scholarly journals Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

2014 ◽  
Vol 41 (4) ◽  
pp. 285-291 ◽  
Author(s):  
José Gustavo Parreira ◽  
Lucas R. Kanamori ◽  
Guilherme C. J. Valinoto ◽  
Jacqueline A. Giannini Perlingeiro ◽  
Silvia Cristine Soldá ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Head Injuries ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Retroperitoneal Hemorrhage ◽  
Lower Systolic Blood Pressure ◽  
Severity Of Injury ◽  
Thoracic And Abdominal ◽  
The Impact ◽  
Group 1

OBJECTIVE:to identify predictors of death in blunt trauma patients sustaining pelvic fractures and, posteriorly, compare them to a previously reported series from the same center.METHOD: Retrospective analysis of trauma registry data, including blunt trauma patients older than 14 y.o. sustaining pelvic fractures admitted from 2008 to 2010. Patients were assigned into group 1 (dead) or 2 (survivors). We used Student's t, qui square and Fisher's tests for statistical analysis, considering p<0.05 as significant. Posteriorly, we compared predictors of death between both periods.RESULTS: Seventy-nine cases were included. Mean RTS, ISS and TRISS were, respectively, 6.44 + 2.22, 28.0 + 15.2 e 0.74 + 0.33. Nineteen patients died (24,0%). Main cause of death was hemorrhage (42,1%). Group 1 was characterized by (p<0.05) lower systolic blood pressure and Glasgow coma scale means on admission, higher heart rate, head AIS, extremity AIS and ISS means, as well as, higher frequency of severe head injuries and complex pelvic fractures. Comparing both periods, we notice that the anatomic and physiologic severity of injury increased (RTS and ISS means). Furthermore, there was a decrease in the impact of associated thoracic and abdominal injuries on the prognosis and an association of lethality with the presence of complex pelvic fractures.CONCLUSION: There were significant changes in the predictors of death between these two periods. The impact of thoracic and abdominal associated injures decreased while the importance of severe retroperitoneal hemorrhage increased. There was also an increase in trauma severity, which accounted for high lethality.

Assessing the influence of non-treatment variables in a study of outcome from severe head injuries

1984 ◽  
Vol 61 (2) ◽  
pp. 254-262 ◽  
Author(s):  
A. Russell Lokkeberg ◽  
Richard M. Grimes
Keyword(s):  
Regression Analysis ◽  
Analysis Of Variance ◽  
Head Injuries ◽  
Trauma Patients ◽  
Severely Injured ◽  
Content Type ◽  
Severity Of Injury ◽  
Mode Of Transportation ◽  
The Impact ◽  
Fine Print

✓ An evaluation was made of the impact of non-treatment variables on severely injured head trauma patients. The principal findings were: 1) severity of injury was the best predictor of outcome; 2) patient's age had a statistically significant but marginally useful impact on outcome; 3) a regression analysis showed that duration of transport, up to 4 hours, had no impact on outcome; 4) time from accident to intubation had a marginal impact on outcome; and 5) one-way analysis of variance showed that mode of transportation, whether helicopter, ambulance, or other means had no impact on outcome.

Body Mass Index and Outcomes in Critically Injured Blunt Trauma Patients: Weighing the Impact

2007 ◽  
Vol 204 (5) ◽  
pp. 1056-1061 ◽  
Author(s):  
Mark A. Newell ◽  
Michael R. Bard ◽  
Claudia E. Goettler ◽  
Eric A. Toschlog ◽  
Paul J. Schenarts ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Blunt Trauma ◽  
Body Mass ◽  
Trauma Patients ◽  
The Impact

The role of associated injuries on outcome of blunt trauma patients sustaining pelvic fractures

Injury ◽  
2000 ◽  
Vol 31 (9) ◽  
pp. 677-682 ◽  
Author(s):  
Jose Gustavo Parreira ◽  
Raul Coimbra ◽  
Samir Rasslan ◽  
Andrea Oliveira ◽  
Marcelo Fregoneze ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Associated Injuries

How (Un)Useful is the Pelvic Ring Stability Examination in Diagnosing Mechanically Unstable Pelvic Fractures in Blunt Trauma Patients?

2009 ◽  
Vol 66 (3) ◽  
pp. 815-820 ◽  
Author(s):  
Gil Z. Shlamovitz ◽  
William R. Mower ◽  
Jonathan Bergman ◽  
Kenneth R. Chuang ◽  
Jonathan Crisp ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Stability Examination ◽  
Ring Stability

scholarly journals Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

2014 ◽  
Vol 41 (4) ◽  
pp. 272-277 ◽  
Author(s):  
José Gustavo Parreira ◽  
Marina Raphe Matar ◽  
André Luis Barreto Tôrres ◽  
Jacqueline A. G. Perlingeiro ◽  
Silvia C. Solda ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Injury Severity ◽  
Pelvic Fractures ◽  
Thoracic Segment ◽  
Chest Drainage ◽  
Chi Square ◽  
Fall From Height ◽  
Group 2 ◽  
Trauma Group ◽  
Group 1

OBJECTIVE: To analyze the lesions diagnosed in victims of falls, comparing them with those diagnosed in other mechanisms of blunt trauma.METHODS: We conducted a retrospective study of trauma protocol charts (prospectively collected) from 2008 to 2010, including victims of trauma over 13 years of age admitted to the emergency room. The severity of injuries was stratified by the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Variables were compared between the group of victims of falls from height (Group 1) and the other victims of blunt trauma (Group 2). We used the Student t, chi-square and Fisher tests for comparison between groups, considering the value of p <0.05 as significant.RESULTS: The series comprised 4,532 cases of blunt trauma, of which 555 (12.2%) were victims of falls from height. Severe lesions (AISe"3) were observed in the extremities (17.5%), in the cephalic segment (8.4%), chest (5.5%) and the abdomen (2.9%). Victims of Group 1 had significantly higher mean age, AIS in extremities / pelvis, AIS in the thoracic segment and ISS (p <0.05). The group 1 had significantly (p <0.05) higher incidence of tracheal intubation on admission, pneumothorax, hemothorax, rib fractures, chest drainage, spinal trauma, pelvic fractures, complex pelvic fractures and fractures to the upper limbs.CONCLUSION: Victims of fall from height had greater anatomic injury severity, greater frequency and severity of lesions in the thoracic segment and extremities.

EARLY IDENTIFICATION OF ACTIVE ARTERIAL HEMORRHAGE IN HYPOTENSIVE BLUNT TRAUMA PATIENTS WITH PELVIC FRACTURES

1998 ◽  
Vol 26 (Supplement) ◽  
pp. 46A
Author(s):  
C. Michael Buechler ◽  
Paul Blostern ◽  
Michael Kasten ◽  
David Ritzo
Keyword(s):  
Blunt Trauma ◽  
Early Identification ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Arterial Hemorrhage

Utility of Plain Film Pelvic Radiographs in Blunt Trauma Patients in the Emergency Department

2006 ◽  
Vol 72 (10) ◽  
pp. 951-954 ◽  
Author(s):  
Amal Kamil Obaid ◽  
Andrew Barleben ◽  
Diana Porral ◽  
Stephanie Lush ◽  
Marianne Cinat
Keyword(s):  
Emergency Department ◽  
Ct Scan ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Plain Film ◽  
Pelvic Fractures ◽  
Trauma Patients ◽  
Pelvic Radiographs ◽  
Highly Sensitive ◽  
Pelvic Embolization

The objective of this study was to evaluate the utility and sensitivity of routine pelvic radiographs (PXR) in the initial evaluation of blunt trauma patients. A retrospective review was performed. One hundred seventy-four patients with a pelvic fracture who had computed tomography (CT) and PXR were included (average age, 36.1; average Injury Severity Score, 16.3). Nine (5%) patients died. Five hundred twenty-one fractures were identified on CT. One hundred sixteen (22%) of these fractures were missed by PXR. Eighty-eight (51%) patients were underdiagnosed by PXR alone. The most common fractures missed by PXR were sacral and iliac fractures. Eight patients required angiograms, with four undergoing therapeutic pelvic embolization. Forty-seven (27%) patients were hypotensive or required a transfusion in the emergency department. These patients were more likely to require an angiogram (17% vs 0%, P < 0.0001) and were more likely to require embolization (9% vs 0%, P < 0.001). This study demonstrates that CT scan is highly sensitive in identifying and classifying pelvic fractures. PXR has a sensitivity of only 78 per cent for identification of pelvic fractures in the acute trauma patient. In hemodynamically stable patients who are going to undergo diagnostic CT scan, PXR is of little value. The greatest use of PXR may be as a screening tool in hemodynamically unstable patients and/or those that require transfusion to allow for early notification of the interventional radiology team.

Airbag head restraint system

2000 ◽  
Vol 214 (3) ◽  
pp. 229-241 ◽  
Author(s):  
J Latchford ◽  
E. C. Chirwa
Keyword(s):  
Injury Severity ◽  
Head Injuries ◽  
Experimental Tests ◽  
Restraint System ◽  
Head Restraint ◽  
Current Test ◽  
Severity Of Injury ◽  
Good Potential ◽  
New Criterion ◽  
The Impact

The function of a head restraint system is to prevent injurious hyperextension of the occupant's neck in the event of a road vehicle rear end impact, and thus it must have adequate stiffness to limit the movement of the head relative to the torso. Also, it should absorb the kinetic energy progressively so that the head does not sustain any injury and does not roll on the cushion. Practically, a well-designed head restraint will have an optimum balance of these features and thereby offer adequate protection for both the head and the neck. This paper presents some pioneering thinking on head restraint design and develops criteria for qualifying the systems. It presents an airbag head restraint system that has optimum stiffness and good potential for reducing head and neck injuries suffered through rear end collisions. It also presents the results of experimental tests conducted on this novel airbag head restraint system and on several randomly selected existing head restraints. Furthermore, analysis of energy absorption capabilities, head injury criterion (HIC) values and a new criterion, called the equivalent impact power criterion (EIPC), is developed in order to quantify the relation between the rate at which energy is imparted to the head during the impact cycle and injury severity. Current test results show that, the lower the EIPC, the better is the head restraint system and the less is the risk of whiplash and head injuries. Moreover, the work has quantified a number of variables, including the optimum stiffness, as the factors governing the severity of injury to the occupant in a rear impact scenario.

Cirrhosis and Trauma: A Deadly Duo

2005 ◽  
Vol 71 (12) ◽  
pp. 996-1000 ◽  
Author(s):  
A. Britton Christmas ◽  
Ashley K. Wilson ◽  
Glen A. Franklin ◽  
Frank B. Miller ◽  
J. David Richardson ◽  
...  
Keyword(s):  
Hepatic Cirrhosis ◽  
Injury Severity ◽  
Prognostic Indicator ◽  
Outcome Data ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Fourfold Increase ◽  
Abdominal Operation ◽  
Severity Of Injury ◽  
The Impact

It has been previously reported that trauma patients with cirrhosis undergoing emergency abdominal operations exhibit a fourfold increase in mortality independent of their Child's classification. We undertook this review to assess the impact of cirrhosis on trauma patients. We reviewed the records of patients from 1993 to 2003 with documented hepatic cirrhosis and compared them to a 2:1 control population without hepatic cirrhosis and matched for age, sex, Injury Severity Score (ISS), and Glasgow Coma Score (GCS). Demographic, severity of injury, and outcome data were recorded. Student's t test and χ2 were used for statistical analysis and a P < 0.05 was significant. Sixty-one patients had documented cirrhosis and were compared to 156 matched controls. Comparing the two groups demonstrates there was no difference in age, ISS, or GCS. Intensive care stay, hospital length of stay, blood requirements in the first 24 hours postinjury, and mortality (33% vs 1%) was significantly greater in the trauma patients with cirrhosis. Fifty-five per cent of deaths in the cirrhosis group was due to sepsis, and, as the Child's class increases, so does the mortality (Child's A, 15%; B, 37%; and C, 63%). In 64 per cent of cirrhotics without an emergent abdominal operation, mortality was 21 per cent. In the 36 per cent of cirrhotics who had emergent abdominal operation, mortality was 55 per cent. Hepatic cirrhosis in trauma patients, regardless of severity of injury or the need for an abdominal intervention, is a poor prognostic indicator. The necessity of an abdominal operative intervention further amplifies this effect. Trauma and cirrhosis is, in fact, a deadly duo.

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