Citation

Schindler CR, Woschek M, Verboket RD, Sturm R, Söhling N, Marzi I, Störmann P. J. Clin. Med. 2020; 9(9): 1-9.

Copyright

(Copyright © 2020, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/jcm9092686

PMID

unavailable

Abstract

BACKGROUND: The treatment of severely injured patients, especially in older age, is complex, and based on strict guidelines.

METHODS: We conducted a retrospective study by analyzing our internal registry for mortality risk factors in deceased trauma patients. All patients that were admitted to the trauma bay of our level-1-trauma center from 2014 to 2018, and that died during the in-hospital treatment, were included. The aim of this study was to carry out a quality assurance concerning the initial care of severely injured patients.

RESULTS: In the 5-year period, 135 trauma patients died. The median (IQR) age was 69 (38-83) years, 71% were male, and the median (IQR) Injury Severity Score (ISS) was 25 (17-34) points. Overall, 41% of the patients suffered from severe traumatic brain injuries (TBI) (AIShead ≥ 4 points). For 12.7%, therapy was finally limited owing to an existing patient's decree; in 64.9% with an uncertain prognosis, a 'therapia minima' was established in consensus with the relatives.

CONCLUSION: Although the mortality rate was primarily related to the severity of the injury, a significant number of deaths were not exclusively due to medical reasons, but also to a self-determined limitation of therapy for severely injured geriatric patients. The conscientious documentation concerning the will of the patient is increasingly important in supporting medical decisions. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Language: en

Keywords

adult; human; female; male; injury; multiple organ failure; aged; resuscitation; traumatic brain injury; quality control; mortality; traffic accident; suicide attempt; hospitalization; risk factor; major clinical study; retrospective study; length of stay; intensive care unit; treatment withdrawal; emergency health service; geriatric patient; heart arrest; Quality of life; traumatology; blood transfusion; Glasgow coma scale; hemorrhagic shock; laparotomy; multiple trauma; injury scale; Polytrauma; Article; observational study; mortality risk; patient decision making; very elderly; extracorporeal oxygenation; craniectomy; Geriatric patients; Severely injured; patient registry; Mortality analysis; Patient’s decree; Trauma registry