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European Journal of Trauma and Emergency Surgery

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Open Access 18-08-2022 | Polytrauma | Original Article

The most critically injured polytrauma patient mortality: should it be a measurement of trauma system performance?

Authors: Benjamin Maurice Hardy, Natalie Enninghorst, Kate Louise King, Zsolt Janos Balogh

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2024

Abstract

Purpose

The risk of death after traumatic injury in developed trauma systems is at an all-time low. Among ‘major trauma’ patients (injury severity score, ISS > 15), the risk of dying is less than 10%. This group contains critical polytrauma patients (ISS 50–75), with high risks of death. We hypothesized that the reduction in trauma mortality was driven by reduction in moderate injury severity and that death from critical polytrauma remained persistently high.

Methods

A 20-year retrospective analysis ending December 2021 of a Level-1 trauma center’s registry was performed on all trauma patients admitted with ISS > 15. Patients’ demographics, injury severity and outcomes were collected. Multivariate logistic regression analysis was performed. Mortality was examined for the entire study group and separately for the subset of critical polytrauma patients (ISS 50–75).

Results

A total of 8462 severely injured (ISS > 15) trauma patients were identified during the 20-year period. Of these 238 (2.8%) were critical polytrauma patients (ISS 50–75). ISS > 15 mortality decreased from 11.3 to 9.4% over the study period (Adjusted OR 0.98, 0.97–0.99). ISS 50–75 mortality did not change significantly (46.2–60.0%), adjusted OR 0.96, 0.92–1.00).

Conclusion

The improvement in trauma mortality over the past 20 years has not been experienced equally. The ISS50-75 critical polytrauma mortality is a practical group to capture. It could be a group for deeper study and reporting to drive improvement.

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Title: The most critically injured polytrauma patient mortality: should it be a measurement of trauma system performance?
Authors: Benjamin Maurice Hardy
Natalie Enninghorst
Kate Louise King
Zsolt Janos Balogh
Publication date: 18-08-2022
Publisher: Springer Berlin Heidelberg
Keywords: Polytrauma
Polytrauma
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2024
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-02073-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The most critically injured polytrauma patient mortality: should it be a measurement of trauma system performance?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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