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.. ...
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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 % ...
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. ...
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: ...
Gareth Bale has picked up another injury playing for Real Madrid that threatens to further disrupt his season in Euro finals year.
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 ...
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 ...
Vol 15: Successful Conviction of Intoxicated Drivers at a Level I Trauma Center.. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
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 ...
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. ...
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 ...
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 ...
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 ...
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.
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, 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.. ...
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.. ...
Dr. Charlotte Yeh was crossing the street in Washington, D.C., on her way to dinner when a car hit her. She ended up in a Level I trauma center, and the experience was sobering for its reminder that in our drive to measure quality indicators, the patient may end up ignored or forgotten. Running Time: 10 minutes A […]. ...
This revised trauma score calculator is one of the physiological scoring systems and assesses the severity and outcome of traumatic injuries in triage.
Ricky Lutton and Johnny Murphy (both groin) are also looking at a return in 2-3 weeks while longer term absentees Dan Tuohy (ankle) and Tommy Bowe (knee) are hopeful of being back soon ...
Odell Beckham Jr. didnt point fingers or make accusations. After possibly dodging a major injury, New Yorks flashy wide receiver calmly moved on. No theatrics were ...
vs. Floortime, Speech, Occupational and Physical Therapy all the while dragging this droopy, lethargic boy along. I cant tell you how many times I had to cajole and jolly this little boy through treatment sessions. His providers have commented that he seems disinterested or has inconsistent energy or seems irritable. I think hes been in pain, I think he is malnutritioned and worn out from constant diarrhea. I wouldnt want to play or learn if I felt like that either and neither would you!. The general consensus is that Autism is a Neurological Disorder. Your child is sent first for a Neuro-Psych or Developmental Evaluation and the treatment plan is most often many, many hours of Applied Behavioral Analysis (ABA). What then about all the other components of the disorder which physically manifest in many other systems and organs in the body? The majority of these are dismissed every day by practitioners as a coincidence, or in my sons case - the result of poor diet. Almost every mother of a ...
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Sort by: title. issue date. submit date. In order: Ascending. Descending. Results/Page 5. 10. 15. 20. 25. 30. 35. 40. 45. 50. 55. 60. 65. 70. 75. 80. 85. 90. 95. 100. Authors/Record: All. 1. 5. 10. 15. 20. 25. 30. 35. 40. 45. 50. ...
The most common cause of death in cases of pelvic trauma is exsanguination caused by associated injuries, not the pelvic injury itself. For patients with relatively isolated pelvic trauma, the impact of vascular injury severity on outcome remains unclear. We hypothesized that the severity of the pelvic vascular injury plays a more decisive role in outcome than fracture pattern complexity. Medical records of patients with pelvic fracture at a single center between January 2016 and December 2017 were retrospectively reviewed. Those with an abbreviated injury scale (AIS) score ≥ 3 in areas other than the pelvis were excluded. Lateral compression (LC) type 1 fractures and anteroposterior compression (APC) type 1 fractures according to the Young-Burgess classification and ischial fractures were defined as simple pelvic fractures, while other fracture types were considered complicated pelvic fractures. Based on CT, vascular injury severity was defined as minor (fracture with or without hematoma) or severe
Introduction: Helicopters play an important role in trauma; however, this service comes with safety risks, high transport costs, and downstream care charges. Objective: Our objective was to determine the characteristics of early discharged trauma patients (,24 h length of stay) in order to reduce overtriage. Methodology: Data were obtained from the trauma registries at one of two Level 1 trauma centers. Eligible patients included all scene trauma patients transported by helicopter to the Level 1 trauma centers from January 1, 2016, to December 31, 2017, who had a length of stay of 24 h or less. Patient factors such as age, gender, scene location, loaded miles, and transportation costs were collected. Trauma type, mechanism of injury, Abbreviated Injury Scale (AIS), Injury Severity Score, Revised Trauma Score, and prehospital vital signs were documented. Driving distances between the accident scene to local hospital, home of record to local hospital, and home of record to the Level I trauma ...
OBJECTIVES: Prehospital triage of trauma patients is of paramount importance because adequate trauma center referral improves survival. We developed a simple score that is easy to calculate in the prehospital phase.. DESIGN: Multicenter prospective observational study.. SETTING: Prehospital physician-staffed emergency system in university and nonuniversity hospitals.. INTERVENTIONS: We evaluated 1360 trauma patients receiving care from a prehospital mobile intensive care unit in 22 centers in France during 2002. The association of prehospital variables with in-hospital death was tested using logistic regression, and a simple score (the Mechanism, Glasgow coma scale, Age, and Arterial Pressure [MGAP] score) was created and compared with the triage Revised Trauma Score, Revised Trauma Score, and Trauma Related Injury Severity Score. The model was validated in 1003 patients from 2003 through 2005.. MEASUREMENTS AND MAIN RESULTS: Four independent variables were identified, and each was assigned a ...
Abnormalities in potassium levels can lead to several clinical difficulties in trauma patients admitted to the ICU. However, the significance of potassium abnormalities soon after admission in trauma patients has not yet been clearly delineated. The objective of this study was to describe the plasma potassium abnormalities in trauma patients on admission and to examine the clinical outcomes associated with these abnormalities. We performed a retrospective observational study of plasma potassium levels in trauma patients admitted to the Fukuyama City Hospital between January 1, 2010 and December 31, 2013. Five hundred twenty consecutive trauma patients were included and categorized into six groups according to their plasma potassium level on admission (|3.0, 3.0-|3.5, 3.5-|4.0, 4.0-|4.5, 4.5-|5.0, and ≥5.0 mEq/L). After adjusting for covariates, including age, gender, the Revised Trauma Score, and the Injury Severity Score, logistic regression analysis was used to examine the association between plasma
Major trauma is any injury that has the potential to cause prolonged disability or death. There are many causes of major trauma, blunt and penetrating, including falls, motor vehicle collisions, stabbing wounds, and gunshot wounds. Depending on the severity of injury, quickness of management and transportation to an appropriate medical facility (called a trauma center) may be necessary to prevent loss of life or limb. The initial assessment is critical, and involves a physical evaluation and also may include the use of imaging tools to determine the types of injuries accurately and to formulate a course of treatment. In 2002, unintentional and intentional injuries were the fifth and seventh leading causes of deaths worldwide, accounting for 6.23% and 2.84% of all deaths. For research purposes the definition often is based on an injury severity score (ISS) of greater than 15. Injuries generally are classified by either severity, the location of damage, or a combination of both. Trauma also may be ...
12. Longo MC, Hunter CE, Lokan RJ, et al. The prevalence of alcohol, cannabinoids, benzodiazepines and stimulants amongst injured drivers and their role in driver culpability. Part II: the relationship between drug prevalence and drug concentration, and driver culpability. Accid Anal Prev. 2000;32:623-32.-1313. Barrio G, Jiménez-Mejías E, Pulido J, et al. Association between cannabis use and non-traffic injuries. Accid Anal Prev. 2012;47:172-6., including prescribed or nonprescribed psychotropic drugs.1414. Cannon R, Bozeman M, Miller KR, et al. The prevalence and impact of prescription controlled substance use among injured patients at a level I trauma center. J Trauma Acute Care Surg. 2014;76:172-5.,1515. Smink BE, Egberts ACG, Lusthof KJ, et al. The relationship between benzodiazepine use and traffic accidents: a systematic literature review. CNS Drugs. 2010;24:639-53.Studies to date conclude that exposure to alcohol and drugs are associated with a higher risk of injury regardless of the ...
Patients with extensive burn injuries suffer from multisystem trauma, which affects their medical, psychological, and social well-being for many years. Monitoring those patients has revealed changes in the endocrine, cardiac, and respiratory systems years after the injury. Our study tries to examine whether changes manifest as a higher risk of death during their lifespan, compared with the general population. Data from the years 1998 to 2013 regarding two groups of patients was obtained from a national trauma registry: one group had suffered burns over 20% of their TBSA and survived the hospitalization period and the second group was a control group of patients admitted with minimal trauma (Injury Severity Score = 1-minor injury to a single body region ...
In a retrospective study performed at a Level I trauma center, we considered all adult patients with major trauma (ISS , 15) and femoral shaft fracture admitted between January 2003 and July 2006. Patients were separated into two groups according to the management strategies for the femoral fracture: group 1, no surgery within 72 hours after primary admission; group 2, surgical stabilization within 72 hours (DCO). To compare the two groups we considered age, ISS, RTS, TRISS, SAPS II, GCS, comorbidity, and other associated surgery. Parameters of evaluation were: mortality in the ICU, ICU length of stay, respiratory failure and length of ventilation, and daily SOFA collected for 8 days. Statistics were determined with the Student t and chi-squared tests; P , 0.05 was considered significant. ...
Abstract INTRODUCTION: Damage control surgery (DCS) is an established option for managing severely injured trauma patients. However, its role in the management of similar patients in the developing world is debatable. The purpose of this study is to describe characteristics and outcomes of patients undergoing DCS. METHODS: All trauma patients requiring laparotomies from 1996 to 2011 at a tertiary care hospital in South Asia were reviewed. DCS was defined in a patient who underwent a truncated laparotomy where the fascia was primarily left open, with the intention of physiological optimization in the Intensive Care Unit, followed by definitive surgery. The primary outcome was in-hospital mortality. Multivariate logistic regression was used to determine the independent predictors of mortality after adjustment for potential confounders. RESULTS: Of 258 patients, 47 underwent DCS. 40% patients were transferred from other hospitals. The time between injury and operation was 152 minutes (IQR: 90-330). Intra