Complications in multitrauma patients in a Dutch level 1 trauma center.
BACKGROUND
Complication registration is an important part of monitoring the quality of health care. The aim of this article was to describe the incidence, type, and impact of complications occurring within 6 months after the initial trauma in multitrauma patients.


METHODS
During a 2-year period, all trauma patients with an Injury Severity Score (ISS) ≥ 16 who were not directly transferred to other hospitals were included. We used the Dutch National Surgical Complication Registry of the Academic Medical Center, a level 1 trauma center, to assess complications within 6 months after the initial trauma. For verification, we additionally performed a chart review. Complications were graded 0 (no real health loss) to 4 (lethal).


RESULTS
Three hundred three multitrauma patients were included with a median ISS of 22 (interquartile range, 17-29). Within 181 patients, 358 complications occurred (60%). The most frequently occurring complications were respiratory and urinary tract infections. Most complications (73%) were grade 1 and resolved completely without operative (re-)intervention There were 27 patients (8%) with a grade 2 complication, which required operative (re-)interventions. All eight (2%) grade 3 complications which caused (potential) permanent damage or disability, were of neurologic origin. Overall mortality was 18.8% and complication associated readmission rate was 4%. Emergency interventions and high ISS tended to be associated with the occurrence of complications. In patients with complications, hospital stay was doubled from 9 to 18 days.


CONCLUSIONS
Multitrauma patients are at high risk for developing complications. Most frequently encountered complications were infections. The majority of complications resolved completely without a surgical intervention.
Saltzherr
Teun P
TP
Trauma Unit Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands. t.p.saltzherr@amc.nl
Visser
Annelies
A
Ponsen
Kees J
KJ
Luitse
Jan S
JS
Goslings
J Carel
JC
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D011785:Quality Assurance, Health Care; D012042:Registries; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult