RESEARCH – May 2021

Trauma team activations at the Estonian largest trauma centre: 1029 cases analysed

Authors: Sten Saar, Edgar Lipping, Henrik Vospert, Raul Volmer, Hanna Kadri Laas, Jaak Lepp, Mari-Liis Ilmoja, Indrek Rätsep, Peep Talving

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Background. The North Estonia Medical Centre (NEMC) is the largest trauma centre in Estonia with evolving capabilities. However, studies scrutinizing trauma team activations (TTA) are currently lacking. Thus, we initiated an investigation to document the TTA profile and outcomes.

Methods. All TTA patients admitted to the NEMC between 1/2016 and 12/2018 were retrospectively identified. The collected data included demographics, injury severity score (ISS), management, hospital length of stay (HLOS), and in-hospital outcomes. Primary outcome was 30-day mortality.

Results. Overall, 1029 patients were included. Mean age was 39. 3 ± 20.4 years and 74.2% were male. Penetrating and blunt trauma accounted for 11.5% and 88.5% of the cases, respectively. Non-ground level falls were the predominant mechanism of injury constituting 32.1% of the admissions. Mean ISS was 10.3 ± 11.5 and 24.7% of the patients were severely injured (ISS >15). Blood alcohol level (BAL) was positive at 31.1%. A total of 21.1% of the patients had an emergency operation. Mean HLOS was 8.0 ± 15.2 days. Overall 30-day mortality was 5.1%. Predicted mortality per TRISS was 7.0%.

Conclusions. The current investigation documents a similar demographic profile and comparable outcomes with Scandinavian trauma facilities. The NEMC trauma system functions better than predicted per TRISS.