Aktas Gökmen, Rolfes Larissa, Koblenzer Maximilian, Brauckmann Vesta, Mayor Jorge, Clausen Jan, Ajouri Jonas, Omar Pacha Tarek, Sehmisch Stephan, Mommsen Philipp
Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg St. 1, 30625 Hannover, Germany.
Department of Anaesthesiology and Critical Care, Campus Kassel of the Philipps University Marburg, Möncheberg St. 41-43, 34125 Kassel, Germany.
Life (Basel). 2025 Sep 6;15(9):1407. doi: 10.3390/life15091407.
The specialty background of intensive physicians managing severely injured patients varies internationally, with trauma ICUs often led by either trauma surgeons or anesthesiologists, both of whom receive additional intensive care training. Whether physician specialty affects outcomes remains uncertain. We conducted a retrospective single-center cohort study of patients aged ≥ 16 years with an Injury Severity Score (ISS) ≥ 16 admitted to a level I trauma center between January 2005 and December 2022. Patients were treated either in a trauma surgery ICU (T-ICU) or an anesthesiology ICU (A-ICU). Briefly, 1:1 matching was conducted based on demographic and injury-related variables, with the primary outcome being in-hospital mortality and secondary outcomes including transfusion requirements, duration of mechanical ventilation, ICU and hospital length of stay, and Glasgow Outcome Scale (GOS) at discharge. Among the 1015 eligible patients (T-ICU: n = 920; A-ICU: n = 95), 52 patients (26 per group) were successfully matched with comparable baseline characteristics. No significant differences were observed in mortality, GOS, transfusion requirements, ventilation duration, or ICU/hospital length of stay. These findings suggest that, when both are led by certified intensive care specialists, trauma surgery- and anesthesiology-based ICUs achieve comparable outcomes, supporting multidisciplinary models while highlighting the need for larger multicenter studies.
在国际上，管理重伤患者的重症医生的专业背景各不相同，创伤重症监护病房（ICU）通常由创伤外科医生或麻醉医生领导，这两类医生都接受了额外的重症监护培训。医生专业是否会影响治疗结果仍不确定。我们对2005年1月至2022年12月期间入住一级创伤中心、年龄≥16岁且损伤严重程度评分（ISS）≥16的患者进行了一项回顾性单中心队列研究。患者分别在创伤外科ICU（T-ICU）或麻醉科ICU（A-ICU）接受治疗。简而言之，根据人口统计学和损伤相关变量进行1:1匹配，主要结局为住院死亡率，次要结局包括输血需求、机械通气时间、ICU和住院时间，以及出院时的格拉斯哥预后评分（GOS）。在1015例符合条件的患者中（T-ICU：n = 920；A-ICU：n = 95），52例患者（每组26例）成功匹配，具有可比的基线特征。在死亡率、GOS、输血需求、通气时间或ICU/住院时间方面未观察到显著差异。这些发现表明，如果两者都由认证的重症监护专家领导，基于创伤外科和麻醉科的ICU可取得相当的治疗效果，这支持了多学科模式，同时也凸显了开展更大规模多中心研究的必要性。
