Survey on structural preparedness for treatment of thoracic and abdominal trauma in German-speaking level 1 trauma centers.

INTRODUCTION

Increasing sub-specialization has reduced the number of general surgeons involved in the care of trauma patients in German-speaking countries (Germany, Austria and Switzerland) over the past decades. Thus, the aim of this study was to assess, to what extent level 1 trauma centers are still prepared to provide immediate emergency surgery in patients with thoracic or abdominal trauma.

METHODS

Web-based and paper questionnaires were sent to all level 1 trauma centers participating in the TraumaRegister DGU® (TR-DGU) in Germany, Austria, and Switzerland from Feb 2017 to Sep 2017. The centers were asked about the presence or availability of surgeons who were able to perform an emergency laparotomy or thoracotomy.

RESULTS

Of all 117 level 1 trauma centers participating in the TR-DGU in Germany, Austria, and Switzerland, 97 (83%) gave a response. A board-certified surgeon who is able to perform an emergency laparotomy is present 24 h/7 days a week in 72% of the centers (emergency thoracotomy: 57%). In centers where no such surgeon was present the whole time, the mean maximum time of arrival of the surgeon on call was 18.9 min (SD 7.0, range 10-40 min) regarding the ability to perform an emergency laparotomy and 19.9 min (SD 7.0, range 10-40 min) regarding the emergency thoracotomy.

CONCLUSION

The majority of level 1 trauma centers in Germany, Switzerland, and Austria in the TR-DGU seem to be well prepared to treat severe injuries of the abdominal and thoracic cavities. In some centers, however, a surgeon able to perform an emergency laparotomy or thoracotomy is not available within 30 min.