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European Journal of Trauma and Emergency Surgery

Published in:

01-02-2022 | Care | Original Article

The yield of tertiary survey in patients admitted for observation after trauma

Authors: Gijs Jacob Jan van Aert, Jelle Corneel van Dongen, Niels Cornelis Adrianus Sebastianus Berende, Hendrikus Gerardus Wilhelmus de Groot, Pieter Boele van Hensbroek, Philip Marcel Jozef Schormans, Dagmar Isabella Vos

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2022

Abstract

Purpose

Existing literature on trauma tertiary survey (TTS) focusses on multitrauma patients. This study examines the yield of the TTS in trauma patients with minor (AIS 1) or moderate (AIS 2) injury for which immediate hospitalization is not strictly indicated.

Method

A single center retrospective cohort study was performed in a level II trauma center. All hospitalized trauma patients with an abbreviate injury score (AIS) of one or two at the primary and secondary survey were included. The primary outcome was defined as any missed injury found during TTS (Type 1). Secondary outcomes were defined as any missed injury found after TTS but during admission (Type 2); overall missed injury rate; mortality and hospital length of stay.

Results

Out of 388 included patients, 12 patients (3.1%) had a type 1 missed injury. ISS and alcohol consumption were associated with an increased risk for type 1 missed injuries (resp. OR = 1.4, OR = 5.49). A type 2 missed injury was only found in one patient. This concerned the only case of trauma related mortality. Approximately one out of five patients were admitted for more than 2 days. These patients were significantly older (66 vs. 41 years, p < 0.001), had a higher ISS (4 vs. 3, p = 0.007) and ASA score, 3–4 vs. 1–2 (42.5% vs. 12.6%, p < 0.001).

Conclusion

TTS showed a low rate of missed injuries in trauma patients with minor or moderate injury. TTS helped to prevent serious damage in two out of 388 patients (0.5%). ISS and alcohol consumption were associated with finding missed injury during TTS.

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Title: The yield of tertiary survey in patients admitted for observation after trauma
Authors: Gijs Jacob Jan van Aert
Jelle Corneel van Dongen
Niels Cornelis Adrianus Sebastianus Berende
Hendrikus Gerardus Wilhelmus de Groot
Pieter Boele van Hensbroek
Philip Marcel Jozef Schormans
Dagmar Isabella Vos
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keyword: Care
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01473-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The yield of tertiary survey in patients admitted for observation after trauma

Abstract

Purpose

Method

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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