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Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade

Trauma injury is the sixth leading cause of death worldwide, and interpersonal violence is one of the major contributors in particular regarding injuries to the head and neck. The incidence, demographics, and outcomes of penetrating trauma reaching hospitals in Sweden are not known. We report the la...

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Autores principales: Günther, Mattias, Dahlberg, Martin, Rostami, Amir, Azadali, Ali, Arborelius, Ulf P., Linder, Fredrik, Rostami, Elham
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634665/
https://www.ncbi.nlm.nih.gov/pubmed/34867718
http://dx.doi.org/10.3389/fneur.2021.730405
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author Günther, Mattias
Dahlberg, Martin
Rostami, Amir
Azadali, Ali
Arborelius, Ulf P.
Linder, Fredrik
Rostami, Elham
author_facet Günther, Mattias
Dahlberg, Martin
Rostami, Amir
Azadali, Ali
Arborelius, Ulf P.
Linder, Fredrik
Rostami, Elham
author_sort Günther, Mattias
collection PubMed
description Trauma injury is the sixth leading cause of death worldwide, and interpersonal violence is one of the major contributors in particular regarding injuries to the head and neck. The incidence, demographics, and outcomes of penetrating trauma reaching hospitals in Sweden are not known. We report the largest, nationwide epidemiological study of penetrating injuries in Sweden, using the Swedish Trauma Registry (SweTrau). A multi-center retrospective descriptive study of 4,776 patients was conducted with penetrating injuries in Sweden, between 2012 and 2018. Due to the increase in coverage of the SweTrau registry during the same period, we chose to analyze the average number of cases for the time intervals 2013–2015 and 2016–2018 and compare those trends to the reports of the Swedish National Council for Crime Prevention (Brå) as well. A total of 663 patients had Injury Severity Score (ISS) ≥ 15 at admission and were included in the study. Three hundred and sixty-eight (55.5%) were stab wounds (SW), 245 (37.0%) gunshot wounds (GSW), and 50 (7.5%) other traumas. A majority of the cases involved injuries to the head, neck, and face. SW increased from 145 during 2013–2015 to 184 during the second period of 2016–2018. The increase was greater for GSW from 92 to 141 during the same respective periods. This trend of increase over time was also seen in head, neck, and face injuries. The 30-day mortality was unaffected (48–47%) in GSW and trended toward lower in SW (24–21%) when comparing 2013–2015 with 2016–2018. Patients with head trauma had 45% mortality compared to 18% for non-head trauma patients. Head trauma also resulted in worse outcomes, only 13% had Glasgow outcome score (GOS) 5 compared to 27% in non-head trauma. The increasing number of cases of both SW and GSW corresponded well with reports from Brå although further studies also are needed to address deaths outside of hospitals and not registered at the SweTrau. The majority of cases had injuries to the head, neck, and face and were associated with higher mortality and poor outcomes. Further studies are needed to understand the contributing factors to these worse outcomes in Sweden and whether more targeted trauma care of these patients can improve outcomes.
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spelling pubmed-86346652021-12-02 Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade Günther, Mattias Dahlberg, Martin Rostami, Amir Azadali, Ali Arborelius, Ulf P. Linder, Fredrik Rostami, Elham Front Neurol Neurology Trauma injury is the sixth leading cause of death worldwide, and interpersonal violence is one of the major contributors in particular regarding injuries to the head and neck. The incidence, demographics, and outcomes of penetrating trauma reaching hospitals in Sweden are not known. We report the largest, nationwide epidemiological study of penetrating injuries in Sweden, using the Swedish Trauma Registry (SweTrau). A multi-center retrospective descriptive study of 4,776 patients was conducted with penetrating injuries in Sweden, between 2012 and 2018. Due to the increase in coverage of the SweTrau registry during the same period, we chose to analyze the average number of cases for the time intervals 2013–2015 and 2016–2018 and compare those trends to the reports of the Swedish National Council for Crime Prevention (Brå) as well. A total of 663 patients had Injury Severity Score (ISS) ≥ 15 at admission and were included in the study. Three hundred and sixty-eight (55.5%) were stab wounds (SW), 245 (37.0%) gunshot wounds (GSW), and 50 (7.5%) other traumas. A majority of the cases involved injuries to the head, neck, and face. SW increased from 145 during 2013–2015 to 184 during the second period of 2016–2018. The increase was greater for GSW from 92 to 141 during the same respective periods. This trend of increase over time was also seen in head, neck, and face injuries. The 30-day mortality was unaffected (48–47%) in GSW and trended toward lower in SW (24–21%) when comparing 2013–2015 with 2016–2018. Patients with head trauma had 45% mortality compared to 18% for non-head trauma patients. Head trauma also resulted in worse outcomes, only 13% had Glasgow outcome score (GOS) 5 compared to 27% in non-head trauma. The increasing number of cases of both SW and GSW corresponded well with reports from Brå although further studies also are needed to address deaths outside of hospitals and not registered at the SweTrau. The majority of cases had injuries to the head, neck, and face and were associated with higher mortality and poor outcomes. Further studies are needed to understand the contributing factors to these worse outcomes in Sweden and whether more targeted trauma care of these patients can improve outcomes. Frontiers Media S.A. 2021-11-15 /pmc/articles/PMC8634665/ /pubmed/34867718 http://dx.doi.org/10.3389/fneur.2021.730405 Text en Copyright © 2021 Günther, Dahlberg, Rostami, Azadali, Arborelius, Linder and Rostami. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Günther, Mattias
Dahlberg, Martin
Rostami, Amir
Azadali, Ali
Arborelius, Ulf P.
Linder, Fredrik
Rostami, Elham
Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade
title Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade
title_full Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade
title_fullStr Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade
title_full_unstemmed Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade
title_short Incidence, Demographics, and Outcomes of Penetrating Trauma in Sweden During the Past Decade
title_sort incidence, demographics, and outcomes of penetrating trauma in sweden during the past decade
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8634665/
https://www.ncbi.nlm.nih.gov/pubmed/34867718
http://dx.doi.org/10.3389/fneur.2021.730405
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