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Patient Safety in Surgery
Published in: Patient Safety in Surgery 1/2008

Open Access 01-12-2008 | Review

Missed injuries in trauma patients: A literature review

Authors: Roman Pfeifer, Hans-Christoph Pape

Published in: Patient Safety in Surgery | Issue 1/2008

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Abstract

Background

Overlooked injuries and delayed diagnoses are still common problems in the treatment of polytrauma patients. Therefore, ongoing documentation describing the incidence rates of missed injuries, clinically significant missed injuries, contributing factors and outcome is necessary to improve the quality of trauma care. This review summarizes the available literature on missed injuries, focusing on overlooked muscoloskeletal injuries.

Methods

Manuscripts dealing with missed injuries after trauma were reviewed. The following search modules were selected in PubMed: Missed injuries, Delayed diagnoses, Trauma, Musculoskeletal injuires. Three time periods were differentiated: (n = 2, 1980–1990), (n = 6, 1990–2000), and (n = 9, 2000-Present).

Results

We found a wide spread distribution of missed injuries and delayed diagnoses incidence rates (1.3% to 39%). Approximately 15 to 22.3% of patients with missed injuries had clinically significant missed injuries. Furthermore, we observed a decrease of missed pelvic and hip injuries within the last decade.

Conclusion

The lack of standardized studies using comparable definitions for missed injuries and clinically significant missed injuries call for further investigations, which are necessary to produce more reliable data. Furthermore, improvements in diagnostic techniques (e.g. the use of multi-slice CT) may lead to a decreased incidence of missed pelvic injuries. Finally, the standardized tertiary trauma survey is vitally important in the detection of clinically significant missed injuries and should be included in trauma care.
Appendix
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Metadata
Title
Missed injuries in trauma patients: A literature review
Authors
Roman Pfeifer
Hans-Christoph Pape
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Patient Safety in Surgery / Issue 1/2008
Electronic ISSN: 1754-9493
DOI
https://doi.org/10.1186/1754-9493-2-20

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