ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Physiology dictated treatment after severe trauma: timing is everything.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Guideline
- Diverging trends in the incidence and mortality of acute severe trauma in Korea, 2020-2024: an analysis based on the National Emergency Department Information System (NEDIS) data and the 2024 healthcare crisis.Clinical and experimental emergency medicine · 2026Article
- Neutrophil phenotyping reflects injury severity when base excess and lactate remain normal.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Injury to the thorax is a dominant contributor to post-traumatic neutrophil mediated inflammatory response.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Clinical Significance of Rotational Thromboelastometry (ROTEM) for Detection of Early Coagulopathy in Trauma Patients: A Retrospective Study.Diagnostics (Basel, Switzerland) · 2025Article
- Delta shock index predicts injury severity, interventions, and outcomes in trauma patients: A 10-year retrospective observational study.World journal of critical care medicine · 2024Article
- Settlement Is at the End-Common Trauma Scores Require a Critical Reassessment Due to the Possible Dynamics of Traumatic Brain Injuries in Patients' Clinical Course.Journal of clinical medicine · 2024Article
- Early vs Late Fixation of Extremity Fractures Among Adults With Traumatic Brain Injury.JAMA network open · 2024Article
- Early correction of base deficit decreases late mortality in polytrauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- [Application of artificial intelligence systems in the emergency room : Do the communication patterns give indications for possible starting points? An observational study].Unfallchirurgie (Heidelberg, Germany) · 2023Review
- Release of exosomes in polytraumatized patients: The injury pattern is reflected by the surface epitopes.Frontiers in immunology · 2023Article
- Longitudinal assessment of the inflammatory response: The next step in personalized medicine after severe trauma.Frontiers in medicine · 2022Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDamage control strategies in resuscitation and (fracture) surgery have become standard of care in the treatment of severely injured patients. It is suggested that damage control improves survival and decreases the incidence of organ failure. However, these strategies can possibly increase the risk of complications such as infections. Indication for damage control procedures is guided by physiological parameters, type of injury, and the surgeon's experience. We analyzed outcomes of severely injured patients who underwent emergency surgery.
methodsSeverely injured patients, admitted to a level-1 trauma center ICU from 2016 to 2020 who were in need of ventilator support and required immediate surgical intervention ( ≤24 h) were included. Demographics, treatment, and outcome parameters were analyzed.
resultsHundred ninety-five patients were identified with a median ISS of 33 (IQR 25-38). Ninety-seven patients underwent immediate definitive surgery (ETC group), while 98 patients were first treated according to damage control principles with abbreviated surgery (DCS group). Although ISS was similar in both groups, DCS patients were younger, suffered from more severe truncal injuries, were more frequently in shock with more severe acidosis and coagulopathy, and received more blood products. ETC patients with traumatic brain injury needed more often a craniotomy. Seventy-four percent of DCS patients received definitive surgery in the second surgical procedure. There was no difference in mortality, nor any other outcome including organ failure and infections.
conclusionsWhen in severely injured patients treatment is dictated by physiology into either early definitive surgery or damage control with multiple shorter procedures stretched over several days combined with aggressive resuscitation with blood products, outcome is comparable in terms of complications.
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