Universität zu Köln

Timm, Alexander, Maegele, Marc, Wendt, Klaus, Lefering, Rolf and Wyen, Hendrik (2019). Pre-hospital rescue times and interventions in severe trauma in Germany and the Netherlands: a matched-pairs analysis. Eur. J. Trauma Emerg. Surg., 45 (6). S. 1059 - 1068. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1863-9941

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Abstract

Purpose The aim of this study was to compare the pre-hospital treatment of major trauma patients with similar injury patterns in Germany and the Netherlands. Patients and methods This matched-pairs analysis is based on the TraumaRegister DGU (R). The authors compared major trauma patients (ISS >= 16) from 2009 to 2015 treated in Dutch and German Level 1 trauma centers (TC). Endpoints were the pre-hospital times and interventions performed until hospital admission. Additional endpoints included hospital mortality, 24-h mortality and standardized mortality ratio (SMR) which was calculated using the Revised Injury Severity Classification, version II (RISC II). Patients were matched by age, gender, injury pattern, vital status on-scene and involvement into a traffic accident. Three subgroups were formed according to the mode of transportation and level of care provided during transport: Ambulance/Physician, Helicopter/Physician and Ambulance/Emergency Medical Technician. Results Patients were matched into 1094 pairs. German patients arrived at the TC after a mean pre-hospital time of 65.6 (+/- 29.6) min while Dutch patients arrived after 61.4 (+/- 28.7) min. Pre-hospital intubation rate was slightly higher in the Netherlands (44.1% GER vs 50.5% NL). Chest tubes were placed in 3.0% of German patients and 8.3% of Dutch patients. 63.5% of the German patients received analgesia/sedation which was below the rate of Dutch patients (71.1%). The hospital mortality was for 17.6% for German patients and 19.8% for Dutch patients. The SMR was about 1.0 for both groups. Conclusion Multiple differences and some similarities in the treatment of major trauma patients with similar injury patterns were found but no clinically relevant differences in the chosen outcome parameters could be observed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Timm, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Maegele, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Wendt, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Lefering, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Wyen, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-125159
DOI:	10.1007/s00068-018-0978-8
Journal or Publication Title:	Eur. J. Trauma Emerg. Surg.
Volume:	45
Number:	6
Page Range:	S. 1059 - 1068
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1863-9941
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EMERGENCY MEDICAL-SERVICES; RETROSPECTIVE ANALYSIS; PATIENT MORTALITY; INJURED PATIENTS; BRAIN-INJURY; HELICOPTER; INTUBATION; MANAGEMENT; SYSTEMS; SOCIETY Multiple languages Emergency Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12515