TY - JOUR AU - Heim, Catherine AU - Bosisio, Francesca AU - Roth, Audrey AU - Bloch, Jocelyne AU - Borens, Olivier AU - Daniel, Roy T AU - Denys, Alban AU - Oddo, Mauro AU - Pasquier, Mathieu AU - Schmidt, Sabine AU - Schoettker, Patrick AU - Zingg, Tobias AU - Wasserfallen, Jean-Blaise PY - 2014/03/23 Y2 - 2024/03/28 TI - Is trauma in Switzerland any different? Epidemiology and patterns of injury in major trauma – a 5-year review from a Swiss trauma centre JF - Swiss Medical Weekly JA - Swiss Med Wkly VL - 144 IS - 1314 SE - Original article DO - 10.4414/smw.2014.13958 UR - https://smw.ch/index.php/smw/article/view/1848 SP - w13958 AB - <p><p>Switzerland, the country with the highest health expenditure per capita, is lacking data on trauma care and system planning. Recently, 12 trauma centres were designated to be reassessed through a future national trauma registry by 2015. Lausanne University Hospital launched the first Swiss trauma registry in 2008, which contains the largest database on trauma activity nationwide.</p> <p>METHODS: Prospective analysis of data from consecutively admitted shock room patients from 1 January 2008 to 31 December 2012. Shock room admission is based on physiology and mechanism of injury, assessed by prehospital physicians. Management follows a surgeon-led multidisciplinary approach. Injuries are coded by Association for the Advancement of Automotive Medicine (AAAM) certified coders.</p> <p>RESULTS: Over the 5 years, 1,599 trauma patients were admitted, predominantly males with a median age of 41.4 years and median injury severity score (ISS) of 13. Rate of ISS &gt;15 was 42%. Principal mechanisms of injury were road traffic (40.4%) and falls (34.4%), with 91.5% blunt trauma. Principal patterns were brain (64.4%), chest (59.8%) and extremity/pelvic girdle (52.9%) injuries. Severe (abbreviated injury scale [AIS] score ≥3) orthopaedic injuries, defined as extremity and spine injuries together, accounted for 67.1%. Overall, 29.1% underwent immediate intervention, mainly by orthopaedics (27.3%), neurosurgeons (26.3 %) and visceral surgeons (13.9%); 43.8% underwent a surgical intervention within the first 24 hours and 59.1% during their hospitalisation. In-hospital mortality for patients with ISS &gt;15 was 26.2%.</p> <p>CONCLUSION: This is the first 5-year report on trauma in Switzerland. Trauma workload was similar to other European countries. Despite high levels of healthcare, mortality exceeds published rates by &gt;50%. Regardless of the importance of a multidisciplinary approach, trauma remains a surgical disease and needs dedicated surgical resources.</p></p> ER -