Browsing by Author "Tammelin, Eeva"

Background and Aims Injuries are often missed during the primary and secondary survey in trauma patients. Studies have suggested that a formal tertiary survey protocol lowers the number of missed injuries. Our aim was to determine the number, severity and consequences of injuries missed by a non-formalised trauma tertiary survey (TTS), but detected prior to hospital discharge in trauma patients admitted to a trauma intensive care unit (TICU). Material and Methods We conducted a cohort study of trauma patients admitted to a TICU between 1st January and 17th October 2013. We reviewed the electronic medical records of patients admitted to the in order to register any missed injuries, their delay and possible consequences. We classified injuries into three types: Type 0, injury detected prior to TTS, Type 1, injury detected by TTS, and Type 2, injury missed by TTS but detected prior to discharge. Results During the study period, we identified a total of 838 injuries in 115 patients. Of these injuries, 94% were Type 0 injuries, 3.9% were Type 1 injuries and 2.5% were Type 2 injuries. Even though most of the missed injuries in TTS (Type 2) were fractures (52%), only two of the 21 Type 2 injuries required surgical intervention. Type 2 injuries presumably did not cause extended length of stay (LOS) in the ICU or in hospital and/ or morbidity. Conclusions In conclusion, the missed injury rate in trauma patients admitted to TICU after TTS was very low in our system without formal TTS-protocol. These missed injuries did not lead to prolonged hospital or TICU stay, and did not contribute to mortality. Most of the missed injuries received non-surgical treatment.