searched for severely injured cases with upper extremity involvement between 2002 and 2015. Patients were separated into two cohorts with regard to presence of an accompanying nerve injury. For all cases demographic data, trauma mechanism, concomitant lesions, severity of injury and outcome characteristics were obtained and group comparisons performed.ResultsAbout 3,3% of all trauma patients with upper limb affection (n = 49,382) revealed additional nerve injuries. PNI cases were more likely of male gender (78,6% vs.73,2%) and tended to be significantly younger than their counterparts without nerve lesions (mean age 40,6 y vs. 47,2 y). Motorcycle accidents were the most frequently encountered single cause of injury in PNI patients (32,5%), whereas control cases primarily sustained their trauma from high or low falls (32,2%). Typical lesions recognized in PNI patients were fractures of the humerus (37,2%) or ulna (20,3%), vascular lacerations (arterial 10,9%; venous 2,4%) and extensive soft tissue damage (21,3%). Despite of similar average trauma severity in both groups patients with nerve affection had a longer primary hospital stay (30,6 d vs. 24,2 d) and required more subsequent inpatient rehabilitation (36,0% vs. 29,2%).ConclusionPNI complicating upper extremity trauma might be more commonly encountered in Central Europe than suggested by previous foreign studies. PNI typically affect males of young age who show significantly increased length of hospitalization and subsequent need for inpatient rehabilitation. Hence these lesions induce extraordinary high financial expenses besides their impact on health related quality of life for the individual patient. Further research is necessary to develop specific prevention strategies for this kind of trauma.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

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Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

Huckhagel

Nüchtern

Regelsberger

et al. 2018

Scand J Trauma Resusc Emerg Med

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“…Both groups (VSI and control group) were compared with regard to demographic and etiological characteristics as well as injury patterns, extent of the trauma measured by the ISS, treatment duration, functional outcome in terms of the Glasgow Outcome Scale Score (GOS) at the end of primary hospital treatment, and need for further inpatient care after primary hospital discharge [13]. Moreover, treatment expenditures were calculated for both cohorts using the TR-DGU cost estimator implemented by Lefering et al [14]. The registry-based data material is outlined in a descriptive mode with primary focus on practical relevance, because the extensive sample size will easily render even clinically negligible differences statistically significant.…”

Section: Methodsmentioning

confidence: 99%

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

Huckhagel

Regelsberger

Westphal

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: To determine the prevalence and characteristics of prechiasmatic visual system injuries (VSI) among seriously injured patients with concomitant head trauma in Europe by means of a multinational trauma registry. Methods: The TraumaRegister DGU® was searched for patients suffering from serious trauma with a Maximum Abbreviated Injury Scale (AIS) ≥ 3 between 2002 and 2015 in Europe. After excluding cases without significant head injury defined by an AIS ≥ 2, groups were built regarding the existence of a concomitant damage to the prechiasmatic optic system comprising globe and optic nerve. Group comparisons were performed with respect to demographic, etiological, clinical and outcome characteristics. Results: 2.2% (1901/84,627) of seriously injured patients with concomitant head trauma presented with additional VSI. These subjects tended to be younger (mean age 44.7 versus 50.9 years) and were more likely of male gender (74.8% versus 70.0%) compared to their counterparts without VSI. The most frequent trauma etiologies were car accidents in VSI patients (28.5%) and falls in the control group (43.2%). VSI cases were prone to additional soft tissue trauma of the head, skull and orbit fractures as well as pneumocephalus. Primary treatment duration was significantly longer in the VSI cohort (mean 23.3 versus 20.5 days) along with higher treatment costs and a larger proportion of patients with moderate or severe impairment at hospital discharge despite there being a similar average injury severity at admission in both groups. Conclusions: A substantial proportion of patients with head injury suffers from additional VSI. The correlation between VSI and prolonged hospitalization, increased direct treatment expenditures, and having a higher probability of posttraumatic impairment demonstrates the substantial socioeconomic relevance of these types of injuries.

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“… 4 In 2015, according to the TraumaRegister DGU®, a German registry that cover patients with severe injuries, the number of severely multiply injured patients was 17 630 (ISS ≥16). 5 In 2012, the number of severely multiply injured patients (ISS ≥16) reached approximately 18 400 per year. This corresponds to a cumulative incidence of 0.02% per year for Germany.…”

Section: Introductionmentioning

confidence: 99%

Assessment of patient-reported outcomes after polytrauma: protocol for a systematic review

et al. 2018

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IntroductionSurvivors of polytrauma experience long-term and short-term burden that influences their lives. The patients’ view of relevant short-term and long-term outcomes should be captured in instruments that measure quality of life and other patient-reported outcomes (PROs) after a polytrauma. The aim of this systematic review is to (1) collect instruments that assess PROs (quality of life, social participation and activities of daily living) during follow-up after polytrauma, (2) describe the instruments’ application (eg, duration of period of follow-up) and (3) investigate other relevant PROs that are also assessed in the included studies (pain, depression, anxiety and cognitive function).Methods and analysisThe systematic review protocol is developed in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Central Register of Controlled Trials and the trials registers ClinicalTrials.gov and WHO International Clinical Trials Registry Platform will be searched. Keywords, for example, ‘polytrauma’, ‘multiple trauma’, ‘quality of life’, ‘activities of daily living’ or ‘pain’ will be used. Publications published between January 2005 and the most recent date (currently: August 2016) will be included. In order to present the latest possible results, an update of the search is conducted before publication. The data extraction and a content analysis will be carried out systematically. A critical appraisal will be performed.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. The results will be published in a peer-reviewed publication.PROSPERO registration numberCRD42017060825.

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Der Kostenschätzer im TraumaRegister DGU®

Abstract: Using only key data available for all patients in the registry, a valid cost estimator for acute care costs is now available in the TraumaRegister DGU®.

Cited by 7 publications

References 7 publications

Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

Nerve injury in severe trauma with upper extremity involvement: evaluation of 49,382 patients from the TraumaRegister DGU® between 2002 and 2015

Damage to the eye and optic nerve in seriously traumatized patients with concomitant head injury: analysis of 84,627 cases from the TraumaRegister DGU® between 2002 and 2015

Assessment of patient-reported outcomes after polytrauma: protocol for a systematic review

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