scholarly journals Evaluation of complete profile and outcome of gunshot injuries in tertiary care centre

2019 ◽  
Vol 6 (2) ◽  
pp. 397
Author(s):  
Fazle Rab Malik ◽  
Santosh Kumar Singh ◽  
Shivam Madeshiya ◽  
Roshni Khan ◽  
Nandan Rai
Keyword(s):  
Glasgow Coma Scale ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Tertiary Care ◽  
Gunshot Injury ◽  
Coma Scale ◽  
Gunshot Injuries ◽  
Revised Trauma Score ◽  
Trauma Score

Background: Gunshot injuries are range from minor superficial pellet injuries to devastating soft tissue and visceral injuries. The objective of study was to evaluate complete profile and outcome of gunshot injuries in tertiary care centre.Methods: This study was a prospective study. All gunshot injury patients who admitted in Department of Surgery, Moti Lal Nehru Medical College, Allahabad were included in study.Results: Result were analysed in terms of age, sex, rural-urban and religion wise distribution, etiology of injury, arms and ammunition, time elapsed in first aid, site of injury, associated injury, organ involved, Glasgow coma scale, injury severity score, revised trauma score, various blood and radiological investigations, treatment and complications.Conclusions: Gunshot injury was common in male patients, age group 21-30years, Hindu community and in rural areas. Most patients received injury by shotgun. Assault was most common cause followed by accidental injury. Majority of patients had Glasgow coma scale between 13-15, injury severity score below 20 and revised trauma score more than eight.  Mortality and morbidity were more common in patients with high injury severity score, low revised trauma score and Glasgow coma scale below 8. Abdomen was most common site involved in gunshot injury. Most of the patients were managed conservatively as these patients had external body surface injury. Laparotomy was done for intra-abdominal injury. Wound infection was the most common complication.

Evaluation of Injury Severity: Review of the Most Commonly Used System for the Evaluation of Injury Severity in Traumatologic Patients

2003 ◽  
Vol 10 (3) ◽  
pp. 16-19 ◽  
Author(s):  
A Karlbauer ◽  
R Woidke ◽  
A Karlbauer ◽  
R Woidke
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Pediatric Trauma ◽  
Abbreviated Injury Scale ◽  
Coma Scale ◽  
Advantages And Disadvantages ◽  
Revised Trauma Score ◽  
Golden Standard ◽  
Trauma Score

The most commonly used systems for the evaluation of injury severity in traumatologic patients are presented: Glasgo Coma Scale, Mangled Extremity Severity Score, Revised Trauma Score, Abbreviated Injury Scale, Injury Severity Score, Pediatric Trauma Score. Their advantages and disadvantages are given. At present Injury Severity Score is considered to be a «Golden Standard.

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.

Pretrauma Functional Independence Measure Score Predicts Survival in Geriatric Trauma

2017 ◽  
Vol 83 (6) ◽  
pp. 559-563 ◽  
Author(s):  
Brian Fletcher ◽  
Eric Bradburn ◽  
Christopher Baker ◽  
Bryan Collier ◽  
Mark Hamill ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Injury Severity Score ◽  
Trauma Patient ◽  
Severity Score ◽  
Injury Severity ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Geriatric Trauma ◽  
Revised Trauma Score ◽  
Trauma Score

The Functional Independence Measure (FIM) is used by rehabilitation professionals to access disability. The FIM score combines both motor and cognitive parameters to assess a patient's level of required assistance in performing activities of daily living (ADL). The geriatric trauma patient is becoming an increasingly important cohort for trauma services. FIM has been shown to predict discharge outcomes and those at high risk for falls. We hypothesized pretrauma FIM scores may predict survival in the geriatric trauma population. This was a retrospective study of patients 65 years and older that were admitted to our Level I trauma center from July 1, 2006 to July 1, 2012. A total 941 patients underwent stepwise regression to identify those factors predicting survival. Age, Injury Severity Score, revised trauma score, body mass index, and pretrauma FIM scores (12-point scale) were studied. The primary outcome was survival. Statistical significance reached at P value <0.05. Multiple logistic regression analysis was then performed. A total of 1315 patients were identified and complete data were available on 941 patients. Mean age was 78 (SD ± 8.2), mean Injury Severity Score was 13(SD ± 8.7), and mean body mass index was 26. Overall mortality was 11 per cent. The odds ratio of survival was 3.532 (95% confidence interval = 2.191–5.718) times greater for every 1-point increase in the preadmission FIM expression score. Glasgow Coma Scale, revised trauma score, gender, and pretrauma FIM expression scores were predictive of survival in the geriatric trauma patient. Pretrauma FIM expression can be used to predict survival in the elderly trauma victim. Further study is needed to establish the role of FIM as part of trauma scoring systems.

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.

scholarly journals Fatores prognósticos relacionados à falha do tratamento não-operatório de lesões esplênicas no trauma abdominal fechado

2009 ◽  
Vol 36 (2) ◽  
pp. 123-130 ◽  
Author(s):  
Fábio Henrique de Carvalho ◽  
Paula Christina Marra Romeiro ◽  
Iwan Augusto Collaço ◽  
Giorgio Alfredo Pedroso Baretta ◽  
Alexandre Coutinho Teixeira de Freitas ◽  
...  
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
American Association ◽  
Revised Trauma Score ◽  
Trauma Score

OBJETIVO: Identificar fatores prognósticos relacionados com a falha do tratamento não-operatório (TNO) de lesões esplênicas no trauma abdominal fechado. MÉTODOS: Análise prospectiva de 56 pacientes adultos submetidos à TNO e divididos em um grupo de sucesso e outro de falha, que foi definida como necessidade de laparotomia por qualquer indicação. As lesões foram diagnosticadas por tomografia computadorizada e classificadas de acordo com os critérios da AAST (American Association for Surgery of Trauma). Os parâmetros estudados foram: na admissão - pressão arterial sistólica, frequências cardíaca e respiratória, nível de consciência (Escala de Glasgow) e RTS (Revised Trauma Score); durante a hospitalização - presença de lesões associadas, transfusão sanguínea e parâmetros hematológicos, tempo de internação e ISS (Injury Severity Score). RESULTADOS: As falhas do TNO (19,6%) foram devidas à dor abdominal (45,4%), instabilidade hemodinâmica (36,4%), queda do volume globular associada a hematoma esplênico (9,1%) e abscesso esplênico (9,1%). Não foram observadas diferenças entre os grupos de sucesso e de falha nos dados na admissão. A taxa de falha de acordo com o grau da lesão esplênica foi 0% nos graus I e II agrupados; 17,5% nos graus III e IV agrupados e 80% no grau V (p = 0,0008). O uso de hemoderivados foi maior e mais frequente no grupo de falha (p=0,05). As relação do ISS (Injury Severity Score) com as taxas de falha foram 0% nos pacientes com ISS = 8; 15,9% nos com ISS entre 9 e 25, e 50% nos com ISS = 26 (p = 0,05). Não houve mortalidade e nem lesões de vísceras ocas despercebidas. CONCLUSÃO: O Injury Severity Score e grau da lesão esplênica relacionaram-se com a falha do tratamento não-operatório.

scholarly journals Toracotomia de reanimação: racionalização do uso do procedimento

2006 ◽  
Vol 33 (6) ◽  
pp. 354-360 ◽  
Author(s):  
Gustavo Pereira Fraga ◽  
Elaine Barberato Genghini ◽  
Mario Mantovani ◽  
Larissa Garcia de Oliveira Cortinas ◽  
Waldemar Prandi Filho
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Revised Trauma Score ◽  
Trauma Score

OBJETIVO: Contesta-se a aplicação indiscriminada da toracotomia de reanimação (TR) no trauma. Este estudo objetiva reavaliar as indicações de TR na nossa instituição. MÉTODO: Estudo retrospectivo envolvendo 126 pacientes submetidos à TR entre janeiro de 1995 e dezembro de 2004. Definiram-se quatro grupos considerando os sinais vitais dos pacientes na admissão: morto ao chegar, fatal, agônico e choque profundo. O protocolo incluiu dados como mecanismo de trauma, sinais vitais, Escore de Trauma Revisado (Revised Trauma Score ou RTS), locais de lesão (identificados durante cirurgia ou autópsia), Índice de Gravidade da Lesão (Injury Severity Score ou ISS) e sobrevida. RESULTADOS: Setenta e dois (57,2%) pacientes apresentavam ferimento por projétil de arma de fogo, 11 (8,7%) ferimento por arma branca e 43 (34,1%) por trauma fechado. Nenhum dos sessenta pacientes (47,6%) dos grupos fatal e morto ao chegar sobreviveu, mas 13 (39,4%) dos pacientes fatais foram encaminhados ao centro cirúrgico (CC) para tratamento definitivo. Dos 66 pacientes dos grupos agônico e choque profundo, 44 (66,7%) foram submetidos a TR no prontosocorro (PS) e 31 (70,5%) destes foram transferidos até o CC. Nos 22 restantes, a parada cardiorrespiratória ocorreu já no CC, onde foi feita a TR. Dois pacientes do grupo choque profundo sobreviveram (1,6% do total) e receberam alta com função cerebral normal. O ISS médio foi 33, sendo exsangüinação a causa mais freqüente de óbito. CONCLUSÕES: Resultados ruins enfatizam a necessidade de uma abordagem mais seletiva para aplicar a TR. Um algoritmo baseado no mecanismo de trauma e nos sinais vitais na admissão é proposto para otimizar as indicações de TR.

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