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Original article

Vol. 144 No. 0708 (2014)

First results from a Swiss level I trauma centre participating in the UK Trauma Audit and Research Network (TARN): prospective cohort study

  • Rebecca Maria Hasler
  • David Srivastava
  • Emin Aghayev
  • Marius Johann Keel
  • Aristomenis Konstantinos Exadaktylos
  • Beat Schnüriger
Cite this as:
Swiss Med Wkly. 2014;144:w13910


QUESTIONS UNDER STUDY: Patient characteristics and risk factors for death of Swiss trauma patients in the Trauma Audit and Research Network (TARN).

METHODS: Descriptive analysis of trauma patients (≥16 years) admitted to a level I trauma centre in Switzerland (September 1, 2009 to August 31, 2010) and entered into TARN. Multivariable logistic regression analysis was used to identify predictors of 30-day mortality.

RESULTS: Of 458 patients 71% were male. The median age was 50.5 years (inter-quartile range [IQR] 32.2–67.7), median Injury Severity Score (ISS) was 14 (IQR 9–20) and median Glasgow Coma Score (GCS) was 15 (IQR 14–15). The ISS was >15 for 47%, and 14% had an ISS >25. A total of 17 patients (3.7%) died within 30 days of trauma. All deaths were in patients with ISS >15. Most injuries were due to falls <2 m (35%) or road traffic accidents (29%). Injuries to the head (39%) were followed by injuries to the lower limbs (33%), spine (28%) and chest (27%). The time of admission peaked between 12:00 and 22:00, with a second peak between 00:00 and 02:00. A total of 64% of patients were admitted directly to our trauma centre. The median time to CT was 30 min (IQR 18–54 min). Using multivariable regression analysis, the predictors of mortality were older age, higher ISS and lower GCS.

CONCLUSIONS: Characteristics of Swiss trauma patients derived from TARN were described for the first time, providing a detailed overview of the institutional trauma population. Based on these results, patient management and hospital resources (e.g. triage of patients, time to CT, staffing during night shifts) could be evaluated as a further step.


  1. [homepage on the internet] Salford: The Trauma Audit and Research Network [updated 2013 April 22, cited 2013 April 22]. Trauma Care. Available from:
  2. [homepage on the internet]. Geneva: World Health Organisation (WHO). World Health Statistics 2010: cause specific mortality and morbidity. [updated 2013 April 22. Cited 2013 April 22]. Available from: WHS09 Table2.pdf ].
  3. Hartog CS, Winning J, Bauer M. Volume replacement after trauma: an update. Swiss Med Wkly. 2012;142:w13685.
  4. Frickmann F, Wurm B, Jeger V, Lehmann B, Zimmermann H, Exadaktylos AK. 782 consecutive construction work accidents: who is at risk? A 10-year analysis from a Swiss university hospital trauma unit. Swiss Med Wkly. 2012;142:w13674.
  5. Finfer S, Cohen J. Severe traumatic brain injury. Resuscitation. 2001;48:77–90.
  6. [homepage on the internet] Salford: The Trauma Audit and Research Network [updated 2013 April 22, cited 2013 April 22]. Trauma Care. “The First Decade”. Available from:
  7. Yates DW, Woodford M, Hollis S. Preliminary analysis of the care of injured patients in 33 British hospitals: first report of the United Kingdom major trauma outcome study. BMJ. 1992;26;305(6856):737–40.
  8. [homepage on the internet] Köln: Deutsche Gesellschaft für Unfallchirurgie (DGU) [updated 2013 April 22, cited 2013 April 22]. Trauma Register DGU. Available from:
  9. [homepage on the internet] Chicago: American College of Surgeons National Trauma Data Bank. [updated 2013 April 22, cited 2013 April 22] Available from:
  10. Hartel MJ, Jordi N, Evangelopoulos DS, Hasler R, Dopke K, Zimmermann H, et al. Optimising care in a Swiss University Emergency Department by implementing a multicentre trauma register (TARN): report on evaluation, costs and benefits of trauma registries. Emerg Med J. 2011;28(3):221–4.
  11. The Trauma Audit & Research Network. The trauma audit & research network. Procedures Manual. Salford, UK: The Trauma Audit & Research Network; 2012.
  12. Committee on Injury Scaling. Association for the advancement of automotive medicine (AAAM). The abbreviated injury scale 2008 revision. Des Plaines, Chicago: AAAM; 2008.
  13. [homepage on the internet] Salford: The Trauma Audit and Research Network [updated 2013 April 22, cited 2013 April 22].TARN Ps12 calculator. Available from:
  14. [homepage on the internet] Chicago: American College of Surgeons. National Trauma Databank Annual Report 2012. [updated 2013 April 22, cited 2013 April 22] Available from:
  15. Brown JB, Stassen NA, Bankey PE, Sangosanya AT, Cheng JD, Gestring ML. Mechanism of injury and special consideration criteria still matter: an evaluation of the National Trauma Triage Protocol. J Trauma. 2011;70:38–44.
  16. MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathans AB, Frey KP, Egleston BL, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354:366–78.
  17. Perel P, Prieto-Merino D, Shakur H, Clayton T, Lecky F, Bouamra O, et al. Predicting early death in patients with traumatic bleeding: development and validation of prognostic model. BMJ. 2012. 15;345:e5166.
  18. Hoyt DB, Hollingsworth-Fridlund P, Winchell RJ, Simons RK, Holbrook T, Fortlage D. Analysis of recurrent process errors leading to provider-related complications on an organized trauma service: directions for care improvement. J Trauma. 1994;36:377–84.
  19. Lloyd DA, Pattereson M, Robson J, Phillips B. A stratified response system for the emergency management of the severely injured. Ann R Coll Surg Engl. 2001;83:15–20.
  20. Phillips JA, Buchmann TG. Optimizing prehospital triage criteria for trauma team alerts. J Trauma. 1993;34:127–32.

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