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Article History

Received: 18 December 2025

Accepted: 3 July 2026

First Online: 15 July 2026

Declarations

Competing interests: The DB is a chairman of the Committee on Emergency Medicine, Intensive Care, and Trauma Management (Sektion NIS) of the German Trauma Society (DGU) and the coordinator of the S3 Guideline Polytrauma Version 4.0 (2022). RL is a consultant for AUC GmbH and has received research support (third-party funds) from AUC GmbH. SI is the speaker of the working group TraumaRegister DGU of the Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS). KG is the lead guideline methodologist for the S3 Guideline Polytrauma Version 4.0 (2022). The other authors (KF, IS, DB) declare that they have no competing financial interests. They received no financial funding.

Ethics approval and consent to participate: The present study and protocol was conducted in accordance with the publication guidelines of the TraumaRegister DGU and was registered and approved by the TR-DGU review board as TR-DGU project ID 2023-008. Patients are included in the TraumaRegister DGU on the basis of informed consent obtained from the patient and/or their legal guardian(s), according to the registry’s procedures. According to the guidelines of the responsible state medical association 48,49 , an ethical vote was not necessary for a retrospective anonymous analysis using routinely collected data. All methods were carried out in accordance with relevant guidelines and regulations, including applicable data-protection requirements, and in line with the principles of the Declaration of Helsinki.