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Clinical Trial
. 2023 May;143(5):2409-2415.
doi: 10.1007/s00402-022-04433-1. Epub 2022 Apr 12.

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

Valerie Weihs  1 , Stephan Frenzel  2 , Michél Dedeyan  2 , Florian Hruska  2 , Kevin Staats  2 , Stefan Hajdu  2 , Lukas Leopold Negrin  2 , Silke Aldrian  2
Affiliations
Clinical Trial

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

Valerie Weihs et al. Arch Orthop Trauma Surg. 2023 May.

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.

Keywords: Epidemiology; Mortality; Outcome; Polytrauma.

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Conflict of interest statement

No conflicts of interest were declared.

Figures

Fig. 1
Fig. 1
The rates of polytraumatized patients remained constant over time (linear regression: p = 0.291)
Fig. 2
Fig. 2
Overall mortality rates in polytraumatized patients over the years without significant changes over time
Fig. 3
Fig. 3
Severe TBI showed a significant influence on the late-phase survival in polytraumatized patients (p < 0.001)
Fig. 4
Fig. 4
Age > 65 years of age showed a significant influence on the late-phase survival of polytraumatized patients
See this image and copyright information in PMC

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