Fracture Liaison Service at a University Hospital with Level 1 Trauma Center 1 year later

Abstract Purpose E-scooters are a new type of urban transportation utilized in Germany since June 2019, primarily in larger cities in the context of sharing offers. Such electrically operated standing scooters can be driven at a maximum speed of 20 km/h. A helmet is not mandatory. The aim of this prospective study is to document the injury patterns over the period of 1 year and compare our findings with already available data. Methods Over a period of 1 year (July 2019–July 2020), data on E-scooter-related accidents treated at a level 1 trauma center of a major German city were prospectively documented. Injury patterns were analyzed, and epidemiological data evaluated. Results Fifty-nine (35 female, 24 male) accidents were included in the observation period. Mean age of accident victims was 30.03 years (± 9.32). Alcohol influence at the time of accident was detected in 9 cases (15.25%). Many of the accident victims suffered multiple injuries. Most of the injuries were upper (50.84%) and lower extremity (47.45%) as well as craniofacial injuries (62.71%). A helmet was not worn in any of the cases. Conclusion In the year following their introduction, E-scooter-related accidents have led to an additional burden on the emergency capacities of the involved University Hospital, especially in the summer months of 2019. Protective equipment is de facto not worn. Injuries to the extremities, head, and face were most common. None of the accident victims died. This coincides with results from other major cities in national and international comparison. A more intensive education about injury consequences of unprotected E-scooter use and the discussion of a possible obligation to wear a helmet and further protection equipment for the extremities should take place.

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Simulated transport time to nearest level 1 trauma center in eastern Gyeongnam province, Korea

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20185285 ◽

2018 ◽

Vol 6 (1) ◽

pp. 437

Author(s):

Yong Han Kim

Keyword(s):

Trauma Center ◽

Motor Vehicle ◽

University Hospital ◽

Transfer Time ◽

Administrative District ◽

Transport Time ◽

Web Mapping ◽

National University ◽

Level 1 ◽

Level 1 Trauma Center

Severe traumatic patients should be transported to level 1 trauma center within one hour. We investigated simulated transport time and distance from eastern Gyeongnam province to nearest level 1 trauma center in South Korea. This scenario was simulated on web mapping service. Transport time and distance was measured by motor vehicle. We decided that one hour is optimal for appropriate trauma care. Estimated transport time were 40 min, 48 min, 55 min and 1 hour 8 min, respectively (Gimhae, Yangsan, Changwon and Miryang). Nearest level 1 trauma center was Pusan National University Hospital outside Gyeongnam province. Transport of traumatic patient was based on real transfer time above administrative district.

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Management of Pediatric Nasoorbitoethmoid Complex Fractures at a Level 1 Trauma Center

The American Surgeon ◽

10.1177/0003134821998682 ◽

2021 ◽

pp. 000313482199868

Author(s):

Margaret M. Luthringer ◽

Nicholas C. Oleck ◽

Thayer J. Mukherjee ◽

Jordan N. Halsey ◽

Mark S. Granick

Keyword(s):

Trauma Center ◽

Surgical Intervention ◽

Plate Fixation ◽

Treatment Algorithm ◽

Retrospective Chart Review ◽

University Hospital ◽

Type I ◽

Level 1 ◽

Level 1 Trauma Center

Purpose A universally accepted treatment algorithm for rare pediatric nasoorbitoethmoid (NOE) fractures has yet to be established. In this study, the authors examine how severity of pediatric NOE fractures interplays with patient characteristics, management choices, and complications from injury and surgical intervention at our institution. Methods A retrospective chart review was performed for all cases of pediatric NOE fracture at a level 1 trauma center (University Hospital in Newark, New Jersey) between 2002 and 2014. Results Fifteen of 1922 patients met our inclusion criteria. Ten (66.7%) demonstrated Markowitz type I injuries, 2 (13.3%) had type II NOEs, and 3 (20%) sustained type III fractures. Five (33.3%) of our patients were only monitored. Six (40.0%) were treated with plate fixation. One patient (6.7%) required enucleation alone, while 1 (6.7%) warranted enucleation with medial canthoplasty and plate fixation. Transnasal canthopexy was performed for 1 patient (6.7%). Zero patients managed without surgery had complications at 1-year follow-up. Surgical intervention was associated with complications in 4 of 15 patients. Both nonoperative treatment and plate fixation were associated with a higher rate of complications from initial injury or subsequent therapy when than other mentioned forms of treatment ( P = .004). Conclusion Nonoperative management for nondisplaced fractures is associated with zero complications at 1-year follow-up in our data; plate fixation and watchful waiting yield significantly fewer postoperative complications and injury sequelae than surgical intervention for medial canthal tendon and globe injuries.

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Longitudinal analysis of the impact of a level 1 trauma center designation at a university hospital

Journal of the American College of Surgeons ◽

10.1016/s1072-7515(98)00312-3 ◽

1999 ◽

Vol 188 (3) ◽

pp. 217-224 ◽

Cited By ~ 7

Author(s):

Jeffrey S Hammond ◽

Mary B Breckenridge

Keyword(s):

Longitudinal Analysis ◽

Trauma Center ◽

University Hospital ◽

Level 1 ◽

The Impact ◽

Level 1 Trauma Center

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Faculty Opinions recommendation of [CONFERENCE POSTER]: Outcomes of endoscopic realignment of blunt posterior urethral injuries at a Level 1 trauma center.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.11414968.12436067 ◽

2011 ◽

Author(s):

Sanjay Kulkarni

Keyword(s):

Trauma Center ◽

Level 1 ◽

Level 1 Trauma Center ◽

Urethral Injuries

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Identifying trauma patients with benefit from direct transportation to Level-1 trauma centers

BMC Emergency Medicine ◽

10.1186/s12873-021-00487-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Charlie A. Sewalt ◽

Benjamin Y. Gravesteijn ◽

Daan Nieboer ◽

Ewout W. Steyerberg ◽

Dennis Den Hartog ◽

...

Keyword(s):

Logistic Regression ◽

Trauma Center ◽

Trauma Patients ◽

Trauma Centers ◽

Absolute Benefit ◽

Predicted Probability ◽

Prehospital Triage ◽

Level 1 ◽

Level 1 Trauma Center ◽

Level 2

Abstract Background Prehospital triage protocols typically try to select patients with Injury Severity Score (ISS) above 15 for direct transportation to a Level-1 trauma center. However, ISS does not necessarily discriminate between patients who benefit from immediate care at Level-1 trauma centers. The aim of this study was to assess which patients benefit from direct transportation to Level-1 trauma centers. Methods We used the American National Trauma Data Bank (NTDB), a retrospective observational cohort. All adult patients (ISS > 3) between 2015 and 2016 were included. Patients who were self-presenting or had isolated limb injury were excluded. We used logistic regression to assess the association of direct transportation to Level-1 trauma centers with in-hospital mortality adjusted for clinically relevant confounders. We used this model to define benefit as predicted probability of mortality associated with transportation to a non-Level-1 trauma center minus predicted probability associated with transportation to a Level-1 trauma center. We used a threshold of 1% as absolute benefit. Potential interaction terms with transportation to Level-1 trauma centers were included in a penalized logistic regression model to study which patients benefit. Results We included 388,845 trauma patients from 232 Level-1 centers and 429 Level-2/3 centers. A small beneficial effect was found for direct transportation to Level-1 trauma centers (adjusted Odds Ratio: 0.96, 95% Confidence Interval: 0.92–0.99) which disappeared when comparing Level-1 and 2 versus Level-3 trauma centers. In the risk approach, predicted benefit ranged between 0 and 1%. When allowing for interactions, 7% of the patients (n = 27,753) had more than 1% absolute benefit from direct transportation to Level-1 trauma centers. These patients had higher AIS Head and Thorax scores, lower GCS and lower SBP. A quarter of the patients with ISS > 15 were predicted to benefit from transportation to Level-1 centers (n = 26,522, 22%). Conclusions Benefit of transportation to a Level-1 trauma centers is quite heterogeneous across patients and the difference between Level-1 and Level-2 trauma centers is small. In particular, patients with head injury and signs of shock may benefit from care in a Level-1 trauma center. Future prehospital triage models should incorporate more complete risk profiles.

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