Evaluation of the necessity of clinical observation of high-energy trauma patients without significant injury after standardized emergency room stabilization.
BACKGROUND
Patients involved in a high-energy trauma (HET) are usually admitted for clinical observation, even when no significant injury is found after standard care in the emergency room (ER). The necessity of this observation period is not evidence based. The goal of this study was to identify patients who revealed an initially undiagnosed injury during the observation period.


METHODS
A retrospective study of consecutive HET patients was conducted in two Level I trauma centers. Patients after a HET with two minor injuries or less, diagnosed during the standard ER care, were included. Data were abstracted from patients' medical records.


RESULTS
Five hundred three patients were included. None of the patients developed any complications during the clinical observation period or were readmitted to their own hospital within a week after the trauma.


CONCLUSIONS
There is no evidence for the necessity of clinical observation of HET patients with minimal or no injuries diagnosed after standard ER stabilization and evaluation.
Lansink
Koen W W
KW
Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands. kwwlansink@hotmail.com
Cornejo
Carol J
CJ
Boeije
Tom
T
Kok
Maarten F
MF
Jurkovich
Gregory J
GJ
Ponsen
Kees J
KJ
D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D003951:Diagnostic Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D009426:Netherlands; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000628:therapy