scholarly journals The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

2021 ◽  
Author(s):  
Suzan Dijkink ◽  
Erik W. van Zwet ◽  
Pieta Krijnen ◽  
Luke P. H. Leenen ◽  
Frank W. Bloemers ◽  
...  
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Trauma System ◽  
Future Research ◽  
Severely Injured ◽  
Trauma Centers ◽  
Severely Injured Patients ◽  
The Right ◽  
Injured Patients ◽  
The Impact

Abstract Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

scholarly journals The evolution of trauma care in the Netherlands over 20 years

2019 ◽  
Vol 46 (2) ◽  
pp. 329-335 ◽  
Author(s):  
Falco Hietbrink ◽  
Roderick M. Houwert ◽  
Karlijn J. P. van Wessem ◽  
Rogier K. J. Simmermacher ◽  
Geertje A. M. Govaert ◽  
...  
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Trauma System ◽  
Trauma Surgeon ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
The Past ◽  
Level 1 ◽  
Trauma Surgeons ◽  
Injured Patients

Abstract Introduction In 1999 an inclusive trauma system was initiated in the Netherlands and a nationwide trauma registry, including all admitted trauma patients to every hospital, was started. The Dutch trauma system is run by trauma surgeons who treat both the truncal (visceral) and extremity injuries (fractures). Materials and Methods In this comprehensive review based on previous published studies, data over the past 20 years from the central region of the Netherlands (Utrecht) was evaluated. Results It is demonstrated that the initiation of the trauma systems and the governance by the trauma surgeons led to a region-wide mortality reduction of 50% and a mortality reduction for the most severely injured of 75% in the level 1 trauma centre. Furthermore, major improvements were found in terms of efficiency, demonstrating the quality of the current system and its constructs such as the type of surgeon. Due to the major reduction in mortality over the past few years, the emphasis of trauma care evaluation shifts towards functional outcome of severely injured patients. For the upcoming years, centralisation of severely injured patients should also aim at the balance between skills in primary resuscitation and surgical stabilization versus longitudinal surgical involvement. Conclusion Further centralisation to a limited number of level 1 trauma centres in the Netherlands is necessary to consolidate experience and knowledge for the trauma surgeon. The future trauma surgeon, as specialist for injured patients, should be able to provide the vast majority of trauma care in this system. For the remaining part, intramural, regional and national collaboration is essential

scholarly journals The Impact of Regionalized Trauma Care on the Distribution of Severely Injured Patients in the Netherlands

2021 ◽  
Vol 233 (5) ◽  
pp. e224
Author(s):  
Suzan Dijkink ◽  
Erik W. Van Zwet ◽  
Pieta Krijnen ◽  
Inger B. Schipper ◽  
Landelijke Beraadsgroep Traumacentra
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Injured Patients ◽  
The Impact

scholarly journals Developing process guidelines for trauma care in the Netherlands for severely injured patients: results from a Delphi study

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Elisabeth Maria Hoogervorst ◽  
Eduard Ferdinand van Beeck ◽  
Johan Carel Goslings ◽  
Pieter Dirk Bezemer ◽  
Joost Jan Laurens Marie Bierens
Keyword(s):  
The Netherlands ◽  
Trauma Care ◽  
Delphi Study ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Injured Patients

Opportunities for improved trauma care of the elderly – A single center analysis of 2090 severely injured patients

2012 ◽  
Vol 55 (3) ◽  
pp. 660-666 ◽  
Author(s):  
Amadéa Schönenberger ◽  
Adrian T. Billeter ◽  
Burkhardt Seifert ◽  
Valentin Neuhaus ◽  
Otmar Trentz ◽  
...  
Keyword(s):  
Trauma Care ◽  
The Elderly ◽  
Severely Injured ◽  
Single Center ◽  
Severely Injured Patients ◽  
Injured Patients

Despite Trauma Center Closures, Trauma System Regionalization Reduces Mortality and Time to Definitive Care in Severely Injured Patients

2017 ◽  
Vol 83 (6) ◽  
pp. 591-597 ◽  
Author(s):  
Jack C. He ◽  
David Schechtman ◽  
Debra L. Allen ◽  
Jillian J. Cremona ◽  
Jeffrey A. Claridge
Keyword(s):  
Median Time ◽  
Injury Severity ◽  
Trauma System ◽  
Relative Reduction ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Trauma Outcomes ◽  
Hospital Systems ◽  
Injured Patients ◽  
Patient Subgroups

The Northern Ohio Trauma System (NOTS), consisting of multiple hospital systems, was established in 2010 to improve trauma outcomes. This study assessed its impact on mortality and time to definitive care, focusing especially on the severely injured patients. NOTS trauma registry was queried for all trauma activations from 2008 to 2013. The years between 2008–2009 and 2011–2013 were designated as pre- and post-NOTS, respectively. Data from 2010 was excluded as a transitional year. Two trauma centers (TCs) closed in 2010. Predetermined patient subgroups were analyzed. A total of 27,843 patients were examined. Mean age was 46 and 64 per cent were male. Median Injury Severity Score (ISS) was five, and 87 per cent sustained blunt injuries. Of these, 10,641 patients were pre-NOTS and 17,202 were post-NOTS. Comparing the two groups, mortality decreased from 5 to 4 per cent post-NOTS (P < 0.001); median time to definitive care increased by 12 minutes post-NOTS. Multivariate logistic regression showed that NOTS implementation was an independent predictor for survival (P = 0.008), whereas time to definitive care was not. Subgroup analyses demonstrated mortality reductions post-NOTS for all subgroups except patients with penetrating injuries, where mortality remained the same despite an increase in ISS. Patients with ISS ≥15 had a 23 per cent relative reduction in mortality, and their median time to definitive care decreased by 12 minutes. Implementation of a collaborative, regional trauma system was associated with mortality reduction and shortened time to definitive care in the severely injured patients. These findings highlight the importance of collaboration in the future development of regional trauma systems.

A Decade Evaluation of a State Trauma System: Has Access to Inpatient Trauma Care at Designated Trauma Centers Improved?

2017 ◽  
Vol 83 (7) ◽  
pp. 769-777 ◽  
Author(s):  
◽  
Dennis W. Ashley ◽  
Etienne E. Pracht ◽  
Regina S. Medeiros ◽  
Elizabeth V. Atkins ◽  
...  
Keyword(s):  
Trauma Care ◽  
Injury Severity ◽  
Trauma System ◽  
Age Groups ◽  
Trauma Centers ◽  
Access To Treatment ◽  
Score Method ◽  
Severity Levels ◽  
Injured Patients ◽  
Discharge Database

Recently, the trauma center component of the Georgia trauma system was evaluated demonstrating a 10 per cent probability of increased survival for severely injured patients treated at designated trauma centers (DTCs) versus nontrauma centers. The purpose of this study was to determine the effectiveness of a state trauma system to provide access to inpatient trauma care at DTCs for its residents. We reviewed 371,786 patients from the state's discharge database and identified 255,657 treated at either a DTC or a nontrauma center between 2003 and 2012. Injury severity was assigned using the International Classification Injury Severity Score method. Injury was categorized as mild, moderate, or severe. Patients were also categorized by age and injury type. Access improved over time in all severity levels, age groups, and injury types. Although elderly had the largest improvement in access, still only 70 per cent were treated at a DTC. During the study period, increases were noted for all age groups, injury severity levels, and types of injury. A closer examination of the injured elderly population is needed to determine the cause of lower utilization by this age group. Overall, the state's trauma system continues to mature by providing patients with increased access to treatment at DTCs.

Sign in / Sign up

Export Citation Format

Share Document