Dittmer H, Faist E, Lauterjung K L, Heberer G
Chirurg. 1983 Apr;54(4):260-6.
433 patients (mean age 33.3 years) with multiple injuries were treated from 1978 to 8/1982. Classification of the injuries was done according the S(skeleton)A(abdomen)T(thorax)scheme. The overall mortality was 18%. The cause of death were CNS-injuries in 50% of the patients. Besides CNS-injuries single and multiple organ failure were limiting the prognosis. In all cases of organ failure the lung was affected. Two patterns of multiple organ failure were found. Significant factors were shock, massive blood transfusions and abdominal trauma--but as well as errors in the treatment. Still improvement of the survival rate of the polytraumatised patients must be achieved in the future. Besides aggressive shock therapy and prevention of posttraumatic pulmonary insufficiency through earliest respiratory support we emphasize a strict strategy of treatment priorities. Based upon an intensive training especially in trauma care the surgeon will be able to recognize complications earlier and thus increase the chance of survival of the polytraumatised patient.
1978年至1982年8月期间，对433例多处受伤患者（平均年龄33.3岁）进行了治疗。根据骨骼（S）、腹部（A）、胸部（T）方案对损伤进行分类。总死亡率为18%。50%的患者死因是中枢神经系统损伤。除中枢神经系统损伤外，单器官和多器官功能衰竭也限制了预后。在所有器官功能衰竭病例中，肺部均受影响。发现了两种多器官功能衰竭模式。重要因素包括休克、大量输血和腹部创伤，以及治疗失误。未来仍必须提高多发伤患者的生存率。除了积极的休克治疗和通过尽早的呼吸支持预防创伤后肺功能不全外，我们强调严格的治疗优先级策略。基于特别是在创伤护理方面的强化培训，外科医生将能够更早地识别并发症，从而增加多发伤患者的生存机会。
