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Outcomes in polytrauma: comparison between the results achieved in the Cesena Trauma Centre and in the Regional Registry of a (RRGT) of Emilia Romagna, Italy.

AIM
The aim of this retrospective study is to compare the outcomes achieved in the Trauma Centre of Cesena to those of the Regional Registry of Major Trauma (RRGT) of Emilia-Romagna, where a coordinated trauma care network has been implemented since 2001, based on the hub & spoke model.


MATERIAL OF STUDY
A group of 747 patients were compared to 3.803 cases of the RRGT. The most serious patients, who arrived to the emergency room with a red or yellow emergency code, were sorted into 3 groups according to their haemodynamic response after the primary survey. Each group of patients was treated following a determined diagnostic and therapeutic protocol. Outcome indicators as well as diagnostic and therapeutic resources were examined.


RESULTS
Mortality at discharge from Intensive Care was 10.6%. A drop of 2.2% mortality in ICU was recorded as well as reductions in the ICU average stay (13.6%) and in the use of CT (3.9%). On the other hand, surgeries increased by 17% in the Trauma Centre of Cesena as well as the use of angiographies (3.8%) compared to the RRGT regional register.


DISCUSSION
The most important data is a sensible reduction in mortality among the group of patients who were hospitalized in ICU. These results can be compared to those which have recently been published by Scalea [1] concerning a retrospective analysis studying a 12-year period.


CONCLUSIONS
A significant improvement of some indicators, with respect to the RRGT, was registered within the last three years among the group of the analyzed major traumas. It is therefore arguable that these protocols may represent a viable and clear reference point for all trauma care providers.