Definition of polytrauma: Discussion on the objective definition based on quantitative estimation of multiply injured patients during wartime.
AIM
There is a clear lack of consensus on a validated definition of the term "polytrauma". This study presents and classifies the extent of injuries during wartime in Croatia using the Revised Trauma Score and Injury Severity Score (TRISS) and compares the scores with a clinical estimation based on subjective assessments of polytraumatised and non-polytraumatised patients.


METHODS
We analysed the data from 426 war victims who sustained multiple injuries and were managed at Osijek University Hospital from September 1st 1991 to December 31st 1991. The victims were divided into polytraumatised (n=149) and multitraumatised (n=277) patients according to the initial clinical estimation of the extent of injury. Patients classified as monotraumatised were excluded from this study. The assessment was based on the following definition of polytrauma: simultaneous injury of two or more body regions or anatomical systems with at least one injury being life-threatening. All data were scored retrospectively using TRISS methodology.


RESULTS
Two patients classified as polytraumatised had an ISS of less than 16, and one patient classified as multitraumatised had an ISS of more than 16. The difference between the actual (29.5%) and expected (40.44%) postoperative mortality in the polytraumatised group was statistically significant (p=0.0016), whereas in the multitraumatised group, the difference between the actual (3.2%) and expected (3.04%) postoperative mortality was not significant (p=0.6103).


CONCLUSIONS
The data show that clinical and subjective assessment of polytraumatised patients can be useful in the management of such cases and can be tested retrospectively using TRISS methodology.
['Lovrić|Zvonimir|Z|']
D015998:Abbreviated Injury Scale D000328:Adult D003210:Concept Formation D032921:Consensus D017523:Croatia D005260:Female D006801:Humans D015601:Injury Severity Score D008297:Male D009104:Multiple Trauma D015203:Reproducibility of Results D012189:Retrospective Studies D009626:Terminology as Topic D015599:Trauma Severity Indices D000067398:War-Related Injuries
Definition of polytrauma Assessment Multiple injuries Management Surgery War injury