Evidence map›Paper›PMID 27114102›Full record

ArticleLangenbeck's archives of surgery2016

Change of initial and ICU treatment over time in trauma patients. An analysis from the TraumaRegister DGU®.

Andreas B Böhmer, Marcel Poels, Kathrin Kleinbrahm, Rolf Lefering, Thomas Paffrath, Bertil Bouillon, Jerome Michel Defosse, Mark U Gerbershagen, Frank Wappler, Robin Joppich

Abstract read
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In one paragraph

Article in Langenbeck's archives of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Andreas B BöhmerDepartment of Anesthesiology, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany. boehmera@kliniken-koeln.de.
Marcel PoelsDepartment of Anesthesiology, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Kathrin KleinbrahmDepartment of Anesthesiology and Intensive Care Medicine, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
Rolf LeferingInstitute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
Thomas PaffrathDepartment of Traumatology and Orthopedic Surgery, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Cologne, Germany.
Bertil BouillonDepartment of Traumatology and Orthopedic Surgery, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Cologne, Germany.
Jerome Michel DefosseDepartment of Anesthesiology, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Mark U GerbershagenDepartment of Anesthesiology, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Frank WapplerDepartment of Anesthesiology, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
Robin JoppichDepartment of Anesthesiology, Hospital Cologne-Merheim, Cologne Medical Center, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical guidelines have been standardized for pre- and in-hospital trauma management in the last decades. Therefore, it is known that prehospital management has changed significantly. Furthermore, in-hospital course may be altered to reduce complications and length of stay (LOS). However, the development of trauma patient in-hospital management as well as LOS in the intensive care unit (ICU) has not been investigated systematically over a long-term period in Germany. Aim of our study is to examine the changes in in-hospital management and LOS in the ICU in moderately and severely injured patients.

methodsPatients documented in the TraumaRegister DGU® (TR-DGU) of the German Trauma Society from 2000 to 2011 and admitted to ICU were included in this study. Demographic data, the pattern of injury, injury severity, duration of mechanical ventilation, LOS in the ICU, hospital LOS, and discharge destination were evaluated. The mean values and the standard deviations are shown. The constant variables were calculated with changes over time analyzed by linear regression analysis, and categorical variables were calculated with the chi-square test.

resultsA total of 18,048 patients were analyzed. The rate of patients being intubated at the time of ICU admission decreased from 86.8 % in 2000 to 60.0 % in 2011 (p < 0.001). The time of mechanical ventilation decreased from 7.5 ± 10.5 to 4.7 ± 8.7 days. The intensive care unit LOS was reduced from 11.7 ± 12.8 to 9.0 ± 11.3 days and the length of hospital stay from 27.9 ± 28.7 to 21.1 ± 20.4 days (both p < 0.01). The ICU LOS remained stable in the subgroup of mechanically ventilated patients (12.7 ± 13.2 day in 2000, 12,6 ± 12.9 in 2011, p = 0.6), whereas it was reduced in non-mechanically ventilated patients (5.5 ± 6.8 days in 2000, 3.6 ± 4.5 days in 2011; p < 0.001).

conclusionsThe reduction LOS in the analyzed dataset is mainly explained by the relevantly reduced rate of patients being intubated at the time of ICU admission. Our data demonstrate that trauma patients' in-hospital course is influenced by reduced intubation rate at the time of ICU admission.

Indexed as

Critical CareAdultFemaleGermanyHumansInjury Severity ScoreLength of StayMaleMiddle AgedRegistriesRespiration, ArtificialRetrospective StudiesTime FactorsWounds and InjuriesYoung AdultIntensive careIntubationLength of stayMultiple traumaPolytrauma

Identifiers

PMID27114102

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.