Reduction in mortality in severely injured patients following the introduction of the 'treatment of patients with severe and multiple injuries' guideline of the German society of trauma surgery - A retrospective analysis of a level 1 trauma center (2010-2012)

摘要

Objective The German society of trauma surgery published the "Treatment of Patients with Severe and Multiple injuries" guideline in 2011. This achieved the highest level of recommendation for guidelines published in Germany. This study investigated if there was an improvement in the survival rates of severed injured patients following the introduction of the guideline in clinical treatment. Methods All patients with an injury severity score ≥16 on primary admission to hospital between January 2010 and December 2012 (a total of 373 patients) were included in this study. The data for these patients were collected from the German Trauma Registry and from patients' hospital records. Patients who were treated in 2010 were compared with patients who were treated in 2011 and 2012, following the introduction of the "treatment of patients with severe and multiple injuries" guideline in the authors' clinic at the beginning of 2011. Results Significant differences were found in ISS, RTS, New ISS, and TRISS between 2010 and 2011/2012. No differences were found in the severity of injury when classified by different body regions. Major differences were found in the total volume replacement, the length of emergency surgery, the length of surgery performed within the first 24 h and the rate of whole-body computed tomography. The mortality rate dropped from 32.48% in 2010 to 18.75% in 2011/2012 (p = 0.003). Conclusions The introduction and use of a guideline-based medical care regime for severely injured patients might reduce the rate of mortality.