Resource use and clinical outcomes in blunt thoracic injury: a 10-year trauma registry comparison between southern Finland and Germany.
European Journal of Trauma and Emergency Surgery · 2018-09-17 · Observational study
Abstract
PURPOSE: Serious thoracic injuries are associated with high mortality, morbidity, and costs. We compared patient populations, treatment, and survival of serious thoracic injuries in southern Finland and Germany. METHODS: Mortality, patient characteristics and treatment modalities were compared over time (2006-2015) in all patients with Abbreviated Injury Scale (AIS) thorax ≥ 3, Injury Severity Score (ISS) > 15, age > 15 years, blunt trauma mechanism, and treatment in Intensive Care Unit (ICU) in Level 1 hospitals included in the Helsinki Trauma Registry (HTR) and the TraumaRegister DGU® (TR-DGU). RESULTS: We included 934 patients from HTR and 25 448 patients from TR-DGU. Pre-hospital differences were seen between HTR and TR-DGU; transportation in the presence of a physician in 61% vs. 97%, helicopter use in 2% vs. 42%, intubation in 31% vs. 55%, and thoracostomy in 6% vs. 10% of cases, respectively. The mean hospital length of stay (LOS) and ICU LOS was shorter in HTR vs. TR-DGU (13 vs. 25 days and 9 vs. 12 days, respectively). Our main outcome measure, standardised mortality ratio, was not statistically significantly different [1.01, 95% confidence interval (CI) 0.84-1.18; HTR and 0.97, 95% CI 0.94-1.00; TR-DGU]. CONCLUSIONS: Major differences were seen in pre-hospital resources and use of pre-hospital intubation and thoracostomy. In Germany, pre-hospital intubation, tube thoracostomy, and on-scene physicians were more prevalent, while patients stayed longer in ICU and in hospital compared to Finland. Despite these differences in resources and treatment modalities, the standardised mortality of these patients was not statistically different.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Helicopter & air ambulance · Endotracheal intubation · Mortality & survival · Prehospital physicians · Thoracostomy
Related articles
- Prehospital Blood Transfusion During Aeromedical Evacuation of Trauma Patients in Israel: The IDF CSAR Experience. (Mil Med, 2017)
- Helicopter Critical Care Retrieval in a Developing Country: A Trauma Case Series from Bhutan. (High Alt Med Biol, 2019)
- Isolated blunt severe traumatic brain injury in Bern, Switzerland, and the United States: A matched cohort study. (J Trauma Acute Care Surg, 2016)
- Prehospital critical care is associated with increased survival in adult trauma patients in Scotland. (Emerg Med J, 2020)
- Physician staffed helicopter emergency medical systems can provide advanced trauma life support in mountainous and remote areas. (Injury, 2017)
- Outcomes of prehospital traumatic cardiac arrest managed by helicopter emergency medical service personnel in Japan: a registry data analysis. (Int J Emerg Med, 2023)