Is trauma in Switzerland any different? epidemiology and patterns of injury in major trauma - a 5-year review from a Swiss trauma centre.

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Serval ID
serval:BIB_A89E87E6A278
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Is trauma in Switzerland any different? epidemiology and patterns of injury in major trauma - a 5-year review from a Swiss trauma centre.
Journal
Swiss medical weekly
Author(s)
Heim C., Bosisio F., Roth A., Bloch J., Borens O., Daniel R.T., Denys A., Oddo M., Pasquier M., Schmidt S., Schoettker P., Zingg T., Wasserfallen J.B.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
144
Pages
w13958
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Switzerland, the country with the highest health expenditure per capita, is lacking data on trauma care and system planning. Recently, 12 trauma centres were designated to be reassessed through a future national trauma registry by 2015. Lausanne University Hospital launched the first Swiss trauma registry in 2008, which contains the largest database on trauma activity nationwide.
Prospective analysis of data from consecutively admitted shock room patients from 1 January 2008 to 31 December 2012. Shock room admission is based on physiology and mechanism of injury, assessed by prehospital physicians. Management follows a surgeon-led multidisciplinary approach. Injuries are coded by Association for the Advancement of Automotive Medicine (AAAM) certified coders.
Over the 5 years, 1,599 trauma patients were admitted, predominantly males with a median age of 41.4 years and median injury severity score (ISS) of 13. Rate of ISS >15 was 42%. Principal mechanisms of injury were road traffic (40.4%) and falls (34.4%), with 91.5% blunt trauma. Principal patterns were brain (64.4%), chest (59.8%) and extremity/pelvic girdle (52.9%) injuries. Severe (abbreviated injury scale [AIS] score ≥ 3) orthopaedic injuries, defined as extremity and spine injuries together, accounted for 67.1%. Overall, 29.1% underwent immediate intervention, mainly by orthopaedics (27.3%), neurosurgeons (26.3 %) and visceral surgeons (13.9%); 43.8% underwent a surgical intervention within the first 24 hours and 59.1% during their hospitalisation. In-hospital mortality for patients with ISS >15 was 26.2%.
This is the first 5-year report on trauma in Switzerland. Trauma workload was similar to other European countries. Despite high levels of healthcare, mortality exceeds published rates by >50%. Regardless of the importance of a multidisciplinary approach, trauma remains a surgical disease and needs dedicated surgical resources.
Keywords
Abbreviated Injury Scale, Accidental Falls/statistics & numerical data, Accidents, Traffic/statistics & numerical data, Adult, Aged, Brain Injuries/epidemiology, Burns/epidemiology, Female, Humans, Injury Severity Score, Lower Extremity/injuries, Male, Middle Aged, Pelvic Bones/injuries, Prospective Studies, Registries, Spinal Injuries/epidemiology, Switzerland/epidemiology, Thoracic Injuries/epidemiology, Trauma Centers/statistics & numerical data, Upper Extremity/injuries, Wounds and Injuries/epidemiology, Wounds and Injuries/surgery, Wounds, Nonpenetrating/epidemiology, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
28/04/2014 9:53
Last modification date
13/08/2020 6:21
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