Five years experience of trauma care in a German urban level I university trauma center

Wyen, H.; Wutzler, Sebastian; Rüsseler, Miriam; Mack, Martin G.; Walcher, Felix; Marzi, Ingo

doi:10.1007/s00068-009-9140-y

Cited by 7 publications

(6 citation statements)

References 19 publications

(19 reference statements)

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“…This rate was significantly less than the results in the other age-dependent groups (74.7-77.8%). However, CT imaging has become essential in the imaging evaluation of trauma patients and is being used with progressively increasing frequency [27,28], caused by the well documented benefit for the outcome of trauma patients [9,29,30]. Nevertheless, a byproduct of the increased use of CT has been the more frequent exposure of injured children to potentially harmful ionizing radiation [27].…”

Section: Discussionmentioning

confidence: 99%

Prehospital and Early Clinical Care of Infants, Children, and Teenagers Compared to an Adult Cohort

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Prehospital and Early Clinical Care of Infants, Children, and Teenagers Compared to an Adult Cohort

et al. 2010

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“…After approval by the Institutional Review Board, we performed a single center, retrospective observational cohort study, reviewing all severely injured trauma patients with pelvic ring injuries which were admitted to our level I trauma center from January 1, 2010 to December 31, 2019. As part of our participation in the German Trauma Registry DGU R and as previously described (29,30), all data was prospectively documented using a computer-based online documentation tool. Patients with pelvic ring injuries were identified using the Abbreviated Injury Scale (AIS) code 8561xx.…”

Section: Methodsmentioning

confidence: 99%

Secondary Angio-Embolization After Emergent Pelvic Stabilization and Pelvic Packing Is a Safe Option for Patients With Persistent Hemorrhage From Unstable Pelvic Ring Injuries

et al. 2020

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Introduction: In patients with severe pelvic ring injuries, exsanguination still is the leading cause of death in the early post-injury phase. While mechanical pelvic ring stabilization and pre-peritoneal pelvic packing are mainly addressing venous bleeding, angio-embolization aims to control arterial bleeding. The goal of the present study was to evaluate the rate of postoperative angio-embolization after mechanical pelvic ring injury stabilization and pre-peritoneal pelvic packing. Bleeding sources detected in the angiography and the patient's outcome were investigated.Patients and Methods: Retrospective observational cohort study at a single academic level I trauma center, reviewing all patients with pelvic ring injuries admitted from 01/2010 to 12/2019. Patients with emergent mechanical pelvic ring stabilization (supraacetabular external fixator and/or pelvic C-clamp) and direct pre-peritoneal pelvic packing were further analyzed. Patients that underwent postoperative angio-embolization were compared with those that did not. All postoperative angio-embolizations were evaluated with regards to bleeding sources and type of embolization.Results: During the study period, a total of 39 patients required immediate mechanical pelvic stabilization and direct pre-peritoneal pelvic packing. Of these, 12 patients (30.8%) underwent a postoperative angio-embolization. The following vessels were identified as bleeding sources: superior gluteal artery (n = 6), obturator artery (n = 2), internal pudendal artery (n = 2), unnamed branches of the internal iliac artery (n = 3). A selective embolization was successful in 11 patients; in 1 patient, an unilateral complete occlusion of the internal iliac artery was performed to control the bleeding. Mean time from hospital admission to the surgical procedure was 52.8 ± 14.7 min and the mean time from admission to angio-embolization was 189.1 ± 55.5 min. The in-hospital mortality rate of patients with angio-embolization was 25.0% (n = 3). Of these, 2 patients died due to multiple organ failure and 1 patient due to severe head injury.Conclusion: Secondary angio-embolization after external pelvic fixation and pre-peritoneal pelvic packing was effective in controlling ongoing bleeding. The most frequently detected bleeding vessel was the superior gluteal artery, which is difficult to surgically address, further highlighting the importance of angio-embolization in the management algorithm.

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“…Correspondingly, trauma surgery has already been an independently discipline rather than a sub-specialty of surgery. 14 …”

Section: Trauma Care In the Westmentioning

confidence: 99%

Trauma care system in China

Liu

Bai

2018

Chinese Journal of Traumatology

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With the development of modern society, high-energy trauma has become an increasing tendency, which brings a great challenge for trauma care. A well-running trauma care system that is composed by pre-hospital and in-hospital care has been proved to decrease the death and disability rate of trauma patients. However, establishment of trauma care system in China is still at the initial stage. Trauma care systems in China and developed countries represented by the United States and Germany are introduced respectively in this article. Construction of regional and hierarchical trauma center, training of specific trauma care team and performance of integrative trauma rescue model are recommended in China.

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Five years experience of trauma care in a German urban level I university trauma center

Abstract: Regionalized trauma care with designated level I trauma centers is justified by the improvement of time intervals and outcome, but adequate resources are required.

Cited by 7 publications

References 19 publications

Prehospital and Early Clinical Care of Infants, Children, and Teenagers Compared to an Adult Cohort

Prehospital and Early Clinical Care of Infants, Children, and Teenagers Compared to an Adult Cohort

Secondary Angio-Embolization After Emergent Pelvic Stabilization and Pelvic Packing Is a Safe Option for Patients With Persistent Hemorrhage From Unstable Pelvic Ring Injuries

Trauma care system in China

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