[Quality management of interdisciplinary treatment of polytrauma. Possibilities and limits of retrospective routine data collection].
BACKGROUND
The purpose of this study was to evaluate the quality of interdisciplinary multiple trauma management using routinely taken data.


METHODS
A retrospective analysis of all multiple traumatized patients [Injury Severity Score (ISS)>15] in a university hospital (n=172; time period 01.01.1997-31.12.1999) was carried out concerning epidemiological and clinical variables and hospital outcome (p<0.05).


RESULTS
The overall mortality was 22% [n=38; expected Trauma Injury Severity Score (TRISS) mortality 29%]. Significant parameters for worse outcome in univariate analysis were age>74 years, hypotension, decreasing hemoglobin level and prothrombin time, decreased Glasgow Coma Scale and the number of erythrocyte or plasma concentrates received in the initial period of treatment. The comparison of our results with the data of the German Association for Trauma Surgery registry demonstrated comparable results with respect to management sequence and outcome.


CONCLUSIONS
In the quality management of multiple trauma patients retrospective analysis of routinely registered parameters can be a reliable and practical alternative to time-consuming prospective studies when based on prognostic relevant data. Such a procedure allows a preliminary critical comparison with other centers.
Hirschmann
M T
MT
Departemente Chirurgie, Universitätsspital Basel, Basel. michael.hirschmann@ksbh.ch
Uike
K-N
KN
Kaufmann
M
M
Huegli
R
R
Regazzoni
P
P
Gross
T
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001784:Blood Gas Analysis; D001794:Blood Pressure; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D015600:Glasgow Coma Scale; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000139:chemically induced / Q000401:mortality / Q000628:therapy*; D010348:Patient Care Team / Q000592:standards* / Q000706:statistics & numerical data*; D011379:Prognosis; D011785:Quality Assurance, Health Care / Q000592:standards* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012769:Shock / Q000628:therapy; D016896:Treatment Outcome