The impact of traffic barrier geometric features on crash frequency and injury severity of non-interstate highways

Abstract Background Treatment of blunt splenic injury has changed over the past decades. Nonoperative management (NOM) is the treatment of choice. Adequate patient selection is a prerequisite for successful NOM. Impaired mental status is considered as a relative contra indication for NOM. However, the impact of altered consciousness in well-equipped trauma institutes is unclear. We hypothesized that impaired mental status does not affect outcome in patients with splenic trauma. Methods Our prospectively composed trauma database was used and adult patients with blunt splenic injury were included during a 14-year time period. Treatment guidelines remained unaltered over time. Patients were grouped based on the presence (Group GCS: < 14) or absence (Group GCS: 14–15) of impaired mental status. Outcome was compared. Results A total of 161 patients were included, of whom 82 were selected for NOM. 36% of patients had a GCS-score < 14 (N = 20). The median GCS-score in patients with reduced consciousness was 9 (range 6–12). Groups were comparable except for significantly higher injury severity scores in the impaired mental status group (19 vs. 17, p = 0.007). Length of stay (28 vs. 9 days, p < 0.001) and ICU-stay (8 vs. 0 days, p = 0.005) were longer in patients with decreased GCS-scores. Failure of NOM, total splenectomy rates, complications and mortality did not differ between both study groups. Conclusion This study shows that NOM for blunt splenic trauma is a viable treatment modality in well-equipped institutions, regardless of the patients mental status. However, the presence of neurologic impairment is associated with prolonged ICU-stay and hospitalization. We recommend, in institutions with adequate monitoring facilities, to attempt nonoperative management for blunt splenic injury, in all hemodynamically stable patients without hollow organ injuries, also in the case of reduced consciousness.

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Simultaneous Casualty Admissions—Do they Affect Treatment in the Receiving Trauma Center?

World Journal of Surgery ◽

10.1007/s00268-021-06074-8 ◽

2021 ◽

Author(s):

Michel Paul Johan Teuben ◽

Carsten Mand ◽

Laura Moosdorf ◽

Kai Sprengel ◽

Alba Shehu ◽

...

Keyword(s):

Injury Severity ◽

Damage Control ◽

Ct Scanning ◽

Mortality Rates ◽

Trauma Centers ◽

Simultaneous Treatment ◽

Diagnostic Pathway ◽

Injured Patients ◽

The Impact ◽

Mean Time

Abstract Background Simultaneous trauma admissions expose medical professionals to increased workload. The impact of simultaneous trauma admissions on hospital allocation, therapy, and outcome is currently unclear. We hypothesized that multiple admission-scenarios impact the diagnostic pathway and outcome. Methods The TraumaRegister DGU® was utilized. Patients admitted between 2002–2015 with an ISS ≥ 9, treated with ATLS®- algorithms were included. Group ´IND´ included individual admissions, two individuals that were admitted within 60 min of each other were selected for group ´MULT´. Patients admitted within 10 min were considered as simultaneous (´SIM´) admissions. We compared patient and trauma characteristics, treatment, and outcomes between both groups. Results 132,382 admissions were included, and 4,462/3.4% MULTiple admissions were found. The SIM-group contained 1,686/1.3% patients. The overall median injury severity score was 17 and a mean age of 48 years was found. MULT patients were more frequently admitted to level-one trauma centers (68%) than individual trauma admissions were (58%, p < 0.001). Mean time to CT-scanning (24 vs. 26/28 min) was longer in MULT / SIM patients compared to individual admissions. No differences in utilization of damage control principles were seen. Moreover, mortality rates did not differ between the groups (13.1% in regular admissions and 11.4%/10,6% in MULT/SIM patients). Conclusion This study demonstrates that simultaneous treatment of injured patients is rare. Individuals treated in parallel with other patients were more often admitted to level-one trauma centers compared with individual patients. Although diagnostics take longer, treatment principles and mortality are equal in individual admissions and simultaneously admitted patients. More studies are required to optimize health care under these conditions.

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Examining crash injury severity and Barrier-Hit outcomes from cable barriers and strong-post guardrails on Alabama’s interstate highways

Journal of Safety Research ◽

10.1016/j.jsr.2021.06.009 ◽

2021 ◽

Author(s):

Mehdi Hosseinpour ◽

Kirolos Haleem

Keyword(s):

Injury Severity ◽

Interstate Highways ◽

Crash Injury Severity

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Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria

Scandinavian Journal of Trauma Resuscitation and Emergency Medicine ◽

10.1186/s13049-020-00827-5 ◽

2021 ◽

Vol 29 (1) ◽

Author(s):

Francois-Xavier Ageron ◽

Timothy J. Coats ◽

Vincent Darioli ◽

Ian Roberts

Keyword(s):

Tranexamic Acid ◽

Acid Treatment ◽

Injury Severity ◽

External Validation ◽

Research Network ◽

Brier Score ◽

Trauma Patients ◽

Using Data ◽

The Uk ◽

The Impact

Abstract Background Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance. We developed a simple score (Bleeding Audit Triage Trauma score) to predict death from bleeding. Methods We conducted an external validation of the BATT score using data from the UK Trauma Audit Research Network (TARN) from 1st January 2017 to 31st December 2018. We evaluated the impact of tranexamic acid treatment thresholds in trauma patients. Results We included 104,862 trauma patients with an injury severity score of 9 or above. Tranexamic acid was administered to 9915 (9%) patients. Of these 5185 (52%) received prehospital tranexamic acid. The BATT score had good accuracy (Brier score = 6%) and good discrimination (C-statistic 0.90; 95% CI 0.89–0.91). Calibration in the large showed no substantial difference between predicted and observed death due to bleeding (1.15% versus 1.16%, P = 0.81). Pre-hospital tranexamic acid treatment of trauma patients with a BATT score of 2 or more would avoid 210 bleeding deaths by treating 61,598 patients instead of avoiding 55 deaths by treating 9915 as currently. Conclusion The BATT score identifies trauma patient at risk of significant haemorrhage. A score of 2 or more would be an appropriate threshold for pre-hospital tranexamic acid treatment.

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Predicting motorcycle crash injury severity using weather data and alternative Bayesian multivariate crash frequency models

Accident Analysis & Prevention ◽

10.1016/j.aap.2017.08.032 ◽

2017 ◽

Vol 108 ◽

pp. 172-180 ◽

Cited By ~ 22

Author(s):

Wen Cheng ◽

Gurdiljot Singh Gill ◽

Taha Sakrani ◽

Mohan Dasu ◽

Jiao Zhou

Keyword(s):

Injury Severity ◽

Weather Data ◽

Crash Frequency ◽

Crash Injury Severity

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The impact of injury severity and prehospital procedures on scene time in victims of major trauma

Annals of Emergency Medicine ◽

10.1016/s0196-0644(05)81070-4 ◽

1991 ◽

Vol 20 (12) ◽

pp. 1299-1305 ◽

Cited By ~ 78

Author(s):

Daniel W Spaite ◽

David J Tse ◽

Terence D Valenzuela ◽

Elizabeth A Criss ◽

Harvey W Meislin ◽

...

Keyword(s):

Major Trauma ◽

Injury Severity ◽

The Impact

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Child safety programs for primary school children decrease the injury severity of dog bites

European Journal of Pediatrics ◽

10.1007/s00431-021-04256-z ◽

2021 ◽

Author(s):

Bernhard Kienesberger ◽

Christoph Arneitz ◽

Vanessa Wolfschluckner ◽

Christina Flucher ◽

Peter Spitzer ◽

...

Keyword(s):

Primary School ◽

School Children ◽

Prevention Program ◽

Injury Severity ◽

Primary School Children ◽

Child Safety ◽

Dog Bite ◽

Severe Injuries ◽

Dog Bites ◽

The Impact

AbstractThis study focuses on the impact of a prevention program regarding dog bites in children. As a consequence of our previous investigation in 2005, we have initiated a child safety program for primary school children starting January 2008 until present to teach children how to avoid dog attacks and how to behave in case of an attack. In our retrospective study, we analyzed all patients younger than 15 years presenting with dog-related injuries between 2014 and 2018. As the main indicator for success of the prevention measures taken, we have defined the severity of injury in comparison to our previous study. Out of 296 children with dog-related injuries, 212 (71.6%) had sustained a dog bite. In the vast majority (n = 195; 92%), these patients presented with minor injuries; the extremities were most commonly affected (n = 100; 47%). Injuries to the head (n = 95; 45%) and trunk (n = 18; 8%) were less frequent. The proportion of severe injuries (8%) was significantly lower compared to our previous study, where 26% of children presented with severe injuries necessitating surgical intervention, while the number of patients requiring in-hospital treatment declined from 27.5% in the period 1994–2003 to 9.0% in the period between 2014 and 2018 (p < 0.05).Conclusion: Teaching of primary school children may effectively reduce the injury severity of dog bites. What is Known:• Dog bites are a substantial healthcare problem especially in children. What is New:• This study shows that a broad-based prevention program for primary school children can effectively decrease the severity but not the frequency of dog bite injuries in children.

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GEOMETRIC FEATURES ANALYSIS FOR THE CLASSIFICATION OF CULTURAL HERITAGE POINT CLOUDS

ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences ◽

10.5194/isprs-archives-xlii-2-w15-541-2019 ◽

2019 ◽

Vol XLII-2/W15 ◽

pp. 541-548 ◽

Cited By ~ 4

Author(s):

E. Grilli ◽

E. M. Farella ◽

A. Torresani ◽

F. Remondino

Keyword(s):

Artificial Intelligence ◽

Machine Learning ◽

Cultural Heritage ◽

Point Clouds ◽

Geometric Features ◽

3D Point Clouds ◽

3D Data ◽

3D Documentation ◽

The Impact

<p><strong>Abstract.</strong> In the last years, the application of artificial intelligence (Machine Learning and Deep Learning methods) for the classification of 3D point clouds has become an important task in modern 3D documentation and modelling applications. The identification of proper geometric and radiometric features becomes fundamental to classify 2D/3D data correctly. While many studies have been conducted in the geospatial field, the cultural heritage sector is still partly unexplored. In this paper we analyse the efficacy of the geometric covariance features as a support for the classification of Cultural Heritage point clouds. To analyse the impact of the different features calculated on spherical neighbourhoods at various radius sizes, we present results obtained on four different heritage case studies using different features configurations.</p>

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