[Polytrauma in the DACH region : Comparison of trauma registry data from Germany, Austria and Switzerland]

Trauma registries provide essential insights into the quality of care for severely injured patients. This study compares key epidemiological, clinical and process-related parameters from Germany, Austria and Switzerland based on the respective national trauma registry data.

A narrative descriptive analysis of the most recently available registry data was performed. For Germany (TR-DGU, 2023) and Austria (TR-ÖGU, 2023), only data from the core dataset were included [1, 2]. For Switzerland, in the absence of national annual reports, published analyses of the Swiss Trauma Registry (STR, 2015-2019; Costa et al.) were used, which exclusively include patients with an injury severity score (ISS) ≥ 16 and/or abbreviated injury scale (AIS) score of the head ≥ 3 [3, 4]. Due to differences in inclusion criteria and time periods, no inferential statistical comparisons were conducted.

In 2023 Germany documented 31,217 patients in the core dataset, including 28,718 primary admissions (mean age 54.5 years, 69.6% male, mean ISS 18.5). The in-hospital mortality in the outcome cohort of 25,208 patients was 7.4% [1]. Austria reported 1060 cases in the same year (mean age 50.2 years, 73.8% male, mean ISS 22.6) with a mortality of 14.7% [2]. In Switzerland, the published STR analyses between 2015 and 2019 included a total of 13,222 patients (mean age 58 years, 68% male, mean ISS 22) with a mortality of 11.6% [3, 4]. While blunt trauma dominated in all three countries (> 90% in Germany and Austria, ≈ 94% estimated for Switzerland), prehospital structures differed: Germany and Austria rely on emergency physician-based systems, whereas Switzerland relies more on paramedics. Process parameters such as prehospital intubation, whole-body CT in the trauma room and transfusion rates vary between countries but overall indicate comparable clinical care pathways.

Trauma care in the DACH region is broadly comparable but differs in patient demographics, case selection, trauma mechanisms and mortality. Because the STR data used in this study are derived exclusively from publications including only severely injured patients, the Swiss cohort by definition reflects a more severely injured population than the German and Austrian core datasets. Harmonized registry structures and joint analyses could enhance transnational learning and further improve the quality of care.