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. 2024 Oct;50(5):2509-2515.
doi: 10.1007/s00068-024-02606-8. Epub 2024 Aug 7.

Association of trauma classifications to long-term outcome in blunt trauma patients

Joonas Kuorikoski  1   2 , Mikko Heinänen  3   4 , Tuomas Brinck  5 , Tim Söderlund  3
Affiliations

Association of trauma classifications to long-term outcome in blunt trauma patients

Joonas Kuorikoski et al. Eur J Trauma Emerg Surg. 2024 Oct.

Abstract

Purpose: The impact of major trauma is long lasting. Although polytrauma patients are currently identified with the Berlin polytrauma criteria, data on long-term outcomes are not available. In this study, we evaluated the association of trauma classification with long-term outcome in blunt-trauma patients.

Methods: A trauma registry of a level I trauma centre was used for patient identification from 1.1.2006 to 31.12.2015. Patients were grouped as follows: (1) all severely injured trauma patients; (2) all severely injured polytrauma patients; 2a) severely injured patients with AIS ≥ 3 on two different body regions (Berlin-); 2b) severely injured patients with polytrauma and a physiological criterion (Berlin+); and (3) a non-polytrauma group. Kaplan-Meier survival analysis was performed to estimate differences in mortality between different groups.

Results: We identified 3359 trauma patients for this study. Non-polytrauma was the largest group (2380 [70.9%] patients). A total of 500 (14.9%) patients fulfilled the criteria for Berlin + definition, leaving 479 (14.3%) polytrauma patients in Berlin- group. Berlin + patients had the highest short-term mortality compared with other groups, although the difference in cumulative mortality gradually plateaued compared with the non-polytrauma patient group; at the end of the 10-year follow up, the non-polytrauma group had the greatest mortality due to the high number of patients with traumatic brain injury (TBI).

Conclusion: Excess mortality of polytrauma patients by Berlin definition occurs in the early phase (30-day mortality) and late deaths are rare. TBI causes high early mortality followed by increased long-term mortality.

Keywords: Berlin definition; Mortality; Polytrauma; Trauma; Trauma care; Trauma registry.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This was a retrospective register study. The HUH scientific review board accepted the study (HUS/221/2017). According to Finnish legislation, consent from patients is not needed for a register study of this type. Data for the register were gathered by patient medical chart review. Consent for publication: All authors have read the final draft of the manuscript and give consent for publication. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Classification flowchart of included trauma patients of different groups
Fig. 2
Fig. 2
Kaplan-Meier survival graph of different patient groups
Fig. 3
Fig. 3
Kaplan-Meier graph of non-polytrauma group divided by different AIS regions
See this image and copyright information in PMC

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