[Clinical management of polytraumatized patients in the emegergency room--duty and assignment of the trauma surgeon]. / Klinisches Polytrauma-Management im Schockraum--Was muss und kann der Unfallchirurg leisten?

After stabilization an optimal therapeutic strategy influences outcome in polytraumatized patients. A trauma team leader in early clinical course is necessary to optimize diagnostics and planning of further treatment. Special training systems like ATLS can help to standardize management of trauma patients. In most German trauma centers an orthopaedic trauma surgeon is the team leader in the emergency room during early clinical course of patients with multiple injuries. After identification of most threatening injuries he must decide next diagnostics steps and planning of further treatment within a short period of time. Especially in patients with abdominal bleeding and severe brain injury time is the most critical factor. If he is not able to treat these injuries alone, physicians from other specialties must be involved. The trauma team leader must be aware of different treatment concepts like early total care and damage control orthopaedics.

[Validation of the Hannover Score for Polytrauma Outcome (HASPOC) in a sample of 170 polytrauma patients and a comparison with the 12-Item Short-Form Health Survey]. / Hannover Score for Polytrauma Outcome (HASPOC). Validierung am Beispiel von 170 Polytrauma-Patienten und Vergleich mit dem SF-12.

Improved survival rates of patients with multiple injuries have increased general interest in the quality of rehabilitation status after polytrauma. Due to the complex nature of multiple injuries, a special score is needed to evaluate the outcome after polytrauma. The aim of this study was to validate the Hannover Score for Polytrauma Outcome (HASPOC). One hundred seventy patients who had sustained multiple injuries were re-examined using the HASPOC 2 years after trauma. Results were correlated with the 12-Item Short Form Health Survey (SF-12), a validated and established scoring system. The HASPOC was also correlated with clinical parameters predictive of poor outcome. Two control groups consisting of either patients after single injuries or healthy controls were also evaluated using the HASPOC. In the group of patients after multiple injuries, the HASPOC correlated with the SF-12 in injury severity and polytrauma scores, intubation period, hospital stay, and occurrence of injuries below the knee. Differences between healthy controls,patients after single injuries, and patients after multiple injuries were statistically significant when evaluated with the HASPOC. This statistical significance was not achieved using the SF-12. The HASPOC is a valid scoring system and useful for evaluating the rehabilitation status after polytrauma.