[Is observation of trauma patients necessary if no significant injury is detected during primary evaluation?].
BACKGROUND
Trauma patients are usually admitted for clinical observation for various periods, even without the discovery of significant injuries after the primary evaluation. The necessity of this is not evidence based. The aim was to evaluate whether patients developed complications from undiagnosed injuries during the observation period.


METHODS
A retrospective study on trauma patients who were directly admitted to a level 1 trauma center in Copenhagen during 2004. Patients without any significant injury discovered after a standardized primary evaluation were included. Data were retrieved from the patients' medical records and the hospital patient administration system.


RESULTS
304 patients met the inclusion criteria. Four patients (1.3%) developed complications during the observation period, and were admitted in the relevant wards for further treatment. In one patient a duodenal ulcer was diagnosed. The patient died later following GI-surgery. The three other patients were discharged 1-6 days after the time of injury. None in the total patient population were readmitted to any other hospital in Denmark as a consequence of the trauma during the following 30 days. The average length of observation was 10.5 hours.


CONCLUSIONS
Observation of trauma patients did not seem to be necessary if no significant injury is detected during primary evaluation as only one patient out of 304 developed symptoms from undiagnosed injury.
Rigshospitalets Traumecenter. hillbillidoc@hotmail.com
Arne Vidar
AV
Wøyen
Annemarie Bondegaard
AB
Thomsen
D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D002648:Child; D004332:Drowning; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D013997:Time Factors; D014754:Violence; D014947:Wounds and Injuries / Q000150:complications / Q000175:diagnosis*