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Eur J Trauma Emerg Surg · Aug 2021
Pre-hospital trauma care in Switzerland and Germany: do they speak the same language?
- Kai Oliver Jensen, Michel Paul Johan Teuben, Rolf Lefering, Sascha Halvachizadeh, Ladislav Mica, Hans-Peter Simmen, Roman Pfeifer, Hans-Christoph Pape, Kai Sprengel, and TraumaRegister DGU.
- Division of Trauma Surgery, Department of Trauma, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. kaioliver.jensen@usz.ch.
- Eur J Trauma Emerg Surg. 2021 Aug 1; 47 (4): 1273-1280.
PurposeSwiss and German (pre-)hospital systems, distribution and organization of trauma centres differ from each other. It is unclear if outcome in trauma patients differs as well. Therefore, this study aims to determine differences in characteristics, therapy and outcome of trauma patients between both German-speaking countries.MethodsThe TraumaRegister DGU® (TR-DGU) was used. Patients with Injury Severity Score ≥ 9 admitted to a level 1 trauma centre between 01/2009 and 12/2017 were included if they required ICU care or died. Trauma pattern, pre-hospital procedures and outcome were compared between Swiss (CH, n = 4768) and German (DE, n = 66,908) groups.ResultsSwiss patients were older than German patients (53 vs. 50 years). ISS did not differ between groups (CH 23.8 vs. DE 23.0 points). There were more low falls < 3 m (34% vs. 21%) at the expense of less traffic accidents (37% vs. 52%) in the Swiss population. In Switzerland 30% of allocations were done without physician involvement, whereas this occurred in 4% of German cases. Despite a comparable number of patients with a GCS ≤ 8 (CH 29.6%; DE 26.4%), differences in pre-hospital intubation rates occurred (CH 31% vs. DE 40%). Severe traumatic brain injuries were diagnosed most frequently in Switzerland (CH 62% vs. DE 49%). Admission vital signs were similar, and standardized mortality ratios were close to one in both countries.ConclusionThis study demonstrates that patients' age, trauma patterns and pre-hospital care differ between Germany and Switzerland. However, adjusted mortality was almost similar. Further benchmarking studies are indicated to optimize trauma care in both German-speaking countries.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.
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