@article{ref1,
title="Emergency department thoracotomy of severely injured patients: an analysis of the TraumaRegister DGU<sup>®</sup>",
journal="European journal of trauma and emergency surgery",
year="2019",
author="Schulz-Drost, Stefan and Merschin, David and Gümbel, Denis and Matthes, Gerrit and Hennig, Friedrich Frank and Ekkernkamp, Axel and Lefering, Rolf and Krinner, Sebastian",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="AIM OF THE STUDY: Emergency department thoracotomy (EDT) may be the last chance for survival in some severe thoracic trauma. This study investigates a representative collective with the aim to compare the findings in Europe to the international experience. Moreover, the influence of different levels of trauma care is investigated. <br><br>METHODS: All emergency thoracotomies in patients with an ISS ≥ 9 from TR-DGU (2009-2014) within the first 60 min after arrival were identified. EDTs were identified separately, and mini thoracotomies and drainage systems were excluded. <br><br>RESULTS: 99,013 patients with sufficient data were observed. 1736 (1.8%) received thoracotomy during their hospital stay. 887 patients had a thoracotomy within the first hour in the emergency department (ED). 52.5% were treated in supraregional trauma centers (STC), 36.4% in regional (RTC) and 11.0% in local trauma centers (LTC). The mortality rates were 39.4% (STC), 20.9% (RTC) and 20.8% (LTC). The overall mortality rate showed no significant differences for blunt (28.2%) and penetrating trauma (31.3%). In case of cardiac arrest in the ED, a survival rate of 4.8% for blunt trauma and 20.7% for penetrating trauma was determined if EDT was carried out. Those patients showed a higher rate in severe thoracic organ injuries due to penetrating trauma but less extrathoracic injuries. <br><br>CONCLUSION: Just over half of EDTs were performed in STC. Emergency room resuscitation followed by EDT had survival rates of 4.8% and 20.7% for blunt and penetrating trauma patients, respectively.<p /> <p>Language: en</p>",
language="en",
issn="1863-9933",
doi="10.1007/s00068-019-01212-3",
url="http://dx.doi.org/10.1007/s00068-019-01212-3"
}