Age and traumatic brain injury as prognostic factors for late-phase mortality in patients defined as polytrauma accordin
- PDF / 741,956 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 103 Downloads / 178 Views
TRAUMA SURGERY
Age and traumatic brain injury as prognostic factors for late‑phase mortality in patients defined as polytrauma according to the New Berlin Definition: experiences from a level I trauma center V. Weihs1 · V. Heel1 · M. Dedeyan1 · N. W. Lang1 · S. Frenzel1 · S. Hajdu1 · T. Heinz1 Received: 16 August 2020 / Accepted: 30 September 2020 © The Author(s) 2020
Abstract Background The rationale of this study was to identify independent prognostic factors influencing the late-phase survival of polytraumatized patients defined according to the New Berlin Definition. Methods Retrospective data analysis on 173 consecutively polytraumatized patients treated at a level I trauma center between January 2012 and December 2015. Patients were classified into two groups: severely injured patients (ISS > 16) and polytraumatized patients (patients who met the diagnostic criteria for the New Berlin Definition). Results Polytraumatized patients showed significantly lower late-phase and overall survival rates. The presence of traumatic brain injury (TBI) and age > 55 years had a significant influence on the late-phase survival in polytraumatized patients but not in severely injured patients. Despite the percentage of severe TBI being nearly identical in both groups, severe TBI was identified as main cause of death in polytraumatized patients. Furthermore, severe TBI remains the main cause of death in polytraumatized patients > 55 years of age, whereas younger polytraumatized patients ( 16 points). Our study addresses this issue and compares patients who were identified as polytraumatized patients according to the criteria of the New Berlin Definition or defined either as severely injured patients with an ISS > 16 points without regard to their pathophysiological conditions: – Do patients defined as polytraumatized according to the New Berlin Definition show different clinical characteristics, trauma mechanisms or different injury characteristics? – Are there any potential prognostic factors especially for the late-phase survival of these polytraumatized patients?
Methods Inclusion criteria In this study 337 consecutive patients who were admitted to our hospital with critical injuries were enrolled retrospectively from January 2012 to December 2015. Patients with an ISS > 16 points and an AIS > 3 and at least 2 or more different body regions affected were included. Patients with isolated traumatic brain injuries (n = 101), patients with minor injuries (AIS 3 in one body region and at least 2 or more different body regions affected (n = 80) and – polytraumatized patients that were classified according to the New Berlin Definition (n = 93): AIS > 3 points for two or more different body regions with the addition of at least one of five standardized physiological conditions (hypotension (SBP 70 years). Three time-dependent events for the analysis of mortality were defined: acute-phase death (death within the first 24 h or on arrival at the hospital), late-phase death (death after the first 24 h within the hospital stay)
Data Loading...
