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Update on the definition of polytrauma
1Division of Surgery, Department of Traumatology, John Hunter Hospital and the University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia. nerida.butcher@gmail.com.
Summary
The definition of polytrauma lacks consensus. An international agreement proposes including anatomical and physiological factors, with an Abbreviated Injury Scale (AIS) of two regions >2 as a practical marker.
Area of Science:
- Trauma surgery
- Emergency medicine
- Injury epidemiology
Background:
- The term "polytrauma" lacks a consistent, validated definition.
- Geographical variations and historical evolution contribute to definitional ambiguity.
Purpose of the Study:
- To review the historical and geographical context of "polytrauma" definitions.
- To identify challenges in establishing a current, adequate definition.
- To outline the direction of international consensus for a validated, universal definition.
Main Methods:
- Historical review of the term "polytrauma".
- Analysis of geographical differences in its application.
- Summary of international consensus-building efforts.
Main Results:
- Significant lack of consensus on the definition of "polytrauma" was identified.
- Preliminary data suggest an Abbreviated Injury Scale (AIS) of two body regions with AIS >2 is a practical anatomical marker.
- Physiological parameters, likely related to tissue hypoxia and coagulopathy, are under consideration.
Conclusions:
- A universally agreed-upon definition of polytrauma is needed.
- The international consensus favors incorporating both anatomical and physiological parameters.
- An AIS-based anatomical definition is proposed as the most feasible approach.
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