The primary aim of the ACE is to foster a collaborative community on research and education and to provide state-of-the-art multidisciplinary care to trauma patients at the largest level I Trauma Center in The Netherlands Specific objectives are:
- To intensify multidisciplinary collaboration between clinical and diagnostic specialties involved in trauma care, with a clear external visibility regarding care, education, and research
- To implement Value-Based Health Care in all dimensions
- To develop teaching modules for students and health care professionals (“Rotterdam International Trauma School”, RITS)
- To develop and implement technical innovations in collaboration with internal and external partners
- To determine (cost-)effectiveness of current and future treatment modalities, where possible in a multicenter approach
Current: Fundamental and translational research:
- Development and in vitro and in vivo testing of novel (3D-printed) bone substitute materials
- Biomechanical testing of current and newly developed implants and devices
- Anatomic specimen studies to determine the risk of soft tissue damage during surgical procedures
- Collaboration with academic (e.g. Medical Delta) and industrial partners Clinical research: an international collaborative of >40 hospitals has been established, and participates in clinical studies focused on: - (European) multicenter studies on (multi-)trauma and traumatic brain injury (TBI)
- Evaluation of current and newly developed treatment strategies with regard to (cost)effectiveness
- Studies on prevention and reversal of adverse events (infections, shock, multiple organ dysfunction, etcetera) Epidemiological research: is needed to obtain insight into impact of trauma on society.
- Extraction of data of National (Trauma) Registries for evaluating long-term trends in age and gender differences in incidence and health care use/costs for several injuries
- Development and validation of risk models and prevention models
- Evaluation of patient-reported outcome measures Future plans: ACE participants will expand existing (inter-)national research activities and new relationships will be initiated. This will improve success rates of (inter-)national grant applications as well as scientific output.
Current: - Bachelor Medicine (Erasmus MC): - BA1: ABCDE cursus - Ba1 and Ba2: PKV, Acute Geneeskunde, Klinisch redeneren, Tutoraat - Ba2: Keuze-onderwijs thema 7 'Acute and Intensive Care' and 10 'Musculoskeletal disorders' - Ba2C: Houding en beweging - Ba3: Verdiepende Minor Hoofdzaken van hoofd-halsgebied - Ba3: Minor 'Reconstruction: from Head to Hands' - Ba3: Minor 'Orthopaedische Traumatologie' - Ba3C: Volksgezondheid (Community Projects) - Bachelor Technical Medicine (TU Delft): - Minor 'Medicine', module 'Trauma Surgery and Orthopaedics' - Master Medicine: - Ma1B: 'De patiënt' - Keuzeonderzoek - Ma2/Ma3: Coschappen - Research master Medicine: - Research internship NIHES, MolMed - PhD education: - Custom-made PhD thesis guidance - Medical Specialist Education - NIHES: 'Injury epidemiology and control' - Training for military surgeons - Advanced Trauma Life Support - Hogeschool Rotterdam: Zorgacademie ED/ICU nurses and PKV NP/PA - Dedicated trauma training for nurses and plaster room technicians - Advanced trauma education for ICU physicians and anaesthesiologists - Technique and approach-specific (cadaveric) courses Future plans: - Develop a multidisciplinary minor 'Trauma' (Ba3) - Establish "Rotterdam International Trauma School" (RITS) as (inter-)national post-academic education program - Use evaluations to improve quality of teaching modules - Increase number of certified teachers (SKO, BKO, teach-the-teacher)
Societal Relevance to Research, Education and Patient Care
In the Netherlands trauma is still the number one cause of death until the age of 47 years. Trauma care is one of the most multidisciplinary areas within health care. Because of the acute onset of trauma and since initial treatment is often time critical, the chain of trauma care reflects the efficiency and quality of the in-hospital organization. Most trauma patients do not suffer from life threatening injuries and survive their trauma. The true impact of excellent trauma care is that it reduces permanent and temporary disability. Good trauma care improves quality of life of individual patients and economic productivity from a societal perspective. The Netherlands has 11 so-called level I Trauma Centers which are appointed to centralize care for these patients, and Erasmus MC is the largest of these. A unique selling point is that our hospital provides the helicopter mobile medical team ("trauma-helicopter" or HEMS), it exploits ECMO facilities for children and adults, and it is the preferred partner for the Ministry of Defense with regard to medical support. This ACE allows to improve education, research, and patient care. Therewith it enables options for valorization of knowledge, development of treatment guidelines, patents, and for designing educational materials.
Viability of Research, Education and Patient Care
Trauma care by nature involves multiple disciplines. State-of-the-art research, education, and patient care can only be reached and maintained if up-to-date knowledge is used and shared across disciplines as well as from seniors to juniors. The composition of the departments involved will enable this.
With the establishment of the ACE Trauma Center, our activities will improve not only in quality, but also in visibility. Research output and funding success will increase, and consequently (inter-)national recognition and valuation will improve. Especially international recognition is a prerequisite to attract international PhD students and to increase the number of PhD students that seek an international career.
The trauma trial network involves multiple (academic) medical centers outside The Netherlands. Participants in this ACE initiated collaborative projects with expert groups in, among others, Belgium, Germany, South Africa, China, Australia, Canada and US. Results are presented in high-impact international journals and at international trauma meetings including annual meetings of the European Society of Trauma and Emergency Care (ESTES), American Orthopedic Trauma Association (OTA), American Association of Orthopaedic Surgery (AAOS), and the British Trauma Society (BTS). Participants are also involved in international research and education programs of (among others) AO Foundation and Osteosynthesis and Trauma Care Foundation.
Key and relevant publications of the last five years
- Vucic S, Drost RW, Ongkosuwito EM, Wolvius EB. Dentofacial trauma and players’ attitude towards mouthguard use in field hockey: a systematic review and meta-analysis. Br J Sports Med. 2016 Mar;50(5):298-304
- Andrews PJ, Sinclair HL, Rodriguez A, Harris BA, Battison CG, Rhodes JK, Murray GD; Eurotherm, 3235 Trial Collaborators. Hypothermia for Intracranial Hypertension after Traumatic Brain Injury. N Engl J Med. 2015 Dec 17;373(25):2403-12
- Iordens GIT, Van Lieshout EMM, Schep NWL, De Haan J, Tuinebreijer WE, Eygendaal D, Van Beeck EF, Patka P, Verhofstad MHJ, Den Hartog D, FuncSiE Trial Investigators. Early mobilisation versus plaster immobilisation of simple elbow dislocations: results of the FuncSiE multicentre randomised clinical trial. Br J Sports Med E-Pub July 14, 2015
- Den Hartog D, Romeo J, Ringburg AN, Verhofstad MHJ, Van Lieshout EMM. Survival Benefit of Physician-staffed Helicopter Emergency Medical Services (HEMS) Assistance for Severely Injured Patients. Injury 2015 uly;46(7):1281-1286
- Zielinski SM, Bouwmans CAM, Heetveld MJ, Bhandari M, Patka P, Van Lieshout EMM, on behalf of the FAITH trial investigators. The societal costs of femoral neck fracture patients treated with internal fixation. Osteoporos Int. 2014 Mar;25(3):875-885
- Bronkhorst MWGA, Boyé NDA, Lomax MAZ, Vossen RHAM, Bakker J, Patka P, Van Lieshout EMM. Single Nucleotide Polymorphisms in the Toll-Like Receptor Pathway increase Susceptibility to Infections in Severely Injured Trauma Patients. J Trauma Acute Care Surg 2013 Mar;74(3):862-870
- De Putter CE, Selles RW, Polinder S, Panneman MJ, Hovius SE, Van Beeck EF Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study. J Bone Joint Surg Am. 2012 May 2;94(9):e56
- Van der Stok J, Van Lieshout EMM, El-Massoudi Y, Van Kralingen GH, Patka P. Bone substitutes in the Netherlands - a Systematic Literature Review. Acta Biomaterialia 2011;7(2):739-750
- Ringburg AN, Polinder A, Van Ierland MCP, Steyerberg EW, Van Lieshout EMM, Patka P, Van Beeck EF, Schipper IB. Prevalence and prognostic factors of disability after major trauma. J Trauma 2011;70(4):916-22
- Hartholt KA, Van Beeck EF, Polinder S, Van der Velde N, Van Lieshout EMM, Panneman MJM, van der Cammen TJM, Patka P. Societal consequences of falls in the older population: injuries, healthcare costs and long term reduced quality of life. J Trauma 2011;71(3):748-753
PhD theses of the last five years
- Colaris J. Forearm Fractures in Children (10OCT2014; Supervisor Verhaar J.A.N., co-supervisor Allema J.H.; ISBN 978-90-8590-059-7)
- De Putter CE. Hand and wrist injuries; Trends and societal consequences (06SEP2016)
- Hartholt K.A. Falls and Drugs in the Older Population: medical and societal consequences (21SEP2011; Supervisor Patka P., co-supervisor Van der Cammen T.J.M., Van Beeck E.F.; ISBN: 978-90-9026282-6)
- Iordens G.I.T. Traumatic Elbow Dislocations (23DEC2015; Supervisors Verhofstad M.H.J., Patka P., co-supervisors Den Hartog D., Schep N.W.L.; ISBN: 978-94-6299-248-1)
- Knops S.P. Treatment Of Pelvic Ring Fractures with Pelvic Circumferential Compression Devices (26SEP2013; Supervisors Patka P., Schipper I.B., co-supervisor Van Lieshout E.M.M.; ISBN: 978-94-6169-547-5)
- Meuffels D.E. Novel Insights into Anterior Cruciate Ligament Injury (26OCT2011; Supervisor Verhaar J.A.N., co-supervisor Reijman M.; ISBN: 978-94-6169-137-8)
- Nijhuis T.H.J. Bridging the gap in relation to nerve injury (16DEC2011; Supervisor Hovius S.E.R., co-supervisor Van Neck J.W.; ISBN 978-94-6191-077-6)
- Ringburg A.N. Helicopter Emergency Medical Services – Effects, Costs and Benefits (10JUN2009; Supervisors Patka P, Schipper I.B.; ISBN: 978-90-8559-499-4)
- Van der Stok J. Bone Graft Substitutes Developed for Trauma and Orthopaedic Surgery (20MAY2015; Supervisors Weinans H., Verhaar J.A.N, Patka P; co-supervisor Van Lieshout E.M.M.; ISBN: 978-94-6169-641-0)
- Zielinski S.M. Internal Fixation of Femoral Neck Fractures; treatment and effects (21MAY2015; Supervisors Patka P., co-supervisors Van Lieshout E.M.M., Heetveld M.J.; ISBN: 978-94-6108-975-5)