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Epidemiology and outcome of penetrating injuries in a Western European urban region

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Abstract

Purpose

Severe life-threatening injuries in Western Europe are mostly caused by blunt trauma. However, penetrating trauma might be more common in urban regions, but their characteristics have not been fully elucidated.

Methods

Retrospective analysis of data from patients admitted to our urban university level I trauma center between 2008 and 2013 with suspicion of severe multiple injuries. Collection of data was performed prospectively using a PC-supported online documentation program including epidemiological, clinical and outcome parameters.

Results

Out of 2095 trauma room patients admitted over the 6-year time period 194 (9.3 %) suffered from penetrating trauma. The mean Injury Severity Score (ISS) was 12.3 ± 14.1 points. In 62.4 % (n = 121) the penetrating injuries were caused by interpersonal violence or attempted suicide, 98 of these by stabbing and 23 by firearms. We observed a widespread injury pattern where mainly head, thorax and abdomen were afflicted. Subgroup analysis for self-inflicted injuries showed higher ISS (19.8 ± 21.8 points) than for blunt trauma (15.5 ± 14.6 points). In 82.5 % of all penetrating trauma a surgical treatment was performed, 43.8 % of the patients received intensive care unit treatment with mean duration of 7.4 ± 9.3 days. Immediate emergency surgical treatment had to be performed in 8.0 vs. 2.3 % in blunt trauma (p < 0.001). Infectious complications of the penetrating wounds were observed in 7.8 %.

Conclusions

Specific characteristics of penetrating trauma in urban regions can be identified. Compared to nationwide data, penetrating trauma was more frequent in our collective (9.3 vs. 5.0 %), which may be due to higher crime rates in urban areas. Especially, self-inflicted penetrating trauma often results in most severe injuries.

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Authors and Affiliations

  1. Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe, University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany

    P. Störmann, K. Gartner, H. Wyen, T. Lustenberger, I. Marzi & S. Wutzler

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  1. P. Störmann
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  2. K. Gartner
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  3. H. Wyen
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  4. T. Lustenberger
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Correspondence to P. Störmann.

Ethics declarations

The study protocol was approved by the local Ethics Commission of the University Hospital Frankfurt (EV 279/14).

Conflict of interest

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Philipp Störmann, Karla Gartner, Hendrik Wyen, Thomas Lustenberger, Ingo Marzi and Sebastian Wutzler hereby declare that they have no conflicts of interest to disclose.

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Störmann, P., Gartner, K., Wyen, H. et al. Epidemiology and outcome of penetrating injuries in a Western European urban region. Eur J Trauma Emerg Surg 42, 663–669 (2016). https://doi.org/10.1007/s00068-016-0630-4

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  • DOI: https://doi.org/10.1007/s00068-016-0630-4

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