Background: Anatomy-based injury severity scores are commonly used with physiological scores for reporting severity of injury in a standardized manner. However, there is lack of consensus on choice of scoring system, with the commonly used injury severity score (ISS) performing poorly for certain sub-groups, eg head-injured patients. We hypothesized that adding a dichotomous variable for polytrauma (yes/no for Abbreviated Injury Scale (AIS) scores of 3 or more in at least two body regions) to the New Injury Severity Score (NISS) would improve the prediction of in-hospital mortality in injured patients, including head-injured patients-a subgroup that has a disproportionately high mortality. Our secondary hypothesis was that the ISS over-estimates the risk of death in polytrauma patients, while the NISS under-estimates it. Methods: Univariate and multivariable analysis was performed on retrospective cohort data of blunt injured patients aged 18 and over with an ISS over 9 from the Singapore ...
Data & statistics on Injury Severity Score by Region: Injury Severity Score by Region, Clinical characteristics of the patients. AIShead, Abbreviated Injury Score for the cephalic region; ISS, Injury Severity Score; Ped., pedestrian; Traf., traffic accident, Total trauma admissions to each Trauma Service for 2002 with ISS |15. The Injury Severity Score, ISS, is a reflection of overall severity and probability of survival based on an anatomical injury severity classification, the AIS or Abbreviated Injury Scale. An ISS | 15 reflects serious injury. Ref: Baker SP, ONeill B, Haddon W, Long WB, The Injury Severity Score: A method for describing patients with ......
Background: Trauma is the leading cause of death in the developed world. In Mulago hospital, it is the single most common indication for admission in the surgical wards. The Kampala Trauma Score II , recommended for use in resource poor setting is a modification of the Injury Severity Score and the Revised Trauma Score and it compares well with the New Injury Severity Score. Objective of this study was to determine the diagnostic accuracy of admission venous lactate levels for injury severity and predict early outcome. Methods: This was a mixed design study with both a cross-sectional design to determine injury severity and prospective cohort design to predict early outcome. A total of 502 trauma patients were conveniently and consecutively recruited daily over a period of 2 months from the A and E department of Mulago Hospital. Pre-resuscitation venous lactate levels were determined on arrival to the emergency department and the patient concurrently given a KTS II score .Admitted patients were ...
The Injury Severity Score (ISS) is an established medical score to assess trauma severity. It correlates with mortality, morbidity and hospitalization time after trauma. It is used to define the term major trauma. A major trauma (or polytrauma) is defined as the Injury Severity Score being greater than 15. The AIS Committee of the Association for the Advancement of Automotive Medicine (AAAM) designed and improves upon the scale. The Abbreviated Injury Scale (AIS) is an anatomically based consensus-derived global severity scoring system that classifies each injury in every body region according to its relative severity on a six-point ordinal scale: Minor Moderate Serious Severe Critical Maximal (currently untreatable). There are nine AIS chapters corresponding to nine body regions: Head Face Neck Thorax Abdomen Spine Upper Extremity Lower Extremity External and other. The ISS is based (see below) upon the Abbreviated Injury Scale (AIS). To calculate an ISS for an injured person, the body is ...
Methods We conducted a retrospective cohort validation study of 40 418 patients with injury using a large regional trauma registry. ICDPIC-generated AIS scores for each body region were compared with trauma registry AIS scores (gold standard) in adult and paediatric populations. A separate analysis was conducted among patients with traumatic brain injury (TBI) comparing the ICDPIC tool with ICD-9-CM embedded severity codes. Performance in characterising overall injury severity, by the ISS, was also assessed.. ...
To define the pattern of injury and aetiology of death of patients who have sustained major trauma due to high fall and its relationship with the mechanism of free fall. A total of 188 consecutive patients who sustained a high fall were included after the TRAUMASUR database was retrospectively reviewed. Demographic characteristics, severity scores, injury type, aetiology of high fall, mortality rate and aetiology of death were analysed. The mean age was 39.7 years (SD 15.5). The main aetiologies were work related (40.4 %) and suicide attempt (22.3 %). The mean injury severity score (ISS) and New Injury Severity Score (NISS) were 27.3 and 34.1, respectively. The most common cause of mortality within the intentional group was exsanguination (66 %), and the most frequent aetiology of death within the non-intentional group was endocranial hypertension (69 %). Differences were found with regard to the pattern of injuries and the aetiology of death according to the mechanism of free fall.. ...
Objectives: Owing to the large number of injury International Classification of Disease-9 revision (ICD-9) codes, it is not feasible to use standard regression methods to estimate the independent risk of death for each injury code. Bayesian logistic regression is a method that can select among a large numbers of predictors without loss of model performance. The purpose of this study was to develop a model for predicting in-hospital trauma deaths based on this method and to compare its performance with the ICD-9-based Injury Severity Score (ICISS). Methods: The authors used Bayesian logistic regression to train and test models for predicting mortality based on injury ICD-9 codes (2,210 codes) and injury codes with two-way interactions (243,037 codes and interactions) using data from the National Trauma Data Bank (NTDB). They evaluated discrimination using area under the receiver operating curve (AUC) and calibration with the Hosmer-Lemeshow (HL) h-statistic. The authors compared performance of these
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Background The current common and dogmatic opinion is that whole-body computed tomography (WBCT) should not be performed in major trauma patients in shock. We aimed to assess whether WBCT during trauma-room treatment has any effect on the mortality of severely injured patients in shock. Methods In a retrospective multicenter cohort study involving 16719 adult blunt major trauma patients we compared the survival of patients who were in moderate, severe or no shock (systolic blood pressure 90-110,|90 or |110 mmHg) at hospital admission and who received WBCT during resuscitation to those who did not. Using data derived from the 2002-2009 version of TraumaRegister®, we determined the observed and predicted mortality and calculated the standardized mortality ratio (SMR) as well as logistic regressions. Findings 9233 (55.2%) of the 16719 patients received WBCT. The mean injury severity score was 28.8±12.1. The overall mortality rate was 17.4% (SMR = 0.85, 95%CI 0.81-0.89) for patients with WBCT and 21.4%
Background Occult hypoperfusion (OH) is defined as hypoperfusion in the presence of normal vital signs. It is associated with increased length of stay (LOS) and increased mortality.. Objectives To compare four methods of detecting OH in adult major trauma patients at a level 1 trauma centre-base excess (BE), non-invasive cardiac index (CI), shock index (SI) and rate over pressure evaluation (ROPE).. Method Patients meeting the Victorian Trauma Registry entrance criteria who presented with normal vital signs were enrolled. CI was obtained half hourly using an USCOM monitor. BE, SI and ROPE were obtained clinically.. Results Sixty-four patients were enrolled. Mean injury severity score (ISS) was 19 (SD 11) and mean hospital LOS was 10 days (SD 8). Two patients (3%) died in hospital. Ten patients (16%) had OH detected by CI, seven (11%) by BE, four (6%) by SI and two (3%) by ROPE. There was a significant association between hospital LOS and BE (p,0.005). Agreement between BE and CI in detecting OH ...
BACKGROUND An early predictive model for massive transfusion (MT) is critical for management of combat casualties because of limited blood product availability, component preparation, and the time necessary to mobilize fresh whole blood donors. The purpose of this study was to determine which variables, available early after injury, are associated with MT. We hypothesized that International Normalized Ratio and penetrating mechanism would be predictive. STUDY DESIGN We performed a retrospective cohort analysis in two combat support hospitals in Iraq. Patients who required MT were compared with patients who did not. Eight potentially predictive variables were subjected to univariate analysis. Variables associated with need for MT were then subjected to stepwise logistic regression. RESULTS Two hundred forty-seven patients required MT and 311 did not. Mean Injury Severity Score was 22 in the MT group and 5 in the non-MT group (p | 0.001). Patients in the MT group received 17.9 U stored RBCs and 2.0 U
The regionalization of trauma care, the Emergency Medical Treatment and Active Labor Act of 1986, the advent of Accountable Care Organizations and bundled payments have brought Level 1 trauma centers (TC) to a new crossroads. By protocol, injured patients are preferentially transferred to designated TCs when a higher level of care is indicated. Trauma transfers frequently come during off hours and may not always appear to be related to injury severity. Based on this observation, we hypothesized patients transferred from regional hospitals to Level 1 TCs would have lower injury severity scores (ISS) and unfavorable payor status. We queried our TC registry to identify trauma transfers (TTP) and primary trauma patients (PTP) treated at our level 1 TC between 2004 and 2012. Demographics, payor status, length of stay (LOS), injury severity score (ISS), and discharging service were compared. 5699 TTP and 11147 PTP were identified. Uninsured patients comprised 11 % (n = 602) of TTP compared with 15 % ...
There are over one million deaths from road traffic collisions. In Afghanistan, there have been 2005 UK battle injuries over 10 years. Advances in military trauma care have improved survival, resulting in more severely injured individuals entering the trauma care pathway. Improved understanding of immunoendocrine changes after severe trauma may facilitate novel interventions to improve outcomes. We prospectively recruited 102 severely injured patients at the QEH Birmingham; 52 military and 50 civilian patients with a mean Injury Severity Score of 27.2±13.9. Blood and 24-hr urine were collected at baseline (injury,24h) and at regular intervals from while in hospital and at 3,4, and 6 months. Results demonstrated a reduced neutrophil function following a surge of DAMPs and cytokines that were released into the circulation. Both DHEA and DHEAS were significantly down-regulated (p,0.0001). Serum testosterone was initially completely suppressed (p,0.0001) but normalised after week 4. Protein and ...
RESULTS: Sport was responsible for injury in 3878 (15.4%) cases during the study period; 3506 (90.4%) were discharged from the hospital, and 372 (9.6%) were admitted. Seventy-three percent were male patients and 78% Caucasian; mean age was 13 ± 3.5 years. ED visits for sports-related TBIs increased 92% over the study period, yet there was no significant change (χ2 = 9.8, df = 9, P = .37) in the percentage of children admitted. Mean injury severity score for those admitted decreased from 7.8 to 4.8 (β = -0.46; P = .006); length of stay trended downward (β = -0.05; P = .05). ...
Naik-Mathuria BJ, Rosenfeld EH, Gosain A, Burd R, Falcone RA, Thakkar R, Gaines B, Mooney D, Escobar M, Jafri M, Stallion A, Klinkner DB, Russell R, Campbell B, Burke RV, Upperman J, Juang D, St Peter S, Fenton SJ, Beaudin M, Wills H, Vogel A, Polites S, Pattyn A, Leeper C, Veras LV, Maizlin I, Thaker S, Smith A, Waddell M, Drews J, Gilmore J, Armstrong L, Sandler A, Moody S, Behrens B, Carmant L. Proposed clinical pathway for nonoperative management of high-grade pediatric pancreatic injuries based on a multicenter analysis: A pediatric trauma society collaborative. J Trauma Acute Care Surg. 2017 10; 83(4):589-596 ...
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. 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. The International Classification of Diseases Injury Severity Score (ICISS) was used to adjust for injury severity, and the Charlson Comorbidity Index to adjust for comorbidity. Age categories (0-14, 15-50, and ≥ 51 years) were used to represent pre-menarche, reproductive and post- menopausal women. Women had overall a survival benefit (OR 0.51; 95% CI 0.50 to 0.53) after adjustment for injury severity and comorbidity. A similar pattern was seen across the age categories (0-14 years OR 0.56 (95% CI 0.25 to 1
BACKGROUND: Pediatric unintentional falls are the leading cause of injury-related emergency visits for children , 5 years old. The purpose of this study was to identify population characteristics, injury mechanisms, and injury severities and patterns among children , 5 years to better inform age-appropriate falls prevention strategies. METHODS: This retrospective database study used trauma registry data from the lead pediatric trauma system in Georgia. Data were analyzed for all patients , 5 years with an international classification of disease, 9th revision, clinical modification (ICD-9 CM) external cause of injury code (E-code) for unintentional falls between 1/1/2013 and 12/31/2015. Age (months) was compared across categories of demographic variables, injury mechanisms, and emergency department (ED) disposition using Kruskal-Wallis ANOVA and the Mann Whitney U test. The relationships between demographic variables, mechanism of injury (MOI), and Injury Severity Score (ISS) were evaluated using ...
The weekly itch severity score is the sum of the daily itch severity scores over 7 days and ranges from 0 to 21. The daily itch severity score is the average of the morning and evening scores on a scale of 0 (none) to 3 (severe). The Baseline weekly itch severity score is the sum of the daily itch severity scores over the 7 days prior to the first treatment. A higher itch severity score indicates more severe itching. A negative change score indicates improvement.. The MID response for weekly itch severity score was defined as a reduction from baseline in weekly itch severity score of 5 points or more. The time to weekly itch severity score MID response was defined as the time (in weeks) from Day 1 to the study week when weekly itch severity score MID response was first achieved. ...
mechanisms, and injury severities Pediatric falls ages 0-4: understanding demographics - Texas A&M University (TAMU) Scholar profile, educations, publications, research, recent courses, and student works
Trauma or injury refers to "a body wound or shock produced by sudden physical injury, as from violence or accident."1 It can also be describes as "a physical wound or injury, such as a fracture or blow."2 Major trauma (defined by an Injury Severity Score of greater than 15)3 can result in...
Taking the pedestrian-vehicle accidents in the China in-Depth Accident Study (CIDAS) database as a sample case, 13 accidents morphological parameters were selected from three aspects: human, vehicle and environmental factors, and their depth analysis was carried out to obtain their distribution law through the card. The chi-square test and logistic regression method are used to analyze the correlation between the injury severity of pedestrians and other accidental morphological parameters in pedestrian-vehicle accidents. The results show that there is no significant correlation between gender/season and injury severity of pedestrians. The age of pedestrians and the collision speed is the strongest correlation with injury severity of pedestrians ...
Taking the pedestrian-vehicle accidents in the China in-Depth Accident Study (CIDAS) database as a sample case, 13 accidents morphological parameters were selected from three aspects: human, vehicle and environmental factors, and their depth analysis was carried out to obtain their distribution law through the card. The chi-square test and logistic regression method are used to analyze the correlation between the injury severity of pedestrians and other accidental morphological parameters in pedestrian-vehicle accidents. The results show that there is no significant correlation between gender/season and injury severity of pedestrians. The age of pedestrians and the collision speed is the strongest correlation with injury severity of pedestrians ...
1. Institutions operating a hospital of the general and specialized class of hospitals and designated by the Minister under section 112 of the Act respecting health services and social services (chapter S-4.2) to operate a trauma centre shall provide the Minister with the following information on users who are major trauma patients: ...
Physicians look at several indicators to predict the level of a patients recovery during the first few weeks and months after injury.
Gareth Bale has picked up another injury playing for Real Madrid that threatens to further disrupt his season in Euro finals year.
In this study, we found that the trauma volume of our regional trauma center was appropriate, comparable to that in level I trauma centers in the US. The American College of Surgeons Committee on Trauma criteria for level I trauma center verification include an annual number of at least 1,200 patients, of which at least 240 must have an ISS ,15 [8]. Before the establishment of the regional trauma center, there were about 250 patients with severe trauma (ISS ,15) annually in GMC Trauma Center. Previous studies have shown that the establishment of a designated trauma center and the centralization of the management of severely injured patients can result in better outcomes [5,9]. Therefore, an increased patient volume after trauma center establishment could help in fulfilling the purpose of the plan. In addition, an increasing rate of direct transportation of severely injured patients via emergency medical services (EMS) was observed in this study. In one study from Korea, the proportion of ...
According to the HISS, 28.5% sustained minor injuries, 34.2% moderate, 20.2% severe and 17.1% major.. Patients who injured their left hand on average sustained a moderate injury (average score = 45), whereas those patients who injured their right hand sustained a severe injury (average score = 57).. The median job tenure was four years, with a range of between one month and 31 years.. Job tenure did not seem to affect the risk of sustaining a work-related hand injury; however, it did affect the severity of the injury incurred. Those patients who were injured in their first year of work sustained a mean injury severity score of 75 (severe), whereas those patients who were injured after they had been at their current job for at least one year sustained a mean injury severity score of 32 (moderate).. Discussion. This research found that occupational hand injuries correlate well with individual patient characteristics such as young age, male gender, poor education and lack of training, which is ...
The technological advances in computed tomography (CT), with faster image acquisition resulting in higher resolution, result in making CT a more widely and intensively used imaging modality in trauma patient care. Thoraco-abdominal CT in addition appears to have additional diagnostic value compared to conventional radiography, especially in severely injured trauma patients.. Nowadays, both clinical data and conventional radiology are used to determine which patient should undergo body CT scanning. Currently there are no widely accepted guidelines for the use of a standard TRAuma CT (TRACT). Although many retrospective and several prospective cohort studies have been published on this topic, the data are not sufficient to sustain evidence-based practice in decision-making.. The aim of this study is, to establish the additional effectiveness and costs of routine thoraco-abdominal CT in blunt trauma patients versus conventional radiological imaging and to determine which clinical parameters ...
Objective:To analyze the characteristics of polytrauma Patients and to assess the outcome of trauma care as this specialty has evolved over the years at a university hospital. Methods: The study included all polytrauma Patients treated between January 1998 and September 2005 at a tertiary care hospital in a megacity. Data of 1009 Patients was collected prospectively and analyzed retrospectively. Patients were divided into two groups A and B, based on their presentation before and after the introduction of a formal trauma training course in 2002. The analysis included demographic data, injury severity score, vital signs including hemodynamics and GCS on admission, intubation rates, mortality and complications. Results: 435 Patients were included in group A (1998-2001) whereas group B (2002-2005) comprised of 574 Patients. The proportion of Patients with accidental versus intentional injuries was similar in both groups. The mean injury severity score of group A was 11.9 whereas that of group B was 11.7.
TY - JOUR. T1 - Evaluation of pregnant women after blunt injury. AU - Towery, R.. AU - English, T. P.. AU - Wisner, David H. AU - Hoelzer, D. J.. AU - Fildes, J.. AU - Bingham, J.. AU - Morris, J.. AU - Gabram, S.. AU - Strauch, G. O.. AU - Mock, C. N.. PY - 1993. Y1 - 1993. N2 - A retrospective review of 125 pregnant women with blunt injuries admitted to a level I trauma center over a 35-month period was performed. The usefulness of three diagnostic tests, fetal ultrasound (US), external fetal monitoring (EFM), and Kleihauer-Betke (KB) tests in detecting fetal or pregnancy-associated complications was evaluated. The majority of women (77.6%) were involved in motor vehicle crashes and the mean Injury Severity Score was low (4.7). The most common complications were premature uterine contractions (67%) and abruptio placentae (11%). When used together, EFM and US identified all complications. Moreover, all complications were manifest within 6 hours of admission. The KB tests had a sensitivity of ...
ECMC is Western New Yorkʼs Adult Regional Trauma Center, treating patients who are accident victims or facing other medical crises from across our area.
Some previous studies have found that the amount and severity of injuries in homicide victims correlate with different homicide characteristics, such as the victim-offender relationship and drug influence of the offender. If such relationships exist, they may be used by homicide investigators as part of an offender profiling.. Furthermore, injury severity may be helpful in understanding the nature of lethal violence. If the injuries change over time or differ between regions, this may say something about the underlying causes and thus help society to take preventive measures. However, measures of injury severity are often missing in homicide epidemiology. This may in part be due to a lack of standardized and accessible ways to quantify injuries in homicide victim.. To address these issues, there is a need for methods to quantify injury severity in homicide victims. The aim of the current thesis was to investigate different types of injury measures and their applicability to homicide victims. The ...
BACKGROUND: As the population ages, the elderly will constitute a prominent proportion of trauma patients. The elderly suffer more severe consequences from traumatic injuries compared with the young, presumably resulting in increased resource use. In this study, we sought to examine ICU resource use in trauma on the basis of age and injury severity. METHODS: This study was a retrospective review of trauma registry data prospectively collected on 26,237 blunt trauma patients admitted to all trauma centers (n = 26) in one state over 24 months (January 1996-December 1997). Age-dependent and injury severity-dependent differences in mortality, ICU length of stay (LOS), and hospital LOS were evaluated by logistic regression analysis. RESULTS: Elderly (age | or = 65 years, n = 7,117) patients had significantly higher mortality rates than younger (age | 65 years) trauma patients after stratification by Injury Severity Score (ISS), Revised Trauma Score, and other preexisting comorbidities. Age | 65 years was
During the study period, 2,516 patients were admitted to the trauma center. Blunt mechanisms (motor vehicle crashes, falls, etc) were most frequent cause for hospital admission. There were 405 patients who were intubated or arrived intubated.. Twenty-four patients were reintubated 27 times for 19 planned, 5 self-extubations, and 3 unplanned extu-bations (Table 2). All patients were intubated orotracheally. There were 8 women and 16 men, with a mean age of 37 years (range, 14 to 80 years). Mean Injury Severity Score (ISS) was 20, and the mean Glasgow Coma Scale (GCS) at hospital admission was 11. Length of intubation ranged from 6 h to 9 days, with a mean of 3.6 days. No patient suffered direct laryngeal trauma, and there were no head and neck bums or smoke inhalation injuries. Reasons for initial intubation were altered senso-rium , airway safety after pain control maneuvers , respiratory distress , or respiratory arrest . Seven were intubated in the field, 14 in the admitting area, 1 at a ...
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After severe tissue injury, innate immunity mounts a robust systemic inflammatory response. However, little is known about the immediate impact of multiple trauma on early complement function in humans. In the present study, we hypothesized that multiple trauma results in immediate activation, consumption, and dysfunction of the complement cascade and that the resulting severe complementopathy may be associated with morbidity and mortality. Therefore, a prospective multicenter study with 25 healthy volunteers and 40 polytrauma patients (mean injury severity score = 30.3 ± 2.9) was performed. After polytrauma, serum was collected as early as possible at the scene, on admission to the emergency room (ER), and 4, 12, 24, 120, and 240 h post-trauma and analyzed for the complement profile. Complement hemolytic activity (CH-50) was massively reduced within the first 24 h after injury, recovered only 5 days after trauma, and discriminated between lethal and nonlethal 28-day outcome. Serum levels of ...
BACKGROUND: The state of Floridas trauma system is organized into seven regions, two of which lack designated pediatric trauma centers. Injured children residing in these regions often require transfer out of their home region for definitive care. The purpose of this study was to evaluate the effectiveness and efficiency of the current regionalization approach, focusing on variations between regions. METHODS: Using the Florida Agency for Health Care Administration database, we identified all trauma patients 15 years old or younger admitted between 2009 and 2014. Patients with high-risk injury (ICD-9 Injury Severity Score < 0.85) who did not receive definitive treatment at a pediatric trauma center (PTC) were considered undertriaged. Outcomes of interest included mortality and long-term disability. Patients who were definitively treated at a facility outside their home region, but who had low risk injuries (ICD-9 Injury Severity Score > 0.9), required no procedures or ICU monitoring, and were ...
Results: Seven hundred and forty five patients including 181 Afghan civilians, 82 non-Afghan civilians, 24 Afghan police and military, and 458 military ISAF, were treated during the study period. There were 10 combat casualties among them. All patients were male and aged 25-30 years; seven had been injured by an explosive and three by firearm; five with head-neck wounds, two with wounds in the upper limbs, two in the abdomen, one in the thorax, and one in the lower limbs. The New Injury Severity Score (NISS) was one mild, five moderate and four severe. There were 14 surgical patients (seven wounded in combat and seven non-combat casualties, and 12 patients were admitted to the Intensive Care Unit (ICU). None of them died. A total of 12 general anesthesias, 11 regional anesthesias (three intradural anesthesias, three interscalene blocks, one axillary block and four femoral blocks) and six local anesthesias with sedation were performed. ...
A threshold Injury Severity Score (ISS) ≥ 16 is common in classifying major trauma (MT), although the Abbreviated Injury Scale (AIS) has been extensively revised over time. The aim of this study was to determine effects of different AIS revisions (1998, 2008 and 2015) on clinical outcome measures. A retrospective observational cohort study including all primary admitted trauma patients was performed (in 2013-2014 AIS98 was used, in 2015-2016 AIS08, AIS08 mapped to AIS15). Different ISS thresholds for MT and their corresponding observed mortality and intensive care (ICU) admission rates were compared between AIS98, AIS08, and AIS15 with Chi-square tests and logistic regression models. Thirty-nine thousand three hundred seventeen patients were included. Thresholds ISS08 ≥ 11 and ISS15 ≥ 12 were similar to a threshold ISS98 ≥ 16 for in-hospital mortality (12.9, 12.9, 13.1% respectively) and ICU admission (46.7, 46.2, 46.8% respectively). AIS98 and AIS08 differed significantly for in-hospital
The article introduces Programs for Injury Categorization, using the International Classification of Diseases (ICD) and R statistical software (ICDPIC-R). Starting with ICD-8, methods have been described to map injury diagnosis codes to severity scores, especially the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). ICDPIC was originally developed for this purpose using Stata, and ICDPIC-R is an open-access update that accepts both ICD-9 and ICD-10 codes. Data were obtained from the National Trauma Data Bank (NTDB), Admission Year 2015. ICDPIC-R derives CDC injury mechanism categories and an approximate ISS (
New generation spiral CT scanners permit multiple consecutive CT examinations on the same trauma patient in a short period of time. The purpose of this study was to evaluate the diagnostic role and therapeutic impact of routine spiral CT chest in multiply injured patients or patients with a suspicious mechanism of injury. This prospective study included 443 patients with blunt chest trauma. All patients underwent a spiral CT chest as part of their routine evaluation. Radiological interpretation of chest x-rays, CT scan findings, and changes in management plan guided by these findings were recorded. The mechanism of injury was road traffic accidents in 422 patients (95.26%). Out of the 167 patients with normal chest radiograph, 136 (81.43%) were found to have an abnormality on chest CT. The management was changed in the form of additional investigations or unplanned intervention in 92 patients (20.76%). Additional investigations included transoesophageal echocardiography (n = 7), bronchoscopy (n ...
TY - JOUR. T1 - Orthopedic injuries associated with jet-skis (personal watercrafts). T2 - A review of 127 inpatients. AU - Donnally, C. J.. AU - Rothenberg, P. M.. AU - Metser, G.. AU - Massel, D. H.. AU - Butler, A. J.. AU - Damodar, D.. AU - Shin, S. H.. AU - Zakrison, T. L.. N1 - Publisher Copyright: © 2018 Elsevier Masson SAS Copyright: Copyright 2018 Elsevier B.V., All rights reserved.. PY - 2018/4. Y1 - 2018/4. N2 - Background: Personal watercrafts (PWC) account for a disproportionate amount of water based injuries. Current literature suggests those with less PWC experience are more at risk for injury. Previous studies have not specifically evaluated the orthopedic implications of PWC usage or how various mechanisms of injury (MOI) contribute to different injury patterns. Hypothesis: PWC injuries will frequently require orthopedic intervention. The presence of an orthopedic injury will result in increased injury severity score (ISS), hospital and intensive care unit (ICU) length of stay ...
New research was presented at AAP 2020, the 2020 American Academy of Pediatrics Virtual National Conference & Exhibition, from October 2-5. The features below highlight some of the studies emerging from the conference that focused on emergency medicine. Black children were overrepresented in suspected child abuse reporting from 2010-2014, despite having less severe injuries when compared with white children, according to a review of more than 4,000 suspected child abuse victims reported to the National Trauma Data Bank. During the study period, victims classified as black represented 32.3% of cases while accounting for 13% of the US population, whereas white children-who were underrepresented-accounted for 51.2% of reports but comprising approximately 70% of the US population. Serious or severe injury severity scores were reported in 22% or white children, compared with 11% of black children, and in-hospital mortality occurred in 11% of white and 8% of black children. However, black children had ...
Patients who are potentially unsuitable for helicopter transport are identified by abnormal physiological variables, either alone or in combination, in the adverse clinical signs box of the transport algorithm (figs 1 and 2). These findings correlate with the potential for life threatening injury pattern, airway obstruction, failure of oxygenation and ventilation, and exsanguination either at the scene or during transport to hospital. Other authors have validated that derangements of respiratory rate, pulse rate, blood pressure, and conscious level, either alone or in combination, accurately predict serious injury patterns, and justify field triage directly to regional level 1 trauma centres in the USA.18 Reduction in level of consciousness to an AVPU score of P or less predicted an injury severity score (ISS) of ,15 with a sensitivity of 93% and a specificity of 85%.18 Similar physiological observations used to derive the prehospital index have been used to justify and validate timely ...
The article by Nathens et al found that lack of insurance was an independent predictor for transfer to a trauma center after adjusting for differences in injury severity. An injury severity score of 36 represents a patient that has sustained life-threatening polytrauma and should be transferred to a Level 1 trauma center ...
The severity levels of brain injuries ranges from mild to moderate through moderate to severe. View this video to learn more about brain injury severity.
TY - JOUR. T1 - Increased CD4+ CD25+ T regulatory cell activity in trauma patients depresses protective Th1 immunity. AU - MacConmara, Malcolm P.. AU - Maung, Adrian A.. AU - Fujimi, Satoshi. AU - McKenna, Ann M.. AU - Delisle, Adam. AU - Lapchak, Peter H.. AU - Rogers, Selwyn. AU - Lederer, James A.. AU - Mannick, John A.. PY - 2006/10/1. Y1 - 2006/10/1. N2 - OBJECTIVES: We recently reported increased CD4 CD25 T regulatory (Treg) activity after burn injury in mice. This study sought to determine if Tregs mediate the reduction in TH1-type immunity after serious injury in man and if Treg function is altered by injury. METHODS: Peripheral blood was withdrawn from 19 consenting adult patients (35.1 ± 16.3 years of age) with Injury Severity Scores (ISS) 36.6 ± 13.9 on days 1 and 7 after trauma and from 5 healthy individuals. CD4 T cells were purified and sorted into Treg (CD25) and Treg-depleted populations. After activation of cells with anti-CD3/CD28 antibody, production of the TH1-type cytokine ...
The Division of Trauma & Critical Care at Northwestern University Feinberg School of Medicines Department of Surgery teaches students to deliver integrated state-of-the-art surgical care to critically ill and injured patients. The Division coordinates the multidisciplinary care of trauma patients at Northwestern Memorial Hospital, an Illinois-designated Level I Trauma Center.. Learn more about our work via the links below.. ...
BACKGROUND: Whole body computed tomography (WBCT) is an important adjunct in trauma care, which is often part of standard protocol in initial management of trauma patients. However, WBCT exposes patients to a significant dose of radiation. The use of WBCT was assessed in a modern trauma cohort in Sweden.. METHODS: A two-center retrospective cohort study was performed. All consecutive trauma alert patients at a university hospital (July-December 2008), and a rural county hospital (January 2009- December 2010) were included. Patients were stratified into three groups (high, intermediate and low risk) based on documented suspected injuries at primary survey at the site of accident or at the emergency department. Injury severity score (ISS) was calculated. Case records were reviewed for clinical and radiological findings at the time of trauma, and during a ≥36 months of follow-up period to identify possible missed injuries.. RESULTS: A total of 523 patients were included in the study (university ...
This last meta-analysis, although methodologically weak, was performed because the number of RCTs available for the first meta-analysis was limited.. We addressed the question of risk factors for developing VT by performing a meta-analysis on studies (RCT and non-RCT) that used risk factors as either dichotomous variables (e.g., age greater or less than 55) or continuous variables (e.g., age, without specifying a particular age cutoff point). We evaluated six dichotomous risk factors (gender, head injury, long-bone fracture, pelvic fracture, spinal fracture, and spinal-cord injury) and three continuous risk factors (age, Injury Severity Score [ISS], and units of blood transfused).. We were unable to address the question about methods of screening for VT using the current literature data. Only three studies addressed this issue in trauma patients, and each compared different methods of screening. The data could not be combined for analysis.. We addressed the question about VCF by combining ...
Objetivo. Determinar la capacidad de predicción del índice de shock y del índice de shock modificado para hemorragia masiva tras sufrir un trauma grave.. Diseño. Cohorte retrospectiva.. Ámbito. Atención inicial hospitalaria al paciente con enfermedad traumática grave en una unidad de cuidados intensivos de trauma de un hospital terciario.. Sujetos. Pacientes mayores de 14 años con trauma grave (injury severity score [ISS],15), admitidos de forma consecutiva desde enero de 2014 hasta diciembre de 2015.. Variables. Se estudiaron sensibilidad (Se), especificidad (Sp), valores predictivos positivo y negativo (VP+ y VP−), razones de verosimilitud positiva y negativa (RV+ y RV−), curvas ROC (receiver operating characteristics) y el área bajo las mismas (AUROC) para predicción de hemorragia masiva.. Resultados. Se incluyeron 287 pacientes, el 76,31% (219) fueron varones, con una edad media de 43,36 (±17,71) e ISS de 26 (rango intercuartil [RIC]: 21-34). La frecuencia global de hemorragia ...
Clearing the Cervical Spine in blunt trauma patients with head injury: Guidelines are under revision for identifying c-spine injuries after trauma. The new guideline does state that MR imaging is no longer required to clear the c-spine as the negative predictive values for CT are 98.9 percent for ligament injury and 100 percent for unstable c-spine injury ...
Solskjaer: Paul Pogbas ankle surgery down to new injury: Ole Gunnar Solskjaer addresses speculation over Paul.. News video on newsR on Friday, 3 January 2020
Pediatric Trauma Score answers are found in the Calculators powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.
By maximally using relevant available positive evidence, the Mayo system classifies a larger number of cases than single indicator systems with reasonable accuracy. This system may be of use in retrospective research and for determination of TBI severity for planning postacute clinical care.
People who experience an accident or other trauma can find specialized care in the regions only level I trauma center at USA Health University Hospital in Mobile, Ala.
The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin. We support a shared mission of patient care, innovation, medical research and education. Our health network includes five hospitals, a Community Hospital with two locations, nearly 2,000 physicians and more than 40 health centers and clinics. We operate eastern Wisconsins only academic medical center and adult Level I Trauma Center at Froedtert Hospital, Milwaukee. It is an internationally recognized training and research center engaged in thousands of clinical trials and studies.. ...
The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin. We support a shared mission of patient care, innovation, medical research and education. Our health network includes five hospitals, more than 1,700 physicians and nearly 40 health centers and clinics. We operate eastern Wisconsins only academic medical center and adult Level I Trauma Center at Froedtert Hospital, Milwaukee. It is an internationally recognized training and research center engaged in thousands of clinical trials and studies.. ...