Analysis of the treatment results of patients with concomitant trauma in a level 1 trauma center
https://doi.org/10.52420/2071-5943-2022-21-2-89-92
Abstract
Adequate treatment of patients with combined trauma requires not only medical care at the highest level, but also coordination of organizational and logistical processes. We performed a retrospective analysis of the results of treatment of 256 patients with concomitant trauma in the regional trauma center from 2019 to 2021. The analysis included patients older than 18 years with (ISS) ≥18 and (AIS)>3 in two or more anatomical areas of the body. The average index of injury severity (ISS) was 30.5. Victims with combined trauma had a predominance of craniocerebral, chest, abdominal, and spinal trauma. The lethality rate was 15.2%, and the ISS of the deceased victims was 40.7. Victims with severe combined trauma do not tolerate time-consuming and traumatic operations, and «damage control» tactics are used for this group. To reduce the mortality rate it is necessary to transport patients with severe combined trauma from the scene to a level 1 trauma center. Only in a large multidisciplinary hospital with strong resource, therapeutic and human resource potential, it is possible to save victims with severe combined trauma.
About the Author
V. A. Demidov
Sverdlovsk Regional Clinical Hospital #1
Russian Federation
Russian Federation
Viktor A. Demidov – MD.
Ekaterinburg.
References
1. Принципы диагностики и лечения тяжелой сочетанной травмы (лекция) / Тулупов А. Н., Мануковский В. А., Самохвалов И. М. [и др.] // Журнал Неотложная хирургия им. И.И. Джанелидзе. – 2021. – № 2(3). – С.11-28.
2. Роль объективной оценки тяжести состояния пострадавших и «DAMAGE CONTROL» в комплексе мер по снижению инфекционных осложнений при политравме / Кондратьев И. П., Шляпников С. А., Линник С. А., Кучеев И. О. // Журнал Неотложная хирургия им. И.И. Джанелидзе. – 2021. – № 2(3). – С.37-42.
3. Milton, M. Predicting mortality in trauma patients — A retrospective comparison of the performance of six scoring systems applied to polytrauma patients from the emergency centre of a South African central hospital / M. Milton, A.S. Engelbrecht, M. Geyser //Afr J Emerg Med. – 2021 Dec;11(4):453-458. doi: 10.1016/j.afjem.2021.09.001.
4. Global changes in mortality rates in polytrauma patients admitted to the ICU — a systematic review / J. M. M. van Breugel1, M. J. S. Niemeyer [et al.] // World Journal of Emergency Surgery. – 2020. 15:55 https://doi.org/10.1186/s13017-020-00330-3.
5. Багненко, С. Ф. Организация и оказание скорой медицинской помощи пострадавшим в дорожно-транспортных происшествиях / С. Ф. Багненко, В. В. Стожаров, А. Г. Мирошниченко. – Спб, 2011. – 400 с.
6. van Wessem K. J. P., Leenen L. P. H. Geriatric polytrauma patients should not be excluded from aggressive injury treatment based on age alone // Eur J Trauma Emerg Surg. – 2022. Feb;48(1):357-365.
7. Хирургическая и эвакуационная тактика у пациентов с политравмой в травмоцентрах II и III уровня / Махновский А. И., Эргашев О. Н., Барсукова И. М. [и др.] // Журнал Неотложная хирургия им. И.И. Джанелидзе. – 2020. – № 1. – С. 28-35.
8. Ketter V., Ruchholtz S.. Trauma center management Med Klin Intensivmed Notfmed 2021 Jun;116(5):400-404. doi: 10.1007/s00063-021-00807-2. Epub 2021 Apr 13.
9. Nicola R. Early total care versus damage control current concepts in the orthopedic care of polytrauma patients // ISRN Orthop. – 2013;2013:1–9. doi: 10.1155/2013/329452.
10. Damage control in orthopaedical and traumatology / A. M. Rondanelli, M. A. Gómez-Sierra, A. A. Ossa [et al.] // Colomb Med (Cali). – 2021 Jun 30;52(2):e4184802. – doi:10.25100/cm.v52i2.4802.
11. The definition of polytrauma revisited An international consensus process and proposal of the new «Berlin definition» / Pape H. C., Lefering R., Butcher N. [et al.] // J Trauma Acute Care. Surg. – 2014;77:780–786. doi: 10.1097/TA.0000000000000453.
12. Polytrauma Defined by the New Berlin Definition: A Validation Test Based on Propensity-Score Matching Approach // Int J Environ Res Public Health. – 2017 Sep 11;14(9):1045. – doi: 10.3390/ijerph14091045.
Review
For citations:
Demidov VA. Analysis of the treatment results of patients with concomitant trauma in a level 1 trauma center. Ural Medical Journal. 2022;21(2):89-92. (In Russ.) https://doi.org/10.52420/2071-5943-2022-21-2-89-92
Views:
185
Email this article 