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"Trauma" AND ("Injury Severity" OR "ISS")

James Vassallo, Jason Smith
INTRODUCTION: A key principle in the effective management of major incidents is triage, the process of prioritising patients on the basis of their clinical acuity. In many countries including the UK, a two-stage approach to triage is practised, with primary triage at the scene followed by a more detailed assessment using a secondary triage process, the Triage Sort. To date, no studies have analysed the performance of the Triage Sort in the civilian setting. The primary aim of this study was to determine the performance of the Triage Sort at predicting the need for life-saving intervention (LSI)...
March 15, 2019: Emergency Medicine Journal: EMJ
Duraid Younan, Joshua Richman, Ahmed Zaky, Jean-Francois Pittet
Background: Although the association of neutrophil proportions with mortality in trauma patients has recently been shown, there is a paucity of research on the association with other outcomes. We sought to investigate the association of neutrophil proportions with organ failure in critically-ill trauma patients. Methods: We reviewed a randomly-selected group of trauma patients admitted to our level-1 trauma intensive care unit between July 2007 and December 2016. Data collected included demographics, injury mechanism and severity (ISS), neutrophil-to-lymphocyte ratio (NLR) at admission and at 24 and 48 hours and organ failure data...
March 14, 2019: Healthcare (Basel, Switzerland)
Robert Larsen, Denise Bäckström, Mats Fredrikson, Ingrid Steinvall, Rolf Gedeborg, Folke Sjoberg
BACKGROUND: A female survival advantage after injury has been observed, and animal models of trauma have suggested either hormonal or genetic mechanisms as component causes. Our aim was to compare age and risk-adjusted sex-related mortality in hospital for the three most common mechanisms of injury in relation to hormonal effects as seen by age. METHODS: All hospital admissions for injury in Sweden during the period 2001-2011 were retrieved from the National Patient Registry and linked to the Cause of Death Registry...
March 15, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Sebastian Wutzler, Felix M Bläsius, Philipp Störmann, Thomas Lustenberger, Michael Frink, Marc Maegele, Matthias Weuster, Jörg Bayer, Michael Caspers, Andreas Seekamp, Ingo Marzi, Hagen Andruszkow, Frank Hildebrand
BACKGROUND: While the incidence and aspects of pneumonia in ICU patients has been extensively discussed in the literature, studies on the occurrence of pneumonia in severely injured patients are rare. The aim of the present study is to elucidate factors associated with the occurrence of pneumonia in severely injured patients with thoracic trauma. SETTING: Level-I University Trauma Centres associated with the TraumaRegister DGU®. METHODS: A total of 1162 severely injured adult patients with thoracic trauma documented in the TraumaRegister DGU® (TR-DGU) were included in this study...
March 14, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Max W de Graaf, Inge H F Reininga, Erik Heineman, Mostafa El Moumni
OBJECTIVE: To develop and internally validate the PROgnosis of functional recovery after Trauma (PRO-Trauma) prediction model. DESIGN: A prospective single-center longitudinal cohort study. Patients were assessed at 6 weeks and 12 months post-injury. METHODS: Patients that presented at the emergency department with an acute traumatic injury, were prompted for participation. Patients that completed the assessments at 6 weeks and 12 months post injury were included...
2019: PloS One
Christopher W Snyder, Paul D Danielson, Raquel Gonzalez, Nicole M Chandler
BACKGROUND: Many non-trauma centers perform computed tomography (CT) on injured children prior to transfer to a pediatric trauma center (PTC), but the institutional variability and clinical impact of this practice is unclear. This study evaluated the association of pre-transfer CT with transfer delays, the likelihood of emergent neurosurgical intervention among patients who underwent pre-transfer head CT, and the effects of transfer distance on prevalence and regional variability of pre-transfer CT...
March 8, 2019: Journal of Trauma and Acute Care Surgery
Michael Caspers, Nadine Schäfer, Matthias Fröhlich, Bertil Bouillon, Manuel Mutschler, Ursula Bauerfeind, Marc Maegele
PURPOSE: Trauma-induced coagulopathy (TIC) is recognised as an own clinical entity which includes all components of haemostasis following rapidly tissue injury, hypoperfusion and shock. Microparticles (MP) are known to be released in large quantities from different cell types after trauma. The present study aimed to perform a phenotypic MP profiling after major trauma and to elucidate potential procoagulative function of MP under simulated conditions of lethal triad. METHODS: For MP isolation, 20 trauma patients (median ISS 24) were included...
March 12, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
David Mills, Bradley Segura, Jen Zaremba, Jeffrey P Louie
INTRODUCTION: Transition of pediatrics services to freestanding children's hospitals is a common trend over the past 3 decades, yet there is no published information on the effect of these moves on the pediatric emergency department (ED). We looked at the effect on trauma volume and severity presenting to the ED after transitioning to a freestanding children's hospital at a location previously without dedicated pediatrics services. METHODS: We analyzed data using a retrospective chart review of pediatric trauma visits (age, <15 years) from our pediatric trauma registry...
March 7, 2019: Pediatric Emergency Care
Woo S Do, Ronald Chang, Erin E Fox, Charles E Wade, John B Holcomb, Matthew J Martin
BACKGROUND: Focused assessment with sonography for trauma (FAST) performance metrics are unknown in patients with non-compressible torso hemorrhage (NCTH). METHODS: Retrospective review of a dedicated NCTH database from four level 1 trauma centers (2008-2012). NCTH was defined as (1) named axial torso vessel disruption; (2) AIS chest or abdomen >2 with shock (base deficit < -4) or truncal operation in ≤ 90 min; or (3) pelvic fracture with ring disruption...
February 13, 2019: American Journal of Surgery
Brice Malgras, Olivier Aoun, Ghislain Pauleau, Guillaume Boddaert, Emmanuel Hornez, Renaud Dulou, Jean-Marc Delmas, Pierre Haen, Sophie Laversanne, Anna Crambert, Paul Balandraud
INTRODUCTION: The military operations carried out by the French armed forces, occasionally require the use of the Surgical Life-saving Module (SLM), to ensure the surgical support of its soldiers. Due to its extreme mobility and capacity of fast deployment, SLM is particularly useful in small-scale military operations, such as Special Forces missions. In 2017, the French SLM was for the first time used to ensure surgical support of allied forces, which were lacking forward surgical capabilities...
March 4, 2019: Injury
Stephen J Fenton, Madison M Hunt, Pamela S Ropski, Eric R Scaife, Katie W Russell
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been used in the non-trauma setting for over 30 years. However, the use of ECMO in trauma remains a difficult question, as the risk of bleeding must be weighed against the benefits of cardiopulmonary support. METHODS: Retrospective review of children who sustained severe thoracic trauma (chest abbreviated injury score ≥3) and required ECMO support between 2009 and 2016. RESULTS: Of the 425 children who experienced severe thoracic trauma, 6 (1...
February 24, 2019: Journal of Pediatric Surgery
Tim P Lawrence, Adam Steel, Martyn Ezra, Mhairi Speirs, Pieter M Pretorius, Gwenaelle Douaud, Stamatios Sotiropoulos, Tom Cadoux-Hudson, Uzay E Emir, Natalie L Voets
The posterior cingulate cortex (PCC) and corpus callosum (CC) are susceptible to trauma, but injury often evades detection. PCC Metabolic disruption may predict CC white matter tract injury and the secondary cascade responsible for progression. While the time frame for the secondary cascade remains unclear in humans, the first 24 h (hyper-acute phase) are crucial for life-saving interventions. OBJECTIVES: To test whether Magnetic Resonance Imaging (MRI) markers are detectable in the hyper-acute phase and progress after traumatic brain injury (TBI) and whether alterations in these parameters reflect injury severity...
March 8, 2019: Brain Injury: [BI]
Sten Saar, Tuomas Brinck, Juhan Laos, Lauri Handolin, Peep Talving
PURPOSE: Evolving trauma system of Estonia has undergone several reforms; however, performance and outcome indicators have not been benchmarked previously. Thus, we initiated a baseline study to compare demographics, management and outcomes of severely injured patients between Southern Finland and Northern Estonia utilizing regional trauma repositories. METHODS: A comparison of data fields of the Helsinki University Hospital trauma registry (HTR) and trauma registry at the North Estonia Medical Centre in Tallinn (TTR) between 1/1/2015 and 31/12/2016 was performed...
January 5, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Shahram Manoochehry, Masoud Vafabin, Saeid Bitaraf, Ali Amiri
Introduction: Describing injury severity in trauma patients is vital. In some recent articles the Revised Trauma Score (RTS) and Kampala Trauma Score (KTS) have been suggested as easily performed and feasible triage tools which can be used in resource-limited settings. The present meta-analysis was performed to evaluate and compare the accuracy of the RTS and KTS in predicting mortality in low-and middle income countries (LMICs). Methods: Two investigators searched the Web of Science, Embase, and Medline databases and the articles which their exact number of true-positive, true-negative, false-positive, and false-negative results could be extracted were selected...
2019: Archives of Academic Emergency Medicine
Adora Tricia Santos, Whiyie Sang, William Nugent
The trauma registry is a locally maintained database with information on all trauma patients, including patient demographics and injury data. One essential field is the injury severity score (ISS). Patients who expire on arrival, either in the emergency department or soon after, often cannot undergo a complete evaluation of their injuries. As a result, many injuries remain undiagnosed, resulting in an erroneously low ISS, and autopsies can identify these unrecognized injuries. The objective of this study was to determine whether and how autopsy data improve the accuracy of the trauma registry data...
March 2019: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Khursheed Alam Khan, Madhur, Virendra Deo Sinha, Nandkishore Gora, Mohan Bairwa
BACKGROUND AND AIMS: Traumatic brain injury ( TBI ) is a major health issue in developing nations like India along with underreporting of TBI data because of lack of major studies targeting TBI population. Various lacunae from field to tertiary centres are responsible for this significant burden of TBIs. Hence, we studied the epidemiological profile of 1150 TBI patients including the predictors of the outcome of TBIs in a tertiary health care institution in North India to identify the modifiable factors which could be used to improve the outcome and reduce the TBI burden...
March 4, 2019: World Neurosurgery
Dario Piazzalunga, Francesca Rubertà, Paola Fugazzola, Niccolò Allievi, Marco Ceresoli, Stefano Magnone, Michele Pisano, Federico Coccolini, Matteo Tomasoni, Giulia Montori, Luca Ansaloni
BACKGROUND: Self-inflicted injuries represent a consistent cause of trauma and falls from heights (FFH) represent a common dynamic used for suicidal attempts. The aim of the current report is to compare, among FFH patients, unintentional fallers and intentional jumpers in terms of demographical characteristics, clinical-pathological parameters and mortality, describing the population at risk for suicide by jumping and the particular patterns of injury of FFH patients. MATERIALS AND METHODS: The present study is a retrospective analysis of prospectively collected data regarding FFH patients, extracted from the Trauma Registry of the Papa Giovanni XXIII Hospital in Bergamo, Italy...
March 6, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Murat Ucak
PURPOSE: The aim of this study was to assess the maxillofacial injuries (MFIs) and our surgical approaches in the Syrian Civil War that emerged during the spring of 2011, among Syria's government and Syrians. PATIENTS AND METHODS: The present study is a prospective clinical study of injured patients at Turkey's Border Hospitals during the Syrian Civil Conflict. Patients' data cover to all emergency and plastic surgery hospitals throughout Turkey. We assessed the patients' data according to location of trauma, duration of hospitalization, the severity and etiology of MFIs with the Injury Severity Score...
March 1, 2019: Journal of Craniofacial Surgery
Kevin D Morrow, Adam G Podet, Casey P Spinelli, Lindsay M Lasseigne, Clifford L Crutcher, Jason D Wilson, Gabriel C Tender, Anthony M DiGiorgio
OBJECTIVEWhile blunt spinal trauma accounts for the majority of spine trauma, penetrating injuries affect a substantial number of patients. The goal of this study was to examine the epidemiology of penetrating spine injuries compared with blunt injuries and review the operative interventions and outcomes in the penetrating spine injury group.METHODSThe prospectively maintained trauma database was queried for spinal fractures from 2012 to 2018. Charts from patients with penetrating spine trauma were reviewed...
March 1, 2019: Neurosurgical Focus
Sandro Hodel, Christian Schraner, Florian Oehme, Robbert van Leeuwen, Björn-Christian Link, Reto Babst, Frank J P Beeres
PURPOSE: To determine risk factors associated with adverse functional and radiological outcome in complete intra-articular distal radius fractures (AO 23 C2-3) with a minimum follow-up of 1 year. METHODS: Retrospective case series of 87 consecutive patients with a complete intra-articular distal radius fracture (AO/OTA 23 C2-3) and a minimum follow-up of 1 year between 2012 and 2016. Risk factors for adverse clinical [using the Patient-Rated Wrist Evaluation (PRWE) score] and radiological outcome (positive ulnar variance 1 year postoperative) were analysed in a linear regression model...
February 28, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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