Abstract
BackgroundPurpose of the presented study is to answer the following questions: Are knee injuries associated with trauma mechanisms or concomitant injuries? Do injuries of the knee region aggravate treatment costs or prolong hospital stay in polytraumatized patients?MethodsA retrospective analysis including 29.779 severely injured patients (Injury Severity Score [greater than or equal to] 16) from the Trauma Registry of the German Society for Trauma Surgery database (1993-2008) was conducted. Patients were subdivided into two groups; the "Knee" group (n=3.458, 11.6% of all patients) including all multiple trauma patients with knee injuries, and the "Non Knee" group (n=26.321) including the remaining patients. Patients with knee injuries were slightly younger, less often male gender and had a significantly increased ISS.ResultsPatients in the Knee group suffered significantly more traffic accidents compared to the Non Knee group (82% vs. 52%, p<0.001). These injuries were more often caused by car or motorbike accidents. Severe thoracic and limb injuries (AIS[greater than or equal to]3) were more frequently found in the Knee group (p<0.001) while head injury was distributed equally. The overall hospital stay, ICU stay, and treatment costs were significantly higher for the Knee group (38.1 vs. 25.5 days, 15.2 vs. 11.4 days, 40,116 vs. 25,336 Euro, respectively; all p<0.001).ConclusionsTraffic accidents are associated with an increased incidence of knee injuries than falls or attempted suicides. Furthermore, severe injuries of the limbs and chest are more common in polytraumatized patients with knee injuries. At last, treatment of these patients is prolonged and consequently more expensive.
Highlights
Purpose of the presented study is to answer the following questions: Are knee injuries associated with trauma mechanisms or concomitant injuries? Do injuries of the knee region aggravate treatment costs or prolong hospital stay in polytraumatized patients?
Despite the obvious relevance of lower limb injuries, they are commonly underestimated during the acute care setting while life threatening injuries or their complications such as sepsis or acute distress syndrome (ARDS) are treated [8]
Injuries are coded according to the Abbreviated Injury Scale (AIS) following its 2005 revised version
Summary
Purpose of the presented study is to answer the following questions: Are knee injuries associated with trauma mechanisms or concomitant injuries? Do injuries of the knee region aggravate treatment costs or prolong hospital stay in polytraumatized patients?. Lower limb injuries and especially below knee injuries may not be life threatening apriori, they could cause significant functional disabilities with long lasting physical and psychosocial consequences [3,4,5]. The increased risk of long-term sequels due to the complexity of knee injuries leads to relatively high financial costs [4,6]. To the best of our knowledge there are currently no studies designed to identify correlations between knee injuries and trauma mechanisms or concomitant injuries in patients suffering multiple trauma. This knowledge would lead physicians to focused search for knee injuries in high risk patients and may influence the early initiation of treatment
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