Mortality in severely injured patients: nearly one of five non-survivors have been already discharged alive from ICU

Hamsen, Uwe; Drotleff, Niklas; Lefering, Rolf; Gerstmeyer, Julius; Schildhauer, Thomas A.; Waydhas, Christian; Dgu, TraumaRegister

doi:10.1186/s12871-020-01159-8

Cited by 5 publications

(5 citation statements)

References 42 publications

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“…This cross-sectional online survey was undertaken with trauma healthcare clinicians who work at public hospitals throughout Australia and New Zealand that deliver care to patients affected by major traumatic injuries. Hospitals needed to meet one of the following criteria to be eligible to participate: [ 1 ] an accredited trauma centre (currently or previously) according to the Royal Australasian College of Surgeons (RACS); [ 2 , 8 ] a regional trauma centre; [ 3 ] a trauma service, or [ 4 ] submit data to the Australian New Zealand Trauma Registry (ATR) [ 5 ].…”

Section: Methodsmentioning

confidence: 99%

“…Study data were collected and managed using REDCap (Research Electronic Data Capture) electronic data capture tool [21,22]. RED-Cap is a secure, web-based software platform designed to support data capture for research studies, providing (1) an intuitive interface for validated data capture; (2) audit trails for tracking data manipulation and export procedures; (3) automated export procedures for seamless data downloads to common statistical packages; and (4) procedures for data integration and interoperability with external sources.…”

Section: Data Collectionmentioning

confidence: 99%

“…Improved survival following traumatic injury has led to increased demand for trauma follow-up care when patients are discharged from hospital. It is estimated that approximately 50% of all patients who experience physical trauma will require some form of follow-up care after hospital discharge [ 1 ]. Almost a quarter of patients continue to have significant health issues after experiencing traumatic injury [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Follow-up after major traumatic injury: a survey of services in Australian and New Zealand public hospitals

Wake,

Ranse,

Campbell

et al. 2024

BMC Health Serv Res

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Background Increased survival from traumatic injury has led to a higher demand for follow-up care when patients are discharged from hospital. It is currently unclear how follow-up care following major trauma is provided to patients, and how, when, and to whom follow-up services are delivered. The aim of this study was to describe the current follow-up care provided to patients and their families who have experienced major traumatic injury in Australia and New Zealand (ANZ). Methods Informed by Donabedian’s ‘Evaluating the Quality of Medical Care’ model and the Institute of Medicine’s Six Domains of Healthcare Quality, a cross-sectional online survey was developed in conjunction with trauma experts. Their responses informed the final survey which was distributed to key personnel in 71 hospitals in Australia and New Zealand that (i) delivered trauma care to patients, (ii) provided data to the Australasian Trauma Registry, or (iii) were a Trauma Centre. Results Data were received from 38/71 (53.5%) hospitals. Most were Level 1 trauma centres (n = 23, 60.5%); 76% (n = 16) follow-up services were permanently funded. Follow-up services were led by a range of health professionals with over 60% (n = 19) identifying as trauma specialists. Patient inclusion criteria varied; only one service allowed self-referral (3.3%). Follow-up was within two weeks of acute care discharge in 53% (n = 16) of services. Care activities focused on physical health; psychosocial assessments were the least common. Most services provided care for adults and paediatric trauma (60.5%, n = 23); no service incorporated follow-up for family members. Evaluation of follow-up care was largely as part of a health service initiative; only three sites stated evaluation was specific to trauma follow-up. Conclusion Follow-up care is provided by trauma specialists and predominantly focuses on the physical health of the patients affected by major traumatic injury. Variations exist in terms of patient selection, reason for follow-up and care activities delivered with gaps in the provision of psychosocial and family health services identified. Currently, evaluation of trauma follow-up care is limited, indicating a need for further development to ensure that the care delivered is safe, effective and beneficial to patients, families and healthcare organisations.

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Section: Methodsmentioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Follow-up after major traumatic injury: a survey of services in Australian and New Zealand public hospitals

Wake,

Ranse,

Campbell

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…On first sight, these cases can be treated as "failure to rescue" of potential recoverable patients. 10 Despite advances in the treatment of abdominal injuries in trauma patients, in the field of prehospital care, emergency department (ED) care, surgical techniques and intensive care, the high mortality rate in these patients remains a challenge for public health. 11,12 Through the use of warning scores and other system monitoring tools or implementation of emergency medical teams, early detection of patients at risk can be achieved.…”

Section: Introductionmentioning

confidence: 99%

Hazard Ratio of 90-Day Mortality in ICU Patients with Abdominal Injuries Compared with Head Injuries

et al. 2021

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Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients. Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality. Results: The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077–7.063, P=0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85±20.1, 30.27±18.22 and 31.43±26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively. Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.

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“…We read the work by Hamsen and Colleagues about mortality in severely injured patients with great interest [ 1 ].…”

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confidence: 99%

Intensive care unit discharge: mind the gap!

2021

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Mortality after intensive care discharge is a hot topic in critical care medicine. Many factors probably play a role: patient’s comorbidities and severity of the disease may have great impact on mortality. However it should be taken into account also the level of care that characterizes the ward in which the patient is discharged to. A soft transition from intensive care units to the other hospital wards is desirable to avoid the traumatic step that the fragile post-ICU patient has to face with.

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Mortality in severely injured patients: nearly one of five non-survivors have been already discharged alive from ICU

Cited by 5 publications

References 42 publications

Follow-up after major traumatic injury: a survey of services in Australian and New Zealand public hospitals

Follow-up after major traumatic injury: a survey of services in Australian and New Zealand public hospitals

Hazard Ratio of 90-Day Mortality in ICU Patients with Abdominal Injuries Compared with Head Injuries

Intensive care unit discharge: mind the gap!

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