title: Epidemiology and outcome of penetrating injuries in a Western European urban region.
abstract: OBJECTIVE
  Severe life-threatening injuries in Western Europe are mostly caused by blunt trauma. However, penetrating trauma might be more common in urban regions, but their characteristics have not been fully elucidated.
  
  
  METHODS
  Retrospective analysis of data from patients admitted to our urban university level I trauma center between 2008 and 2013 with suspicion of severe multiple injuries. Collection of data was performed prospectively using a PC-supported online documentation program including epidemiological, clinical and outcome parameters.
  
  
  RESULTS
  Out of 2095 trauma room patients admitted over the 6-year time period 194 (9.3 %) suffered from penetrating trauma. The mean Injury Severity Score (ISS) was 12.3 ± 14.1 points. In 62.4 % (n = 121) the penetrating injuries were caused by interpersonal violence or attempted suicide, 98 of these by stabbing and 23 by firearms. We observed a widespread injury pattern where mainly head, thorax and abdomen were afflicted. Subgroup analysis for self-inflicted injuries showed higher ISS (19.8 ± 21.8 points) than for blunt trauma (15.5 ± 14.6 points). In 82.5 % of all penetrating trauma a surgical treatment was performed, 43.8 % of the patients received intensive care unit treatment with mean duration of 7.4 ± 9.3 days. Immediate emergency surgical treatment had to be performed in 8.0 vs. 2.3 % in blunt trauma (p < 0.001). Infectious complications of the penetrating wounds were observed in 7.8 %.
  
  
  CONCLUSIONS
  Specific characteristics of penetrating trauma in urban regions can be identified. Compared to nationwide data, penetrating trauma was more frequent in our collective (9.3 vs. 5.0 %), which may be due to higher crime rates in urban areas. Especially, self-inflicted penetrating trauma often results in most severe injuries.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe, University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany. philipp.stoermann@kgu.de.
authors.forename: P
authors.initials: P
authors.lastname: Störmann
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe, University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Gartner
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe, University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Wyen
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe, University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Lustenberger
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe, University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Marzi
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe, University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Wutzler
mesh_terms: D000328:Adult; D003625:Data Collection / Q000379:methods; D005260:Female; D005858:Germany / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D014193:Trauma Centers; D014505:Urban Population; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy
keywords: Abdominal; Gunshot; Injury; Penetrating; Shock