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Vol. 101. Issue 9.
Pages 609-616 (September 2023)
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Vol. 101. Issue 9.
Pages 609-616 (September 2023)
Original article
Results of the Spanish National Polytrauma Registry. Where are we and where are we heading?
Resultados del Registro Nacional de Politraumatismos español. ¿Dónde estamos y a dónde nos dirigimos?
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Andrea Campos-Serraa,
Corresponding author
acampos@tauli.cat

Corresponding author.
, Lola Pérez-Díazb, Cristina Rey-Valcárcelb, Sandra Montmany-Vioquea, Manuel Artiles-Armasc, Daniel Aparicio-Sánchezd, Luís Tallón-Aguilard, Marta Gutiérrez-Andreue, Julia Bernal-Tirapoe, Francisca Garcia-Moreno Nisaf, Cristina Vera-Mansillaf, Ricardo González-Condeg, Leticia Gómez-Vianah, Alberto Titos-Garcíah, Jose Aranda-Narvaezh, RNP Collaboration Group
a Departamento de Cirugía General, Hospital Universitario Parc Taulí, Sabadell, Barcelona, Spain
b Departamento de Cirugía General, Hospital General Universitario Gregorio Marañón, Madrid, Spain
c Departamento de Cirugía General, Hospital de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
d Departamento de Cirugía General, Hospital Universitario Virgen del Rocío, Sevilla, Spain
e Departamento de Cirugía General, Hospital Universitario 12 de Octubre, Madrid, Spain
f Departamento de Cirugía General, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
g Departamento de Cirugía General, Complejo Hospitalario Universitario de Ourense, Ourense, Spain
h Departamento de Cirugía General, Hospital Regional Universitario de Málaga, Málaga, Spain
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Tables (4)
Table 1. Demographic data.
Table 2. Injuries according to affected area (n = 4521).
Table 3. Most frequent lesions.
Table 4. Treatments performed.
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Additional material (3)
Abstract
Introduction

In 2017, the Spanish National Polytrauma Registry (SNPR) was initiated in Spain with the goal to improve the quality of severe trauma management and evaluate the use of resources and treatment strategies. The objective of this study is to present the data obtained with the SNPR since its inception.

Methods

We conducted an observational study with prospective data collection from the SNPR. The trauma patients included were over 14 years of age, with ISS ≥ 15 or penetrating mechanism of injury, from a total of 17 tertiary hospitals in Spain.

Results

From 1/1/17 to 1/1/22, 2069 trauma patients were registered. The majority were men (76.4%), with a mean age of 45 years, mean ISS 22.8, and mortality 10.2%. The most common mechanism of injury was blunt trauma (80%), the most frequent being motorcycle accident (23%). Penetrating trauma was presented in 12% of patients, stab wounds being the most common (84%).

On hospital arrival, 16% of patients were hemodynamically unstable. The massive transfusion protocol was activated in 14% of patients, and 53% underwent surgery. Median hospital stay was 11 days, while 73.4% of patients required intensive care unit (ICU) admission, with a median ICU stay of 5 days.

Conclusions

Trauma patients registered in the SNPR are predominantly middle-aged males who experience blunt trauma with a high incidence of thoracic injuries. Early addressed detection and treatment of these kind of injuries would probably improve the quality of trauma care in our environment.

Keywords:
Trauma
Prospective registry
National results
Mortality
Resumen
Introducción

En 2017 se emprendió el Registro Nacional de Politraumatismos (RNP) a nivel estatal español, cuya finalidad residía en mejorar la calidad de la atención al paciente politraumatizado grave y evaluar el uso de recursos y estrategias de tratamiento. El objetivo de este trabajo es presentar los datos recogidos en el RNP hasta la actualidad.

Métodos

Estudio observacional retrospectivo a partir de los datos recogidos prospectivamente en el RNP. Se incluyen pacientes mayores de 14 años, con ISS ≥ 15 o mecanismo de trauma penetrante, atendidos en 17 hospitales de tercer nivel de España.

Resultados

Del 1/1/17 al 1/1/22 se han registrado un total de 2069 pacientes politraumatizados. El 76.4% son hombres; edad media: 45 años; ISS medio: 22.8 y mortalidad: 10.2%. El mecanismo de lesión más frecuente es el cerrado (80%) con mayor incidencia de accidentes de moto (23%). Un 12% de los pacientes sufren un traumatismo penetrante, por arma blanca en el 84%.

Un 16% de los pacientes ingresa hemodinámicamente inestable en el hospital. Activando el protocolo de transfusión masiva en el 14% de los pacientes e interviniendo quirúrgicamente a un 53%. La estancia hospitalaria mediana es de 11 días. Precisando ingreso en UCI un 73.4% (estancia mediana 5 días).

Conclusiones

Los pacientes politraumatizados registrados en el RNP son mayoritariamente varones de mediana edad, que sufren traumatismos cerrados y presentan una elevada incidencia de lesiones torácicas. La detección y tratamiento dirigido de este tipo de lesiones probablemente permitirá mejorar la calidad asistencial del politraumatizado en nuestro medio.

Palabras clave:
Politraumatismo
Registro prospectivo
Resultados nacionales
Mortalidad

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