Introduction: The management of trauma patients differs depending upon the healthcare system available. Aim: To compare the pre-hospital management and outcome of polytrauma patients between two countries with differing approaches to pre-hospital management. Materials and Methods: The Scottish trauma and audit group (STAG) and the German trauma registry (GTR) databases were used to compare the management and outcome of trauma patients in Scotland and Germany. Severely injured patients (injury severity score (ISS) > 16) were analyzed for a 3 year period (2000 to 2002). Patient demographics, pre-hospital interventions, ISS, revised trauma score (RTS), time from scene of injury to arrival to the emergency department (ED), 120 day mortality and standardized mortality ratios using TRISS methodology were compared. Results: There were 227 patients identified from the STAG registry and 6878 patients from the GTR registry. There was a significant difference in ISS (24.9 vs. 29.8, P = 0.001, respectively). No significant difference was observed for the RTS (P = 0.2). There was a significantly higher rate of pre-hospital interventions in the German group (P < 0.001). The mean time from an injury to arrival to the ED (73 vs. 247 minutes, P = 0.001) was longer for the Scottish patients. There was no difference for an unadjusted mortality rate between the groups, but the standardized mortality ratio was significantly greater for the Scottish population (3.8 vs. 2.2, P = 0.036). Conclusion: Despite variation in pre-hospital transfer times and interventions, no significant difference was demonstrated in RTS upon arrival, or for the unadjusted mortality rates.
Available from: https://www.tarn.ac.uk/Login.aspx. [Last cited on 2011 Mar 8].
Documentation of blunt trauma in Europe. Eur J Trauma 2000;26:233-47.
The German trauma system: infrastructure and organization. Trauma Quarterly 1999;14:227-31.
Available from: http://www.stag.scot.nhs.uk/. [Last cited on 2011 Mar 8].
Trauma care in Germany. Injury 2003;34:674-83.
Guidelines in Multiple Injured Patients: The Approach of the German Trauma Registry. Euroacademia Multidisciplinaria Neurotraumatologica. Available from: http://www.emn-neurotrauma.de/publications/1999_congress4_tenerife/119emn99.pdf. [Last cited 2011 Mar 8].
Calculation of different triage scores based on the German Trauma Registry. Eur J Trauma 2005:31:480-7.
Official online gateway to Scotland. Available from: http://www.scotland.org/about/fact-file/population/. [Last cited on 2011 Mar 8].
Bevölkerung nach dem Gebietsstand. Available from: http://www.destatis.de/jetspeed/portal/cms/......., templateId=renderPrint.psml. [Last cited on 2011 Mar 8].
Scottish urban versus rural trauma outcome study. J Trauma 2005;59:632-8.
TRISS methodology: an inappropriate tool for comparing outcomes between trauma centers. J Am Coll Surg 2001;193:250-4.
Impact of helicopter transport and hospital level on mortality of polytrauma patients. J Trauma 2004;56:94-8.
Available from: http://www.scottishambulanceservice.co.uk/. [Last cited on 2011 Mar 8].
Available from: http://www.agn.at/html1.php?hid=213. [Last cited on 2011 Mar 8].
The importance of access-to-patient-period in the emergency service. Anasthesiol Intensivmed Notfallmed Schmerzther 2001;36:742-8.
Available from: http://www.forplan.de/tl_files/downloads/Hilfsfrist%20Bundeslaender.pdf. [Last cited on 2011 Mar 8].
Prehospital trauma management: a national study of paramedic activities. Emerg Med J 2005;22:60-63.
Securing the prehospital airway: a comparison of laryngeal mask insertion and endotracheal intubation by UK paramedics. Emerg Med J 2005;22:64-7.
Prehospital advanced life support vs “scoop and run” in trauma management. Ann Emerg Med 1987;16:797-801.
The impact of injury severity and prehospital procedures on scene time in victims of major trauma. Ann Emerg Med 1991;20:1299-305.
Prehospital stabilization of critically injured patients: a failed concept. J Trauma 1985;25:65-70.
Panel: prehospital trauma care–stabilize or scoop and run. J Trauma 1983;23:708-11.
Is ALS Necessary for pre-hospital trauma care? J Trauma 1984;24:86-7.
Ineffective therapy and delayed transport. Prehosp Disaster Med 1989:4:129-30.
The effect of pre-existing medical conditions and age on mortality after injury. J Trauma 2006;61:1255-60.
Trauma scoring systems: a review. J Am Coll Surg 1999:189:491-503.