Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister

Abstract To describe the incidence, therapy and outcome of traumatic tracheobronchial injuries (TTBI) in trauma patients with multiple injuries derived from the DGU TraumaRegister. We analyzed the data on all patients listed on the TraumaRegister DGU (TR-DGU) in Germany between 2002 and 2015 aged 16...

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Autores principales:	David Schibilsky, Arne Driessen, William James White, Rolf Lefering, Thomas Paffrath, Bertil Bouillon, Tobias Walker, Christian Schlensak, Manuel Mutschler
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8e1b15006c7f44ed8d60029047fa84fe
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spelling	oai:doaj.org-article:8e1b15006c7f44ed8d60029047fa84fe2021-12-02T15:10:30ZTraumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister10.1038/s41598-020-77613-x2045-2322https://doaj.org/article/8e1b15006c7f44ed8d60029047fa84fe2020-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-77613-xhttps://doaj.org/toc/2045-2322Abstract To describe the incidence, therapy and outcome of traumatic tracheobronchial injuries (TTBI) in trauma patients with multiple injuries derived from the DGU TraumaRegister. We analyzed the data on all patients listed on the TraumaRegister DGU (TR-DGU) in Germany between 2002 and 2015 aged 16 years or older and with an Injury Severity Score (ISS) of ≥ 9. We analyzed the data on 136,389 trauma patients, 561 of whom had suffered tracheobronchial injuries (0.4%). The majority were male (73.4%) and had a mean age of 43.7 years. In total, 84.0% of all TTBI injuries occurred secondary to blunt trauma, caused mainly by accidents (71.2%). TTBI was accompanied by several concomitant thoracic injuries such as pneumo- (41.2%) and hemothorax (23.2%), lacerations (7.8%) and contusions (32.3%) of the lung, as well as multiple rib fractures (29.6%). The severity of injury was classified via the abbreviated injury scale (AIS): 39.3% with AIS = 3, 51.3% with AIS = 4 and 60% with AIS = 5 patients underwent surgical interventions. The mortality of patients with tracheobronchial injuries was higher: 24.6%, versus 13.7% in all patients (control group). This high percentage reflects their generally severe injury burden through concomitant injuries. The incidence of TTBI in this large cohort of trauma patients is very low. However, its high mortality rate emphasizes its importance. Mortality was associated with higher ISS and AIS scores. Higher rates of concomitant injuries were therefore associated with a higher mortality rate. TTBI injuries revealed a higher rate of progression to surgical management, with 35% undergoing surgery within the first 24 h. This excessive mortality rate demonstrates a high overall injury burden in patients with TTBI and high mortality of associated injuries. A surgical intervention’s impact on mortality cannot be assessed in this study, as it would need to be investigated in a case-matched study.David SchibilskyArne DriessenWilliam James WhiteRolf LeferingThomas PaffrathBertil BouillonTobias WalkerChristian SchlensakManuel MutschlerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-7 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David Schibilsky Arne Driessen William James White Rolf Lefering Thomas Paffrath Bertil Bouillon Tobias Walker Christian Schlensak Manuel Mutschler Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister
description	Abstract To describe the incidence, therapy and outcome of traumatic tracheobronchial injuries (TTBI) in trauma patients with multiple injuries derived from the DGU TraumaRegister. We analyzed the data on all patients listed on the TraumaRegister DGU (TR-DGU) in Germany between 2002 and 2015 aged 16 years or older and with an Injury Severity Score (ISS) of ≥ 9. We analyzed the data on 136,389 trauma patients, 561 of whom had suffered tracheobronchial injuries (0.4%). The majority were male (73.4%) and had a mean age of 43.7 years. In total, 84.0% of all TTBI injuries occurred secondary to blunt trauma, caused mainly by accidents (71.2%). TTBI was accompanied by several concomitant thoracic injuries such as pneumo- (41.2%) and hemothorax (23.2%), lacerations (7.8%) and contusions (32.3%) of the lung, as well as multiple rib fractures (29.6%). The severity of injury was classified via the abbreviated injury scale (AIS): 39.3% with AIS = 3, 51.3% with AIS = 4 and 60% with AIS = 5 patients underwent surgical interventions. The mortality of patients with tracheobronchial injuries was higher: 24.6%, versus 13.7% in all patients (control group). This high percentage reflects their generally severe injury burden through concomitant injuries. The incidence of TTBI in this large cohort of trauma patients is very low. However, its high mortality rate emphasizes its importance. Mortality was associated with higher ISS and AIS scores. Higher rates of concomitant injuries were therefore associated with a higher mortality rate. TTBI injuries revealed a higher rate of progression to surgical management, with 35% undergoing surgery within the first 24 h. This excessive mortality rate demonstrates a high overall injury burden in patients with TTBI and high mortality of associated injuries. A surgical intervention’s impact on mortality cannot be assessed in this study, as it would need to be investigated in a case-matched study.
format	article
author	David Schibilsky Arne Driessen William James White Rolf Lefering Thomas Paffrath Bertil Bouillon Tobias Walker Christian Schlensak Manuel Mutschler
author_facet	David Schibilsky Arne Driessen William James White Rolf Lefering Thomas Paffrath Bertil Bouillon Tobias Walker Christian Schlensak Manuel Mutschler
author_sort	David Schibilsky
title	Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister
title_short	Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister
title_full	Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister
title_fullStr	Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister
title_full_unstemmed	Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister
title_sort	traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the dgu traumaregister
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/8e1b15006c7f44ed8d60029047fa84fe
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Traumatic tracheobronchial injuries: incidence and outcome of 136.389 patients derived from the DGU traumaregister

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