Document Detail


Complications in multitrauma patients in a Dutch level 1 trauma center.
MedLine Citation:
PMID:  20400919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Complication registration is an important part of monitoring the quality of health care. The aim of this article was to describe the incidence, type, and impact of complications occurring within 6 months after the initial trauma in multitrauma patients.
METHODS: During a 2-year period, all trauma patients with an Injury Severity Score (ISS) ≥ 16 who were not directly transferred to other hospitals were included. We used the Dutch National Surgical Complication Registry of the Academic Medical Center, a level 1 trauma center, to assess complications within 6 months after the initial trauma. For verification, we additionally performed a chart review. Complications were graded 0 (no real health loss) to 4 (lethal).
RESULTS: Three hundred three multitrauma patients were included with a median ISS of 22 (interquartile range, 17-29). Within 181 patients, 358 complications occurred (60%). The most frequently occurring complications were respiratory and urinary tract infections. Most complications (73%) were grade 1 and resolved completely without operative (re-)intervention There were 27 patients (8%) with a grade 2 complication, which required operative (re-)interventions. All eight (2%) grade 3 complications which caused (potential) permanent damage or disability, were of neurologic origin. Overall mortality was 18.8% and complication associated readmission rate was 4%. Emergency interventions and high ISS tended to be associated with the occurrence of complications. In patients with complications, hospital stay was doubled from 9 to 18 days.
CONCLUSIONS: Multitrauma patients are at high risk for developing complications. Most frequently encountered complications were infections. The majority of complications resolved completely without a surgical intervention.
Authors:
Teun P Saltzherr; Annelies Visser; Kees J Ponsen; Jan S Luitse; J Carel Goslings
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  69     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-11     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1143-6     Citation Subset:  AIM; IM    
Affiliation:
Trauma Unit Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands. t.p.saltzherr@amc.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Incidence
Injury Severity Score
Length of Stay
Male
Middle Aged
Multiple Trauma / complications*,  diagnosis,  epidemiology
Netherlands / epidemiology
Quality Assurance, Health Care
Registries
Respiratory Tract Infections / epidemiology,  etiology*
Retrospective Studies
Risk Factors
Trauma Centers / statistics & numerical data*
Urinary Tract Infections / epidemiology,  etiology*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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