Major blunt trauma causes increased mortality up to 12 years: Long-term survival in 3 557 patients compared to 35 502 control persons
| Autor: | Kirsi Willa, Lauri Handolin, Mikko Heinänen, Tim Söderlund, Joonas Kuorikoski, Tuomas Brinck |
|---|---|
| Přispěvatelé: | HUS Musculoskeletal and Plastic Surgery, I kirurgian klinikka (Töölö), Clinicum, Helsinki University Hospital Area, Department of Surgery |
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Disease Wounds Nonpenetrating Trauma 03 medical and health sciences Injury Severity Score 0302 clinical medicine Blunt Long-term Trauma Centers Long term survival medicine Humans Hospital Mortality Registries 030212 general & internal medicine Mortality Finland Outcome Retrospective Studies General Environmental Science Cause of death business.industry Major trauma 030208 emergency & critical care medicine 3126 Surgery anesthesiology intensive care radiology medicine.disease 3. Good health Blunt trauma Cohort Wounds and Injuries General Earth and Planetary Sciences business |
| Zdroj: | Injury. 51:2517-2523 |
| ISSN: | 0020-1383 |
| Popis: | Background: Trauma registries usually report 30-day or in-hospital mortality as an outcome measure. However, some studies criticize this measure as inadequate; the impact of a major trauma could last longer than 1 month after the injury. We studied the long-term mortality of patients who sustained a major trauma. Methods: The Helsinki University Hospital's trauma registry was used for patient identification from 2006 to 2015 (New Injury Severity Score >= 16 and blunt mechanism of injury). For each trauma registry patient, 10 control persons matched by age, sex, and county of residency were obtained from the Population Register Center of Finland. Cause of death information was obtained from Statistics Finland. Results: We included 3 557 trauma registry patients and 35 502 control persons. Follow-up ranged from 1 year 7 months to 11 years 7 months. The 1-year mortality was 11 times higher in the trauma-patient group (22% vs. 2%). The long-term (approximately 12 years) mortality after the injury was 2.6 times higher in the trauma-patient group (46% vs. 18%). For patients surviving at least 1 year post-trauma, the mortality at 12 years was 2.2 times higher than in the control group (31% vs. 14 %). The cause of death was a disease in 73.3% of the trauma patients and 93.6% of the controls. Accidents were more often a cause of death in the patient population than in the control population (21.2% vs. 4.1%). Suicide was the cause of death in 3.0% of patients and 1.1% in controls. Several factors associated with increased mortality were identified. Conclusions: Major trauma patients had significantly higher long-term mortality compared to controls. To the best of our knowledge, this is the first study on this subject with a follow up of this duration with patients this severely injured and a cohort this large. (C) 2020 Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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