Treatment management and outcome of polytraumatized patients in a German certified trauma center-comparing standard versus maximum care

被引:0
|
作者
Radetzki, F. [1 ,2 ,6 ]
Massarwa, H. [3 ]
Wienke, A. [4 ]
Delank, K. S. [5 ]
Zagrodnick, J. [1 ]
机构
[1] Dessau Municipal Hosp, Dept Orthoped & Trauma Surg, Dessau Rosslau, Germany
[2] Brandenburg Med Sch Theodor Fontane MHB, Neuruppin, Germany
[3] Franziskus Hosp Harderberg, Dept Orthoped & Trauma Surg, Georgsmarienhutte, Germany
[4] Martin Luther Univ Halle Wittenberg, Inst Med Epidemiol Biostat & Informat, Halle An Der Saale, Germany
[5] Martin Luther Univ Halle Wittenberg, Dept Orthopaed Trauma & Reconstruct Surg, Halle An Der Saale, Germany
[6] Dessau Municipal Hosp, Dept Orthoped & Trauma Surg, Auenweg 38, D-06847 Dessau Rosslau, Germany
来源
ACTA ORTHOPAEDICA BELGICA | 2023年 / 89卷 / 01期
关键词
German Trauma society; trauma network; maximum care provider; polytraumatized patients; MULTIPLE TRAUMA; DEATHS; EPIDEMIOLOGY; FRACTURES; MORTALITY; FAILURE; SYSTEM; LEVEL;
D O I
10.52628/89.1.0002
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
German hospitals are classified as basic, standard and maximum care facilities within the German trauma networks. The Municipal Hospital Dessau was upgraded in 2015 as a maximum care provider. The aim of this study is to investigate whether a change in treatment management and outcome of polytraumatized patients has occurred afterwards. The study compared polytraumatized patients, treated in the Dessau Municipal Clinic as a standard care facility (DessauStandard) from 2012-2014 vs. those treated in the Dessau Municipal Clinic as a maximum care facility (DessauMax) from 2016-2017. Data of the German Trauma Register were analysed using the chi-square test, t-test and odds ratios with 95% confidence intervals.In DessauMax (238 patients; 0 54 years, SD 22.3; & MALE; 160, & FEMALE; 78), the shock room time with 40.7 min (SD 21.4) was shorter than in DessauStandard (206 patients; 0 56.1 years, SD 22.1; & MALE; 133, & FEMALE; 73 ) with 49 min (SD 25.1) (p=0.001). The transfer rate of 1.3% (n=3) to another hospital was lower in DessauMax (p=0.01). DessauStandard had 9 (4%) thromboembolic events and DessauMax 3 (1.3%) (p=0.7). Multiorgan failure was more common in DessauStandard, (16%) than in DessauMax (1.3%; p=0,001). DessauStandard showed a mortality of 13.1% (n=27), and DessauMax 9.2% (n=22) (p=0.22; OR=0.67, 95% CI, 0.37-1.23). The GOS in DessauMax (4.5, SD 1.2) was higher than in DessauStandard (4.1, SD 1.3) (p=0.002).The Dessau Municipal Clinic as a maximum care facility has achieved improved shock room time, fewer complications, lower mortality and an improved outcome.
引用
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页码:7 / 14
页数:8
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