The usefulness of a Trauma Registry and the role of the general surgeon in the multidisciplinary approach to trauma patients

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COD: 001-10 Categorie: ,

Gianluca Costa, Francesco Stella, Luigi Venturini, Simone Maria Tierno, Federico Tomassini, Pietro Fransvea, Barbara Frezza, Tommaso Bocchetti, Salvatore Di Somma, Genoveffa Balducci

Ann. Ital. Chir., 2013 84: 1-9

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The purpose of this study is to verify the usefulness of a multidisciplinary Trauma Registry in the evaluation of trauma,
particularly in relation to the number of specialists involved, and to analyze the effective role of the general trauma
surgeon in an integrated trauma care system. The present study was performed by analyzing data from the Trauma
Registry of the University Hospital Sant’Andrea in Rome, which was set up in March 2006. Data recorded between
March 2006 and March 2009 was considered for the present study. The severity of trauma was categorized by dividing
patients into 4 subgroups based on the value of ISS: minor injuries (ISS 1-8), moderate (ISS 9-15), severe (ISS
16-24) and very severe (ISS> 24). Patients who had an ISS greater than 9 were taken into account for further analysis
and comparison. To evaluate the significance of the multidisciplinarity the patients were stratified in subgroups considering
the number of specialists involved in relation to the anatomic location of injuries. In the 1386 trauma patients
entered in the registry, the mean and median ISS value were 10.7±8.4 and 9 respectively. The overall mortality and
morbidity were 4.1% and 7.4% respectively. There was a statistically significant linear relationship between the number
of specialists involved and the ISS (multidisciplinarity / ISS r = 0.493, p <0.001). Patients with ISS greater than 9 were 358, 25.8% of all cases. The mean ISS was 21.4±10.3. Mortality and morbidity rates were 9.8% (35 patients) and 22.1% (79 patients) respectively. The average number of specialists involved was 2.4 ± 1.1, median 2 (range 1- 6). Results confirmed the significance of the multidisciplinary treatment for patients with trauma and the central role played by the general surgeon.

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