-
Comparative Study
Complications in multitrauma patients in a Dutch level 1 trauma center.
- Teun P Saltzherr, Annelies Visser, Kees J Ponsen, Jan S Luitse, and J Carel Goslings.
- Trauma Unit Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands. t.p.saltzherr@amc.nl
- J Trauma. 2010 Nov 1; 69 (5): 1143-6.
BackgroundComplication registration is an important part of monitoring the quality of health care. The aim of this article was to describe the incidence, type, and impact of complications occurring within 6 months after the initial trauma in multitrauma patients.MethodsDuring a 2-year period, all trauma patients with an Injury Severity Score (ISS) ≥ 16 who were not directly transferred to other hospitals were included. We used the Dutch National Surgical Complication Registry of the Academic Medical Center, a level 1 trauma center, to assess complications within 6 months after the initial trauma. For verification, we additionally performed a chart review. Complications were graded 0 (no real health loss) to 4 (lethal).ResultsThree hundred three multitrauma patients were included with a median ISS of 22 (interquartile range, 17-29). Within 181 patients, 358 complications occurred (60%). The most frequently occurring complications were respiratory and urinary tract infections. Most complications (73%) were grade 1 and resolved completely without operative (re-)intervention There were 27 patients (8%) with a grade 2 complication, which required operative (re-)interventions. All eight (2%) grade 3 complications which caused (potential) permanent damage or disability, were of neurologic origin. Overall mortality was 18.8% and complication associated readmission rate was 4%. Emergency interventions and high ISS tended to be associated with the occurrence of complications. In patients with complications, hospital stay was doubled from 9 to 18 days.ConclusionsMultitrauma patients are at high risk for developing complications. Most frequently encountered complications were infections. The majority of complications resolved completely without a surgical intervention.
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