Management of Polytrauma Patients During 10 Years

Abstract

Background: This epidemiological study presents the treatment results of multiple traumatised patients over the last 10 years. Method: Our study includes all polytrauma patients treated between 1992 and 2002 at a level 1 trauma centre. Data of 501 cases were collected prospectively and analysed retrospectively. Major issues of this analysis were the ISS, preclinical haemodynamics and intubation rate, incidence of MOF, ARDS and mortality. Results: In the last few years an increase in frequency of preclinical intubation was apparent (1992-1997: 69.3 % 1998-2002: 76.1 %). The number of primary shock patients decreased from the first period (34.0 %) to the second period (27.0 %). Comparing both periods, the mean ISS (34.3) and injury pattern showed no significant difference. The incidence of MOF decreased from 10.3 % in the first period to 5.5 % in the second period, while the frequency of ARDS decreased from 19.7 % to 9.4 %. The mortality rate increased from 28.2 % in the first to 32.2 % in the last 5 years. Conclusion: Protracted time of initial rescue, early intubation and good quality of preclinical treatment leads to a reduction of complications during ICU therapy. The transport of more patients who would have died in the field if there had not been a reduced scene time and rapid transport available in our trauma system could be a reason for the increasing mortality of multiple traumatised patients in our hospital.

Key words

multiple trauma - epidemiological study - multiorgan failure - adult respiratory distress syndrome - mortality

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