Trauma facilities in Denmark - a nationwide cross-sectional benchmark study of facilities and trauma care organisation

Weile, Jesper; Nielsen, Klaus; Primdahl, Stine C.; Frederiksen, Christian Alcaraz; Laursen, Christian B.; Sloth, Erik; Mølgaard, Ole; Knudsen, Lars; Kirkegaard, Hans

doi:10.1186/s13049-018-0486-1

Cited by 10 publications

(5 citation statements)

References 19 publications

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“…Yet all cardiac arrest cases, regardless of the cause, are treated according to the European Resuscitation Council guidelines [ 12 ]. A TCA will result in the activation of a trauma team within one of the four Level 1 trauma centres as defined by the Danish Health Authorities [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

Traumatic cardiac arrest – a nationwide Danish study

et al. 2023

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Background Cardiac arrest following trauma is a leading cause of death, mandating urgent treatment. This study aimed to investigate and compare the incidence, prognostic factors, and survival between patients suffering from traumatic cardiac arrest (TCA) and non-traumatic cardiac arrest (non-TCA). Methods This cohort study included all patients suffering from out-of-hospital cardiac arrest in Denmark between 2016 and 2021. TCAs were identified in the prehospital medical record and linked to the out-of-hospital cardiac arrest registry. Descriptive and multivariable analyses were performed with 30-day survival as the primary outcome. Results A total of 30,215 patients with out-of-hospital cardiac arrests were included. Among those, 984 (3.3%) were TCA. TCA patients were younger and predominantly male (77.5% vs 63.6%, p = < 0.01) compared to non-TCA patients. Return of spontaneous circulation occurred in 27.3% of cases vs 32.3% in non-TCA patients, p < 0.01, and 30-day survival was 7.3% vs 14.2%, p < 0.01. An initial shockable rhythm was associated with increased survival (aOR = 11.45, 95% CI [6.24 – 21.24] in TCA patients. When comparing TCA with non-TCA other trauma and penetrating trauma were associated with lower survival (aOR: 0.2, 95% CI [0.02–0.54] and aOR: 0.1, 95% CI [0.03 – 0.31], respectively. Non-TCA was associated with an aOR: 3.47, 95% CI [2.53 – 4,91]. Conclusion Survival from TCA is lower than in non-TCA. TCA has different predictors of outcome compared to non-TCA, illustrating the differences regarding the aetiologies of cardiac arrest. Presenting with an initial shockable cardiac rhythm might be associated with a favourable outcome in TCA.

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Section: Methodsmentioning

confidence: 99%

Traumatic cardiac arrest – a nationwide Danish study

et al. 2023

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“…The implementation of national HEMS in 2014 and centralization may have enlarged the catchment area. In 2018, Weile et al found heterogenous composition of the trauma team and TTA criteria at trauma facilities in Denmark (33) and some major trauma patients are still treated at acute-care hospitals in Central Denmark Region. A national benchmark study including the entire Danish trauma patient population is warranted.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Trier¹,

Fjølner

Raaber

et al. 2021

Preprint

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Background: Trauma causes a considerable economic and societal burden and the trauma patient population and its prognosis changes over time. The aim of this study is to analyze ten-year trends of trauma patients at a major trauma center in Denmark. Methods: 5366 patients aged ≥ 16 years with Injury Severity Score (ISS) > 0 admitted by trauma team activation at Aarhus University Hospital Trauma Center between January 1, 2010 and December 31, 2019 were included. Descriptive statistics, incidence rate calculation, parametric and non-parametric test were used. An annual percent change with 95% confidence interval was used to estimate trend in mechanism of injuries. Multiple logistic regression with mortality as outcome were adjusted for age, sex and ISS. Results: The median age increased from 37 in 2010 to 49 in 2019 and the proportion of patients aged ≥ 65 doubled. The incidence of minor injuries (ISS 1-15) decreased from 181.3/105 inhabitants in 2010 to 112.7/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 0.62 (95% CI: 0.54 to 0.72). Severe injuries (ISS > 15) increased from 10.1/105 inhabitants in 2010 to 13.6/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 1.35 (95% CI: 1.04 to 1.76). The proportion of patients with ISS > 15 increased from 18.1% in 2010 to 31.1% in 2019. Multivariable logistic regression showed lower 30-day mortality for all trauma patients with ISS > 0 over the study period when adjusting for age, sex and ISS (Odds ratio: 0.94, 95% CI: 0.90 to 0.99). The 30-day mortality for severely injured patients with ISS > 15 decreased during the study period when adjusting for age, sex and ISS (Odds ratio: 0.92, 95% CI: 0.87 to 0.97). Fall injuries increased with an annual percent change of 4.1% (95% CI: 2.3% to 6.1%). Conclusions: Ten-year trends of trauma patients in Central Denmark Region show an increasing median age, injury severity and number of fall injuries. The 30-day mortality of trauma patients decreased for both minor injuries and severe injuries when adjusting for age, sex and injury severity. Trial registration: Not applicable.

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“…Furthermore, previous studies have been designed for specific evaluations such as the heart or the lungs [5,[12][13][14][15][16][17][18]. These patients only represent a small sample of the patients seen in the ED [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Point-of-care ultrasound induced changes in management of unselected patients in the emergency department - a prospective single-blinded observational trial

Weile

Frederiksen

Laursen

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: Point-of-Care ultrasound (POCUS) changes the management in specific groups of patients in the Emergency Department (ED). It seems intuitive that POCUS holds an unexploited potential on a wide variety of patients. However, little is known about the effect of ultrasound on the broad spectrum of unselected patients in the ED. This study aimed to identify the effect on the clinical management if POCUS was applied on unselected patients. Secondarily the study aimed to identify predictors of ultrasound changing management. Methods: This study was a blinded observational single center trial. A basic whole body POCUS protocol was performed in extension to the physical examination. The blinded treating physicians were interviewed about the presumptive diagnosis and plan for the patient. Subsequently the physicians were unblinded to the POCUS results and asked to choose between five options regarding the benefit from POCUS results. Results: A total of 403 patients were enrolled in this study. The treating physicians regarded POCUS examinations influence on the diagnostic workup or treatment as following: 1) No new information: 249 (61.8%), 2) No further action: 45 (11.2%), 3) Further diagnostic workup needed: 52 (12.9%), 4) Presumptive diagnosis confirmed 38 (9.4%), and 5) Immediate treatment needed: 19 (4.7%). Predictors of beneficial ultrasound were: (a) triage > 1, (b) patient comorbidities (cardiac disease, hypertension or lung disease), or (c) patients presenting with abdominal pain, dyspnea, or syncope. Conclusion: POCUS was found to be potentially beneficial in 27.0% of all patients. High triage score, known cardiac disease, hypertension, pulmonary diseases, a clinical presentation with abdominal pain, dyspnea, or syncope are predictors of this. Future research should focus on patient-important outcomes when applying POCUS on these patients.

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Trauma facilities in Denmark - a nationwide cross-sectional benchmark study of facilities and trauma care organisation

Cited by 10 publications

References 19 publications

Traumatic cardiac arrest – a nationwide Danish study

Traumatic cardiac arrest – a nationwide Danish study

Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study

Point-of-care ultrasound induced changes in management of unselected patients in the emergency department - a prospective single-blinded observational trial

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