Management of Major Trauma Patients at Aarau Trauma Center - Evaluation of Processes and Patient Outcome

Trauma Clinical Trial

Official title:

Quality Control in the Management of Major Trauma Patients at Aarau Cantonal Hospital - Evaluation of Processes and Patient Outcome

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02165137
• Other study ID #: 2012-008
• Secondary ID: 2012-008
• Status: Completed
• Start date: January 2010
• Est. completion date: December 2020

Study information

• Verified date: March 2024
• Source: Kantonsspital Aarau
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational [Patient Registry]

Clinical Trial Summary

Quality control and improvement project: Assessment and analysis of processes and outcome in trauma emergency room and major trauma patients at the Aarau trauma center (cantonal hospital) with regard to initial emergency management, hospital processes and short- and long-term (1-and 2-year) outcome of patients (subjective and objective). Comparison of processes and outcome pre- and post- project initiative. Benchmarking with the literature and by participation in the German and Swiss Trauma registry each.

Description:

Registry of all emergency patients arriving at Aarau trauma center following trauma with regard to possibly injury related pre- and inhospital demographic factors, process variables and outcome Parameters.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 3800
• Est. completion date: December 2020
• Est. primary completion date: December 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• major trauma: New Injury Severity Score (NISS) >=8
• for longer-term outcome: only patients firm in German language and able to respond to the postal questionnaire by themselves

Exclusion Criteria:

• no Trauma
• injury >24h before arrival at Aarau Cantonal Hospital
• NISS<8
• for longer-term outcome: patients not firm in German language and not able to respond to the postal questionnaire by themselves (dead, unavailable, refusal to participate, dementia, age<16 years ecc.); a categorising compilation of cases is supposed to exclude any possible study bias

Related Conditions & MeSH terms

• Injury
• Major Trauma
• Multiple Trauma
• Trauma
• Wounds and Injuries

Locations

Country	Name	City	State
Switzerland	Aarau Cantonal Hospital	Aarau	Aargau

Sponsors (3)

Lead Sponsor	Collaborator
Kantonsspital Aarau	Kantonsspital Aarau, Wissenschaftlicher Fond, Suva

Country where clinical trial is conducted

Switzerland, 

References & Publications (23)

Attenberger C, Amsler F, Gross T. Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients. Injury. 2012 Sep;43(9):1566-74. doi: 10.1016/j.injury.2011.01.002. Epub 2011 Jan 20. — View Citation

Born K, Amsler F, Gross T. Prospective evaluation of the Quality of Life after Brain Injury (QOLIBRI) score: minor differences in patients with major versus no or mild traumatic brain injury at one-year follow up. Health Qual Life Outcomes. 2018 Jul 9;16( — View Citation

Braken P, Amsler F, Gross T. Simple modification of trauma mechanism alarm criteria published for the TraumaNetwork DGU(R) may significantly improve overtriage - a cross sectional study. Scand J Trauma Resusc Emerg Med. 2018 Apr 24;26(1):32. doi: 10.1186/ — View Citation

Bundi M, Meier L, Amsler F, Gross T. [Impact of weather, time of day and season on the admission and outcome of major trauma patients]. Unfallchirurg. 2018 Jan;121(1):10-19. doi: 10.1007/s00113-016-0267-0. German. — View Citation

Fiumedinisi FA, Amsler F, Gross T. Short-term outcome following significant trauma: increasing age per se has only a relatively low impact. Eur J Trauma Emerg Surg. 2021 Dec;47(6):1979-1992. doi: 10.1007/s00068-020-01357-6. Epub 2020 Apr 16. — View Citation

Fueglistaler P, Amsler F, Schuepp M, Fueglistaler-Montali I, Attenberger C, Pargger H, Jacob AL, Gross T. Prognostic value of Sequential Organ Failure Assessment and Simplified Acute Physiology II Score compared with trauma scores in the outcome of multiple-trauma patients. Am J Surg. 2010 Aug;200(2):204-14. doi: 10.1016/j.amjsurg.2009.08.035. Epub 2010 Mar 15. — View Citation

Fuglistaler-Montali I, Attenberger C, Fuglistaler P, Jacob AL, Amsler F, Gross T. In search of benchmarking for mortality following multiple trauma: a Swiss trauma center experience. World J Surg. 2009 Nov;33(11):2477-89. doi: 10.1007/s00268-009-0193-1. — View Citation

Gross T, Amsler F. [Emergency room and major trauma treatment is a "loss-making business" : A Swiss trauma center experience with current DRG reimbursement]. Unfallchirurg. 2021 Sep;124(9):747-754. doi: 10.1007/s00113-020-00937-w. Epub 2020 Dec 18. German — View Citation

Gross T, Amsler F. [Long-term outcome following multiple trauma in working age : A prospective study in a Swiss trauma center]. Unfallchirurg. 2016 Nov;119(11):921-928. doi: 10.1007/s00113-014-2720-2. German. — View Citation

Gross T, Amsler F. Main factors predicting somatic, psychological, and cognitive patient outcomes after significant injury: a pilot study of a simple prognostic tool. BJS Open. 2021 Nov 9;5(6):zrab109. doi: 10.1093/bjsopen/zrab109. — View Citation

Gross T, Amsler F. One-year outcome following brain injury: a comparison of younger versus elderly major trauma patients. Arch Orthop Trauma Surg. 2018 Oct;138(10):1375-1387. doi: 10.1007/s00402-018-2974-1. Epub 2018 Jun 11. — View Citation

Gross T, Amsler F. Prevalence and incidence of longer term pain in survivors of polytrauma. Surgery. 2011 Nov;150(5):985-95. doi: 10.1016/j.surg.2011.04.003. Epub 2011 Jun 15. — View Citation

Gross T, Attenberger C, Huegli RW, Amsler F. Factors associated with reduced longer-term capacity to work in patients after polytrauma: a Swiss trauma center experience. J Am Coll Surg. 2010 Jul;211(1):81-91. doi: 10.1016/j.jamcollsurg.2010.02.042. Epub 2010 May 15. — View Citation

Gross T, Braken P, Amsler F. Trauma center need: the American College of Surgeons' definition in contrast to Swiss highly specialized medicine regulations-a Swiss trauma center perspective. Eur J Trauma Emerg Surg. 2020 Apr;46(2):397-406. doi: 10.1007/s00 — View Citation

Gross T, Morell S, Amsler F. Gender-Specific Improvements in Outcome 1 and 2 Years After Major Trauma. J Surg Res. 2019 Mar;235:459-469. doi: 10.1016/j.jss.2018.10.024. Epub 2018 Nov 21. — View Citation

Gross T, Morell S, Amsler F. Longer-term quality of life following major trauma: age only significantly affects outcome after the age of 80 years. Clin Interv Aging. 2018 Apr 30;13:773-785. doi: 10.2147/CIA.S158344. eCollection 2018. — View Citation

Gross T, Morell S, Amsler F. Medically graded reduced capacity to work (RCW) following significant injury as explained by patient related outcome measures (PROMs): A prospective trauma center evaluation. Disabil Health J. 2021 Oct;14(4):101114. doi: 10.10 — View Citation

Gross T, Morell S, Amsler F. To What Extent Are Main Accident-Insurer Cases Representative of All Significantly Injured? A Swiss Monocenter Perspective. J Insur Med. 2019;48(1):65-78. doi: 10.17849/insm-48-1-1-14.1. Epub 2019 Apr 24. — View Citation

Gross T, Morell S, Scholz SM, Amsler F. The capacity of baseline patient, injury, treatment and outcome data to predict reduced capacity to work and accident insurer costs - a Swiss prospective 4-year longitudinal trauma centre evaluation. Swiss Med Wkly. — View Citation

Gross T, Schuepp M, Attenberger C, Pargger H, Amsler F. Outcome in polytraumatized patients with and without brain injury. Acta Anaesthesiol Scand. 2012 Oct;56(9):1163-74. doi: 10.1111/j.1399-6576.2012.02724.x. Epub 2012 Jun 26. — View Citation

Magyar CTJ, Maeder F, Diepers M, Amsler F, Gross T. Detailed information gain and therapeutic impact of whole body computed tomography supplementary to conventional radiological diagnostics in blunt trauma emergency treatment: a consecutive trauma centre — View Citation

Walkner S, Amsler F, Gross T. [How often is a chest tube needed following thoracic trauma in the severely injured-and when is more needed? : Data from a Swiss trauma center for planning of resources and surgical training]. Chirurg. 2021 Aug;92(8):721-728. — View Citation

Zeindler M, Amsler F, Gross T. Comparative analysis of MGAP, GAP, and RISC2 as predictors of patient outcome and emergency interventional need in emergency room treatment of the injured. Eur J Trauma Emerg Surg. 2021 Dec;47(6):2017-2027. doi: 10.1007/s000 — View Citation

* Note: There are 23 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	invalidity	% of disability to work (i.e., basis for resulting amount of insurance pension)	at least 4 year post-injury
Other	insurance payments	Swiss Francs	at least 4 years post-injury
Primary	emergency room process times		hours (<6)
Secondary	hospital mortality		30 days
Secondary	Euro Quality of Life Group health-related quality of life on five dimensions (EQ-5D)	score	1 and 2 year follow-up
Secondary	Trauma Outcome Profile (TOP)	score	1 and 2 year follow-up
Secondary	Quality of Life after Brain Injury (QOLIBRI)	score	1 and 2 year follow-up
Secondary	medical outcomes study Short Form-36 (SF-36)	score	1 and 2 year follow-up
Secondary	reduced capacity to work	Value (%);e.g. see Gross T, Attenberger C, Huegli RW, Amsler F. Factors associated with reduced longer-term capacity to work in patients after polytrauma: a Swiss trauma center experience. J Am Coll Surg. 2010 Jul;211(1):81-91	1 and 2 year outcome