ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024
Standards of fracture care in polytrauma: results of a Europe-wide survey by the ESTES polytrauma section.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Developments in the understanding of staging a "major fracture" in polytrauma: results from an initiative by the polytrauma section of ESTES.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Transferrals and clinical pathways of unstable pelvic fractures over the last 10 years - a retrospective analysis of the Trauma Register DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Chinese expert consensus on the prehospital management of major trauma.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- Development and validation of a machine learning-based model to assess probability of systemic inflammatory response syndrome in patients with severe multiple traumas.BMC medical informatics and decision making · 2024Observational
- Further refinement of high standards of care- focus on polytrauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Fracture fixation in polytraumatized patients-From an interdisciplinary early total/appropriate care to the safe definitive surgery concept.Frontiers in medicine · 2024Review
- The sequence of the treatment of combined fractures of the pelvis, spine, and extremities in polytraumatized patients.EFORT open reviews · 2023Review
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Authors and funding
12 authors at 10 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFixation of major fractures plays a pivotal role in the surgical treatment of polytrauma patients. In addition to ongoing discussions regarding the optimal timing in level I trauma centers, it appears that the respective trauma systems impact the implementation of both, damage control and safe definitive surgery strategies. This study aimed to assess current standards of polytrauma treatment in a Europe-wide survey.
methodsA survey, developed by members of the polytrauma section of ESTES, was sent online via SurveyMonkey
resultsIn total, questionnaires of 87 participants (19.3% response rate) were included. The majority of participants were senior consultants (50.57%). The mean work experience was 19 years, and on average, 17 multiple-injured patients were treated monthly. Most of the participants stated that a polytrauma patient is defined by ISS ≥ 16 (44.16%), followed by the "Berlin Definition" (25.97%). Systolic blood pressure < 90 mmHg, tachycardia or vasopressor administration (86.84%), pH deviation, base excess shift (48.68%), and lactate > 4 mmol (40.79%) or coagulopathy defined by ROTEM (40.79%) were the three most often stated indicators for shock. Local guidelines (33.77%) and the S-3 Guideline by the DGU® (23.38%) were mostly stated as a reference for the treatment of polytrauma patients. Normal coagulation (79.69%), missing administration of vasopressors (62.50%), and missing clinical signs of "SIRS" (67.19%) were stated as criteria for safe definite secondary surgery.
conclusionDifferent definitions of polytrauma are used in the clinical setting. Indication for and the extent of secondary (definitive) surgery are mainly dependent on the polytrauma patient`s physiology. The «Window of Opportunity» plays a less important role in decision making.
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