NDLI: Head injury and outcome--what influence do concomitant injuries have?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lefering, Rolf Paffrath, Thomas Linker, Ralph Bouillon, Bertil Neugebauer, Edmund A. M.
Organization	Deutsche Gesellschaft fur Unfallchirurgie/German Society for Trauma Surgery
Spatial Coverage	Europe
Description	Country affiliation: Germany Author Affiliation: Lefering R ( Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany. rolf.lefering@ifom-uni-wh.de)
Abstract	BACKGROUND: Severe head injury (HI) is known to be a major determinant of mortality in patients with multiple injuries but additional injuries also contribute to the clinical outcome. The Trauma Registry of the German Society for Trauma Surgery offers sufficient data for comparative outcome analysis in relation to the injury pattern. METHODS: A total of 21,356 cases from Trauma Registry of the German Society for Trauma Surgery with complete data for pattern of injury (Abbreviated Injury Scale [AIS], Injury Severity Score), the incidence of hospital mortality, organ failure, sepsis, duration of hospital stay, and intubation-free days. Maximum AIS severity of HI, including brain, skull, face, and cervical spine, and injuries to the torso and/or extremities (TEI) were used for comparative subgroup analysis. RESULTS: Overall mortality rate was 13.7% (mean age, 41.3 years; 72.6% men; mean Injury Severity Score, 24.4). Patients with relevant HI (AISHI >/=3) were found to have a higher mortality rate (22.1%) than patients with relevant TEI (12.9%). In all HI severity subgroups mortality increased consistently by about 5% with TEI of grade 4, and by 15% with TEI of grade 5, but no increase is observed for lower severity grades. The incidence of organ failure (overall 31.4%), multiple organ failure (15.0%), and sepsis (9.9%) are mainly influenced by the severity of TEI. Intubation-free days are equally influenced by both types of injuries of grade 3 or higher. CONCLUSIONS: Mortality in patients with severe trauma is mainly determined by the severity of HI, while TEI contribute consistently only from AIS grade 4 or higher.
File Format	HTM / HTML
ISSN	00225282
Issue Number	5
Volume Number	65
e-ISSN	15298809
Journal	The Journal of Trauma: Injury, Infection, and Critical Care
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-11-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Research Support, Non-u.s. Gov't Comparative Study Comorbidity Europe Humans Middle Aged Male Treatment Outcome Epidemiology Discipline Traumatology Multiple Trauma Journal Article Injury Severity Score Craniocerebral Trauma Adult Female Registries Diagnosis
Content Type	Text
Resource Type	Article
Subject	Surgery Critical Care and Intensive Care Medicine

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