Abstract
Background. Severe trauma (ST) is a great burden to healthcare systems worldwide. The most severely injured patients in Estonia are admitted to one of the two Level I trauma centres (North Estonia
Medical Centre in cooperation with Tallinn’s Children Hospital – NEMC+TCH or Tartu University Hospital – TUH). Data about all ST patients is inserted into the Estonian trauma repository (ETR). The current study was initiated to investigate the demographics and outcomes of severely injured patients admitted to the Estonian trauma centers.
Methods. All ST patients admitted to the NEMC+TCH or TUH between 1/1/2021 and 31/12/2022 were enrolled using the ETR. Data for analysis included demographics, injury profile, mechanism of injury and outcomes. Primary outcomes were in-hospital mortality and hospital length of stay (HLOS).
Results. Overall, during the two-year study period 284 patients with ST were admitted with 190 and 94 cases to the NEMC+TCH and TUH, respectively. Mean age was 46.3 ±19.7 years and 80.6% were male. Compared to TUH, more injuries occurred in streets/ settlement areas (42.6% vs 21.3%, p<0.001) and ground level falls were more frequent (16.8% vs 6.4%, p = 0.015) in the NEMC+TCH catchment area. Injuries on the highways (29.8% vs 14.7%, p = 0.003) and motor vehicle accidents (29.8% vs 12.1%, p < 0.001) were more frequent in the TUH than in theNEMC+TCH catchment area. Mean HLOS was 12.0 ± 11.1 days. In-hospital mortality was 20.4%. Primary outcomes were similar between the trauma centres.
Conclusions. The overall number of ST cases has declined during the last seven-eightyear period. Outcomes at the Estonian trauma centres were similar. We believe that the regional differences in the Estonian ST profile are the result of geographic, economic, and epidemiological variances.