25-Year experience with adult polytraumatized patients in a European level 1 trauma center: polytrauma between 1995 and 2019. What has changed? A retrospective cohort study

Purpose To analyze the changes of the clinical characteristics, injury patterns, and mortality rates of polytraumatized patients within the past 25 years in a European Level I trauma center. Methods 953 consecutive polytraumatized patients treated at a single-level 1 trauma center between January 19...

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Veröffentlicht in:Archives of orthopaedic and trauma surgery 2023-05, Vol.143 (5), p.2409-2415
Hauptverfasser: Weihs, Valerie, Frenzel, Stephan, Dedeyan, Michél, Hruska, Florian, Staats, Kevin, Hajdu, Stefan, Negrin, Lukas Leopold, Aldrian, Silke
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container_end_page 2415
container_issue 5
container_start_page 2409
container_title Archives of orthopaedic and trauma surgery
container_volume 143
creator Weihs, Valerie
Frenzel, Stephan
Dedeyan, Michél
Hruska, Florian
Staats, Kevin
Hajdu, Stefan
Negrin, Lukas Leopold
Aldrian, Silke
description Purpose To analyze the changes of the clinical characteristics, injury patterns, and mortality rates of polytraumatized patients within the past 25 years in a European Level I trauma center. Methods 953 consecutive polytraumatized patients treated at a single-level 1 trauma center between January 1995 and December 2019 were enrolled retrospectively. Polytrauma was defined as AIS ≥ 3 points in at least two different body regions. Retrospective data analysis on changes of clinical characteristics and mortality rates over time. Results A significant increase of the average age by 2 years per year of the study could be seen with a significant increase of geriatric patients over time. No changes of the median Injury Severity Score (ISS) could be seen over time, whereas the ISS significantly decreased by patient’s year. The rates of concomitant severe traumatic brain injury (TBI) remained constant over time, and did not increase with rising age of the patients. Although, the mortality rate remained constant over time the relative risk of overall in-hospital mortality increased by 1.7% and the relative risk of late-phase mortality increased by 2.2% per patient’s year. Conclusion The number of polytraumatized patients remained constant over the 25-year study period. Also, the mortality rates remained stable over time, although a significant increase of the average age of polytraumatized patients could be seen with stable injury severity scores. Severe TBI and age beyond 65 years remained independent prognostic factors on the late-phase survival of polytraumatized patients. Trial registration : NCT04723992. Level of evidence : Prognostic study, level III.
doi_str_mv 10.1007/s00402-022-04433-1
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What has changed? A retrospective cohort study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Weihs, Valerie ; Frenzel, Stephan ; Dedeyan, Michél ; Hruska, Florian ; Staats, Kevin ; Hajdu, Stefan ; Negrin, Lukas Leopold ; Aldrian, Silke</creator><creatorcontrib>Weihs, Valerie ; Frenzel, Stephan ; Dedeyan, Michél ; Hruska, Florian ; Staats, Kevin ; Hajdu, Stefan ; Negrin, Lukas Leopold ; Aldrian, Silke</creatorcontrib><description>Purpose To analyze the changes of the clinical characteristics, injury patterns, and mortality rates of polytraumatized patients within the past 25 years in a European Level I trauma center. Methods 953 consecutive polytraumatized patients treated at a single-level 1 trauma center between January 1995 and December 2019 were enrolled retrospectively. Polytrauma was defined as AIS ≥ 3 points in at least two different body regions. Retrospective data analysis on changes of clinical characteristics and mortality rates over time. Results A significant increase of the average age by 2 years per year of the study could be seen with a significant increase of geriatric patients over time. No changes of the median Injury Severity Score (ISS) could be seen over time, whereas the ISS significantly decreased by patient’s year. The rates of concomitant severe traumatic brain injury (TBI) remained constant over time, and did not increase with rising age of the patients. Although, the mortality rate remained constant over time the relative risk of overall in-hospital mortality increased by 1.7% and the relative risk of late-phase mortality increased by 2.2% per patient’s year. Conclusion The number of polytraumatized patients remained constant over the 25-year study period. Also, the mortality rates remained stable over time, although a significant increase of the average age of polytraumatized patients could be seen with stable injury severity scores. Severe TBI and age beyond 65 years remained independent prognostic factors on the late-phase survival of polytraumatized patients. Trial registration : NCT04723992. 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What has changed? A retrospective cohort study</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Purpose To analyze the changes of the clinical characteristics, injury patterns, and mortality rates of polytraumatized patients within the past 25 years in a European Level I trauma center. Methods 953 consecutive polytraumatized patients treated at a single-level 1 trauma center between January 1995 and December 2019 were enrolled retrospectively. Polytrauma was defined as AIS ≥ 3 points in at least two different body regions. Retrospective data analysis on changes of clinical characteristics and mortality rates over time. Results A significant increase of the average age by 2 years per year of the study could be seen with a significant increase of geriatric patients over time. No changes of the median Injury Severity Score (ISS) could be seen over time, whereas the ISS significantly decreased by patient’s year. The rates of concomitant severe traumatic brain injury (TBI) remained constant over time, and did not increase with rising age of the patients. Although, the mortality rate remained constant over time the relative risk of overall in-hospital mortality increased by 1.7% and the relative risk of late-phase mortality increased by 2.2% per patient’s year. Conclusion The number of polytraumatized patients remained constant over the 25-year study period. Also, the mortality rates remained stable over time, although a significant increase of the average age of polytraumatized patients could be seen with stable injury severity scores. Severe TBI and age beyond 65 years remained independent prognostic factors on the late-phase survival of polytraumatized patients. Trial registration : NCT04723992. 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What has changed? A retrospective cohort study</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2023-05-01</date><risdate>2023</risdate><volume>143</volume><issue>5</issue><spage>2409</spage><epage>2415</epage><pages>2409-2415</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Purpose To analyze the changes of the clinical characteristics, injury patterns, and mortality rates of polytraumatized patients within the past 25 years in a European Level I trauma center. Methods 953 consecutive polytraumatized patients treated at a single-level 1 trauma center between January 1995 and December 2019 were enrolled retrospectively. Polytrauma was defined as AIS ≥ 3 points in at least two different body regions. Retrospective data analysis on changes of clinical characteristics and mortality rates over time. Results A significant increase of the average age by 2 years per year of the study could be seen with a significant increase of geriatric patients over time. No changes of the median Injury Severity Score (ISS) could be seen over time, whereas the ISS significantly decreased by patient’s year. The rates of concomitant severe traumatic brain injury (TBI) remained constant over time, and did not increase with rising age of the patients. Although, the mortality rate remained constant over time the relative risk of overall in-hospital mortality increased by 1.7% and the relative risk of late-phase mortality increased by 2.2% per patient’s year. Conclusion The number of polytraumatized patients remained constant over the 25-year study period. Also, the mortality rates remained stable over time, although a significant increase of the average age of polytraumatized patients could be seen with stable injury severity scores. Severe TBI and age beyond 65 years remained independent prognostic factors on the late-phase survival of polytraumatized patients. Trial registration : NCT04723992. Level of evidence : Prognostic study, level III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35412071</pmid><doi>10.1007/s00402-022-04433-1</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-1697-1381</orcidid><oa>free_for_read</oa></addata></record>
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1434-3916
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subjects Adult
Aged
Brain Injuries, Traumatic
Child, Preschool
Cohort analysis
Humans
Injury Severity Score
Medical prognosis
Medicine
Medicine & Public Health
Mortality
Multiple Trauma
Orthopedics
Patients
Prognosis
Retrospective Studies
Trauma
Trauma Centers
Trauma Surgery
Traumatic brain injury
title 25-Year experience with adult polytraumatized patients in a European level 1 trauma center: polytrauma between 1995 and 2019. What has changed? A retrospective cohort study
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