Factors affecting the prognosis of multiply injured patients: an analysis of 1169 consecutive cases.
When analysing 1169 multiply injured patients treated in the intensive care unit between 1966 and 1984 we noticed a dramatic fall in mortality from a level of about 14.6 per cent to 4.8 per cent since 1981. The patient populations and accident patterns were surprisingly identical, though since 1981 the severity of thoracic injuries has increased and the brain injuries decreased. The fall in mortality was great for all causes of death but most significant for patients with severe thoracic, brain and cervical spine injuries. The trend is to treat more and more fractures operatively and immediately after the injury. There has been a better diagnosis of all injuries according to autopsy findings. An attitude of prophylactic treatment on a respirator which leads to better oxygenation, together with a well-organized, co-ordinated injury care system with systematized diagnostic, laboratory and therapeutic procedures, are among the most important factors in the lowering of the mortality.
Kivioja
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Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Finland.
D003422:Critical Care / Q000639:trends; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis