[Trauma centers in Germany. Status report].
BACKGROUND
In Germany, a total of more than 30,000 polytraumatized patients are treated in level I-IV trauma centers. The exact number of hospitals fulfilling the requirements for the treatment of severely injured patients is unknown. We analyzed the number of hospitals in Germany capable of managing polytraumatized patients. We further analyzed the influence of various geographic and infrastructure conditions on the management of severely injured patients in the various Federal States in Germany.


METHODS
First we conducted a nationwide research of all hospitals specialized in trauma management. Points of interest were structural and personnel requirements. These data were compared to the data obtained by the Federal Statistical Office. With a special software program we were able to conduct for the first time a geographic visualization of all trauma hospitals.


RESULTS
There are 108 level I trauma centers, 209 level II trauma centers, and 431 level III and IV trauma centers in Germany. The geographic concentration of hospitals fulfilling the requirements for the treatment of severely injured patients differs regionally. There is an obvious correlation between trauma deaths and a low hospital concentration and less developed infrastructure.


CONCLUSIONS
Objectively, the number of trauma centers for the treatment of severely injured patients seems to be adequate in Germany. Nevertheless, there are substantial differences between various Federal States in Germany concerning the distribution of hospitals as well as the geographic and infrastructure conditions. To optimize trauma management in Germany we think that the formation of regional trauma networks is mandatory.
Kühne
C A
CA
Klinik für Unfallchirurgie, Universitätsklinikum, Essen. christian.kuehne@uni-essen.de
Ruchholtz
S
S
Buschmann
C
C
Sturm
J
J
Lackner
C K
CK
Wentzensen
A
A
Bouillon
B
B
Waydhas
C
C
Weber
C
C
D000063:Accidents, Traffic; D017732:Air Ambulances; D005858:Germany; D006801:Humans; D009104:Multiple Trauma / Q000628:therapy; D011787:Quality of Health Care; D014187:Transportation of Patients; D014193:Trauma Centers / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000628:therapy*