Evidence map›Paper›PMID 35445813›Full record

Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022

Severe isolated injuries have a high impact on resource use and mortality: a Dutch nationwide observational study.

Mitchell L S Driessen, Mariska A C de Jongh, Leontien M Sturms, Frank W Bloemers, Henk Jan Ten Duis, Michael J R Edwards, Dennis den Hartog, Peter A Leenhouts, Martijn Poeze, Inger B Schipper and 5 more

Open access · bronzeAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study 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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

15 authors at 11 institutions in 2 countries.

Mitchell L S DriessenDutch Network Emergency Care ((LNAZ)), Newtonlaan 115, 3584 BH, Utrecht, The Netherlands. mls.driessen@lnaz.nl.ORCID http://orcid.org/0000-0002-9699-5422
Mariska A C de JonghNetwork Emergency Care Brabant, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
Leontien M SturmsDutch Network Emergency Care ((LNAZ)), Newtonlaan 115, 3584 BH, Utrecht, The Netherlands.
Frank W BloemersDepartment of Surgery, Amsterdam University Medical Center, Location VU, P.O. Box 1081 HV, Amsterdam, The Netherlands.
Henk Jan Ten Duis, Groningen, The Netherlands.
Michael J R EdwardsDepartment of Trauma Surgery, Radboud University Medical Center, 618., P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Dennis den HartogTrauma Research Unit, Department of Surgery, Erasmus MC, Rotterdam, P.O. Box 3000 CA, Rotterdam, The Netherlands.
Peter A LeenhoutsDepartment of Surgery, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands.
Martijn PoezeDepartment of Surgery, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
Inger B SchipperDepartment of Trauma Surgery, Leiden University Medical Center, P.O Box 9600, 2300 RC, Leiden, The Netherlands.
Richard W SpanjersbergDepartment of Trauma Surgery, Isala Hospitals, Zwolle, The Netherlands.
Klaus W WendtDepartment of Trauma Surgery, University Medical Center Groningen, P.O Box 30.001, 9700 RB, Groningen,, The Netherlands.
Ralph J de WitDepartment of Trauma Surgery, Medical Spectrum Twente, P.O. Box 50000, 7500 KA, Enschede, The Netherlands.
Stefan W A M van ZutphenDepartment of Surgery, Elisabeth Two Cities Hospital, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
Luke P H LeenenDepartment of Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Amsterdam University Medical Centers · NLDutch Health Care Inspectorate · NLDialyse Centrum Groningen · NLErasmus MC · NLIsala · NLLeiden University Medical Center · NLMedisch Spectrum Twente · NLRadboud University Nijmegen · NLUniversity Medical Center · USUniversity Medical Center Groningen · NLUniversity Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Berlin poly-trauma definition (BPD) has proven to be a valuable way of identifying patients with at least a 20% risk of mortality, by combining anatomical injury characteristics with the presence of physiological risk factors (PRFs). Severe isolated injuries (SII) are excluded from the BPD. This study describes the characteristics, resource use and outcomes of patients with SII according to their injured body region, and compares them with those included in the BPD.

methodsData were extracted from the Dutch National Trauma Registry between 2015 and 2019. SII patients were defined as those with an injury with an Abbreviated Injury Scale (AIS) score ≥ 4 in one body region, with at most minor additional injuries (AIS ≤ 2). We performed an SII subgroup analysis per AIS region of injury. Multivariable linear and logistic regression models were used to calculate odds ratios (ORs) for SII subgroup patient outcomes, and resource needs.

resultsA total of 10.344 SII patients were included; 47.8% were ICU admitted, and the overall mortality was 19.5%. The adjusted risk of death was highest for external (2.5, CI 1.9-3.2) and for head SII (2.0, CI 1.7-2.2). Patients with SII to the abdomen (2.3, CI 1.9-2.8) and thorax (1.8, CI 1.6-2.0) had a significantly higher risk of ICU admission. The highest adjusted risk of disability was recorded for spine injuries (10.3, CI 8.3-12.8). The presence of ≥ 1 PRFs was associated with higher mortality rates compared to their poly-trauma counterparts, displaying rates of at least 15% for thoracic, 17% for spine, 22% for head and 49% for external SII.

conclusionA severe isolated injury is a high-risk entity and should be recognized and treated as such. The addition of PRFs to the isolated anatomical injury criteria contributes to the identification of patients with SII at risk of worse outcomes.

Indexed as

Trauma CentersAbbreviated Injury ScaleHumansInjury Severity ScoreLogistic ModelsOdds RatioRegistriesIsolated injuryOutcomePhysiological risk factorResourcesScales and system of injury

Identifiers

PMID35445813
OpenAlexW4224255509

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.