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European Journal of Trauma and Emergency Surgery

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Open Access 01-04-2022 | Triage | Original Article

The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

Authors: Suzan Dijkink, Erik W. van Zwet, Pieta Krijnen, Luke P. H. Leenen, Frank W. Bloemers, Michael J. R. Edwards, Dennis Den Hartog, Peter A. Leenhouts, Martijn Poeze, W. Richard Spanjersberg, Klaus W. Wendt, Ralph J. De Wit, Stefan W. A. M. Van Zuthpen, Inger B. Schipper

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2022

Abstract

Background

Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time.

Methods

All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS.

Results

The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC.

Conclusion

Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

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Title: The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands
Authors: Suzan Dijkink
Erik W. van Zwet
Pieta Krijnen
Luke P. H. Leenen
Frank W. Bloemers
Michael J. R. Edwards
Dennis Den Hartog
Peter A. Leenhouts
Martijn Poeze
W. Richard Spanjersberg
Klaus W. Wendt
Ralph J. De Wit
Stefan W. A. M. Van Zuthpen
Inger B. Schipper
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Triage
Care
Published in: European Journal of Trauma and Emergency Surgery / Issue 2/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01615-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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