Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU®
IntroductionDespite tremendous clinical efforts over the past few decades, the treatment of severely injured patients remains still challenging. Concomitant soft tissue injuries represent a particular challenge, as they can lead to complications at any time of trauma care, hold a high risk of infect...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-02-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1508172/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1825201945022824448 |
|---|---|
| author | Nora Kirsten Georg Maximilian Franke Rolf Lefering Tim Klüter Matthias Weuster Michael Müller Sebastian Lippross Andreas Seekamp TraumaRegister DGU® Stefanie Fitschen-Oestern |
| author_facet | Nora Kirsten Georg Maximilian Franke Rolf Lefering Tim Klüter Matthias Weuster Michael Müller Sebastian Lippross Andreas Seekamp TraumaRegister DGU® Stefanie Fitschen-Oestern |
| author_sort | Nora Kirsten |
| collection | DOAJ |
| description | IntroductionDespite tremendous clinical efforts over the past few decades, the treatment of severely injured patients remains still challenging. Concomitant soft tissue injuries represent a particular challenge, as they can lead to complications at any time of trauma care, hold a high risk of infection and often require multiple surgical interventions and interdisciplinary collaboration.MethodsThis retrospective, multicentric study used the TraumaRegister DGU® to examine the effect of open fractures and severe soft tissue injuries on outcome of multiple trauma patients. Primary admitted multiple trauma patients at the age of 16 to 70 years, treated from 2010 to 2021, were included. A Matched pair analysis was performed for better comparability of trauma patients with and without open fractures and/or severe soft tissue injuries.ResultsAfter applying the matching criteria, 5,795 pairs were created and analyzed. The group with sustained soft tissue injuries/open fractures was found to have a higher ISS ([mean ± SD] 22.1 ± 10.4 vs. 20.6 ± 10.2, p < 0.001). Endotracheal tube insertion (27.7% vs. 30.4%, p = 0.003), catecholamine administration (6.0% vs. 8.4%, p < 0.001) and cardio-pulmonary resuscitation (1.6% vs. 2.1%, p = 0.027) were more frequent in the group with sustained soft tissue injury. Both groups were equally frequent admitted to the intensive care unit (ICU) and length of stay (LOS) at the ICU (median (quartiles) 3 (1–9) versus 3 (1–9)) did not differ significantly. However, total LOS at the hospital was longer for the group with sustained soft tissue injury (median (quartiles) 18 (11–29) versus 17 (10–27)). Sepsis occurred more often in patients with soft tissue injury (4.3% vs. 5.2%, p = 0.034). There was no significant difference in prevalence of multi organ failure, 24 h-mortality (2.1% vs. 2.5%, p = 0.151) and overall-mortality (3.6% vs. 3.9%, p = 0.329) between both groups.ConclusionDue to database analysis and revision of guidelines, the treatment of severely injured patients has steadily improved in recent years. Patients with severe soft tissue injuries/open fractures required more medical interventions and length of stay at the hospital was longer. In this study, we were able to show that although concomitant severe soft tissue injuries required more ICU interventions and led to a longer length of stay, 24-h and all-cause mortality were not significantly increased. |
| format | Article |
| id | doaj-art-c6affac6dcf34346a9be9ab6f1969e2a |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-c6affac6dcf34346a9be9ab6f1969e2a2025-02-07T18:08:39ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-02-011210.3389/fmed.2025.15081721508172Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU®Nora Kirsten0Georg Maximilian Franke1Rolf Lefering2Tim Klüter3Matthias Weuster4Michael Müller5Sebastian Lippross6Andreas Seekamp7TraumaRegister DGU®Stefanie Fitschen-Oestern8Department of Trauma Surgery, Hannover Medical School, Hannover, GermanyDepartment of Trauma Surgery, University Medical Center of Schleswig-Holstein, Kiel, GermanyInstitute for Research in Operative Medicine (IFOM), University Witten/Herdecke, Cologne, GermanyDepartment of Trauma Surgery, University Medical Center of Schleswig-Holstein, Kiel, GermanyDepartment of Trauma Surgery, DIAKO Hospital Flensburg, Flensburg, GermanyDepartment of Trauma Surgery, University Medical Center of Schleswig-Holstein, Kiel, GermanyDepartment of Surgical Sciences, University of Otago, Dunedin, New ZealandDepartment of Trauma Surgery, University Medical Center of Schleswig-Holstein, Kiel, GermanyDepartment of Trauma Surgery, University Medical Center of Schleswig-Holstein, Kiel, GermanyIntroductionDespite tremendous clinical efforts over the past few decades, the treatment of severely injured patients remains still challenging. Concomitant soft tissue injuries represent a particular challenge, as they can lead to complications at any time of trauma care, hold a high risk of infection and often require multiple surgical interventions and interdisciplinary collaboration.MethodsThis retrospective, multicentric study used the TraumaRegister DGU® to examine the effect of open fractures and severe soft tissue injuries on outcome of multiple trauma patients. Primary admitted multiple trauma patients at the age of 16 to 70 years, treated from 2010 to 2021, were included. A Matched pair analysis was performed for better comparability of trauma patients with and without open fractures and/or severe soft tissue injuries.ResultsAfter applying the matching criteria, 5,795 pairs were created and analyzed. The group with sustained soft tissue injuries/open fractures was found to have a higher ISS ([mean ± SD] 22.1 ± 10.4 vs. 20.6 ± 10.2, p < 0.001). Endotracheal tube insertion (27.7% vs. 30.4%, p = 0.003), catecholamine administration (6.0% vs. 8.4%, p < 0.001) and cardio-pulmonary resuscitation (1.6% vs. 2.1%, p = 0.027) were more frequent in the group with sustained soft tissue injury. Both groups were equally frequent admitted to the intensive care unit (ICU) and length of stay (LOS) at the ICU (median (quartiles) 3 (1–9) versus 3 (1–9)) did not differ significantly. However, total LOS at the hospital was longer for the group with sustained soft tissue injury (median (quartiles) 18 (11–29) versus 17 (10–27)). Sepsis occurred more often in patients with soft tissue injury (4.3% vs. 5.2%, p = 0.034). There was no significant difference in prevalence of multi organ failure, 24 h-mortality (2.1% vs. 2.5%, p = 0.151) and overall-mortality (3.6% vs. 3.9%, p = 0.329) between both groups.ConclusionDue to database analysis and revision of guidelines, the treatment of severely injured patients has steadily improved in recent years. Patients with severe soft tissue injuries/open fractures required more medical interventions and length of stay at the hospital was longer. In this study, we were able to show that although concomitant severe soft tissue injuries required more ICU interventions and led to a longer length of stay, 24-h and all-cause mortality were not significantly increased.https://www.frontiersin.org/articles/10.3389/fmed.2025.1508172/fullsevere soft tissue injuriesmultiple traumaTraumaRegister DGU®sepsispolytrauma care |
| spellingShingle | Nora Kirsten Georg Maximilian Franke Rolf Lefering Tim Klüter Matthias Weuster Michael Müller Sebastian Lippross Andreas Seekamp TraumaRegister DGU® Stefanie Fitschen-Oestern Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU® Frontiers in Medicine severe soft tissue injuries multiple trauma TraumaRegister DGU® sepsis polytrauma care |
| title | Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU® |
| title_full | Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU® |
| title_fullStr | Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU® |
| title_full_unstemmed | Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU® |
| title_short | Severe soft tissue injuries in multiple trauma patients—a challenge we can meet? A matched-pair analysis from the TraumaRegister DGU® |
| title_sort | severe soft tissue injuries in multiple trauma patients a challenge we can meet a matched pair analysis from the traumaregister dgu r |
| topic | severe soft tissue injuries multiple trauma TraumaRegister DGU® sepsis polytrauma care |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1508172/full |
| work_keys_str_mv | AT norakirsten severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT georgmaximilianfranke severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT rolflefering severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT timkluter severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT matthiasweuster severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT michaelmuller severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT sebastianlippross severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT andreasseekamp severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT traumaregisterdgu severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu AT stefaniefitschenoestern severesofttissueinjuriesinmultipletraumapatientsachallengewecanmeetamatchedpairanalysisfromthetraumaregisterdgu |