Lina Holmberg, Kevin Mani, Fredrik Linder, Anders Wanhainen, Carl Magnus Wahlgren, Håkan Andréasson
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引用次数: 0
Abstract
Purpose: Sweden has an established trauma system involving national trauma criteria and the Swedish trauma registry (SweTrau), since over a decade. Meanwhile, the injury panorama has evolved, with an increase in gang-related violence in the Swedish community. In this study, we aimed to investigate long-term trends in mortality, management and trauma type in two major Swedish trauma centers over a nine-year period.
Methods: All trauma patients with a New Injury Score (NISS) > 15 or a Trauma Alert (TA) call during 2013-2021 were identified in the participating centers' SweTrau registries. Data were analysed regarding mortality, proportion of emergency interventions, intensive care unit (ICU) admissions, mechanism of injury and type of trauma (penetrating or blunt). To assess trends, Chi-Squared test for trend and JoinPoint regression method were used.
Results: A total of 10,587 patients were included in the study. Mortality remained unchanged over time in patients with NISS > 15 (10.0-10.9%, p = 0.963) but increased in patients with a TA and NISS < 15 (1.3-2.7%, p = 0.005). For NISS > 15, the proportion undergoing emergency interventions was stable (53.9%-48.8%, p = 0.297) while ICU admissions declined (62.1%-45.7%, p < 0.001). Penetrating trauma increased (12.4-19.6%, p < 0.001), including knife (10.0-15.7%, p < 0.001) and gunshot wounds (2.3-3.8%, p < 0.001), whereas accidents involving motorcycles (8.8%-7.0%, p = 0.004) and pedestrians (5.3%-2.2%, p < 0.001) decreased. Assaults (both penetrating and blunt) increased from 14.7 to 21.4% (p < 0.001).
Conclusions: In this trend analysis at two major Swedish trauma centers during 2013-2021, penetrating trauma increased with over 50% while traffic injuries decreased. The rise in mortality in patients with a TA and NISS < 15 is concerning and requires further evaluation, as do the reduction in ICU admissions.
期刊介绍:
The European Journal of Trauma and Emergency Surgery aims to open an interdisciplinary forum that allows for the scientific exchange between basic and clinical science related to pathophysiology, diagnostics and treatment of traumatized patients. The journal covers all aspects of clinical management, operative treatment and related research of traumatic injuries.
Clinical and experimental papers on issues relevant for the improvement of trauma care are published. Reviews, original articles, short communications and letters allow the appropriate presentation of major and minor topics.