Document Detail


Head injury and outcome--what influence do concomitant injuries have?
MedLine Citation:
PMID:  19001971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Severe head injury (HI) is known to be a major determinant of mortality in patients with multiple injuries but additional injuries also contribute to the clinical outcome. The Trauma Registry of the German Society for Trauma Surgery offers sufficient data for comparative outcome analysis in relation to the injury pattern. METHODS: A total of 21,356 cases from Trauma Registry of the German Society for Trauma Surgery with complete data for pattern of injury (Abbreviated Injury Scale [AIS], Injury Severity Score), the incidence of hospital mortality, organ failure, sepsis, duration of hospital stay, and intubation-free days. Maximum AIS severity of HI, including brain, skull, face, and cervical spine, and injuries to the torso and/or extremities (TEI) were used for comparative subgroup analysis. RESULTS: Overall mortality rate was 13.7% (mean age, 41.3 years; 72.6% men; mean Injury Severity Score, 24.4). Patients with relevant HI (AISHI >/=3) were found to have a higher mortality rate (22.1%) than patients with relevant TEI (12.9%). In all HI severity subgroups mortality increased consistently by about 5% with TEI of grade 4, and by 15% with TEI of grade 5, but no increase is observed for lower severity grades. The incidence of organ failure (overall 31.4%), multiple organ failure (15.0%), and sepsis (9.9%) are mainly influenced by the severity of TEI. Intubation-free days are equally influenced by both types of injuries of grade 3 or higher. CONCLUSIONS: Mortality in patients with severe trauma is mainly determined by the severity of HI, while TEI contribute consistently only from AIS grade 4 or higher.
Authors:
Rolf Lefering; Thomas Paffrath; Ralph Linker; Bertil Bouillon; Edmund A M Neugebauer;
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  65     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-12     Completed Date:  2008-11-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1036-43; discussion 1043-4     Citation Subset:  AIM; IM    
Affiliation:
Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany. rolf.lefering@ifom-uni-wh.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Comorbidity
Craniocerebral Trauma / diagnosis,  epidemiology*
Europe
Female
Humans
Injury Severity Score
Male
Middle Aged
Multiple Trauma / diagnosis,  epidemiology*
Registries
Treatment Outcome

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