• Jonas Roos, Thomas Loy, Milena M Ploeger, Leonie Weinhold, Matthias Schmid, Moritz Mewes, Christian Prangenberg, and Martin Gathen.
• Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany. jonas.roos@ukbonn.de.
• Eur J Trauma Emerg Surg. 2023 Dec 1; 49 (6): 260526132605-2613.

BackgroundWhile inter-hospital transfers for patients who have suffered major trauma have been well investigated, patient flows for other injured patients, or cases with orthopedic complications, are rarely described. This study aims to analyze the affected collective and to show possible reasons, patterns, and pitfalls to optimize the process in future.Materials And MethodsIn a prospective cohort study, all consecutive transfers to a Level I trauma center in Germany were documented and assessed. Patients suffering a major trauma were excluded. Data on the primary treating hospital, patient characteristics, and differences between emergency and elective surgery were analyzed.ResultsA total of 227 patients were included; 162 were injured, while 65 had suffered a complication after elective orthopedic surgery or had a complex orthopedic pathology. The most common diagnoses leading to transfer were pathologies of the extremities (n = 62), pathologies of the spine (n = 50), and infections (n = 18). The main reasons stated by the transferring hospitals were a lack of expertise (137 cases) and a lack of capacity (43 cases). There was a significantly higher rate of transfers due to trauma (n = 162) than for orthopedic patients (n = 65), p < 0.0001.ConclusionThere is currently no structured procedure or algorithm for transferring patients in orthopedics and trauma surgery.© 2023. The Author(s).

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