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
• Priv.-Doz. Dr. Thomas Haider MBA PhD
  (inflammation, trauma, neurotrauma, spinal cord injury, hand surgery)
  ORCID-ID: 0000-0003-3192-8453
  thomas.a.haider@meduniwien.ac.at
• Dr. 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 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

• 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.
• Halát G, Haider T, Dedeyan M, Heinz T, Hajdu S, Negrin LL. IL-33 and its increased serum levels as an alarmin for imminent pulmonary complications in polytraumatized patients. World J Emerg Surg. 2019 Jul 19;14:36. doi: 10.1186/s13017-019-0256-z. PMID: 31360218; PMCID: PMC6642565.
• Haider T, Simader E, Glück O, Ankersmit HJ, Heinz T, Hajdu S, Negrin LL. Systemic release of heat-shock protein 27 and 70 following severe trauma. Sci Rep. 2019 Jul 3;9(1):9595. doi: 10.1038/s41598-019-46034-w. PMID: 31270381; PMCID: PMC6610099.
• Negrin LL, Ristl R, Halat G, Heinz T, Hajdu S. The impact of polytrauma on sRAGE levels: evidence and statistical analysis of temporal variations. World J Emerg Surg. 2019 Mar 18;14:13. doi: 10.1186/s13017-019-0233-6. PMID: 30923559; PMCID: PMC6421664.
• Haider T, Simader E, Hacker P, Ankersmit HJ, Heinz T, Hajdu S, Negrin LL. Increased serum concentrations of soluble ST2 are associated with pulmonary complications and mortality in polytraumatized patients. Clin Chem Lab Med. 2018 Apr 25;56(5):810-817. doi: 10.1515/cclm-2017-0762. PMID: 29341938.