Evidence map›Paper›PMID 42457785›Full record

ArticleScientific reports2026

Adherence to strong recommendations of the German Polytrauma Guideline: an analysis of TraumaRegister DGU data over a decade.

Katharina Fetz, Dan Bieler, Sebastian Imach, Rolf Lefering, Käthe Goossen

Abstract read
In one paragraph

Article in Scientific reports, 2026. 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
–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

1 citing paper in PubMed.

  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

5 authors.

Katharina FetzInstitute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany. katharina.fetz@uni-wh.de.
Dan BielerInstitute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany. Dan.Bieler@med.uni-duesseldorf.de.
Sebastian ImachDepartment of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center, University Witten/Herdecke, Cologne, Germany.
Rolf LeferingInstitute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.
Käthe GoossenInstitute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The treatment of severely injured patients requires complex pre-hospital and in-hospital emergency interventions. The German Guideline on the Treatment of Multiple and/or Severe Injuries ('German Polytrauma Guideline') was developed to provide a standardized, evidence-based treatment approach for this purpose. High guideline adherence is supposed to positively affect quality of care and patient outcomes. The aim of this study is to quantify the adherence to the strong recommendations of the German Polytrauma Guideline in a sample of patients treated at all German trauma centres using data from the TraumaRegister DGU (TR-DGU, Trauma Registry) from over a decade (2011-2022). All strong recommendations from the 2016 version of the German Polytrauma Guideline that could be operationalised in the TR-DGU were selected. Adherence to these recommendations was examined for a population of adults (≥ 16 years) with severe injuries (injury severity score ≥ 16) who were directly admitted to a German trauma centre in the period of 2011-2022 and for whom TR-DGU data were available (N = 141,073). Adherence rates were calculated at the recommendation level. We found acceptable adherence rates for most of the investigated recommendations in the pre-hospital and in-hospital trauma data combined. Poor adherence rates were observed for pre-hospital decompression of tension pneumothoraxes, pre-hospital administration of tranexamic acid (TXA), exploratory thoracotomy in hemodynamically unstable patients with penetrating injuries, and decompression of space-occupying intracranial injuries. Our results indicate that many of the strong recommendations of the German Polytrauma Guideline are adhered to in the pre-hospital and in-hospital care of severely injured patients in Germany. We have also identified recommendations where measures should be taken to improve adherence. These results need to be interpreted in the context of the limitations of registry-based studies.The present study is registered as TRDGU project ID 2,023,008 and follows the publication guidelines of the TraumaRegister DGU.

Indexed as

Guideline AdherenceMultiple TraumaAdultAgedFemaleGermanyHumansInjury Severity ScoreMaleMiddle AgedPractice Guidelines as TopicRegistriesTrauma CentersAdherenceComplianceGuidelineHuman factorsRegistryTraumaTraumaRegisterTreatment recommendation

Identifiers

PMID42457785
PMCPMC13373211

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