Clinical and epidemiological characteristics severe injuries in military personnel in peacetime

Abstract

The purpose of the study: to study the clinical and epidemiological aspects of severe trauma (polytrauma), accompanied by shock and (or) coma, in military personnel in peacetime.Material and methods. During the period 2015–2021, 280 cases of severe trauma were studied in servicemen who were initially hospitalized in medical or military medical organizations of the zone of territorial medical responsibility of the Western Military District of the Russian Defense Ministry. Polytrauma (ISS≥18 points, “Berlin Definition”) was recorded in 137 cases (48.9%). 252 victims (90.0%) were subsequently evacuated to higher-level trauma centers for medical, tactical and organizational reasons. Statistical processing of information and analytical work were carried out with the help of the original trauma register.Results and discussion. In the structure of the causes of severe trauma (traumogenesis) military personnel in peacetime, as well as in the whole of the Russian Federation, were dominated by traffic accidents. The injury structure д. was dominated by injury without severe leading damage (max AIS=2 points). The most severe and unfavorable in prognostic terms were injuries of two or more anatomical areas; injuries with leading damage to soft tissues and breast organs. In general, compliance with the principles of primary routing of victims with mechanical injuries was noted, the proportion of victims with polytrauma taken to level 3 trauma centers is minimal. More than half of the victims (52.1%) are initially taken to trauma centers after hours, when their medical and diagnostic resources are limited. During the initial delivery to military medical organizations, military personnel are more often delivered to level 3 trauma centers. Victims with an ISS index of less than 18 points were taken to trauma centers of all levels in approximately equal proportions. The proportion of polytrauma victims taken to level 3 trauma centers was minimal. Inter-hospital transportation of victims from level 3 trauma centers was carried out on average 27 hours earlier than from level 2 trauma centers.Conclusions. Timely inter-hospital transportation of victims with polytrauma increased their chances of a favorable outcome. When studying the problem of severe trauma, the trauma register allows you to conduct high-quality analytical work. The problem of timeliness of inter-hospital transportation for medical and tactical indications is still relevant, especially in the central area of medical responsibility of the Western Military District.