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European Journal of Trauma and Emergency Surgery

Erschienen in:

16.07.2018 | Original Article

Pre-hospital rescue times and interventions in severe trauma in Germany and the Netherlands: a matched-pairs analysis

verfasst von: Alexander Timm, Marc Maegele, Klaus Wendt, Rolf Lefering, Hendrik Wyen, the TraumaRegister DGU

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 6/2019

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Abstract

Purpose

The aim of this study was to compare the pre-hospital treatment of major trauma patients with similar injury patterns in Germany and the Netherlands.

Patients and methods

This matched-pairs analysis is based on the TraumaRegister DGU®. The authors compared major trauma patients (ISS ≥ 16) from 2009 to 2015 treated in Dutch and German Level 1 trauma centers (TC). Endpoints were the pre-hospital times and interventions performed until hospital admission. Additional endpoints included hospital mortality, 24-h mortality and standardized mortality ratio (SMR) which was calculated using the Revised Injury Severity Classification, version II (RISC II). Patients were matched by age, gender, injury pattern, vital status on-scene and involvement into a traffic accident. Three subgroups were formed according to the mode of transportation and level of care provided during transport: Ambulance/Physician, Helicopter/Physician and Ambulance/Emergency Medical Technician.

Results

Patients were matched into 1094 pairs. German patients arrived at the TC after a mean pre-hospital time of 65.6 (± 29.6) min while Dutch patients arrived after 61.4 (± 28.7) min. Pre-hospital intubation rate was slightly higher in the Netherlands (44.1% GER vs 50.5% NL). Chest tubes were placed in 3.0% of German patients and 8.3% of Dutch patients. 63.5% of the German patients received analgesia/sedation which was below the rate of Dutch patients (71.1%). The hospital mortality was for 17.6% for German patients and 19.8% for Dutch patients. The SMR was about 1.0 for both groups.

Conclusion

Multiple differences and some similarities in the treatment of major trauma patients with similar injury patterns were found but no clinically relevant differences in the chosen outcome parameters could be observed.

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Titel: Pre-hospital rescue times and interventions in severe trauma in Germany and the Netherlands: a matched-pairs analysis
verfasst von: Alexander Timm
Marc Maegele
Klaus Wendt
Rolf Lefering
Hendrik Wyen
the TraumaRegister DGU
Publikationsdatum: 16.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 6/2019
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-0978-8

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Pre-hospital rescue times and interventions in severe trauma in Germany and the Netherlands: a matched-pairs analysis

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Conclusion

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