Abstract
Abstract
Background
Blunt and penetrating trauma differ in injury patterns, management, and outcomes, but data comparing early physiological and haemostatic responses within Scandinavian trauma systems remain limited. We aimed to investigate differences in clinical characteristics, early physiology, and outcomes between blunt and penetrating trauma patients at a major Swedish trauma centre.
Methods
This registry-based observational cohort study included adult trauma patients admitted to the Karolinska University Hospital, Stockholm, between November 2022 and December 2024. Detailed prospective data were collected for patients receiving blood transfusion within two hours of arrival. Patients were categorised by injury type (blunt vs. penetrating). Clinical outcomes included 30-day mortality, hospital length of stay, and functional outcome. Secondary analyses compared physiological, metabolic, and coagulation parameters. Multivariable logistic regression was used to compare 30-day mortality between groups, adjusted for age, sex, Injury Severity Score, and preinjury comorbidity.
Results
A total of 2,193 patients were included, of whom 353 (16%) sustained penetrating trauma. Patients with penetrating trauma were younger (median 34 vs. 49 years,
p
p
p
p
p
p
7 days: 26% vs. 18%,
p
= 0.001), and worse functional outcomes at discharge (Glasgow Outcome Scale 2 or 3: 40% vs. 12%,
p
1.2 (23% vs. 16%, p = 0.32). After exclusion of non-trauma-related deaths, 30-day mortality did not differ significantly between groups in unadjusted or adjusted analyses.
Conclusions
Within this Scandinavian trauma system, blunt and penetrating trauma represent distinct clinical entities with differing injury patterns, physiological responses, and management needs. Despite these differences, adjusted mortality was comparable. These findings may support mechanism-specific assessment and prioritisation in trauma management.
Trial registration
This study is a secondary analysis of a prospectively registered observational trauma cohort (ClinicalTrials.gov NCT05573841, registered 6 October, 2022).