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Five years experience of trauma care in a German urban level I university trauma center

  • Focus on Diagnostic and Prognosis of Severely Traumatized Patients
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Background:

A regionalized approach to trauma care with the implementation of designated level I trauma centers has been shown to improve survival after multiple injuries. Our study aimed to describe the current reality in an urban German level I university trauma center concerning the primary admission of patients into the emergency room.

Materials and Methods:

We performed a retrospective analysis of all multiple trauma patients that were prospectively documented in our documentation system TraumaWatch® from 2003 to 2007. Documentation included physiological findings as well as diagnostic and therapeutic procedures structured as: (A) preclinical phase; (B) emergency room treatment; (C) intensive care unit; and (D) final outcome according to the German Trauma Registry.

Results:

In total, 1,848 patients were completely documented and, thus, analyzed. The mean ± standard deviation (SD) Injury Severity Score (ISS) was 16.5 ± 14.1 points and the mean ± SD age was 38.7 ± 21.9 years. An increasing number of patients received whole-body computed tomography (48.8% in 2003 vs. 83.3%in 2007, p < 0.001) and, on average, the ISS increased over the years (14.4 points in 2003 vs. 17.9 points in 2007). The overall hospital mortality was 7.1%, without significant change over time. The completionofimagingdiagnostics became significantly faster for all of the documented procedures (X-ray pelvis, X-ray chest, whole-body CT, abdominal ultrasound) (p < 0.001).

Discussion:

Descriptive data on the current reality in urban level I trauma care can be derived from our study. Additionally, we achieved improved time intervals for emergency diagnostics and treatment, while hospital mortality remained constant, despite a higher injury severity. This is due to a standardized protocol which is applied during the 24-h in-house attending coverage.

Conclusion:

Regionalized trauma care with designated level I trauma centers is justified by the improvement of time intervals and outcome, but adequate resources are required.

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Authors and Affiliations

  1. Department of Trauma, Hand, and Reconstructive Surgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany

    Hendrik Wyen, Sebastian Wutzler, Miriam Rüsseler, Felix Walcher &  Ingo Marzi

  2. Department of Radiology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany

    Martin Mack

  3. Department of Trauma, Hand, and Reconstructive Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, 60590, Frankfurt, Germany

    Ingo Marzi

Authors
  1. Hendrik Wyen
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  2. Sebastian Wutzler
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  3. Miriam Rüsseler
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  4. Martin Mack
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  5. Felix Walcher
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  6. Ingo Marzi
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Correspondence to Ingo Marzi.

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Wyen, H., Wutzler, S., Rüsseler, M. et al. Five years experience of trauma care in a German urban level I university trauma center. Eur J Trauma Emerg Surg 35, 448–454 (2009). https://doi.org/10.1007/s00068-009-9140-y

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  • DOI: https://doi.org/10.1007/s00068-009-9140-y

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