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Could a regional trauma system in eastern Switzerland decrease the mortality of blunt polytrauma patients? A

Joseph Johann Osterwalder1

  • 1Emergency Department, Cantonal Hospital, St. Gallen, Switzerland. joseph.osterwalder@kssg.ch

The Journal of Trauma
|June 5, 2002
PubMed
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A regional trauma system in eastern Switzerland could improve survival for blunt polytrauma patients. Transferred patients had significantly higher mortality than predicted, suggesting a need for organized trauma care.

Area of Science:

  • Trauma Surgery
  • Public Health
  • Emergency Medicine

Background:

  • Limited research exists on regional trauma systems in Europe and Switzerland.
  • This study investigates the impact of an organized trauma system on blunt polytrauma patient survival in eastern Switzerland.

Purpose of the Study:

  • To evaluate the effectiveness of a regional trauma system modeled after the American system.
  • To compare actual mortality with predicted mortality for blunt polytrauma patients.

Main Methods:

  • Prospective observational cohort study (1990-1996) of 280 directly admitted and 190 transferred blunt polytrauma patients.
  • Inclusion criteria: blunt trauma to at least two body sites and Injury Severity Score (ISS) ≥ 8.
  • Comparison of actual mortality against predicted mortality using the A Severity Characterization of Trauma score.

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Main Results:

  • Direct admissions: 11.8% mortality; 10% more deaths than predicted (not significant).
  • Transferred admissions: 14.2% mortality; 46% more deaths than predicted (significant, p < 0.05).

Conclusions:

  • A regional trauma system in eastern Switzerland shows potential for moderately improving polytrauma patient mortality.
  • Transferred patients experienced significantly higher mortality, highlighting the benefits of an organized system.
  • Implementing a regional trauma system could potentially save 1-3 lives annually.