Hazard Ratio of 90-Day Mortality in ICU Patients with Abdominal Injuries Compared with Head Injuries

2021 ◽  
Vol 24 (12) ◽  
pp. 897-902
Author(s):  
Farshid Rahimi-Bashar ◽  
Sara Ashtari ◽  
Ali Fathi Jouzdani ◽  
Seyed Jalal Madani ◽  
Keivan Gohari-Moghadam
Keyword(s):  
Head Trauma ◽  
Abdominal Trauma ◽  
Head Injuries ◽  
Public Health Problem ◽  
Hazard Ratio ◽  
Major Public Health Problem ◽  
Trauma Patients ◽  
Abdominal Injuries ◽  
Icu Patients ◽  
Surgical Icu

Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients. Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality. Results: The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077–7.063, P=0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85±20.1, 30.27±18.22 and 31.43±26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively. Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.

scholarly journals An analysis of injury patterns of abdominal trauma in patients attending surgical emergency department of rural hospital, Karnataka, India

2017 ◽  
Vol 4 (11) ◽  
pp. 3736
Author(s):  
Narasimhaiah Krishnappa ◽  
Asif Khan ◽  
Saraswathi Sakranaik
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Trauma Patients ◽  
Abdominal Injuries ◽  
Mortality And Morbidity ◽  
Revised Trauma Score

Background: Globally, abdominal trauma is a major public health problem irrespective of socioeconomic levels. Severe blood loss and infection are the serious complication of any abdominal trauma. A detailed assessment for early identification and prompt management is required to reduce the mortality and morbidity in any abdominal trauma. Hence this study was designed to assess the incidence and patterns of abdominal injuries in trauma patients.Methods: It was assorted and identified the incidence and sub type of abdominal injuries and associated trauma, and identified variables related to morbidity and mortality.Results: A total of 150 abdominal trauma cases were analyzed; 103 patients with blunt abdominal trauma and 47 with penetrating. The most frequent type of abdominal trauma was blunt trauma; its most common cause was motor vehicle accident. Most abdominal trauma patients presented with other injuries, especially patients with blunt abdominal trauma. Mortality was higher among penetrating abdominal trauma patients.Conclusions: Type of abdominal trauma, associated injuries, and Revised Trauma Score are independent risk factors for mortality in abdominal trauma patients.

scholarly journals THERE IS NO ASSOCIATION BETWEEN SYSTOLIC BLOOD PRESSURE AND MORTALITY IN HEAD TRAUMA PATIENTS

2019 ◽  
Vol 3 (2) ◽  
pp. 43
Author(s):  
Akhmad Renaldi Renaldi ◽  
Rismia Agustina ◽  
Oski Illiandri
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Head Trauma ◽  
Public Health Problem ◽  
Sampling Technique ◽  
Major Public Health Problem ◽  
Trauma Patients ◽  
Pressure Measurements

Head trauma is a major public health problem and is a major cause of mortality worldwide. In the case of head trauma patients, the mortality is determined by using systolic blood pressure as one of the predictors. This research aims to identify the association between systolic blood pressure and mortality in head trauma patients at Ulin Hospital, Banjarmasin. As a method, nonprobability sampling was used with accidental sampling technique and thirty-eight head trauma patients come to the A&E of Ulin Hospital. The observation sheet was used to record the initial systolic blood pressure measurements as well as the assessment of mortality in head trauma patients within twenty-four hours to find out whether the patient had mortality or not. Based on the data analysis, it showed that there is no association between systolic blood pressure and mortality in head trauma patients at Ulin Hospital. Other risk factors may cause mortality in head trauma patients.

Trauma

2021 ◽  
pp. 795-812
Author(s):  
Douglas A. Wilkinson ◽  
Aidan C. Kingwill
Keyword(s):  
Head Trauma ◽  
Abdominal Trauma ◽  
Chest Trauma ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Paediatric Trauma ◽  
Limb Trauma ◽  
Secondary Survey ◽  
Primary Assessment

Primary assessment in trauma: ABCDE?, Airway?, Breathing?, Circulation?, Secondary survey?, Chest trauma?, Abdominal trauma?, Head trauma?, Spinal trauma?, Limb trauma?, Burns?, Pregnant trauma patients?, Paediatric trauma?

Diagnostic Laparoscopy Reduces the Rate of Negative Laparotomy in Trauma Patients

2020 ◽  
Vol 22 (1) ◽  
pp. 47-51
Author(s):  
Debashish Bar ◽  
Masrur Akbar Khan ◽  
Sanjana Sharmin Shashi ◽  
AZM Mahfuzur Rahman ◽  
ABM Khurshid Alam ◽  
...  
Keyword(s):  
Abdominal Trauma ◽  
Diagnostic Laparoscopy ◽  
Exploratory Laparotomy ◽  
Operative Management ◽  
Bowel Injury ◽  
Trauma Patients ◽  
Abdominal Injuries ◽  
College Hospital ◽  
Negative Laparotomy ◽  
Intraabdominal Injuries

Background: The last century has witnessed immense evolvement of management of patients with abdominal trauma. Moreover the recent trend has shifted to selective operative management rather than exploratory laparotomy in trauma patients with suspected intraabdominal injuries and is considered more rational as well. Diagnostic laparoscopy is highly sensitive in detecting intra-abdominal injury with subsequent reduction in the rate of negative laparotomy and procedure related morbidity. Objective: The study was carried out to find the role of diagnostic laparoscopy in abdominal trauma. Methods: An observational study was carried out in the casualty block of Dhaka Medical College Hospital from 1st June 2015 to 30th March 2016. A total of 50 successive patients were assigned in this study. All of them were admitted with abdominal trauma and underwent diagnostic laparoscopy during the period of 10 months. The study was designed to find out whether laparoscopy can help in identifying intra-abdominal injuries with consequent avoidance of unnecessary operative explorations. Results: Intra-abdominal injuries other than GIT perforation were diagnosed by laparoscopy with 100% accuracy but in case of bowel injury the diagnostic accuracy was 80%. Conclusion: Diagnostic laparoscopy is the procedure of choice in doubtful intra-abdominal injuries with impressive accuracy except for bowel injury. Subsequently it reduced the need for negative laparotomies with their procedure related adverse effects. Journal of Surgical Sciences (2018) Vol. 22 (1): 47-51

Retrospective Analysis of the Risk Factors and Pathogens Associated With Early-onset Ventilator-associated Pneumonia in Surgical-ICU Head-trauma Patients

2010 ◽  
Vol 22 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Didier Lepelletier ◽  
Antoine Roquilly ◽  
Dominique Demeure dit latte ◽  
Pierre Joachim Mahe ◽  
Olivier Loutrel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Analysis ◽  
Head Trauma ◽  
Early Onset ◽  
Trauma Patients ◽  
Ventilator Associated Pneumonia ◽  
Surgical Icu

scholarly journals Multiple Infectious Complications in a Severely Injured Patient with Single Nucleotide Polymorphisms in Important Innate Immune Response Genes

2015 ◽  
Vol 9 (1) ◽  
pp. 367-371
Author(s):  
Maarten W.G.A. Bronkhorst ◽  
Peter Patka ◽  
Esther M.M. Van Lieshout
Keyword(s):  
Single Nucleotide Polymorphisms ◽  
Public Health Problem ◽  
Injured Patient ◽  
Severe Trauma ◽  
Infectious Complications ◽  
Innate Immune ◽  
Major Public Health Problem ◽  
Trauma Patients ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide

Trauma is a major public health problem worldwide. Infectious complications, sepsis, and multiple organ dysfunction syndrome (MODS) remain important causes for morbidity and mortality in patients who survive the initial trauma. There is increasing evidence for the role of genetic variation in the innate immune system on infectious complications in severe trauma patients. We describe a trauma patient with multiple infectious complications caused by multiple micro-organisms leading to prolonged hospital stay with numerous treatments. This patient had multiple single nucleotide polymorphisms (SNPs) in the MBL2, MASP2, FCN2 and TLR2 genes, most likely contributing to increased susceptibility and severity of infectious disease.

Risk Factors for Delirium and Association of Antipsychotic Use with Delirium Progression in Critically Ill Trauma Patients

2022 ◽  
pp. 000313482110697
Author(s):  
Bethany R. Shoulders ◽  
Sarah Elsabagh ◽  
Douglas J. Tam ◽  
Amanda M. Frantz ◽  
Kaitlin M. Alexander ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Negative Impact ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Trauma Patients ◽  
Icu Patients ◽  
Tertiary Referral Center ◽  
Surgical Icu ◽  
The Impact

Background Delirium occurs frequently in critically ill and injured patients and is associated with significant morbidity and mortality. Limited data exists on the risk factors for developing delirium in critically ill trauma patients and the effect of antipsychotic (AP) medications on delirium progression. Objective The objective of this study is to determine the incidence of delirium in critically ill trauma versus non-trauma surgical patients and determine if the presence of trauma was associated with intensive care unit (ICU) delirium. Secondary outcomes included identifying risk factors for delirium and determining the impact of AP medication use on delirium progression in critically ill trauma patients. Methods This retrospective review studies adult trauma/surgical ICU patients admitted between May 2017-July 2018 to a level I trauma and tertiary referral center. Regression modeling was used to determine the impact of AP use on delirium-free days. Results Delirium was more common in critically ill trauma patients versus non-trauma surgical ICU patients [54/157 (34.4%) vs 42/270 (15.6%), P < .001]. Of the 54 trauma patients with delirium, 28 (52%) received an AP medication for delirium treatment and in the multiple linear regression analysis, AP use was significantly associated with fewer delirium-free days ( P = .02). Discussion Higher admission sequential organ failure assessment scores and increased length of stay were significantly associated with delirium onset in critically ill trauma patients. Use of AP medications for delirium treatment in this population had a negative impact on delirium-free days.

scholarly journals Utility of CT in Head Injury- A Prospective Study

2020 ◽  
Vol 8 (1) ◽  
pp. 64-68
Author(s):  
Anil Kumar Bansal ◽  
Anil Kumar Gupta
Keyword(s):  
Head Injury ◽  
Clinical Features ◽  
Severe Head Injury ◽  
Structural Changes ◽  
Road Traffic ◽  
Head Injuries ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Age Group ◽  
History Of

Background: Head injury is defined as an impairment in brain function as a result of mechanical force. The dysfunction can be temporary or permanent, and may or may not result in underlying structural changes in the brain. Head injuries are a major public health problem worldwide. A limited amount of neurological damage occurs at the time of impact (primary injury). Subjects and Methods: The study was a prospective observational study took place in the Department of Radiology, over a 8 month period which involves all type of head injuries. Informed consent was obtained by the subjects who participated in the study. All head injury patients attending the emergency department were included, while those with no clear history of trauma as the primary event and neurologic deficit that could not be explained by head trauma were excluded. Results:  A total of 1000 patients underwent CT for a head injury. Table 1 shows baseline characteristics as age, gender, referred cases, type  of injury, mode of injury and clinical features where we observed 48.2% cases were in the age group between 21-40 years with 80% of male subjects. While observing for the mode of injury, we found most of the cases falls in the category of road traffic accidents (77%) with external injury (83.5%) and loss of consciousness (63.4%) as highly observed clinical features. Conclusion: This study showed a significant association of overall CT positivity with patients sociodemographic and clinical factors such as: male gender, elderly age group (>60 years), history of alcohol consumption, LOC >5 min, history of vomiting, history of seizures, evidence of ear bleed, evidence of nosebleed, and GCS 12 (moderate and Severe head injury). From the results of this study, we recommend the following indications for doing CT in head injury patients: (1) CT is indicated in all patients with moderate and severe head injury (GCS ≤12).

scholarly journals Pola trauma tembus toraks di Instalasi Rawat Darurat Bedah RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2013 – Juni 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Christianto Kissra ◽  
Adrian Tangkilisan ◽  
Heber B. Sapan
Keyword(s):  
Traffic Accidents ◽  
Thoracic Trauma ◽  
Public Health Problem ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Trauma Patients ◽  
Age Group ◽  
Penetrating Thoracic Trauma ◽  
Keywords Trauma ◽  
Common Causes

Abstract: Trauma continues to be major public health problem worldwide since it is associated with high morbidity and mortality in developed and developing countries. Penetrating thoracic trauma respresents a common and challenging problem whether it is caused either by gunshot or by non-gunshot-related accidents (stabs, traffic accidents). This study was aimed to obtain the profile of penetrating thoracic trauma in Surgery Emergency Unit of Prof. Dr. R. D. Kandou Hospital Manado from July 2013 to June 2015. This was a retrospactive descriptive study using the medical record data of penetrating thoracic trauma patients. The results showed that there were 31 patients of penetrating thoracic trauma out of 108 patients of thoracic trauma patients. Most cases occurred in 2014 (48.41%). Based on age group, the majority of patients were at the age group 16-30 years old (58.05%). Based on sex, most patients were males (96.80%). The most common causes of penetrating thoracic trauma was puncture wounds/stabs (80.64%) and the most common intrathoracic complication was hemothorax (58.1%).Keywords: trauma, penetrating thoracic trauma. Abstrak: Trauma merupakan masalah kesehatan masyarakat yang utama di seluruh dunia karena dikaitkan dengan morbiditas dan mortalitas yang tinggi baik di negara maju dan berkembang. Trauma tembus toraks merupakan masalah umum dan menantang, baik oleh tembakan atau non-tembakan-kecelakanaan (tikaman, kecelakaan lalu lintas). Penelitian ini bertujuan untuk mendapatkan pola trauma tembus toraks di IRDB RSUP Prof. Dr. R. D. Kandou Manado periode Juli 2013 – Juni 2015. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data rekam medik pasien trauma tembus toraks di IRDB RSU Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan jumlah kasus trauma tembus toraks sebanyak 31 pasien dari 108 pasien trauma toraks. Kasus terbanyak terjadi pada tahun 2014 (48,41%). Berdasarkan kelompok usia mayoritas penderita trauma tembus toraks (58,05%)pada usia 16-30 tahun. Berdasarkan jenis kelamin sebagian besar penderita (96,80%) berjenis kelamin laki-laki. Penyebab trauma tembus toraks terbanyak karena luka tusukan/tikaman (80,64%), dan komplikasi intratoraks terbanyak yaitu hemotoraks (58,1%). Kata kunci: trauma, trauma tembus toraks

Serum and urine zinc response in head-injured patients

1986 ◽  
Vol 64 (2) ◽  
pp. 224-230 ◽  
Author(s):  
Craig J. McClain ◽  
Diana L. Twyman ◽  
Linda G. Ott ◽  
Robert P. Rapp ◽  
Phillip A. Tibbs ◽  
...  
Keyword(s):  
Head Trauma ◽  
Head Injuries ◽  
Serum Zinc ◽  
Zinc Metabolism ◽  
Trauma Patients ◽  
Content Type ◽  
Urinary Zinc Excretion ◽  
Zinc Concentrations ◽  
Prospective Longitudinal ◽  
Urine Zinc

✓ A prospective longitudinal evaluation of serum zinc concentrations was performed in 26 head-trauma patients, and 24-hour urine zinc excretion was determined in 15 of these subjects. Patients had markedly depressed admission serum zinc concentrations (mean ± standard error of the mean: 40.2 ± 3.2 µg/dl; normal values: 70 to 120 µg/dl), which gradually increased during the 16-day study period. All subjects demonstrated increased urinary zinc losses throughout the study period. Urinary zinc excretion was greater in patients with more severe head injuries. Indeed, patients with more severe head trauma had mean peak urinary zinc losses of greater than 7000 µg/day (normal less than 500 (µg/day). The implications of this altered zinc metabolism for protein metabolism, wound healing, and immune function, and the specific role of zinc in brain function and recovery from injury are discussed.

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