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Nolte, Philip-C.; Häske, David; Lefering, Rolf; Bernhard, Michael; Casu, Sebastian; Frankenhauser, Susanne; Gather, Andreas; Grützner, Paul A.; Münzberg, Matthias

Training to identify red flags in the acute care of trauma: who are the patients at risk for early death despite a relatively good prognosis? An analysis from the TraumaRegister DGU®

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  • Medientyp: E-Artikel
  • Titel: Training to identify red flags in the acute care of trauma: who are the patients at risk for early death despite a relatively good prognosis? An analysis from the TraumaRegister DGU®
  • Beteiligte: Nolte, Philip-C.; Häske, David; Lefering, Rolf; Bernhard, Michael; Casu, Sebastian; Frankenhauser, Susanne; Gather, Andreas; Grützner, Paul A.; Münzberg, Matthias
  • Erschienen: Springer Science and Business Media LLC, 2020
  • Erschienen in: World Journal of Emergency Surgery
  • Sprache: Englisch
  • DOI: 10.1186/s13017-020-00325-0
  • ISSN: 1749-7922
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>In the acute care of trauma, some patients with a low estimated risk of death die suddenly and unexpectedly. In this study, we aim to identify predictors for early death within 24 h following hospital admission in low-risk patients.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>The TraumaRegister DGU® was used to collect records of patients who were primarily treated in a participating hospital between 2004 and 2013 with a RISC II score below 10%.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>During the study period, 64,379 patients met the inclusion criteria. The mean RISC II score was 2.0%, and the mean ISS was 16 ± 9. The overall hospital mortality rate was 2.1%, and 0.5% of patients (<jats:italic>n</jats:italic> = 301) died within the first 24 h. A SPB of ≤ 90 mmHg was associated with an increased risk of death (<jats:italic>p</jats:italic> &lt; 0.001). An AIS abdomen score of ≥ 3 was associated with increased risk of death within the first 24 h (<jats:italic>p</jats:italic> &lt; 0.001). A high risk of early death was also seen in patients with an AIS score (thorax) ≥ 3; 51% of those who died died within the first 24 h (<jats:italic>p</jats:italic> &lt; 0.005). Death in patients over 60 years was more common after 24 h (<jats:italic>p</jats:italic> &lt; 0.001). Patients with an ASA score of ≥ 3 were more likely to die after the first 24 h (<jats:italic>p</jats:italic> &lt; 0.001).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Indicators predicting a high risk of early death in patients with a low RISC II score include a SPB ≤ 90 mmHg and severe chest and abdominal trauma. Emergency teams involved in the acute care of trauma patients should be aware of these “red flags” and treat their patients accordingly.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang