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[Quality management of interdisciplinary treatment of polytrauma. Possibilities and limits of retrospective routine
M T Hirschmann1, K-N Uike, M Kaufmann
1Departemente Chirurgie, Universitätsspital Basel, Basel. michael.hirschmann@ksbh.ch
Background:
The purpose of this study was to evaluate the quality of interdisciplinary multiple trauma management using routinely taken data.
Methods:
A retrospective analysis of all multiple traumatized patients [Injury Severity Score (ISS)>15] in a university hospital (n=172; time period 01.01.1997-31.12.1999) was carried out concerning epidemiological and clinical variables and hospital outcome (p<0.05).
Results:
The overall mortality was 22% [n=38; expected Trauma Injury Severity Score (TRISS) mortality 29%]. Significant parameters for worse outcome in univariate analysis were age>74 years, hypotension, decreasing hemoglobin level and prothrombin time, decreased Glasgow Coma Scale and the number of erythrocyte or plasma concentrates received in the initial period of treatment. The comparison of our results with the data of the German Association for Trauma Surgery registry demonstrated comparable results with respect to management sequence and outcome.
Conclusions:
In the quality management of multiple trauma patients retrospective analysis of routinely registered parameters can be a reliable and practical alternative to time-consuming prospective studies when based on prognostic relevant data. Such a procedure allows a preliminary critical comparison with other centers.
