Impact of a Femoral Fracture on Outcome after Traumatic Brain Injury-A Matched-Pair Analysis of the TraumaRegister DGU(®).

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Abstract

Conflict of interest statement: R.L. and his institution (IFOM) have an ongoing service agreement with AUC GmbH, the holder of the TraumaRegister DGU®. This includes statistical consultations relating to scientific analyses. All other authors declare no conflict of interest. 10. Eur J Trauma Emerg Surg. 2022 Jun;48(3):1769-1778. doi: 10.1007/s00068-020-01599-4. Epub 2021 Feb 15. Strategies for the treatment of femoral fractures in severely injured patients: trends in over two decades from the TraumaRegister DGU(®). Bläsius FM(1), Laubach M(2)(3), Andruszkow H(2), Lichte P(2), Pape HC(4), Lefering R(5), Horst K(2), Hildebrand F(2); Trauma Register DGU®. Author information: (1)Department of Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany. fblaesius@ukaachen.de. (2)Department of Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany. (3)Centre for Regenerative Medicine, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia. (4)Department of Trauma, Universitaetsspital, University of Zurich, Zurich, Switzerland. (5)Faculty of Health, Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany. PURPOSE: Treatment strategies for femoral fracture stabilisation are well known to have a significant impact on the patient's outcome. Therefore, the optimal choices for both the type of initial fracture stabilisation (external fixation/EF, early total care/ETC, conservative treatment/TC) and the best time point for conversion from temporary to definitive fixation are challenging factors. PATIENTS: Patients aged ≥ 16 years with moderate and severe trauma documented in the TraumaRegister DGU® between 2002 and 2018 were retrospectively analysed. Demographics, ISS, surgical treatment strategy (ETC vs. EF vs. TC), time for conversion to definitive care, complication (MOF, sepsis) and survival rates were analysed. RESULTS: In total, 13,091 trauma patients were included. EF patients more often sustained high-energy trauma (car: 43.1 vs. 29.5%, p