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Current status of trauma surgery at a Japanese prefectural academic institute: improved organization in a regional prefecture

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Abstract

Purposes

Balancing scheduled surgery and trauma surgery is difficult with a limited number of surgeons. To address the issues and systematize education, we analyzed the current situation and the effectiveness of having a trauma team in the ER of a regional hospital.

Methods

This retrospective study analyzed the demographics, traumatic variables, procedures, postoperative morbidities, and outcomes of 110 patients who underwent trauma surgery between 2012 and 2019. The trauma team was established in 2016 and our university hospital Emergency Room (ER) opened in 2012.

Results

Blunt trauma accounted for 82% of the trauma injuries and 39% of trauma victims were transported from local centers to our institute. The most frequently injured organs were in the digestive tract and about half of the interventions were for hemostatic surgery alone. Concomitant treatments for multiple organ injuries were performed in 31% of the patients. The rates of postoperative severe complications (over Clavien–Dindo IIIb) and mortality were 10% and 13%, respectively. Fourteen (12.7%) of 24 patients who underwent damage-control surgery died, with multiple organ injury being the predominant cause of death.

Conclusion

Systematic education or training of medical students and general surgeons, as well as the co-operation of the team at the regional academic institute, are necessary to overcome the limited human resources and save trauma patients.

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Acknowledgements

We would like to thank all co-authors and the ER staff from Miyazaki prefecture who supported the operations and data collection in the present study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or nonprofit sectors.

Author information

Authors and Affiliations

  1. Division of Gastrointestinal, Endocrine and Pediatric Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Fumiaki Kawano, Kousei Tashiro, Makoto Ikenoue, Shun Munakata, Hironobu Nakao, Takayuki Mizuno, Hiroki Mori, Takuto Ikeda, Shinsuke Takeno & Atsushi Nanashima

  2. Division of Cardiovascular Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Koji Furukawa & Kunihide Nakamura

  3. Division of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Masaki Tomita

  4. Emergency and Critical Care Center, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    George Endo & Hidenobu Ochiai

  5. Division of Hepato-Biliary-Pancreas Surgery of the Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan

    Atsushi Nanashima

Authors
  1. Fumiaki Kawano
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  2. Kousei Tashiro
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  3. Makoto Ikenoue
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  4. Shun Munakata
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  5. Hironobu Nakao
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  6. Takayuki Mizuno
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  7. Hiroki Mori
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  8. Takuto Ikeda
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  9. Shinsuke Takeno
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  10. Koji Furukawa
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  11. Masaki Tomita
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  12. George Endo
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  13. Hidenobu Ochiai
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  14. Kunihide Nakamura
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  15. Atsushi Nanashima
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Corresponding author

Correspondence to Atsushi Nanashima.

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Conflict of interest

We have no financial or conflicts of interest to declare.

Ethical approval

The investigations were performed in accordance with the Declaration of Helsinki and the institutional ethical approval was obtained by the University of Miyazaki Faculty of Medicine May 2020 (#O-0698).

Informed consent

Agreement to this retrospective survey and patient’s approval were accepted following the opt-out announcement at the outpatient clinic in our hospital and published on the institutional website of the University of Miyazaki Faculty of Medicine (UoMFM) (http://www.med.miyazaki-u.ac.jp/home/hospital/about/5433/).

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Kawano, F., Tashiro, K., Ikenoue, M. et al. Current status of trauma surgery at a Japanese prefectural academic institute: improved organization in a regional prefecture. Surg Today 51, 1001–1009 (2021). https://doi.org/10.1007/s00595-020-02196-z

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  • DOI: https://doi.org/10.1007/s00595-020-02196-z

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