Penetrating trauma in Spain: analysis of the Spanish trauma registry (RETRAUCI)

Abstract

Objective

To describe the epidemiology of penetrating trauma, mortality associated factors and its management in Spanish intensive care units.

Design

Multicenter, prospective registry. A comparison is established between two cohorts defined by the type of trauma (blunt and penetrating).

Patients

Patients with traumatic injury admitted to the participating ICUs from June 2015 to June 2022.

Interventions

None.

Main variable of interest

Epidemiology, injury pattern, prehospital and hospital care, resource utilization, and clinical outcomes.

Results

12,806 patients were eligible, of whom 821 (6.4%) suffered penetrating trauma; 418 patients (50.9%) from stab wounds, 93 (11.3%) from gunshot wounds, and 310 (37.8%) from other objects. The most common intent was assault (47.7%). The mean ISS was 15.2 ± 10.6 in penetrating trauma and 19.8 ± 11.9 in blunt trauma (p < 0.001). ICU mortality was 7.8% compared to 11.7% in blunt trauma, with deaths more frequently occurring within the first 24 hours (64% vs. 39%). Factors associated with mortality included female sex, prior use of antithrombotic agents, older age, higher NISS score, and the presence of cranial trauma or shock.

Conclusions

Penetrating trauma is an emergent pathology in our context with high complexity, highlighting the need for focused study and documentation, protocol development, and resource optimization to provide quality care.