The treatment and rehabilitation of traffic accident victims

Purpose of Assessment

To summarize and critically analyze the current facts concerning the acute care, treatment and rehabilitation of trauma victims, and evaluate the trauma care in Sweden.

Methods

Systematic Review, Cost analysis

Primary Data Collection

Review of medical record on care provided to 223 severe traffic injury victims at five Swedish acute care hospitals to evaluate Swedish trauma care.

Review process for the publication

Internal review by project group, SBU Board and SBU Expert Group. Additional external review by experts in the field.

Summary and Conclusions

In Sweden around 800 persons are killed annually in traffic accidents and 14,000 are treated in hospital for injury caused by traffic accidents. The trauma care is decentralized; for a population of 8.7 million there are around 90 hospitals with emergency departments, and traffic victims are almost always brought to the nearest hospital.

The quality of the care is not standardized. In hospitals with advanced equipment, the rate of avoidable deaths can be relatively high. A study from the north of Sweden shows that of 74 deaths in hospital due to trauma, 13 (17%) were judged as probably avoidable.

The review of the scientific literature has shown that the quality of trauma care has increased after centralization of the trauma care to trauma centers with specialized resources. However, the issue is multi-faceted, and many aspects have to be considered in the evaluation of the trauma care, ie, the need for triage and treatment at the place of the accident, the means of transportation, and the qualifications of the personnel and the doctors in the emergency department, who primarily take care of the patient.

The scientific literature on rehabilitation is scarce and there is an urgent need for more studies of good quality.