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Article

Trauma Team Activation: Which Surgical Capability Is Immediately Required in Polytrauma? A Retrospective, Monocentric Analysis of Emergency Procedures Performed on 751 Severely Injured Patients

by
Daniel Schmitt
1,2,*,
Sascha Halvachizadeh
1,2,
Robin Steinemann
1,2,
Kai Oliver Jensen
1,2,
Till Berk
1,2,
Valentin Neuhaus
1,2,
Ladislav Mica
1,2,
Roman Pfeifer
1,2,
Hans Christoph Pape
1,2 and
Kai Sprengel
1,2,3
1
Department of Trauma, University Hospital Zurich (USZ), Raemistrasse 100, 8091 Zurich, Switzerland
2
Faculty of Medicine, University of Zurich (UZH), Raemistrasse 71, 8006 Zurich, Switzerland
3
Hirslanden Clinic St. Anna, St. Anna-Strasse 32, 6006 Lucerne, Switzerland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(19), 4335; https://doi.org/10.3390/jcm10194335
Submission received: 16 August 2021 / Revised: 14 September 2021 / Accepted: 18 September 2021 / Published: 23 September 2021
(This article belongs to the Special Issue Clinical Management and Challenges in Polytrauma)
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Abstract

There has been an ongoing discussion as to which interventions should be carried out by an “organ specialist” (for example, a thoracic or visceral surgeon) or by a trauma surgeon with appropriate general surgical training in polytrauma patients. However, there are only limited data about which exact emergency interventions are immediately carried out. This retrospective data analysis of one Level 1 trauma center includes adult polytrauma patients, as defined according to the Berlin definition. The primary outcome was the four most common emergency surgical interventions (ESI) performed during primary resuscitation. Out of 1116 patients, 751 (67.3%) patients (male gender, 530, 74.3%) met the inclusion criteria. The median age was 39 years (IQR: 25, 58) and the median injury severity score (ISS) was 38 (IQR: 29, 45). In total, 711 (94.7%) patients had at least one ESI. The four most common ESI were the insertion of a chest tube (48%), emergency laparotomy (26.3%), external fixation (23.5%), and the insertion of an intracranial pressure probe (ICP) (19.3%). The initial emergency treatment of polytrauma patients include a limited spectrum of potential life-saving interventions across distinct body regions. Polytrauma care would benefit from the 24/7 availability of a trauma team able to perform basic potentially life-saving surgical interventions, including chest tube insertion, emergency laparotomy, placing external fixators, and ICP insertion.
Keywords: polytrauma; emergency surgery; trauma team competence; trauma system; life-saving intervention polytrauma; emergency surgery; trauma team competence; trauma system; life-saving intervention

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MDPI and ACS Style

Schmitt, D.; Halvachizadeh, S.; Steinemann, R.; Jensen, K.O.; Berk, T.; Neuhaus, V.; Mica, L.; Pfeifer, R.; Pape, H.C.; Sprengel, K. Trauma Team Activation: Which Surgical Capability Is Immediately Required in Polytrauma? A Retrospective, Monocentric Analysis of Emergency Procedures Performed on 751 Severely Injured Patients. J. Clin. Med. 2021, 10, 4335. https://doi.org/10.3390/jcm10194335

AMA Style

Schmitt D, Halvachizadeh S, Steinemann R, Jensen KO, Berk T, Neuhaus V, Mica L, Pfeifer R, Pape HC, Sprengel K. Trauma Team Activation: Which Surgical Capability Is Immediately Required in Polytrauma? A Retrospective, Monocentric Analysis of Emergency Procedures Performed on 751 Severely Injured Patients. Journal of Clinical Medicine. 2021; 10(19):4335. https://doi.org/10.3390/jcm10194335

Chicago/Turabian Style

Schmitt, Daniel, Sascha Halvachizadeh, Robin Steinemann, Kai Oliver Jensen, Till Berk, Valentin Neuhaus, Ladislav Mica, Roman Pfeifer, Hans Christoph Pape, and Kai Sprengel. 2021. "Trauma Team Activation: Which Surgical Capability Is Immediately Required in Polytrauma? A Retrospective, Monocentric Analysis of Emergency Procedures Performed on 751 Severely Injured Patients" Journal of Clinical Medicine 10, no. 19: 4335. https://doi.org/10.3390/jcm10194335

APA Style

Schmitt, D., Halvachizadeh, S., Steinemann, R., Jensen, K. O., Berk, T., Neuhaus, V., Mica, L., Pfeifer, R., Pape, H. C., & Sprengel, K. (2021). Trauma Team Activation: Which Surgical Capability Is Immediately Required in Polytrauma? A Retrospective, Monocentric Analysis of Emergency Procedures Performed on 751 Severely Injured Patients. Journal of Clinical Medicine, 10(19), 4335. https://doi.org/10.3390/jcm10194335

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