Impact of the implementation of a trauma system on compliance with evidence-based clinical management guidelines in penetrating thoracic trauma

Purpose Since 2014, a trauma system (TS) for the Provence-Alpes-Cote-d’Azur (PACA) region has been set up with protocols based on the European guidelines for the management of bleeding trauma patients. The present study aims to assess compliance with protocols in penetrating thoracic trauma on admis...

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Bibliographic Details
Published in:European journal of trauma and emergency surgery (Munich : 2007) 2023-02, Vol.49 (1), p.351-360
Main Authors: Vasse, Matthieu, Leone, Marc, Boyer, Laurent, Michelet, Pierre, Goudard, Yvain, Cardinale, Michael, Paris, Raphael, Avaro, Jean Philippe, Thomas, Pascal Alexandre, de Lesquen, Henri
Format: Article
Language:English
Subjects:
Critical Care Medicine
Emergency medical care
Emergency Medicine
Guideline Adherence
Hemorrhage
Humans
Intensive
Medicine
Medicine & Public Health
Morbidity
Mortality
Original Article
Patient compliance
Retrospective Studies
Sports Medicine
Surgery
Surgical Orthopedics
Thoracic Injuries - therapy
Trauma
Trauma Centers
Traumatic Surgery
Wounds, Penetrating - therapy
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Summary:Purpose Since 2014, a trauma system (TS) for the Provence-Alpes-Cote-d’Azur (PACA) region has been set up with protocols based on the European guidelines for the management of bleeding trauma patients. The present study aims to assess compliance with protocols in penetrating thoracic trauma on admission to a level I trauma centre and to determine whether compliance impacts morbidity and mortality. Methods This multicentric pre–post study included all penetrating thoracic trauma patients referred to Marseille area level I centres between January 2009 and December 2019. On the basis of the European guidelines, eight objectively measurable recommendations concerning the in-hospital trauma care for the first 24 h were analysed. Per-patient and per-criterion compliance rates and their impact on morbidity and mortality were evaluated before and after TS implementation. Results A total of 426 patients were included. No differences between the two groups (before and after 2014) were reported for demographics or injury severity. The median (interquartile range) per-patient compliance rate increased from 67% [0.50; 0.75] to 75% [0.67; 1.0] ( p  
ISSN:1863-9933
1863-9941
DOI:10.1007/s00068-022-02071-1