738\u2003Missed Injuries in Trauma Patients Attending a London Trauma Centre

Abstract

\n \n \n Patients attending following trauma present a diagnostic challenge. Missed injuries may lead to increased morbidity, mortality and length of hospital stay. We reviewed the incidence of and contributing factors to missed injuries in trauma patients attending a London Trauma Centre.\n \n \n \n The records of all trauma patients admitted to a London Trauma Centre during September 2019 were studied to determine the extent and type of missed injuries. Missed injuries were classified as: Type 1 – missed during initial management (on primary and secondary survey) or Type 2 – missed on primary, secondary, and tertiary survey, but detected prior to discharge.\n \n \n \n Forty-two (42.4%) of 99 patients (24 Female, 75 Male) had 63 missed injuries (an average of 1.5 missed injuries per patient). Thirty-seven type 1 missed injuries occurred (5 fractures, 28 soft tissue injuries, 4 neurological injuries). Twenty-six type 2 missed injuries occurred (13 fractures, 7 soft tissue injuries, 3 neurological injuries and 3 visceral injuries).\n \n \n \n Significant injuries can be missed despite primary, secondary, and tertiary surveys in trauma patients. Clinicians involved in the care of trauma patients should therefore remain alert to evolving/new injuries throughout hospital admission.\n