History, Development and Future of Trauma Care for Multiple Injured Patients in the Netherlands

Overview

Journal Eur J Trauma Emerg Surg

Specialties Critical Care
Emergency Medicine

Date 2016 Jan 28

PMID 26814917

Citations 5

Authors

K W W Lansink

L P H Leenen

Affiliations

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Abstract

Introduction: The development of trauma systems all over the world resulted in improved outcome for a broad range of trauma victims. In this review, we demonstrate the developments of an inclusive regionalised trauma system in the Netherlands and the subsequent developments in our level one trauma centre and trauma region in comparison.

Comparison With Other Trauma Systems: With the seasoning of the trauma system, further improvements in outcome could be demonstrated, in the region an OR of 0.84 and in the trauma centre an OR of 0.61, in a later comparison over the years another OR 0.74 was noted. In addition, a further diversification of the trauma populations was seen in the various hospitals with different levels, based on a pre-hospital triage system. Torso and multiple injured patients were more seen in the trauma centre and increased to more than 350 patients with an ISS of >15, whereas monotrauma was almost exclusively seen in the level two and three hospitals. The further development of the trauma system is discussed, in which the minimum requirements of the individual trauma surgeon and institution are taken as a guideline.

Future, Discussion And Conclusion: Based on these considerations, a further concentration of the most severely injured patients is proposed in a small country as the Netherlands culminating in one trauma centre for the most severely injured patients, combined with an integrated pre-hospital helicopter system, on top of the current good functioning inclusive trauma system. These developments could be a template for further developments of trauma systems in Europe.

Citing Articles

Is there a difference between the incidence of subtypes of tibial plateau fractures between six different level 1, level 2 and level 3 trauma centers in the Netherlands?.

van der Gaast N, Jaarsma R, Edwards M, Doornberg J, Hermans E BMC Musculoskelet Disord. 2025; 26(1):169.

PMID: 39972294 PMC: 11837648. DOI: 10.1186/s12891-025-08383-8.

The Relationship between Hospital Volume and In-Hospital Mortality of Severely Injured Patients in Dutch Level-1 Trauma Centers.

Sewalt C, Venema E, van Zwet E, Van Ditshuizen J, Schuit S, Polinder S J Clin Med. 2021; 10(8).

PMID: 33920899 PMC: 8071237. DOI: 10.3390/jcm10081700.

Global changes in mortality rates in polytrauma patients admitted to the ICU-a systematic review.

van Breugel J, Niemeyer M, Houwert R, Groenwold R, Leenen L, van Wessem K World J Emerg Surg. 2020; 15(1):55.

PMID: 32998744 PMC: 7526208. DOI: 10.1186/s13017-020-00330-3.

The evolution of trauma care in the Netherlands over 20 years.

Hietbrink F, Houwert R, van Wessem K, Simmermacher R, Govaert G, de Jong M Eur J Trauma Emerg Surg. 2019; 46(2):329-335.

PMID: 31760466 PMC: 7113214. DOI: 10.1007/s00068-019-01273-4.

Differentiation in an inclusive trauma system: allocation of lower extremity fractures.

Wurdemann F, Smeeing D, Ferree S, Nawijn F, Verleisdonk E, Leenen L World J Emerg Surg. 2018; 13:18.

PMID: 29682003 PMC: 5899363. DOI: 10.1186/s13017-018-0178-1.

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