Reduction in mortality in severely injured patients following the introduction of the “treatment of patients with severe and multiple injuries” guideline of the German society of trauma surgery – a retrospective analysis of a level 1 trauma center (2010–2012)

Schoeneberg, Carsten; Schilling, M.; Burggraf, Manuel; Fochtmann, Ulrike; Lendemans, Sven

doi:10.1016/j.injury.2013.11.024

Cited by 27 publications

(24 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present study, the overall mortality of patients with multiple traumas was 18.8%, which is similar to the findings of previous studies in which the mortality of patients with multiple traumas was 18.7%-22.8% [ 1 11 13 21 ]. Comparatively, in patients with trauma in one body region, global mortality is reportedly 0.5%-6% [ 22 ]; these results collectively indicate higher mortality in patients with multiple traumas.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Risk factors for mortality of severe trauma based on 3 years' data at a single Korean institution

Sim

Lee

et al. 2015

Ann Surg Treat Res

View full text Add to dashboard Cite

PurposeThis study aimed to determine the mortality rate in patients with severe trauma and the risk factors for trauma mortality based on 3 years' data in a regional trauma center in Korea.MethodsWe reviewed the medical records of severe trauma patients admitted to Ajou University Hospital with an Injury Severity Score (ISS) > 15 between January 2010 and December 2012. Pearson chi-square tests and Student t-tests were conducted to examine the differences between the survived and deceased groups. To identify factors associated with mortality after severe trauma, multivariate logistic regression was performed.ResultsThere were 915 (743 survived and 172 deceased) enrolled patients with overall mortality of 18.8%. Age, blunt trauma, systolic blood pressure (SBP) at admission, Glasgow Coma Scale (GCS) at admission, head or neck Abbreviated Injury Scale (AIS) score, and ISS were significantly different between the groups. Age by point increase (odds ratio [OR], 1.016; P = 0.001), SBP ≤ 90 mmHg (OR, 2.570; P < 0.001), GCS score ≤ 8 (OR, 6.229; P < 0.001), head or neck AIS score ≥ 4 (OR, 1.912; P = 0.003), and ISS by point increase (OR, 1.042; P < 0.001) were significant risk factors.ConclusionIn severe trauma patients, age, initial SBP, GCS score, head or neck AIS score, and ISS were associated with mortality.

show abstract

Section: Discussionsupporting

confidence: 91%

“…Recent improvements in trauma and critical care systems have decreased the global mortality rate of patients with multiple traumas [ 1 2 ]. However, the national trauma system in Korea was only recently implemented in 2012, and the nationwide trauma registry is still in its infancy [ 3 4 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for mortality of severe trauma based on 3 years' data at a single Korean institution

Sim

Lee

et al. 2015

Ann Surg Treat Res

View full text Add to dashboard Cite

show abstract

“…Another child needed a second surgery within the first 24 hours. In an analysis of adults who died after trauma, a longer surgery time within the first 24 hours was associated with a worse outcome [36]. …”

Section: Discussionmentioning

confidence: 99%

Mortality in severely injured children: experiences of a German level 1 trauma center (2002 – 2011)

et al. 2014

Self Cite

View full text Add to dashboard Cite

BackgroundTrauma in pediatric patients is a major cause of death. This study investigated differences between decedents and survivors. Furthermore, an analysis of preventable and potential preventable trauma deaths was conducted and errors in the acute trauma care were investigated.MethodsAll patients aged less than 16 years with an Injury Severity Score (ISS) ≥ 16 upon primary admission to the hospital between July 2002 and December 2011 were included in this study. Decedents were compared with survivors and an analysis of deceased children for preventable and potential preventable deaths was conducted. The acute trauma care was investigated regarding errors in treatment.ResultsSignificant differences were found in Glasgow Coma Scale, Injury Severity Score, Revised Trauma Score, New ISS, Revised Injury Severity Classification, and Trauma and Injury Severity Score. Decedents had a worse head trauma with associated coagulopathy. The overall mortality rate was 13.4%. The majority of death occurred soon after arrival. No long term intensive care unit stay was found.No preventable but one potential preventable death was analyzed. Most errors occurred in fluid volume management and in a delay of starting the therapy for hemorrhage and coagulopathy.Prolonged preclinical rescue time and surgery time within the first 24 hours was found.ConclusionsHead trauma is the determinant factor for mortality in severely injured pediatric patients. Death occurred shortly after arrival and long term intensive care stays might be an exception. In treatment of severely injured children volume management, hemorrhage and coagulopathy management, rescue time, and total surgery time should receive more attention.

show abstract

“…Permissive or low volume resuscitation is a concept that has evolved over the last years in the management of adult trauma patient and has gained considerable attention both in clinical setting and the related basic research [ 16 – 19 ]. This practice has not gained wide acceptance in the management of paediatric patients and some authors advocate extreme vigilance, questioning the non-validated theoretical benefits of such an approach in children [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Paediatric trauma resuscitation: an update

Tosounidis

Giannoudis

2015

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

PurposePaediatric trauma is the leading cause of mortality in children. Paediatric trauma resuscitation is the first and foremost step towards a successful treatment and subsequent recovery. Significant advances have taken place in the last years in relation to this field of trauma care.MethodsIn this narrative review, we attempt to summarise the recent development in the concepts of fluid resuscitation, massive transfusion, permissive resuscitation, management of coagulopathy and use of tranexamic acid, literature pertaining to implementation of transfusion protocols in the paediatric population and education related to the paediatric trauma resuscitation.Results/ConclusionsThe current evidence although emerging is still sparse and high-quality studies are needed to shed more light on most of the above domains of resuscitation.

show abstract

Reduction in mortality in severely injured patients following the introduction of the “treatment of patients with severe and multiple injuries” guideline of the German society of trauma surgery – a retrospective analysis of a level 1 trauma center (2010–2012)

Cited by 27 publications

References 12 publications

Risk factors for mortality of severe trauma based on 3 years' data at a single Korean institution

Risk factors for mortality of severe trauma based on 3 years' data at a single Korean institution

Mortality in severely injured children: experiences of a German level 1 trauma center (2002 – 2011)

Paediatric trauma resuscitation: an update

Contact Info

Product

Resources

About