scholarly journals (A127) Major Trauma in a Swedish Paediatric Population – A Survey of Children Admitted to a Neuro Intensive Care Unit (NICU)

2011 ◽  
Vol 26 (S1) ◽  
pp. s36-s36
Author(s):  
L.E. Franzén
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Injury Severity Score ◽  
Severity Score ◽  
Major Trauma ◽  
Injury Severity ◽  
Good Survival ◽  
Severe Injuries ◽  
Severity Of Injury ◽  
Trauma Score

PurposeTo describe the demographics, mechanism, pattern, and severity of injury, prehospital and hospital care (first 24 hours) and the patient outcome in severely injured children in a NICU. This study was made to complete the study of Swedish children admitted to a paediatric intensive care unit (PICU) due to major trauma in the same region and during the same period.MethodThe medical records of 124 traumatized children (0–16 years of age), admitted to the NICU in Gothenburg 1992–2001, were retrospectively examined. The Injury Severity Score (ISS), Glasgow Paediatric Coma Scale (GSC), Revised Trauma Score (T-RTS/RTS), Paediatric Trauma Score (PTS), Trauma Score Injury Severity Score (TRISS) and Paediatric Risk of Mortality Score (PRISM) estimated the severity of injury.ResultsAbout 7/100 000 children with severe injuries were admitted to the NICU each year from 1992–2001 inclusive. Epidemiology showed a similar pattern as in other OECD countries. Severity of injury was recorded as an ISS median of 17. Mortality rate in our series was 6%.ConclusionMajor trauma with admission to a NICU is rare in Swedish children. With management in conjunction with a pediatric centre, these children have a good survival rate.

Car Surfing: Case Studies of a Growing Dangerous Phenomenon

2008 ◽  
Vol 74 (3) ◽  
pp. 260-261
Author(s):  
Steven Clark ◽  
Alicia Mangram ◽  
Ernest Dunn
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Surgical Intervention ◽  
Ventilatory Support ◽  
Retrospective Chart Review ◽  
Severe Injuries ◽  
Revised Trauma Score ◽  
Urban Level ◽  
Trauma Score

Car surfing is a dangerous new pastime for American youth. Car surfing is an activity that is defined as standing (or lying) on a vehicle while it is being driven. This activity frequently results in severe injuries that often require significant surgical intervention. Despite its destructive nature, however, there are many Internet sites that encourage this behavior and view it as amusing. As a result, car surfing is becoming increasingly popular. We conducted a retrospective chart review of all patients injured as a result of car surfing over the last 4 years at our Urban Level II trauma center. Data collected included Injury Severity Score (ISS), Revised Trauma Score (RTS), age, gender, injury pattern, surgical intervention, and length of stay. Eight car surfers were identified. The average age was 17. The average Revised Trauma Score was 6.8 with an average Injury Severity Score of 16.9. Five patients were admitted to the intensive care unit. Four of these five patients needed to be intubated for ventilatory support. Five of the eight patients had significant intracranial injuries. Two patients had epidural hematomas that required evacuation. Two other patients had subdural hematomas that were treated nonoperatively, and one patient had a subarachnoid hemorrhage that was also treated nonoperatively. Four of the eight patients required surgical intervention. There were no deaths in this study. Car surfing leads to severe injuries that can result in significant morbidity. American youth have access to Internet sites that project this activity as an acceptable behavior. Five of our eight patients had a significant intra-cranial injury. Trauma surgeons need to be more aware of this injury phenomenon.

Predictors of blunt diaphragm injury in Australia

Trauma ◽  
2021 ◽  
pp. 146040862110418
Author(s):  
Annelise M Cocco ◽  
Vignesh Ratnaraj ◽  
Benjamin PT Loveday ◽  
Kellie Gumm ◽  
Phillip Antippa ◽  
...  
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Major Trauma ◽  
Injury Severity ◽  
Rib Fractures ◽  
Organ Injury ◽  
Trauma Patients ◽  
Missed Injury ◽  
Diaphragm Injury ◽  
Trauma Service

Introduction Blunt diaphragm injury (BDI) is an uncommon, potentially fatal consequence of blunt torso injury. While associations between BDI and other factors such as mechanism of injury or other injuries have been described elsewhere, little recent research has been done in Australia into BDI. The aims of this study were to determine the incidence rate of BDI in our centre, identify how it was diagnosed, determine rates of missed injury and identify predictive factors for BDI. The hypothesis was that patients with BDI would significantly differ to those without BDI. Methods All major trauma patients with blunt torso injuries at our Level 1 major trauma service from 2010 to 2018 were included. Data for patient demographics, other injuries, diagnosis and treatment of BDI were extracted. Patients with BDI were compared with patients without BDI in order to identify differences that could be used to predict BDI in future patients. Results Of 5190 patients with a blunt torso injury, 51 (0.98%) had a BDI at a mean age of 53 ± 19.6 years, and median Injury Severity Score (ISS) of 27(IQR 21–38.5) compared with 5139 patients with a mean age of 48.2 ± 20.7 years and median ISS of 21.9(IQR 14–26) who did not have a BDI. The diagnosis of BDI was made at CT ( n = 35), surgery ( n = 14) or autopsy ( n = 2). Blunt diaphragm injury was missed on index imaging for 11 of 43 patients (25.6%). On multivariate analysis, each point increase in ISS (OR 1.03, p = 0.02); rib fractures (OR 4.65, p = 0.004); splenic injury (OR 2.60, p = 0.004); and liver injury (OR 2.78, p = 0.003) were independently associated with BDI. Conclusion Injury Severity Score, rib fractures and solid abdominal organ injury increase the likelihood of BDI. In patients with these injuries, BDI should be considered even in the presence of normal CT findings.

scholarly journals Desempenho dos ajustes do Trauma and Injury Severity Score (TRISS): revisão integrativa

2015 ◽  
Vol 49 (spe) ◽  
pp. 138-146 ◽  
Author(s):  
Cristiane de Alencar Domingues ◽  
Lilia de Souza Nogueira ◽  
Cristina Helena Costanti Settervall ◽  
Regina Marcia Cardoso de Sousa
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Revised Trauma Score ◽  
Trauma Score ◽  
Trauma And Injury

RESUMO Objetivo identificar estudos que realizaram ajustes na equação do Trauma and InjurySeverity Score (TRISS) e compararam a capacidade discriminatória da equação modificada com a original. Método Revisão integrativa de pesquisas publicadas entre 1990 e 2014 nas bases de dados LILACS, MEDLINE, PubMed e SciELO utilizando-se a palavra TRISS. Resultados foram incluídos 32 estudos na revisão. Dos 67 ajustes de equações do TRISS identificados, 35 (52,2%) resultaram em melhora na acurácia do índice para predizer a probabilidade de sobrevida de vítimas de trauma. Ajustes dos coeficientes do TRISS à população de estudo foram frequentes, mas nem sempre melhoraram a capacidade preditiva dos modelos analisados. A substituição de variáveis fisiológicas do Revised Trauma Score (RTS) e modificações do Injury Severity Score (ISS) na equação original tiveram desempenho variado. A mudança na forma de inclusão da idade na equação, assim como a inserção do gênero, comorbidades e mecanismo do trauma apresentaram tendência de melhora do desempenho do TRISS. Conclusão Diferentes propostas de ajustes no TRISS foram identificadas nesta revisão e indicaram, principalmente, fragilidades do RTS no modelo original e necessidade de alteração da forma de inclusão da idade na equação para melhora da capacidade preditiva do índice.

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