Severe penetrating trauma in Switzerland: first analysis of the Swiss Trauma Registry (STR).

Magyar, Christian T. J.; Bednarski, Piotr; Jakob, Dominik A.; Schnüriger, Beat (2022). Severe penetrating trauma in Switzerland: first analysis of the Swiss Trauma Registry (STR). European journal of trauma and emergency surgery, 48(5), pp. 3837-3846. Springer-Medizin-Verlag 10.1007/s00068-021-01822-w

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PURPOSE

The purpose of this study was to examine the epidemiology, demographics, injury characteristics and outcomes of patients who presented to Swiss trauma centers following severe penetrating trauma.

METHODS

Swiss Trauma Registry (STR)-cohort analysis including patients with severe (ISS ≥ 16 or AIS head ≥ 3) penetrating trauma between 2017 and 2019. Primary outcome was mortality. Secondary outcomes were hospital and intensive care unit (ICU) length of stay (LOS), and prehospital times.

RESULTS

During the 3-year study period, 134 (1.6% of entire STR) patients with severe penetrating trauma were identified [64 (48%) gunshot wounds (GSW), 70 (52%) stab wounds (SW)]. Median age was 40.5 (IQR 29.0-59.0) and 82.8% were male. Mortality rate was 50% for GSW; 9% for SW. Overall, prehospital time [incident to arrival emergency department (ED)] was 65 (IQR 45-94) minutes. The median number of patients admitted for a severe GSW/SW per center and year was 2 (range 0-14). Of 64 patients who sustained a GSW, 42 (65.6%) were self-inflicted. Mortality in self-inflicted GSW reached 66.7%, with the head being severely injured in 78.6%. The 67 patients with severe isolated torso GSW/SW had an ISS of 20 (IQR 16-26) and a mortality of 15%. Multivariable analysis identified severe chest trauma, ED Glasgow Coma Scale ≤ 8, age, self-infliction, massive blood transfusion and ISS as independent predictors for mortality.

CONCLUSION

Severe penetrating trauma is very rare in Switzerland. Mortality ranges from 9% in SW to 67% in self-inflicted GSW. Particularly in the setting of GSW/SW to the torso, reduction in prehospital time may further improve patient outcomes.

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

 Magyar, Christian Tibor Josef, Bednarski, Piotr, Jakob, Dominik, Schnüriger, Beat

Subjects:

 600 Technology > 610 Medicine & health

ISSN:

 1863-9933

Publisher:

 Springer-Medizin-Verlag

Language:

 English

Submitter:

 Rahel Fuhrer

Date Deposited:

 23 Dec 2021 11:11

Last Modified:

 05 Dec 2022 15:55

Publisher DOI:

 10.1007/s00068-021-01822-w

PubMed ID:

 34727193

Uncontrolled Keywords:

 Gunshot wound Mortality Penetrating trauma Prehospital Stab wound Swiss Trauma Registry

BORIS DOI:

 10.48350/161924

URI:

 https://boris.unibe.ch/id/eprint/161924

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