Seat Belt Use and its Effect on Abdominal Trauma: A National Trauma Databank Study

2016 ◽  
Vol 82 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Nick A. Nash ◽  
Obi Okoye ◽  
Ozgur Albuz ◽  
Kelly N. Vogt ◽  
Efstathios Karamanos ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Motor Vehicle ◽  
Seat Belt ◽  
Solid Organ ◽  
Seat Belts ◽  
Abdominal Injuries ◽  
National Trauma ◽  
Seat Belt Use

We sought to use the National Trauma Databank to determine the demographics, injury distribution, associated abdominal injuries, and outcomes of those patients who are restrained versus unrestrained. All victims of motor vehicle collisions (MVCs) were identified from the National Trauma Databank and stratified into subpopulations depending on the use of seat belts. A total of 150,161 MVC victims were included in this study, 72,394 (48%) were belted. Young, male passengers were the least likely to be wearing a seat belt. Restrained victims were less likely to have severe injury as measured by Injury Severity Score and Abbreviated Injury Score. Restrained victims were also less likely to suffer solid organ injuries (9.7% vs 12%, P < 0.001), but more likely to have hollow viscous injuries (1.9% vs 1.3%, P < 0.001). The hospital and intensive care unit length of stay were significantly shorter in belted victims with adjusted mean difference: -1.36 (-1.45, -1.27) and -0.96 (-1.02, -0.90), respectively. Seat belt use was associated with a significantly lower crude mortality than unrestrained victims (1.9% vs 3.3%, P < 0.001), and after adjusting for differences in age, gender, position in vehicle, and deployment of air bags, the protective effect remained (adjusted odds ratio for mortality 0.50, 95% confidence interval 0.47, 0.54). In conclusion, MVC victims wearing seat belts have a significant reduction in the severity of injuries in all body areas, lower mortality, a shorter hospital stay, and decreased length of stay in the intensive care unit. The nature of abdominal injuries, however, was significantly different, with a higher incidence of hollow viscous injury in those wearing seat belts.

On Informing Women of Child Bearing Age about Seat Belt Risk during Pregnancy

2002 ◽  
Vol 46 (11) ◽  
pp. 943-946
Author(s):  
Kenya Freeman ◽  
Michael S. Wogalter
Keyword(s):  
Pregnant Women ◽  
Motor Vehicle ◽  
Seat Belt ◽  
Seat Belts ◽  
Third Trimester ◽  
Severe Injuries ◽  
Vehicle Accidents ◽  
Child Bearing ◽  
Seat Belt Use ◽  
Serious Injuries

Seat belts have been effective in reducing serious injuries and deaths in vehicular accidents. However, their use by women in the third trimester of pregnancy can cause placental damage and fetal injury or death in relatively minor motor vehicle accidents without severely injuring pregnant women. The lack of seat belt use in similar or more serious accidents could cause severe injuries or death to pregnant women from impacts within the cabin or from ejection, and in turn could lead to fetal injuries or deaths. The present study sought to determine whether women between the ages of 16 and 45 (child bearing age) would like to be informed of these risks. Ninety-nine of the 101 women surveyed indicated they would like to be informed of the risks, and that they would expect to find this information in the vehicle's owners manual. in dealing with the risks, some women indicated that they would wear the seatbelts and others indicated they would not. Most respondents indicated that they would reduce the risks by reducing their use of the vehicle during pregnancy. These results have implications for risk communications.

scholarly journals The assessment of clinical evaluation and treatment results of high-energy blunt polytrauma patients

Medicina ◽  
2007 ◽  
Vol 43 (2) ◽  
pp. 137 ◽  
Author(s):  
Algimantas Pamerneckas ◽  
Andrei Pijadin ◽  
Giedrius Pilipavičius ◽  
Gintaras Tamulaitis ◽  
Vytautas Toliušis ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Injury Severity ◽  
Motor Vehicle ◽  
High Energy ◽  
Ventilation Time ◽  
Polytrauma Patients ◽  
The Mean

The aim of this study was to evaluate the mechanism of high-energy blunt trauma, age and gender of patients, severity of regional and multiple injury, ventilation time, length of stay in intensive care unit and in-hospital stay, in-hospital complications, and treatment outcome. Materials and methods. Data on 159 patients with severe multiple injuries, meeting inclusion criteria, were collected prospectively and evaluated retrospectively. Results. The mean age of multiple trauma patients was 43.9±1.4 years; males were injured 2.5 times more often than females (P<0.001). More than half (66.7%) of patients were 17–64-year-old males. Majority (83%) of all patients were injured in motor vehicle crashes, and 52.2% of these patients were pedestrians. The mean Injury Severity Score was 29.5±0.8, and severe (Abbreviated Injury Scale score of 3 and more) injuries of extremities, head, and chest made up 69.1% of all injuries. The mean ventilation time, mean length of stay in intensive care unit, and mean in-hospital stay were 5.5±0.7, 7.0±0.8, and 23.6±1.6 days, respectively. Acute lung complications were the most common (25.2%). Systemic inflammatory response syndrome developed in 7.5% of patients, and sepsis in 3.8% of patients. More than one-fifth (20.8%) of polytrauma patients died. Conclusions. Working-age male pedestrians (17–64 years old) made up two-thirds of all polytrauma patients. Severe injuries of extremities, head, and chest were present in 69.1% of all cases. Lung complications were the most common.

scholarly journals Chance Fracture in Three Brothers

2018 ◽  
Vol 24 (4) ◽  
pp. 322-326
Author(s):  
Lucidio Duarte De Souza Filho ◽  
Geraldo Vitor Cardoso Bicalho ◽  
Bernardo Drummond ◽  
Rafael Stein Rosseto ◽  
Rodrigo Moreira Faleiro ◽  
...  
Keyword(s):  
Fracture Mechanism ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Seat Belt ◽  
Seat Belts ◽  
Abdominal Injuries ◽  
Chance Fracture ◽  
Belo Horizonte ◽  
Type Of Injury ◽  
Type Of Fracture

Chance fracture, suggestive of a flexion-distraction mechanism, is an uncommon type of injury in the pediatric population. Its occurrence, with associated intra-abdomimal lesions, has increased with the widespread use of seat belts. Since this type of fracture presents subtle variations on common image examinations, its diagnosis may be delayed increasing the probability of subsequent neurologic deficits. In this paper we report the case of three siblings, victims of a motor vehicle head-on collision,either presenting seat belt fracture or Chance fracture. They were treated in the Hospital João XXIII, Belo Horizonte. The case reported reinforces the hypothesis describing the fracture mechanism and associated intra-abdominal injuries.

Driving habits – A Canadian study

Trauma ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 225-229
Author(s):  
Shayesteh Jahanfar
Keyword(s):  
Motor Vehicle ◽  
Seat Belt ◽  
Canadian Community Health Survey ◽  
Population Based ◽  
Motor Vehicle Accidents ◽  
Seat Belts ◽  
Safe Driving ◽  
Vehicle Accidents ◽  
Seat Belt Use ◽  
The Times

Introduction Motor vehicle accidents are a significant cause of morbidity and mortality. Safe driving behavior constitutes proper use of seat belts as a driver and as a passenger. The correct use of seat belts has been shown to reduce death and injury following motor vehicle accidents by more than 50%. This study aims at investigating seat belt use and driving habits among Canadians. Method A population-based database from the Canadian Community Health Survey was analyzed. Result About 12% reported that they use seat belts most of the times, rarely or never and 27% of respondents were using cellphone while driving often or sometimes; 8% of respondents admitted to driving after 2 or more alcoholic drinks. Seat belt use in taxi passengers is much lower than in own cars, with 40% not using a seatbelt all of the time when in a taxi. Discussion and conclusions The major risk factors for not wearing seat belt as a passenger include age, education, ethnicity and income.

scholarly journals 1412. The utility of respiratory viral panel testing for nosocomial fever in the neonatal intensive care unit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S713-S713
Author(s):  
Carlo Fopiano Palacios ◽  
Eric Lemmon ◽  
James Campbell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Linear Regression ◽  
Length Of Stay ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
P Value ◽  
Fisher Exact Test ◽  
The Mean ◽  
Pcr Test

Abstract Background Patients in the neonatal intensive care unit (NICU) often develop fevers during their inpatient stay. Many neonates are empirically started on antibiotics due to their fragile clinical status. We sought to evaluate whether the respiratory viral panel (RVP) PCR test is associated with use of antibiotics in patients who develop a fever in the NICU. Methods We conducted a retrospective chart review on patients admitted to the Level 4 NICU of the University of Maryland Medical Center from November 2015 to June 2018. We included all neonates who developed a fever 48 hours into their admission. We collected demographic information and data on length of stay, fever work-up and diagnostics (including labs, cultures, RVP), and antibiotic use. Descriptive statistics, Fisher exact test, linear regression, and Welch’s ANOVA were performed. Results Among 347 fever episodes, the mean age of neonates was 72.8 ± 21.6 days, and 45.2% were female. Out of 30 total RVP samples analyzed, 2 were positive (6.7%). The most common causes of fever were post-procedural (5.7%), pneumonia (4.8%), urinary tract infection (3.5%), meningitis (2.6%), bacteremia (2.3%), or due to a viral infection (2.0%). Antibiotics were started in 208 patients (60%), while 61 neonates (17.6%) were already on antibiotics. The mean length of antibiotics was 7.5 ± 0.5 days. Neonates were more likely to get started on antibiotics if they had a negative RVP compared to those without a negative RVP (89% vs. 11%, p-value &lt; 0.0001). Patients with a positive RVP had a decreased length of stay compared to those without a positive RVP (30.3 ± 8.7 vs. 96.8 ± 71.3, p-value 0.01). On multivariate linear regression, a positive RVP was not associated with length of stay. Conclusion Neonates with a negative respiratory viral PCR test were more likely to be started on antibiotics for fevers. Respiratory viral PCR testing can be used as a tool to promote antibiotic stewardship in the NICU. Disclosures All Authors: No reported disclosures

scholarly journals Postoperative delirium after cardiac surgery of elderly patients as an independent risk factor for prolonged length of stay in intensive care unit and in hospital

2021 ◽  
Author(s):  
Andrea Kirfel ◽  
Jan Menzenbach ◽  
Vera Guttenthaler ◽  
Johanna Feggeler ◽  
Andreas Mayr ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Hospital Length Of Stay ◽  
Confusion Assessment

Abstract Background Postoperative delirium (POD) is a relevant and underdiagnosed complication after cardiac surgery that is associated with increased intensive care unit (ICU) and hospital length of stay (LOS). The aim of this subgroup study was to compare the frequency of tested POD versus the coded International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis of POD and to evaluate the influence of POD on LOS in ICU and hospital. Methods 254 elective cardiac surgery patients (mean age, 70.5 ± 6.4 years) at the University Hospital Bonn between September 2018 and October 2019 were evaluated. The endpoint tested POD was considered positive, if one of the tests Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method (CAM), 4 'A's Test (4AT) or Delirium Observation Scale (DOS) was positive on one day. Results POD occurred in 127 patients (50.0%). LOS in ICU and hospital were significantly different based on presence (ICU 165.0 ± 362.7 h; Hospital 26.5 ± 26.1 days) or absence (ICU 64.5 ± 79.4 h; Hospital 14.6 ± 6.7 days) of POD (p < 0.001). The multiple linear regression showed POD as an independent predictor for a prolonged LOS in ICU (48%; 95%CI 31–67%) and in hospital (64%; 95%CI 27–110%) (p < 0.001). The frequency of POD in the study participants that was coded with the ICD F05.0 and F05.8 by hospital staff was considerably lower than tests revealed by the study personnel. Conclusion Approximately 50% of elderly patients who underwent cardiac surgery developed POD, which is associated with an increased ICU and hospital LOS. Furthermore, POD is highly underdiagnosed in clinical routine.

scholarly journals Carbapenem-resistant Enterobacteriaceae carriage risk for parameterization of a regional healthcare network agent-based model

2020 ◽  
Vol 41 (S1) ◽  
pp. s148-s149
Author(s):  
Sarah Rhea ◽  
Lei Li ◽  
Pooja Iyer ◽  
Lauren DiBiase ◽  
Kasey Jones ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Unit Stay ◽  
Agent Based ◽  
Healthcare Network ◽  
Transmission Parameters ◽  
Carbapenem Resistant ◽  
Comorbidity Index ◽  
Systemic Antibiotics

Background: Carbapenem-resistant Enterobacteriaceae (CRE) are increasingly common in the United States and have the potential to spread widely across healthcare networks. Only a fraction of patients with CRE carriage (ie, infection or colonization) are identified by clinical cultures. Interventions to reduce CRE transmission can be explored with agent-based models (ABMs) comprised of unique agents (eg, patients) represented by a synthetic population or model-generated representation of the population. We used electronic health record data to determine CRE carriage risk, and we discuss how these results can inform CRE transmission parameters for hospitalized agents in a regional healthcare network ABM. Methods: We reviewed the laboratory data of patients admitted during July 1, 2016−June 30, 2017, to any of 7 short-term acute-care hospitals of a regional healthcare network in North Carolina (N = 118,022 admissions) to find clinically detected cases of CRE carriage. A case was defined as the first occurrence of Enterobacter spp, Escherichia coli, or Klebsiella spp resistant to any carbapenem isolated from a clinical specimen in an admitted patient. We used Poisson regression to estimate clinically detected CRE carriage risk according to variables common to data from both the electronic health records and the ABM synthetic population, including patient demographics, systemic antibiotic administration, intensive care unit stay, comorbidities, length of stay, and admitting hospital size. Results: We identified 58 (0.05%) cases of CRE carriage among all admissions. Among these cases, 30 (52%) were ≥65 years of age and 37 (64%) were female. During their admission, 47 cases (81%) were administered systemic antibiotics and 18 cases (31%) had an intensive care unit stay. Patients administered systemic antibiotics and those with an intensive care unit stay had CRE carriage risk 6.5 times (95% CI, 3.4–12.5) and 4.9 times (95% CI, 2.8–8.5) higher, respectively, than patients without these exposures (Fig. 1). Patients ≥50 years of age and those with a higher Elixhauser comorbidity index score and with longer length of stay also had increased CRE carriage risk. Conclusions: Among admissions in our dataset, CRE carriage risk was associated with systemic antibiotic exposure, intensive care unit stay, higher Elixhauser comorbidity index score, and longer length of stay. We will use these risk estimates in the ABM to inform agents’ CRE carriage status upon hospital admission and the CRE transmission parameters for short-term acute-care hospitals. We will explore CRE transmission interventions in the parameterized regional healthcare network ABM and assess the impact of CRE carriage underestimation.Funding: This work was supported by Centers for Disease Control and Prevention (CDC) Cooperative Agreement number U01CK000527. The conclusions, findings, and opinions expressed do not necessarily reflect the official position of CDC.Disclosures: None

Sign in / Sign up

Export Citation Format

Share Document