Solid Organ Injury Grading in Trauma: Accuracy of Grading by Surgical Residents

2012 ◽  
Vol 78 (8) ◽  
pp. 834-836 ◽  
Author(s):  
William F. Powers ◽  
L. Neal Beard ◽  
Ashley Adams ◽  
Cyrus A. Kotwall ◽  
Thomas V. Clancy ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Organ Injury ◽  
Solid Organ ◽  
Test Analysis ◽  
Surgical Residents ◽  
Liver Injuries ◽  
Significant Difference ◽  
Computed Tomography Scans ◽  
Injury Grade ◽  
The Impact

The American Association for the Surgery of Trauma developed an Organ Injury Scale for management of patients with splenic, kidney, or liver injuries. Despite widespread use of the guidelines, the person who determines the injury grade varies among institutions. Our purpose was to determine the accuracy and interobserver agreement between surgical residents and a radiologist in grading solid organ injuries. We retrospectively reviewed patients with solid organ injuries from January 2009 to May 2010 and compared the grade of solid organ injuries by a single resident with grades by a single blinded radiologist using a paired t test, analysis of variance, or Kruskal-Wallis. Computed tomography scans of 58 patients with splenic injuries, 43 with liver injuries, and 16 with kidney injuries were reviewed. Average grades for splenic injuries were 2.5 and 2.4 (radiologist/resident); liver injuries, 2.6 and 2.1; and kidney injuries, 2.7 and 2.8. There were no significant differences in grading by the radiologist and resident for splenic and kidney injuries; however, equal values were only achieved in 43 and 38 per cent, respectively. There was a significant difference (average rating difference 0.54, P = 0.0002) in grading between the radiologist and resident for liver injuries with only 35 per cent having equal values and the radiologist grading on average 0.5 points higher than the resident. No demographic, injury, or outcome variables were significantly associated with interobserver variability ( P > 0.05). Despite a significant difference for liver injury grading, interobserver agreement between residents and a single radiologist was low. Clinical implications and the impact on outcomes related to interobserver variations require further study.

scholarly journals ANALISIS TINGKAT KEPUASAN PASIEN TERHADAP PENANGANAN TERAPI OKUPASI DI INSTALASI REHABILITASI MEDIK RSUP PROF. DR. R. D. KANDOU MANADO

e-CliniC ◽  
2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Meilany D. Wongkar ◽  
Joudy Gessal ◽  
Leonard S. Angliadi
Keyword(s):  
Dynamic Condition ◽  
Medical Rehabilitation ◽  
P Value ◽  
Test Analysis ◽  
Purposive Sampling ◽  
Patients Satisfaction ◽  
Satisfaction Degree ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

Abstract: Medical rehabilitation aims to lessen the impact of a disability and enhance the ability of people with disabilities, therefore, they can be involved in social interaction. One of the rehabilitation treatments is occupation therapy which helps individuals by giving suggestions and enhancing independence. Quality is a dynamic condition which fills or surpass the expectations. Quality is closely related to costumers’ satisfaction. It encourages the costumers to create a strong bond of relationship. This study aimed to obtain patients’ satisfaction degree toward the implementation of occupation therapy in the Medical Rehabilitation Installation Prof. Dr. R. D Kandou Hospital, Manado. This was a descriptive observational study. Sampleds were collected by using purposive sampling. The result of the T Test analysis showed that there was a significant difference between before and after the therapy with a p value = 0.000. Based on the result of the satisfaction degree to the variable of expectation and reality, the average obatined was 7.9. Conclusion: Patients’ expectation degree was higher than the reality of service that they received.Keywords: medical rehabilitation, occupation therapy, patients satisfaction degree.Abstrak: Rehabilitasi medik bertujuan untuk mengurangi dampak keadaan cacat dan meningkatkan kemampuan penyandang cacat sampai interaksi sosial. Salah satu pelayanan rehabilitasi ialah terapi okupasi, yang membantu individu dalam memberi anjuran dan menjamin bantuan untuk meningkatkan kemandirian. Kualitas merupakan kondisi dinamis yang memenuhi atau melebihi harapan. Kualitas memiliki hubungan yang sangat erat dengan kepuasan pelanggan, yaitu kualitas memberikan suatu dorongan kepada pelanggan untuk menjalani ikatan hubungan yang kuat. Penelitian ini bertujuan untuk mengetahui gambaran tingkat kepuasan pasien terapi okupasi di Instalasi Rehabilitas Medik RSUP. Prof. Dr. R. D. Kandou. Penelitian ini bersifat deskriptif observasional. Pengambilan sampel dilakukan secara purposive sampling. Hasil analisis uji t menunjukkan terdapat perbedaan bermakna sebelum dan sesudah terapi dengan nilai p = 0,000. Berdasarkan hasil uji nilai tingkat kepuasan terhadap variabel harapan dan kenyataan menunjukkan perbedaan dengan nilai rata-rata 7,9. Simpulan: Nilai harapan pasien lebih besar dari kenyataan pelayanan yang mereka terima.Kata kunci: rehabilitasi medik, terapi okupasi, tingkat kepuasan pasien

scholarly journals A Sustainable Tourism Based on a New Institutional Economics Approach: Ecotourism Based on the Community in the Gasan Gadang Fishermen Village

2021 ◽  
Vol 934 (1) ◽  
pp. 012031
Author(s):  
L Zamzami ◽  
A Azwar ◽  
E Ermayanti
Keyword(s):  
Environmental Impacts ◽  
Institutional Economics ◽  
Descriptive Analysis ◽  
New Institutional Economics ◽  
Environmental Aspects ◽  
Change Analysis ◽  
Community Based ◽  
Test Analysis ◽  
Significant Difference ◽  
The Impact

Abstract This study aimed to determine the patterns of development and implementation of community-based ecotourism management and identify the impact of the community-based ecotourism in Gasan Gadang Village on the economic, social, and environmental aspects of the surrounding community. The methodology used was descriptive analysis with a new institutional economics approach and the Kruskal-Wallis Test analysis. The patterns of development and implementation of community-based ecotourism management with all levels of social change analysis, including formal and informal rules such as culture, customs, habits of Gasan Gadang villagers, institutional and governance management, and even the economy, are considered good. The Community-based ecotourism management has adopted the theory of resource allocation among stakeholders of Gasan Gadang Village. The findings of this study showed that community-based ecotourism institutions and management bring positive impacts on economic, social, and culture. There was no significant difference among economic, social, and environmental impacts between the non-authorities and community-based ecotourism authorities of Gasan Gadang Village. Thus, it could be said that the benefits of community-based ecotourism received by the community were all the same. Everyone got positive benefits. However, based on the findings, it could be seen that the biggest difference was the economic impacts followed by the social impacts, while the smallest difference is the environmental impacts. From this situation, it could be concluded that the performance of community-based ecotourism authorities in Gasan Gadang Village was good and positively impacted the economic, social, and environmental aspects of the Gasan Gadang Village fishermen community.

scholarly journals THE IMPACT OF IFRS ADOPTION ON EARNINGS MANAGEMENT IN BANKING COMPANIES IN INDONESIA STOCK EXCHANGE

2016 ◽  
Vol 13 (2) ◽  
pp. 176
Author(s):  
Prima Santy ◽  
Tawakkal Tawakkal ◽  
Grace T. Pontoh
Keyword(s):  
Earnings Management ◽  
Stock Exchange ◽  
Research Result ◽  
Control Variable ◽  
T Test ◽  
Test Analysis ◽  
Ifrs Adoption ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

The issue of the IFRSadoption as a standard that can lead to a reduction of earnings management. The research aimed to give empirical evidence concerning the impact of the IFRS adoption on earnings management, and the test of the difference level of earnings management between before and after the IFRS adoption. The research scope focused on the implementation of IFRS adoption particularly in PSAK No. 50 and PSAK No. 55 (revised 2006) concerningfinancial instruments. The research objects were the banking companies listed in Indonesia Stock Exchange for 4 years (2008-2011), i.e. as many as 23 banks. Samples were taken by using the purposive sampling technique. The main variables in this research are IFRS and earnings management,and includes several control variable, among others are, size, financial leverage, market to book value and institutional investors. The data were analyzed usingmultiple regression analysis and different t-test analysis. The research result indicates that the IFRS adoption has not effect the decreaseon the earnings management.Among the four control variables, the variable institutional investor is found not to have theeffect on earnings management, whereas the other three variables haveeffect.The result of the different t-test analysis also indicates that statistically there is not significant difference on the level of the earnings management between before and after IFRS adoption. Thus, based on this study concluded that the adoption of IFRS still allow for the occurrence of earnings management.

Variable Risk of Second Primary Malignancy In Multiple Myeloma Patients of Different Ethnicities

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 678-678
Author(s):  
Pedram Razavi ◽  
Gaurav Patel ◽  
Asher Chanan-Khan ◽  
Sikander Ailawadhi
Keyword(s):  
Multiple Myeloma ◽  
Conflicts Of Interest ◽  
Latency Period ◽  
Incidence Rates ◽  
Second Primary ◽  
Solid Organ ◽  
Specific Patient ◽  
Significant Difference ◽  
Race Ethnicity ◽  
The Impact

Abstract Abstract 678 Background: Second primary malignancies (SPM) among multiple myeloma (MM) patients have been reported with an estimated incidence varying from 1%–15%. We have previously reported that significant disparity exists in MM survival across patients of different ethnicities. We undertook a Surveillance Epidemiology and End Results (SEER) based analysis to describe the incidence of SPM among MM patients of different ethnicities, in order to explore the variable impact that SPM might have on MM outcomes of patients across racial subgroups. Methods: SEER database was used to examine the standardized incidence rates (SIR) of SPM among MM patients diagnosed between 1973–2008. Observed to expected ratio (O/E) of SPM was calculated using incidence rates of cancers for the general population. The 95% confidence limits (CI) were constructed using Fisher's exact test. The analysis was restricted to patients with MM as first primary, microscopic confirmation of diagnosis, reporting sources not coded as autopsy- or death-certificate-only, and SPM reported more than 2 month after MM diagnosis. Mutually exclusive race/ethnicity categories were: African-Americans (AA), Asians/Pacific Islanders (API), Hispanic whites (HW), Non-Hispanic whites (NHW), and others. The risk of SPM among MM patients was explored by ethnicity, type of SPM, and latency period. Results: A total of 3090 cases of MM with SPM were diagnosed between 1973–2008, of which, 2021 patients met our inclusion criteria. Stratification of SPM by ethnicity revealed: 387 AA (19%), 72 API (4%), 51 HW (3%), 1500 NHW (74%) and 11 other (<1%) cases. There was an average 4.7-year latency period between diagnosis of MM and SPM (mean age 68.2 and 72.9 years, respectively). The latency period was not significantly different by type of SPM (solid organ vs. hematological) or ethnicity. AA had the youngest age at diagnosis for both, MM and SPM (65.6 and 70.1 year, respectively). (Figure 1) For all SPM sites analyzed together, there was no significant difference between the observed and expected incidence (O/E 0.98; 95% CI 0.94–1.02). However, O/E risk was significantly decreased for solid organ SPM (N=1695; O/E 0.92; 95% CI 0.88–0.96) and increased for hematological malignancies (N=263; O/E 1.63; 95% CI 1.44–1.84). Highest excess risk among all SPM was noted for acute non-lymphocytic leukemia (ANLL) (O/E 6.51; 95% CI 5.37–7.83). The overall risk of observed SPM was not different from expected rates by ethnicity, with the exception of HW who had a significantly decreased overall SPM risk. Table 1 summarizes significant results of O/E risk of SPM by race and site. HW and NHW were less likely to develop overall solid organ SPM. Within solid organ sites, HW had a significantly decreased O/E risk of developing lung/bronchus and prostate SPM. NHW were the only ethnic subgroup with an increased O/E risk of developing melanoma of skin, while the O/E risk of developing SPM of kidney/renal pelvis was increased only among AA. The risk of ANLL as SPM was significantly increased among AA, API, and NHW, while risk of NHL as SPM was only increased among NHW. Conclusion: Exploring potential causes of outcome disparities is important for evaluating disease characteristics and optimal triaging of healthcare resources for specific patient populations. We have performed the largest population-based analysis for the risk of SPM in MM patients stratified by race/ethnicity. We found that the risk of developing SPM among MM patients is variable depending on the patient's ethnic background. This warrants further exploration of the impact of SPM on outcomes of MM patients across different racial subgroups. Disclosures: No relevant conflicts of interest to declare.

The Impact ofClostridium difficileInfection on Future Outcomes of Solid Organ Transplant Recipients

2018 ◽  
Vol 39 (5) ◽  
pp. 563-570 ◽  
Author(s):  
Ruihong Luo ◽  
Janice M. Weinberg ◽  
Tamar F. Barlam
Keyword(s):  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Control Group ◽  
Solid Organ ◽  
Increased Risk ◽  
Significant Difference ◽  
First Occurrence ◽  
Future Outcomes ◽  
The Impact

OBJECTIVEClostridium difficileinfection (CDI) is common in solid organ transplant (SOT) recipients, but few studies have examined long-term outcomes. We studied the impact of CDI after SOT on mortality and transplant organ complication-related hospitalizations (TOH).METHODSSOT recipients ≥18 years of age with at least 1 year of posttransplant data were analyzed using the MarketScan database for 2007–2014. Patients who died within one year of transplant were followed until death. Patients were grouped as early CDI (ie, first occurrence ≤90 days posttransplant), late CDI (ie, first occurrence >90 days posttransplant) and controls (ie, no CDI occurrence during follow-up). The risk of mortality or TOH after CDI was evaluated using Cox and logistic regressions, respectively.RESULTSOverall, 96 patients had early CDI, 97 patients had late CDI, and 5,913 patients were used as controls. The risk for death was significantly higher in the early CDI group than the control group (hazard ratio [HR],1.92; 95% confidence interval [CI], 1.12–3.29;P=.018); there was no significant difference between the late CDI group and the control group (HR, 0.86; 95% CI, 0.38–1.94;P=.717). Both the early CDI group (odds ratio [OR], 2.19; 95% CI, 1.45–3.31;P<.001) and the late CDI group (OR, 4.36; 95% CI, 2.84–6.71;P<.001) had higher risk for TOH than the control group. For those patients who survived >90 days posttransplant, both the early CDI group (n=89) and the late CDI group (n=97) had increased risk for death or TOH during follow-up than the control group (n=5,734).CONCLUSIONThough our study could not prove causality, both early and late CDI occurrence in SOT recipients were associated with worse future outcomes than for SOT recipients without CDI.Infect Control Hosp Epidemiol2018;39:563–570

The impact of morbid obesity on solid organ injury in children using the ATOMAC protocol at a pediatric level I trauma center

2017 ◽  
Vol 52 (2) ◽  
pp. 345-348 ◽  
Author(s):  
Nathan Vaughan ◽  
Jeff Tweed ◽  
Cynthia Greenwell ◽  
David M. Notrica ◽  
Crystal S. Langlais ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Trauma Center ◽  
Organ Injury ◽  
Solid Organ ◽  
Solid Organ Injury ◽  
Level I ◽  
The Impact

scholarly journals Analysis of Covid-19 Impact on Stock’s Abnormal Return in Sub Cigarette Sector Companies Listed on BEI

2021 ◽  
Vol 03 (01) ◽  
Author(s):  
May Mulyaningsih ◽  
◽  
Sri Hartini Sri Hartini ◽  
Resta Anggraeni ◽  
Denis Putra Mahendra ◽  
...  
Keyword(s):  
Stock Price ◽  
Abnormal Return ◽  
Stock Exchange ◽  
Hypothesis Test ◽  
Abnormal Returns ◽  
Secondary Data ◽  
Analysis Data ◽  
Test Analysis ◽  
Significant Difference ◽  
The Impact

Covid-19 is an international pandemic that has paralyzed the national economic sector. This study aims to analyze the impact of Covid-19 on stock’s abnormal return in cigarette sub sector companies listed on the Indonesia Stock Exchange in the January to May 2020 period. The population of this study is 5 cigarette sub sector companies listed on the Indonesia Stock Exchange in 2020. The research sample selection uses census method so as to obtain 5 sample companies with an observation period of 5 months (January to May 2020). Secondary data in this study regarding stock’s abnormal returns with actual return and market return proxies. Data obtained from the company's daily stock price and composite stock price index. Descriptive statistical analysis, data normality test analysis and hypothesis test analysis are processed using SPSS 25. Statistical test with paired sample t test showed no significant difference in abnormal return between the period of 52 days before and when WFH with a significant level of 95% (α = 0.05). From the SPSS test results it is known that the significance value obtained is equal to 0.911. When compared with the significance value that has been set. The value is greater (α> 0.05). So H1 which states there are differences in stock’s abnormal returns before and during the WFH Covid-19 is rejected.

scholarly journals EFEKTIFITAS JUICE SEMANGKA DAN SENAM KEBUGARAN TERHADAP PENURUNAN BERAT BADAN PADA ANAK OBESITAS

2020 ◽  
Vol 7 (1) ◽  
pp. 62-70
Author(s):  
Priyo Priyo ◽  
Sigit Priyanto
Keyword(s):  
Elementary School ◽  
Health Workers ◽  
T Test ◽  
Behavioral Changes ◽  
Wilcoxon Test ◽  
Test Analysis ◽  
Watermelon Juice ◽  
Significant Difference ◽  
The Difference ◽  
The Impact

The culture of consuming instant food and reducing physical exercise result in increasing obesity in children today. The impact that occurs if not overcome can lead to the occurrence of various types of non-infectious diseases in the future such as: heart disease, hypertension, stroke and diabetes. To overcome the problem of obesity, behavioral changes are needed in childhood, namely fruit consumption and regular exercise. However, this behavior still becomes a national problem, especially in Magelang Regency. Consuming fruit juice and having exercise enables ones to lose weight.A kind of fruits that can be consumed is watermelon and the kind of sport that can be practiced is fitness exercise. The research is aimed to identify the difference in effectiveness between consuming watermelon juice and having fitness exercises in weight loss in obese children at Sawitan State Elementary School. The method used in this study is quasy-experiment. The number of samples was 24 respondents consisting of 12 respondents treated with watermelon juice consumption, and 12 respondents treated with fitness exercises. To take samples, it is used purposive sampling method. the treatment was carried out 3 times in a week. The results showed there was a decrease in weight lose in obese elementary school children, both with watermelon juice treatment and fitness exercises. The results of the independent t-test analysis, on watermelon juice therapy showed P ^ 0.00 and the Wilcoxon test on fitness exercises was P ^ 0.04, which means that both therapies have an influence in decreasing one’s weight. The result of the dependent T test on watermelon juice consumption and fitness exercise was P ^ 0.261, which means that the two therapies have no significant difference of influence. Health workers, especially nurses, are expected to be able to provide alternative therapies to reduce children’s overweight by using watermelon juice consumption or fitness exercises.  

scholarly journals Implementation of Cigarette Excise Policy against Cigarette Consumption Reduction among Adolescent in Kuningan, Indonesia

2017 ◽  
Vol 12 (2) ◽  
pp. 67
Author(s):  
Jani Ramjani ◽  
Fitri Kurnia Rahim ◽  
Icca Stella Amalia ◽  
Wahyu Manggala Putra
Keyword(s):  
Sampling Technique ◽  
Simple Random Sampling ◽  
Cigarette Consumption ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Test Analysis ◽  
Excise Tax ◽  
Excise Taxes ◽  
Significant Difference ◽  
The Impact

Indonesia has the highest prevalence of smoking (50.68%) compared to other ASEAN countries. On January 1st, 2017, the Indonesian government raised cigarette excise taxes. The purpose of this study was to analysis the impact of cigarette excise increase on cigarette consumption among adolescents aged 17 to 25 years. The study design used cross-sectional survey. A total of 153 adolescents were recruited in this study through simple random sampling technique. Questionnaires and observation papers were used in this study. A face-to-face interview was conducted to fulfill the data collection through home visit for each respondent. The data were obtained during May – June 2017. This study used paired t test analysis. The number of cigarettes consumed by adolescent decreased significantly by two cigarettes per day after the increase in cigarette excise tax. There is a significant difference of the average cigarettes price based on the brand after the implementation of cigarette excise tax increase, the difference of cigarette price is IDR 200 per stick of cigarettes after excise tax increase. Increased cigarette excise taxes may affect the increasing of cigarette prices. Threfore, it could reduce the number of cigarette consumption.

scholarly journals The impact of obesity on severity of solid organ injury in the adult population at a Level I trauma center

2019 ◽  
Vol 4 (1) ◽  
pp. e000318 ◽  
Author(s):  
Allen K Chen ◽  
David Jeffcoach ◽  
John C Stivers ◽  
Kyle A McCullough ◽  
Rachel C Dirks ◽  
...  
Keyword(s):  
Trauma Center ◽  
Pediatric Patients ◽  
Splenic Injury ◽  
Adult Population ◽  
Organ Injury ◽  
Solid Organ ◽  
Obese Patients ◽  
Solid Organ Injury ◽  
Liver Injuries ◽  
Level I

BackgroundThe obese (body mass index, BMI > 30) have been identified as a subgroup of patients in regards to traumatic injuries. A recent study found that high-grade hepatic injuries were more common in obese than non-obese pediatric patients. This study seeks to evaluate whether similar differences exist in the adult population and examine differences in operative versus non-operative management between the obese and non-obese in blunt abdominal trauma.MethodsPatient with trauma evaluated at an American College of Surgeons verified Level I trauma center from February 2013 to November 2016 were retrospectively reviewed. All patients aged >18 years with blunt mechanism of injury and a BMI listed in the trauma registry were included. Patients were excluded for incomplete data, including BMI or inability to grade hepatic or splenic injury. Data collected included age, gender, BMI, injury severity score, hospital length of stay, procedures on liver or spleen, and mortality. Organ injuries were scored using the American Association for the Surgery of Trauma grading scales, and were determined by either imaging or intraoperative findings. Obesity was classified as BMI > 30 compared with non-obese with BMI < 30.ResultsDuring the study period, 9481 patients were included. There were 322 spleen injuries and 237 liver injuries, with 64 patients sustaining both liver and splenic injuries. No differences existed in the percentage of high-grade hepatic or splenic injuries between the obese and non-obese. Obese patients with liver injuries were more likely to have procedural intervention than non-obese liver injuries and had higher rates of mortality. No differences were found in intervention for splenic injury between obese and non-obese.ConclusionsContrary to prior studies on adult and pediatric patients with trauma, this study found no difference between obese and non-obese patients in severity of solid organ injury after blunt abdominal trauma in the adult population. However, there was an increased rate of procedural intervention and mortality for obese patients with liver injuries.Level of Evidence3.

Sign in / Sign up

Export Citation Format

Share Document