[German trauma centers: level-dependent differences in polytrauma care regarding resources and diagnostic concepts].
BACKGROUND
The aim was to survey the radiological diagnostics and type of primary radiological examination of polytraumatized patients treated in German hospitals at various levels in the three-tiered system.


METHODS
A questionnaire was sent in October 2007 to every traumatology department registered in the DGU (German Society for Trauma Surgery) databank and forms returned by January 2008 were included in this study.


RESULTS
A total of 273 (54.71 %) of forms were returned and were applicable to statistical analysis. In the three-tiered hospital system 35.9 % of returned questionnaires came from third-tier hospitals, 41.02 % from second-tier and 23.08 % from highest tier (maximum care) hospitals. With a higher hospital level of inpatient care more computed tomography (CT) scans were examined by a radiologist during 24 h daily (p = 0.0014) and CT scanners were located closer to the resuscitation room (p < 0.0001). We found significant differences in the ratios of primary whole-body CTs (WBCT) performed depending on the hospital level: third-tier hospitals 44 %, second tier hospitals 67 % and maximum care hospitals 84 % (p < 0.05).


CONCLUSIONS
Standardized structures regarding radiological diagnostics of polytraumatized patients do not exist at either the same level of the three-tiered hospital system or between levels of care of German hospitals..
Department Orthopädie und Traumatologie, Klinikum der Albert-Ludwigs-Universität Freiburg, Hugstetter Str. 55, 79106, Freiburg, Deutschland. joerg.bayer@uniklinik-freiburg.de
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Bayer
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Pache
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Hammer
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Zwingmann
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D005858:Germany; D006297:Health Services Accessibility / Q000592:standards*; D006302:Health Services Research; D017052:Hospital Mortality; D006801:Humans; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D010348:Patient Care Team / Q000592:standards; D011785:Quality Assurance, Health Care / Q000592:standards*; D012042:Registries; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000592:standards*; D014193:Trauma Centers / Q000592:standards*; D051598:Whole Body Imaging / Q000592:standards