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European Journal of Trauma and Emergency Surgery

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02-11-2021 | Gunshot Wound | Original Article

Severe penetrating trauma in Switzerland: first analysis of the Swiss Trauma Registry (STR)

Authors: Christian T. J. Magyar, Piotr Bednarski, Dominik A. Jakob, Beat Schnüriger, the “Swiss Trauma Registry”

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2022

Abstract

Purpose

The purpose of this study was to examine the epidemiology, demographics, injury characteristics and outcomes of patients who presented to Swiss trauma centers following severe penetrating trauma.

Methods

Swiss Trauma Registry (STR)-cohort analysis including patients with severe (ISS ≥ 16 or AIS head ≥ 3) penetrating trauma between 2017 and 2019. Primary outcome was mortality. Secondary outcomes were hospital and intensive care unit (ICU) length of stay (LOS), and prehospital times.

Results

During the 3-year study period, 134 (1.6% of entire STR) patients with severe penetrating trauma were identified [64 (48%) gunshot wounds (GSW), 70 (52%) stab wounds (SW)]. Median age was 40.5 (IQR 29.0–59.0) and 82.8% were male. Mortality rate was 50% for GSW; 9% for SW. Overall, prehospital time [incident to arrival emergency department (ED)] was 65 (IQR 45–94) minutes. The median number of patients admitted for a severe GSW/SW per center and year was 2 (range 0–14). Of 64 patients who sustained a GSW, 42 (65.6%) were self-inflicted. Mortality in self-inflicted GSW reached 66.7%, with the head being severely injured in 78.6%. The 67 patients with severe isolated torso GSW/SW had an ISS of 20 (IQR 16–26) and a mortality of 15%. Multivariable analysis identified severe chest trauma, ED Glasgow Coma Scale ≤ 8, age, self-infliction, massive blood transfusion and ISS as independent predictors for mortality.

Conclusion

Severe penetrating trauma is very rare in Switzerland. Mortality ranges from 9% in SW to 67% in self-inflicted GSW. Particularly in the setting of GSW/SW to the torso, reduction in prehospital time may further improve patient outcomes.

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Title: Severe penetrating trauma in Switzerland: first analysis of the Swiss Trauma Registry (STR)
Authors: Christian T. J. Magyar
Piotr Bednarski
Dominik A. Jakob
Beat Schnüriger
the “Swiss Trauma Registry”
Publication date: 02-11-2021
Publisher: Springer Berlin Heidelberg
Keyword: Gunshot Wound
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01822-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severe penetrating trauma in Switzerland: first analysis of the Swiss Trauma Registry (STR)

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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