MORTALITY ANALYSIS IN BLUNT COMBINED TRAUMA AND POLYTRAUMA

Abstract

Introduction. Modern traumatism from the standpoint of clinical epidemiology meets the classification criteria of a global pandemic. Important factors triggering the global clinical and epidemiological picture are the unsatisfactory state of prevention of all types of injuries in developing countries, traffic injuries in industrialized countries and the progressively increasing number of armed conflicts. The aim of the study. To conduct a comparative clinical and epidemiological analysis of mortality in blunt combined trauma and polytrauma. Materials and methods. A retrospective single-center cohort 10-year clinical and epidemiological study of 933 fatal clinical cases of blunt combined trauma on the basis of polytrauma department of the Kyiv City Clinical Emergency Hospital has been conducted. Clinical diagnoses and forensic medical conclusions were transformed into Hannover Polytrauma Score scale codes. The clinical and epidemiological experiment was based on the clustering of the research array according to the severity of the injury. Results. As a result of the clinical and epidemiological experiment, 5 stable clusters which can be characterized as separate randomized clinical-epidemiological groups were obtained. Clinical profile was determined by the dominant injury: cluster-1 (patients with an extremely severe thoracic profile), cluster-2 (patients with a severe thoracic profile), cluster-3 (patients with an extremely severe abdominal profile), cluster-4 (patients with a severe neurosurgical profile), cluster-5 (patients with an extremely severe neurosurgical profile). Conclusions. Lethal blunt combined injury has a clear hierarchical structure based on the severity of the injury and the presence of dominant damage to the corresponding anatomical and functional area. The results obtained during the current study indicate the need to find new technological approaches to the treatment of extremely severe injuries, as well as treatment and prevention of the development of complications of severe injuries in order to reduce mortality in polytrauma.