The definition of polytrauma

Butcher, Nerida E.; Enninghorst, Natalie; Sisák, Krisztián; Balogh, Zsolt J.

doi:10.1097/ta.0b013e31827e1bad

Cited by 40 publications

(17 citation statements)

References 36 publications

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“…Although this term has been in use for many decades, there is no consensus among clinicians and researchers about the most appropriate definition to identify multiple injured patients with a substantial systemic inflammatory response [6]. A review article, published in 2009, revealed 47 different definitions [7].…”

Section: Introductionmentioning

confidence: 99%

Does the applied polytrauma definition notably influence outcome and patient population? – a retrospective analysis

Frenzel

Krenn

Heinz

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundAlthough the term “polytrauma” has been in use for decades, no generally accepted definition exists. The aim of this study was to demonstrate that different polytrauma definitions applied to a specific patient population result in diverse subgroups of individuals, who in turn present a varying outcome.MethodsAll patients (≥18 years) treated at our level I trauma center within a time period of three years were classified according to 11 selected polytrauma definitions and included in our study, if they were rated “polytraumatized” by at least one of these definitions. All patients, who met the criteria of a certain definition, were combined to the relevant definition-positive group, thus resulting in 11 patient subgroups. Their demographic data (number of patients, mean patient age, mean Injury Severity Score value, median number of ventilator days, median length of stay at the intensive care unit and at the hospital, mortality rate and odds ratio) were statistically compared.ResultsThree hundred seventy-five patients (73% male) with a mean age of 47 years met the inclusion criteria and were allocated to the relevant subgroups; their patient number varied from 55 to 346 and their mean Injury Severity Score value ranged from 4 to 75. Not surprisingly, all examined parameters were subject to variations. Whereas most definition-positive groups showed a mortality rate of about 21% to 30%, 18% of the individuals, who met the criteria according to Blacker, and 40% of the polytrauma victims according to Schalamon died. The Pape 1-, Schalamon-, and Berlin-positive groups presented a significant odds ratio with regard to mortality that considerably exceeded 1.DiscussionA polytrauma definition can only be a reliable tool in classifying trauma victims if it provides a significant odds ratio with regard to mortality that considerably exceeds 1 and if it succeeds in capturing patients with multiple severe injuries and a higher mortality rate without reducing the number of polytraumatized patients to a not representatively small number.ConclusionsSolely the Berlin definition resulted in a patient number reflecting clinical reality, thus enabling a transparent evaluation of treatment results provided by different institutions and allowing objective comparison of published studies.

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Section: Introductionmentioning

confidence: 99%

Does the applied polytrauma definition notably influence outcome and patient population? – a retrospective analysis

Frenzel

Krenn

Heinz

et al. 2017

Scand J Trauma Resusc Emerg Med

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“…The term “multiple trauma” is used interchangeably with “polytrauma”, “major injury” and “severe trauma” [ 4 ]. It defines trauma patients whose injuries involve multiple body regions, organ systems or cavities.…”

Section: Definitionmentioning

confidence: 99%

“…However, considerable inconsistency exists for the definition of “multiple trauma” in terms of number of injuries, body regions or organs involved, pattern or mechanism of injuries and severity of injury. Butcher and Balogh, stated that based on the Abbreviated Injury Scale (AIS), two points or above in at least two body regions embrace the greatest percentage of the worst outcomes and significantly larger percentage of the multiple trauma patients [ 4 , 5 ].…”

Section: Definitionmentioning

confidence: 99%

“…The trauma surgeons still lack consensus and should agree on a universal, comprehensive and validated definition for multiple trauma. The subjective definition of multiple trauma can differ across and even within the institutions [ 4 ]. Lack of an agreed definition affects classification of patients and consequently leads to difference in treatment strategies.…”

Section: Definitionmentioning

confidence: 99%

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Current Concepts in Orthopedic Management of Multiple Trauma

Küçükdurmaz

Alijanipour

2015

TOORTHJ

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Multiple trauma patients frequently present challenging clinical scenarios with musculoskeletal injuries being the most common indications for surgical procedures in these patients. Despite our substantial knowledge, a universally approved objective definition for “multiple trauma” is yet to be delineated. Several controversial aspects of economics, pathophysiology, animal models, diagnosis, management and outcome of patients with multiple trauma have recently been explored and although some progress has been made, it seems that the available evidence is still inconclusive in some occasions. This manuscript revisits several current concepts of multiple trauma that have been the focus of recent investigation. We aim to provide the reader with an updated perspective based on the most recently published literature in the field of multiple trauma.

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“…We urge an international consensus group on the definition of post‐injury MOF and the use of uniform criteria for this syndrome. This approach is proven to be useful in the definition of other critical care entities such as ARDS and abdominal compartment syndrome 9 and is currently being developed for polytrauma 10 …”

mentioning

confidence: 99%