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https://www.readbyqxmd.com/read/28716210/exploring-injury-severity-measures-and-in-hospital-mortality-a-multi-hospital-study-in-kenya
#1
Yuen W Hung, Huan He, Amber Mehmood, Isaac Botchey, Hassan Saidi, Adnan A Hyder, Abdulgafoor M Bachani
INTRODUCTION: Low- and middle-income countries (LMICs) have a disproportionately high burden of injuries. Most injury severity measures were developed in high-income settings and there have been limited studies on their application and validity in low-resource settings. In this study, we compared the performance of seven injury severity measures: estimated Injury Severity Score (eISS), Glasgow Coma Score (GCS), Mechanism, GCS, Age, Pressure score (MGAP), GCS, Age, Pressure score (GAP), Revised Trauma Score (RTS), Trauma and Injury Severity Score (TRISS) and Kampala Trauma Score (KTS), in predicting in-hospital mortality in a multi-hospital cohort of adult patients in Kenya...
July 8, 2017: Injury
https://www.readbyqxmd.com/read/28688663/comparing-traditional-and-novel-injury-scoring-systems-in-a-us-level-i-trauma-center-an-opportunity-for-improved-injury-surveillance-in%C3%A2-low-and-middle-income-countries
#2
Adam D Laytin, Rochelle A Dicker, Martin Gerdin, Nobhojit Roy, Bhakti Sarang, Vineet Kumar, Catherine Juillard
BACKGROUND: In most low- and middle-income countries (LMICs), the resources to accurately quantify injury severity using traditional injury scoring systems are limited. Novel injury scoring systems appear to have adequate discrimination for mortality in LMIC contexts, but they have not been rigorously compared where traditional injury scores can be accurately calculated. To determine whether novel injury scoring systems perform as well as traditional ones in a HIC with complete and comprehensive data collection...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28688639/identifying-preventable-trauma-death-does-autopsy-serve-a-role-in-the-peer-review-process
#3
Dane Scantling, Amanda Teichman, Robert Kucejko, Brendan McCracken, James Eakins, Richard Burns
BACKGROUND: Missing life-threatening injuries is a persistent concern in any trauma program. Autopsy is a tool routinely utilized to determine an otherwise occult cause of death in many fields of medicine. It has been adopted as a required component of the trauma peer review (PR) process by both the American College of Surgeons and the Pennsylvania Trauma Foundation. We hypothesized that autopsy would not identify preventable deaths for augmentation of the PR process. MATERIALS AND METHODS: A retrospective chart review using our institutional trauma registry of all trauma deaths between January 2012 and December 2015 was performed...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28676300/can-residents-be-trained-and-safety-maintained
#4
Marina Gorelik, Steven Godelman, Adel Elkbuli, Lauren Allen, Dessy Boneva, Mark McKenney
INTRODUCTION: Teaching hospitals and faculty need to balance the educational mission for training residents with patient safety. There are no data studying the change in trauma patient outcomes before and after implementation of a surgical residency. The objective of this study was to compare trauma center outcomes before and after the advent of a surgical training program. We predicted that patient-centric outcome metrics would not be affected by the integration of surgical residents into trauma patient care...
July 1, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28658339/tracheobronchial-injuries-in-chest-trauma-a-17-year-experience
#5
Roberto Saad, Roberto Gonçalves, Vicente Dorgan, Jacqueline Arantes G Perlingeiro, Jorge Henrique Rivaben, Márcio Botter, José César Assef
Objective: to discuss the clinical and therapeutic aspects of tracheobronchial lesions in victims of thoracic trauma. Methods: we analyzed the medical records of patients with tracheobronchial lesions treated at the São Paulo Holy Home from April 1991 to June 2008. We established patients' severity through physiological (RTS) and anatomical trauma indices (ISS, PTTI). We used TRISS (Trauma Revised Injury Severity Score) to evaluate the probability of survival. Results: nine patients had tracheobronchial lesions, all males, aged between 17 and 38 years...
March 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28637583/the-revised-trauma-score-plus-serum-albumin-level-improves-the-prediction-of-mortality-in-trauma-patients
#6
Seong Chun Kim, Dong Hoon Kim, Tae Yun Kim, Changwoo Kang, Soo Hoon Lee, Jin Hee Jeong, Yong Joo Park, Sang Bong Lee, Daesung Lim
INTRODUCTION: The Revised Trauma Score (RTS) is used worldwide in prehospital practice and in the emergency department (ED) settings to triage trauma patients. The main purpose of this study was to evaluate the value of the RTS plus serum albumin (RTS-A) and to compare it with other existing trauma scores as well as to compare the predictive performance of the Trauma and Injury Severity Score with the RTS-A (TRISS-A) with the original TRISS. METHODS: This was a single center, trauma registry based observational cohort study...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28597478/safety-of-the-use-of-group-a-plasma-in-trauma-the-stat-study
#7
Nancy M Dunbar, Mark H Yazer
BACKGROUND: Use of universally ABO-compatible group AB plasma for trauma resuscitation can be challenging due to supply limitations. Many centers are now using group A plasma during the initial resuscitation of traumatically injured patients. This study was undertaken to evaluate the impact of this practice on mortality and hospital length of stay (LOS). STUDY DESIGN AND METHODS: Seventeen trauma centers using group A plasma in trauma patients of unknown ABO group participated in this study...
August 2017: Transfusion
https://www.readbyqxmd.com/read/28581278/reduced-mortality-in-severely-injured-patients-using-hospital-based-helicopter-emergency-medical-services-in-interhospital-transport
#8
Oh Hyun Kim, Young Il Roh, Hyung Il Kim, Yong Sung Cha, Kyoung Chul Cha, Hyun Kim, Sung Oh Hwang, Kang Hyun Lee
Recent evidence has demonstrated the survival benefits of helicopter transport for trauma patients. The purpose of this study was to evaluate the effectiveness of hospital-based helicopter emergency medical services (H-HEMS) in comparison with ground ambulance transport in improving mortality outcomes in patients with major trauma. Study participants were divided into 2 groups according to type of transport to the trauma center; that is, either via ground emergency medical services (GEMS) or via H-HEMS. The study was conducted from October 2013 to July 2015...
July 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28538630/the-evolution-of-care-improves-outcome-in-blunt-thoracic-aortic-injury-a-western-trauma-association-multicenter-study
#9
Steven R Shackford, Casey E Dunne, Riyad Karmy-Jones, William Long, Desarom Teso, Martin A Schreiber, Justin Watson, Cheri Watson, Robert C McIntyre, Lisa Ferrigno, Mark L Shapiro, Kevin Southerland, Julie A Dunn, Paul Reckard, Thomas M Scalea, Megan Brenner, William A Teeter
BACKGROUND: The management of blunt thoracic aortic injury (BTAI) has evolved radically in the last decade with changes in the processes of care and the introduction of thoracic endovascular repair (TEVAR). These changes have wrought improved outcome, but the direct effect of TEVAR on outcome remains in question as previous studies have lacked vigorous risk adjustment and long-term follow-up. To address these knowledge gaps, we compared the outcomes of TEVAR, open surgical repair, and nonoperative management for BTAI...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422904/a-comparison-of-prognosis-calculators-for-geriatric-trauma-a-prognostic-assessment-of-life-and-limitations-after-trauma-in-the-elderly-consortium-study
#10
Tarik David Madni, Akpofure Peter Ekeh, Scott C Brakenridge, Karen J Brasel, Bellal Joseph, Kenji Inaba, Brandon R Bruns, Jeffrey D Kerby, Joseph Cuschieri, M Jane Mohler, Paul A Nakonezny, Audra Clark, Jonathan Imran, Steven E Wolf, M Elizabeth Paulk, Ramona L Rhodes, Herb A Phelan
BACKGROUND: The nine-center Prognostic Assessment of Life and Limitations After Trauma in the Elderly consortium has validated the Geriatric Trauma Outcome Score (GTOS) as a prognosis calculator for injured elders. We compared GTOS' performance to that of the Trauma Injury Severity Score (TRISS) in a multicenter sample. METHODS: Three Prognostic Assessment of Life and Limitations After Trauma in the Elderly centers not submitting subjects to the GTOS validation study identified subjects aged 65 years to 102 years admitted from 2000 to 2013...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28360930/performance-of-new-adjustments-to-the-triss-equation-model-in-developed-and-developing-countries
#11
Cristiane de Alencar Domingues, Raul Coimbra, Renato Sérgio Poggetti, Lilia de Souza Nogueira, Regina Marcia Cardoso Sousa
BACKGROUND: The Trauma and Injury Severity Score (TRISS) has been criticized for being based on data from the USA and Canada-high-income countries-and therefore, it may not be applicable to low-income and middle-income countries. The present study evaluated the accuracy of three adjustments to the TRISS equation model (NTRISS-like; TRISS SpO2; NTRISS-like SpO2) in a high-income and a middle-income country to compare their performance when derived and applied to different groups. METHODS: This was a retrospective study of trauma patients admitted to two institutions: a university medical center in São Paulo, Brazil (a middle-income country), and a level 1 university trauma center in San Diego, USA (a high-income country)...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28258762/patient-outcomes-at-urban-and-suburban-level-i-versus-level-ii-trauma-centers
#12
Amy H Kaji, Nichole Bosson, Marianne Gausche-Hill, Aaron J Dawes, Brant Putnam, Tchaka Shepherd, Roger J Lewis
STUDY OBJECTIVE: Regionalized systems of trauma care and level verification are promulgated by the American College of Surgeons. Whether patient outcomes differ between the 2 highest verifications, Levels I and II, is unknown. In contrast to Level II centers, Level I centers are required to care for a minimum number of severely injured patients, have immediate availability of subspecialty services and equipment, and demonstrate research, substance abuse screening, and injury prevention...
August 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28229175/survival-prediction-of-trauma-patients-a-study-on-us-national-trauma-data-bank
#13
I Sefrioui, R Amadini, J Mauro, A El Fallahi, M Gabbrielli
BACKGROUND: Exceptional circumstances like major incidents or natural disasters may cause a huge number of victims that might not be immediately and simultaneously saved. In these cases it is important to define priorities avoiding to waste time and resources for not savable victims. Trauma and Injury Severity Score (TRISS) methodology is the well-known and standard system usually used by practitioners to predict the survival probability of trauma patients. However, practitioners have noted that the accuracy of TRISS predictions is unacceptable especially for severely injured patients...
February 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28222915/comparison-of-modified-kampala-trauma-score-with-trauma-mortality-prediction-model-and-trauma-injury-severity-score-a-national-trauma-data-bank-study
#14
Serhat Akay, Ahmet Mucteba Ozturk, Huriye Akay
BACKGROUND: Mortality prediction of trauma patients relies on anatomical, physiological or combined scores. The purpose of this study is to compare the diagnostic accuracy of the modified Kampala Trauma Score (M-KTS) with the Trauma Mortality Prediction Model (TMPM), and Trauma-Injury Severity Score (TRISS) using data from a large dataset from a developed registry, the National Trauma Data Bank (NTDB). METHODS: Using 2011 and 2012 data from NTDB, patient based trauma scores (M-KTS, TMPM, and TRISS) were calculated and predictive ability of M-KTS for mortality was compared with other trauma scores using receiver operating characteristics (ROC) curves...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28129260/long-term-outcomes-of-thoracic-endovascular-aortic-repair-a-single-institution-s-11-year-experience
#15
Megan Brenner, William Teeter, Muhammed Hadud, Melanie Hoehn, James O'Connor, Deborah Stein, Thomas Scalea
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has largely replaced traditional open aortic repair for anatomically suitable lesions, however, long-term outcomes are unknown. METHODS: All patients who underwent TEVAR from December 2004 to October 2015 at a single tertiary care institution were included. Demographics, injury pattern, operative details, outcomes, and surveillance were reviewed. Follow-up ranged from 2 to 132 months and was obtained from clinic notes and imaging reports...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28074459/comparison-of-revised-trauma-score-injury-severity-score-and-trauma-and-injury-severity-score-for-mortality-prediction-in-elderly-trauma-patients
#16
COMPARATIVE STUDY
Shahrokh Yousefzadeh-Chabok, Marieh Hosseinpour, Leila Kouchakinejad-Eramsadati, Fatemeh Ranjbar, Reza Malekpouri, Alireza Razzaghi, Zahra Mohtasham-Amiri
BACKGROUND: Trauma is the fifth leading cause of death in patients 65 years and older. This study is a comparison of results of Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma. METHODS: This is a cross-sectional study of records of 352 elderly trauma patients who were admitted to Pour-Sina Hospital in Rasht between 2010 and 2011. Injury scoring systems were compared in terms of specificity, sensitivity, and cut-off points using receiver operating characteristic curve of patient prognosis...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28011072/mortality-prediction-models-in-the-general-trauma-population-a-systematic-review
#17
REVIEW
Leonie de Munter, Suzanne Polinder, Koen W W Lansink, Maryse C Cnossen, Ewout W Steyerberg, Mariska A C de Jongh
BACKGROUND: Trauma is the leading cause of death in individuals younger than 40 years. There are many different models for predicting patient outcome following trauma. To our knowledge, no comprehensive review has been performed on prognostic models for the general trauma population. Therefore, this review aimed to describe (1) existing mortality prediction models for the general trauma population, (2) the methodological quality and (3) which variables are most relevant for the model prediction of mortality in the general trauma population...
February 2017: Injury
https://www.readbyqxmd.com/read/27999959/validation-of-trauma-scales-iss-niss-rts-and-triss-for-predicting-mortality-in-a-colombian-population
#18
Carlos Oliver Valderrama-Molina, Nelson Giraldo, Alfredo Constain, Andres Puerta, Camilo Restrepo, Alba León, Fabián Jaimes
BACKGROUND: Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting. MATERIALS AND METHODS: Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#19
RANDOMIZED CONTROLLED TRIAL
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27888344/impact-of-urgent-resuscitative-surgery-for-life-threatening-torso-trauma
#20
Hisashi Matsumoto, Yoshiaki Hara, Takanori Yagi, Nobuyuki Saito, Kazuki Mashiko, Hiroaki Iida, Tomokazu Motomura, Fumihiko Nakayama, Kazuhiro Okada, Hiroshi Yasumatsu, Taigo Sakamoto, Takao Seo, Yusuke Konda, You Hattori, Hiroyuki Yokota
PURPOSE: This study investigated the advantages of performing urgent resuscitative surgery (URS) in the emergency department (ED); namely, our URS policy, to avoid a delay in hemorrhage control for patients with severe torso trauma and unstable vital signs. METHODS: We divided 264 eligible cases into a URS group (n = 97) and a non-URS group (n = 167) to compare, retrospectively, the observed survival rate with the predicted survival using the Trauma and Injury Severity Score (TRISS)...
July 2017: Surgery Today
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