THE SEVERE POLYTRAUMA WITH AN ISS ≥ 50

Abstract

In Germany 427.500 persons per year were injured in traffic accidents. Because of faster cars the number of seriously injured persons increased.

In a retrospective study we analysed the outcome and the posttraumatic quality of life (POLO Chart) of patients suffering from a severe trauma (ISS ≥ 50).

Highlight of interest were:

• pattern of injury

• injured part of the body

• days in ICU/days of external ventilation

• outcome

• actual state of health

• mental health

• changes in the social environment

Between 1/2000 and 12/2005 1435 patients with multiple trauma were hospitalized in our Trauma Center, 88 (6,5%) suffered from a severe trauma with ISS ≥ 50. A total of 29 patients answered the POLO Chart.

The most important pattern of injury were caused by traffic accidents (62%),

Thoracic injury was the most common injury (94%) with an average AIS of 4,1.

The patients with an ISS ≥ 50 spent significant more days in ICU and had significant more days of external ventilation than polytraumatized patients with an ISS < 50.

23% of the patients had a good outcome, 15% were severe physically handicapped and 36% died.

Actually, more than half of the patients were more or less physically handicapped. 62% suffered from pain.

41% showed characteristics typically for a posttraumatic stress disorder.

Only 15% were able to go back to work - on average two years after trauma.

In conclusion the patients with severe trauma had a good survival rate, but they showed a poor posttraumatic quality of life, predominantly because of pain and mental ill like posttraumatic stress disorder. So in the time after trauma it is important to treat the whole patient and not only the physical lesions.