scholarly journals Correlation between injury and the injury severity score in geriatric traffic accident patients transported by 119 rescue services

2016 ◽  
Vol 20 (3) ◽  
pp. 7-19
Author(s):  
Yu-Jin Park ◽  
Byung-Woo Kim
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Traffic Accident ◽  
Injury Severity ◽  
Rescue Services

scholarly journals Pattern of Morbidity and Mortality Due to Road Traffic Accident Cases at BP Koirala Institute of Health Sciences, Dharan

2020 ◽  
Vol 3 (2) ◽  
pp. 9-14
Author(s):  
Sugam Shrestha ◽  
BN Yadav ◽  
Shivendra Jha ◽  
Bikash Sah
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Injury Severity ◽  
Road Traffic ◽  
Health Sciences ◽  
Morbidity And Mortality ◽  
Female Ratio ◽  
Body Regions

Introduction: Road traffic injuries and deaths caused by motor vehicles is a growing public health problem all over the world. Head injury and blunt abdominal trauma are major health problems and are frequent causes of death among Road Traffic Accident (RTA) victims. Methods: A total of 348 cases were examined in Emergency department and the Department of Forensic Medicine and Toxicology at B.P Koirala Institute of Health Sciences, Dharan during the period of one year. Data were collected using proforma and analyzed using Statistical Package for Social Sciences (SPSS) 11.5. Injury Severity Score (ISS) was used to assess the severity of injuries. Result: There were 318 morbidity and 30 mortality cases. Male to female ratio was 2.2:1. The commonest age group involved was 21-30 years i.e.32.1%. The most common vehicle involved was two wheelers (60.9%) followed by heavy four or more wheelers (20.9%) and the most common nature of accident was through collision of the vehicles. Abrasion was the most common injury occurred during the RTA (61.2%). 34.1% of the victims had laceration, 8.6% had contusion and 20.9% had fractures. Median Injury Severity Score was 31.5 in mortality and 1 in morbidity cases. Conclusion: Road traffic accident is one of the major causes of morbidity and mortality. Injuries in various body regions are frequent findings in victims of RTA. The median Injury Severity Score (ISS) of mortality cases was significantly high compared to that of morbidity cases.

scholarly journals Injuries type and its relation with Glasgow Coma Scale, injury severity score and blood transfusion in road traffic accident Victims.

2018 ◽  
Vol 23 (2) ◽  
pp. 148-159
Author(s):  
Abdullah Alqarni Abdulaziz ◽  
Ghanem Alanazi Radhi ◽  
Anthony Morgan ◽  
Ahmed Saud Alharbi ◽  
Faisal Fahad Aljuaid ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Glasgow Coma Scale ◽  
Injury Severity Score ◽  
Severity Score ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Injury Severity ◽  
Road Traffic ◽  
Coma Scale

Disseminierte intravasale Gerinnung und Fibrinolyse in der Frühphase nach Polytrauma

1995 ◽  
Vol 15 (02) ◽  
pp. 79-86
Author(s):  
L. Lampl ◽  
M. Helm ◽  
M. Tisch ◽  
K. H. Bock ◽  
E. Seifried
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Tissue Type ◽  
Disseminierte Intravasale Gerinnung

ZusammenfassungGerinnungsstörungen nach einem Polytrauma werden eine große Bedeutung für die weitere Prognose der Patienten beigemessen. In einer prospektiv angelegten Studie wurden bei 20 polytraumatisierten Patienten Gerinnungsund Fibrinolyseparameter analysiert, um deren Veränderungen während der präklinischen Phase zu definieren. Die Blutentnahmen wurden zum frühestmöglichen Zeitpunkt am Unfallort und bei Klinikübergabe durchgeführt. Die gewonnenen Proben wurden mit Hilfe eines speziell konzipierten »Kleinlabors« noch vor Ort verarbeitet, um möglichst native Meßwerte zu erhalten. Die Patienten wurden dem Schweregrad der Verletzung entsprechend kategorisiert und hatten einen Verletzungsschweregrad nach NACA > IV und einen Injury Severity Score (ISS) > 20. Die Ergebnisse zeigen, daß bereits in der sehr frühen Phase nach Eintritt des Traumas schwerwiegende Veränderungen des Gerinnungsund Fibrinolysesystems eintreten. Die frühzeitige Thrombingenerierung führt zu einer Verbrauchskoagulopathie und reaktiven Hyperfibrinolyse. Zusätzlich erzeugt die Freisetzung von endothelständigem Tissue-type-Plasminogenaktivator eine primäre Hyperfibrinolyse. Die Veränderungen des Gerinnungsund Fibrinolysesystems in der frühen präklinischen Phase nach Polytrauma können zu schwerwiegenden klinischen Komplikationen wie Blutungen, thromboembolischen Komplikationen und zur Ausbildung von Schockorganen führen.

Non-Selective Thoracic Computed Tomography in Trauma Patients Results in Injury Severity Score Inflation

2021 ◽  
pp. 000313482110249
Author(s):  
Leonardo Alaniz ◽  
Omaer Muttalib ◽  
Juan Hoyos ◽  
Cesar Figueroa ◽  
Cristobal Barrios
Keyword(s):  
Computed Tomography ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Treatment Plan ◽  
Mortality Prediction ◽  
Trauma Patients ◽  
Mortality Benefit ◽  
Severity Scores ◽  
Score Inflation

Introduction Extensive research relying on Injury Severity Scores (ISS) reports a mortality benefit from routine non-selective thoracic CTs (an integral part of pan-computed tomography (pan-CT)s). Recent research suggests this mortality benefit may be artifact. We hypothesized that the use of pan-CTs inflates ISS categorization in patients, artificially affecting admission rates and apparent mortality benefit. Methods Eight hundred and eleven patients were identified with an ISS >15 with significant findings in the chest area. Patient charts were reviewed and scores were adjusted to exclude only occult injuries that did not affect treatment plan. Pearson chi-square tests and multivariable logistic regression were used to compare adjusted cases vs non-adjusted cases. Results After adjusting for inflation, 388 (47.8%) patients remained in the same ISS category, 378 (46.6%) were reclassified into 1 lower ISS category, and 45 (5.6%) patients were reclassified into 2 lower ISS categories. Patients reclassified by 1 category had a lower rate of mortality ( P < 0.001), lower median total hospital LOS ( P < .001), ICU days ( P < .001), and ventilator days ( P = 0.008), compared to those that remained in the same ISS category. Conclusion Injury Severity Score inflation artificially increases survival rate, perpetuating the increased use of pan-CTs. This artifact has been propagated by outdated mortality prediction calculation methods. Thus, prospective evaluations of algorithms for more selective CT scanning are warranted.

INJURY SEVERITY SCORE, HEAD INJURY, AND PATIENT WAIT DAYS

1992 ◽  
Vol 33 (2) ◽  
pp. 219-220 ◽  
Author(s):  
James Andersen ◽  
William Sharkey ◽  
Michael L. Schwartz ◽  
Barry A. McLellan
Keyword(s):  
Head Injury ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity

scholarly journals Schockraum- und Schwerverletztenversorgung als „Verlustgeschäft“

2020 ◽  
Author(s):  
Thomas Gross ◽  
Felix Amsler
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Diagnosis Related Groups ◽  
Case Mix ◽  
Multivariate Analyse ◽  
New Injury Severity Score ◽  
Case Mix Index

Zusammenfassung Hintergrund Es galt herauszufinden, wie kostendeckend die Versorgung potenziell Schwerverletzter in einem Schweizer Traumazentrum ist, und inwieweit Spitalgewinne bzw. -verluste mit patientenbezogenen Unfall‑, Behandlungs- oder Outcome-Daten korrelieren. Methodik Analyse aller 2018 im Schockraum (SR) bzw. mit Verletzungsschwere New Injury Severity Score (NISS) ≥8 notfallmäßig stationär behandelter Patienten eines Schwerverletztenzentrums der Schweiz (uni- und multivariate Analyse; p < 0,05). Ergebnisse Für das Studienkollektiv (n = 513; Ø NISS = 18) resultierte gemäß Spitalkostenträgerrechnung ein Defizit von 1,8 Mio. CHF. Bei einem Gesamtdeckungsgrad von 86 % waren 66 % aller Fälle defizitär (71 % der Allgemein- vs. 42 % der Zusatzversicherten; p < 0,001). Im Mittel betrug das Defizit 3493.- pro Patient (allg. Versicherte, Verlust 4545.-, Zusatzversicherte, Gewinn 1318.-; p < 0,001). Auch „in“- und „underlier“ waren in 63 % defizitär. SR-Fälle machten häufiger Verlust als Nicht-SR-Fälle (73 vs. 58 %; p = 0,002) wie auch Traumatologie- vs. Neurochirurgiefälle (72 vs. 55 %; p < 0,001). In der multivariaten Analyse ließen sich 43 % der Varianz erhaltener Erlöse mit den untersuchten Variablen erklären. Hingegen war der ermittelte Deckungsgrad nur zu 11 % (korr. R2) durch die Variablen SR, chirurgisches Fachgebiet, Intensivaufenthalt, Thoraxverletzungsstärke und Spitalletalität zu beschreiben. Case-Mix-Index gemäß aktuellen Diagnosis Related Groups (DRG) und Versicherungsklasse addierten weitere 13 % zu insgesamt 24 % erklärter Varianz. Diskussion Die notfallmäßige Versorgung potenziell Schwerverletzter an einem Schweizer Traumazentrum erweist sich nur in einem Drittel der Fälle als zumindest kostendeckend, dies v. a. bei Zusatzversicherten, Patienten mit einem hohen Case-Mix-Index oder einer IPS- bzw. kombinierten Polytrauma- und Schädel-Hirn-Trauma-DRG-Abrechnungsmöglichkeit.

scholarly journals Factors influencing the injury severity score and the probability of survival in patients who fell from height

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masashi Fujii ◽  
Tsutomu Shirakawa ◽  
Mami Nakamura ◽  
Mineko Baba ◽  
Masahito Hitosugi
Keyword(s):  
Regression Analysis ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Injury Severity Score ◽  
Survival Probability ◽  
Severity Score ◽  
Hospital Care ◽  
Injury Severity ◽  
Body Position ◽  
Fall Height

AbstractIn Japan, falls from height result in the second highest trauma mortality rate after traffic motor vehicle collisions and the highest trauma-related mortality rate amongst young people. We aimed to identify factors that worsen injury severity and lower survival probability of patients who fell from height and to contribute to the improvement of their prehospital and in-hospital care. This retrospective analysis retrieved hospital records of 179 patients aged ≥ 15 years who were transported to our hospital after a fall from height during April 2014–March 2020. On multiple regression analysis, fall height ≥ 5 m more significantly resulted in higher the injury severity score. Logistic regression analysis revealed that fall height ≥ 5 m with the reference of 2–3 m significantly resulted in lower the survival probability with odds ratio (95% confidence interval) of 0.10 (0.02–0.55). Using ‘feet-first’ as the reference body position, the odds ratios (95% confidence interval) of survival for those who impacted the surface on the lateral or dorsal regions were 0.11 (0.02–0.64) and 0.17 (0.03–0.99), respectively. Collecting information on the abovementioned factors at pre-hospitalisation may facilitate prompt diagnosis and treatment. These results may help improve prehospital and in-hospital care, avoiding preventable trauma deaths.

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