The yield of tertiary survey in patients admitted for observation after trauma

Gijs Jacob Jan van Aert*, Jelle Corneel van Dongen, Niels Cornelis Adrianus Sebastianus Berende, Hendrikus Gerardus Wilhelmus de Groot, Pieter Boele van Hensbroek, Philip Marcel Jozef Schormans, Dagmar Isabella Vos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Purpose Existing literature on trauma tertiary survey (TTS) focusses on multitrauma patients. This study examines the yield of the TTS in trauma patients with minor (AIS 1) or moderate (AIS 2) injury for which immediate hospitalization is not strictly indicated. Method A single center retrospective cohort study was performed in a level II trauma center. All hospitalized trauma patients with an abbreviate injury score (AIS) of one or two at the primary and secondary survey were included. The primary outcome was defined as any missed injury found during TTS (Type 1). Secondary outcomes were defined as any missed injury found after TTS but during admission (Type 2); overall missed injury rate; mortality and hospital length of stay. Results Out of 388 included patients, 12 patients (3.1%) had a type 1 missed injury. ISS and alcohol consumption were associated with an increased risk for type 1 missed injuries (resp. OR = 1.4, OR = 5.49). A type 2 missed injury was only found in one patient. This concerned the only case of trauma related mortality. Approximately one out of five patients were admitted for more than 2 days. These patients were significantly older (66 vs. 41 years,p < 0.001), had a higher ISS (4 vs. 3,p = 0.007) and ASA score, 3-4 vs. 1-2 (42.5% vs. 12.6%,p < 0.001). Conclusion TTS showed a low rate of missed injuries in trauma patients with minor or moderate injury. TTS helped to prevent serious damage in two out of 388 patients (0.5%). ISS and alcohol consumption were associated with finding missed injury during TTS.
Original languageEnglish
Pages (from-to)423-429
Number of pages7
JournalEuropean Journal of Trauma and Emergency Surgery
Volume48
Issue number1
Early online date5 Sep 2020
DOIs
Publication statusPublished - Feb 2022

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© Springer-Verlag GmbH Germany, part of Springer Nature 2020

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