![]() The incidence of penetrating injuries is higher in metropolitan areas than in rural areas. It is associated with high mortality and substantial hospital costs. Penetrating injury is a relative rare occurrence in the Netherlands compared with other countries. Differences in demographics between the two centers were not significant. High mortality figures were associated with injuries caused by firearms (19.4%), injuries to the head (27.9%), and alleged assaults (10.9%). ![]() Mortality among these patients was 7.1%, ranging from 0% among patients with Injury Severity Score 1–8 to 100% in patients with Injury Severity Score > 34. Median stay in the intensive care unit was 5.1 days (range = 1–96 days) and median total hospital stay was 8 days (range = 1–95 days). Admission to the intensive care unit occurred in 41.1% of all patients. Most injuries were caused by stabbings (51.1%) followed by shootings (26.3%). Patients were overwhelmingly male (83.1%) and median age was 36 years (range = 1–88 years). In total, 354 patients were identified, making up around 2% of all admitted trauma patients 3.1% (VU Medical Center) and 1.6% (Radboud Medical Center). Patient results were stratified by Injury Severity Score. Data concerning age, gender, mechanism of injury, Glasgow Coma Scale, number of injuries, type of injury, and Injury Severity Score were collected and analyzed. Penetrating injury was defined as an injury that caused disruption of the body surface and extended into the underlying tissue or into a body cavity. Using the trauma registry of the Radboud University Medical Center in Nijmegen and VU University Medical Center in Amsterdam, all patients with penetrating injury were identified who were admitted to these level 1 trauma centers in the period between January 1, 2009, and January 1, 2014. No universal definition of penetrating injury exists in the literature and little is known about the demographics and outcome of penetrating injury in the Netherlands.Ī research was carried out to ascertain the size and outcome of penetrating injuries in two level-one trauma centers in the Netherlands. Therefore, the management of penetrating injuries can be challenging and often requires rapid assessment and intervention. Penetrating injury can encompass a large spectrum of injuries dependent on the penetrating object, the location of entry, and the trajectory of the object through the human body. A good collaboration is, however, required between ambulance services and the trauma center for reliable registration. A change in Ps is a promising outcome parameter for a more efficient evaluation of pre-hospital trauma care. ![]() A 3% difference in mortality would require 6800 patients, in contrast to 3500 when the change in Ps was the primary outcome parameter. Between these three groups, significant differences were found in Revised Trauma Score and age, but no clear differences in Injury Severity Score or mortality. In 36, the Ps increased and in 15 patients, the Ps decreased. In 140 of 191 patients with an Injury Severity Score > or =16, the Ps did not change. Further, required sample sizes were calculated for an 80% power to detect a hypothetical 3% reduction in mortality and the corresponding change in Ps. Correlations between patient characteristics and a change in Ps were assessed. We therefore studied an alternative method to evaluate pre-hospital trauma care by calculating the change in probability of survival (Ps) according to the TRISS methodology, before and directly after the pre-hospital trauma care. Although mortality is an important outcome parameter for pre-hospital trauma care, it is influenced by many factors other than pre-hospital trauma care alone.
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