Poly- und Schädelhirntrauma

Managing polytraumatized patients represents a challenging and complex clinical scenario, particularly when the brain is injured. Due to medical and technical progress, the mortality rate in polytraumatized patients has decreased over the last decades. However, survivors may have tremendous damaging long-term effects on their quality of life caused by functional limitations, mental complaints, and cognitive disorders.

Since avoiding complications may reduce mortality and morbidity, we acquire and analyze data routinely assessed at our trauma surgery department referring to patients suffering polytrauma or traumatic brain injury. We search for significant differences in clinically relevant parameters and patient characteristics between specific subgroups and test them for their suitability to determine high-risk patients. We evaluate and compare treatment strategies and recommend how to apply them.

Identifying the most appropriate time point to perform the definitive osteosynthesis of major fractures was the impetus of our serum biomarker research in 2011. Meanwhile, we also explore diagnostic biomarkers to quantify the extent of an injury, prognostic biomarkers to indicate the probable outcome, and predictive biomarkers to forecast the likelihood of complications in polytrauma victims. Furthermore, we focus on the time course of serum biomarker levels to elucidate pathophysiological changes that might contribute to an improved polytrauma regimen.

Principal investigators

• Dr. Anna Antoni
  (traumatic brain injury, antithrombotic therapy, polytrauma)
  ORCID ID: 0000-0003-2294-649X
  anna.antoni@meduniwien.ac.at
• Ap. Prof. Priv.-Doz. Dr. Thomas Haider MBA PhD FEBOT
  (inflammation, trauma, neurotrauma, spinal cord injury, hand surgery)
  ORCID-ID: 0000-0003-3192-8453
  thomas.a.haider@meduniwien.ac.at
• DDr. Valerie Weihs
  (polytrauma, traumatic brain injury, long-term outcome, epidemiology, survival analysis)
  ORCID ID: 0000-0003-1697-1381
  valerie.weihs@meduniwien.ac.at
• Ap.Prof. Priv.-Doz. Dr. Harald Widhalm MBA
  (polytrauma, traumatic brain injury, intracerebral bleeding, diagnostics)
  ORCID ID: 0000-0001-9739-6176
  harald.widhalm@meduniwien.ac.at
• Ap.Prof. Priv.-Doz. Dr. Lukas Negrin MBA MMSc. PhD
  (serum biomarkers in polytrauma care, pulmonary complications, injuries to the central nervous system, innovative outcome predictors, knee injuries)
  ORCID ID: 0000-0002-7195-2223
  lukas.negrin@meduniwien.ac.at

Important publications

• Negrin LL, Ristl R, Wollner G, Hajdu S. Differences in Eotaxin Serum Levels between Polytraumatized Patients with and without Concomitant Traumatic Brain Injury-A Matched Pair Analysis. J Clin Med. 2024;13(14):4218. Published 2024 Jul 19. doi:10.3390/jcm13144218. PMID: 39064258; PMCID: PMC11277900
• Negrin LL, Carlin GL, Ristl R, Hajdu S. Time trajectories and within-subject correlations of matrix metalloproteinases 3, 8, 9, 10, 12, and 13 serum levels and their ability to predict mortality in polytraumatized patients: a pilot study. Eur J Med Res. 2024;29(1):225. Published 2024 Apr 10. doi:10.1186/s40001-024-01775-x. PMID: 38594750; PMCID: PMC11005259
• Negrin LL, Carlin GL, Ristl R, Hajdu S. Serum levels of matrix metalloproteinases 1, 2, and 7, and their tissue inhibitors 1, 2, 3, and 4 in polytraumatized patients: Time trajectories, correlations, and their ability to predict mortality. PLoS One. 2024;19(3):e0300258. Published 2024 Mar 8. doi:10.1371/journal.pone.0300258. PMID: 38457458; PMCID: PMC10923431
• Negrin LL, Hajdu S. Serum Angiopoietin-2 level increase differs between polytraumatized patients with and without central nervous system injuries. Sci Rep. 2023;13(1):19338. Published 2023 Nov 7. doi:10.1038/s41598-023-45688-x. PMID: 37935720, PMCID: PMC10630405
• Antoni A, Wedrich L, Schauperl M, Höchtl-Lee L, Sigmund IK, Gregori M, Leitgeb J, Schwendenwein E, Hajdu S. Management of Traumatic Brain Injury in Patients with DOAC Therapy-Are the "New" Oral Anticoagulants Really Safer? J Clin Med. 2022 Oct 25;11(21):6268. doi: 10.3390/jcm11216268. PMID: 36362496; PMCID: PMC9658566.
• Bumberger A, Braunsteiner T, Leitgeb J, Haider T. Intracranial pressure monitoring following traumatic brain injury: evaluation of indications, complications, and significance of follow-up imaging-an exploratory, retrospective study of consecutive patients at a level I trauma center. Eur J Trauma Emerg Surg. 2022 Apr;48(2):863-870. doi: 10.1007/s00068-020-01570-3. Epub 2020 Dec 22. PMID: 33351163; PMCID: PMC7754179.
• Weihs V, Heel V, Dedeyan M, Lang NW, Frenzel S, Hajdu S, Heinz T. Age and traumatic brain injury as prognostic factors for late-phase mortality in patients defined as polytrauma according to the New Berlin Definition: experiences from a level I trauma center. Arch Orthop Trauma Surg. 2021 Oct;141(10):1677-1681. doi: 10.1007/s00402-020-03626-w. Epub 2020 Oct 17. PMID: 33070209; PMCID: PMC8437859.
• Binder H, Majdan M, Leitgeb J, Payr S, Breuer R, Hajdu S, Tiefenboeck TM. Management and Outcome of Traumatic Intracerebral Hemorrhage in 79 Infants and Children from a Single Level 1 Trauma Center. Children (Basel). 2021 Sep 26;8(10):854. doi: 10.3390/children8100854. PMID: 34682119; PMCID: PMC8534601.
• Negrin LL, Dedeyan M, Plesser S, Hajdu S. Impact of Polytrauma and Acute Respiratory Distress Syndrome on Markers of Fibrinolysis: A Prospective Pilot Study. Front Med (Lausanne). 2020 Jun 2;7:194. doi: 10.3389/fmed.2020.00194. PMID: 32582720; PMCID: PMC7280477.
• Antoni A, Schwendenwein E, Binder H, Schauperl M, Datler P, Hajdu S. Delayed Intracranial Hemorrhage in Patients with Head Trauma and Antithrombotic Therapy. J Clin Med. 2019 Oct 25;8(11):1780. doi: 10.3390/jcm8111780. PMID: 31731421; PMCID: PMC6912196.