scholarly journals CORRELATION OF FACIAL INJURY SEVERITY SCALE (FISS) WITH LENGTH OF STAY, THE NEED FOR SURGERY AND THE INVOLVEMENT OF OTHER SPECIALISTS IN MAXILLOFACIAL TRAUMA PATIENTS AT H. ADAM MALIK GENERAL HOSPITAL MEDAN

2019 ◽  
pp. 1-3
Author(s):  
Darwin Firmansyah Siregar ◽  
Frank Bietra Buchari ◽  
Utama Abdi Tarigan ◽  
Aznan Lelo
Keyword(s):  
Length Of Stay ◽  
General Hospital ◽  
Injury Severity ◽  
The Body ◽  
Maxillofacial Trauma ◽  
Mandibular Fractures ◽  
Trauma Patients ◽  
Facial Injury ◽  
Single Operator ◽  
Surgery Department

Background: Facial Injury Severity Severity Score (FISS) has been used to assess the severity of facial injuries. However, FISS scores as a useful predictor of length of stay and changes between FISS scores and injuries to other parts of the body have not evaluated. In this study, we want to know the relationship between FISS score as the clinical assessment of maxillofacial trauma with the length of stay, the need for surgery, and the involvement of other specialist elds. Method: This research was conducted using analytical research through a retrospective approach by looking at the medical records of patients who suffered maxillofacial trauma at H. Adam Malik General Hospital Medan from June to August 2019. Result : From a total of 43 patients included in the study, there were 22 mandibular fractures, with mandibular angulus (29.0%), parasymphysis (22.4%), and mandibular corpus (21.5%). Thirty subjects (69.8%) needed surgery, and xation of the fracture and subjects without intervention were 13 (30.2%). Patients who needed surgical intervention, the average time needed for hospitalization was 10.98 + 7.72 days (p = 0.007). The most collaboration found with neurosurgeons specialists, 39.53% of subjects who performed the surgery. A total of 55.8% of surgeries performed by a single operator from the plastic surgery department. Relationship between the length of stay with FISS, obtained for FISS> 3 (OR 14.37) (p = 0.01), meaning that patients with FISS> 3 are likely to stay longer for 14 times. Subsequent results related to the need for surgery obtained signicant results (OR = 8.26, p = 0.026). signicant (p = 0.059). Conclusion: A FISS score signicantly affects the length of stay for a maxillofacial trauma patient. FISS score also affects the involvement of other specialists in maxillofacial trauma patients but not statistically signicant.

PP8 Trauma and the obesity epidemic: a systematic review of the impact of obesity on trauma mortality and morbidity

2019 ◽  
Vol 36 (10) ◽  
pp. e5.1-e5
Author(s):  
Simon Mayer ◽  
Sumitra Lahiri ◽  
Joseph Rowles
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Injury Severity ◽  
Traumatic Injury ◽  
Strong Relationship ◽  
Normal Weight ◽  
The Body ◽  
Trauma Patients ◽  
Mortality And Morbidity ◽  
The Impact

BackgroundTrauma and obesity are both current global epidemics. A simple way to measure the body habitus of patients, to identify the overweight or obese is via the internationally recognized calculation of body mass index (BMI). The primary aim of this systematic review is to assess the mortality rate of those patients with a BMI > 30 kg/m2 in relation to traumatic injury and secondly to assess the effect of those patients with BMI > 30 kg/m2 upon the length of stay in hospital with regards to traumatic injury.MethodA systematic review of the literature was conducted via an internet search of databases and hand searching of references in identified publications from 1st January 1990 to 17th February 2018. Data was extracted from identified publications to include odds ratios of mortality and total length of stay in hospital (days) for patients with a BMI >30 kg/m2 from included studies when compared to patients with a BMI <24.9 kg/m2.ResultsA total of 23 studies met the inclusion criteria. 32, 378 patients were admitted to hospital with a BMI >30 kg/m2 and recorded injury severity score (ISS). Data collated identified BMI >30 kg/m2 OR 1.66 (95% CI 0.75 – 4.2) vs BMI <24.9 kg/m2 OR 0.93 (95% CI 0.82–1.5) to suffer mortality. ISS, BMI >30 kg/m2–19.93 vs 22.3 respectively. Furthermore, those categorised as BMI >30 kg/m2 have 3.78 additional days in the hospital compared to those defined as normal weight.ConclusionThis systematic review presents a strong relationship of increased mortality and complications in trauma patients with BMI >30 kg/m2. Complications are suggestive of those who have a BMI >30 kg/m2 are more likely to suffer detrimental effects following trauma predominantly due to pre-existing unknown co-morbidities. Although, the direct relationship between obesity, trauma and mortality is not fully understood at present and requires more research.

scholarly journals Facial Injury Severity Scale Score as a Predictor of Length of Stay for Maxillofacial Fracture at Sanglah General Hospital, Denpasar, Bali, Indonesia

2020 ◽  
Vol 8 (B) ◽  
pp. 291-294
Author(s):  
Esther Felicita Tambayong ◽  
Nengah Kuning Atmadjaya ◽  
Nyoman Golden ◽  
Ketut Wiargitha ◽  
Gede Bagus Mahadewa Tjokorda
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Length Of Stay ◽  
General Hospital ◽  
Injury Severity ◽  
Linear Regression Analysis ◽  
Facial Injury ◽  
Severity Scale ◽  
Operating Characteristics ◽  
Maxillofacial Fracture

INTRODUCTION: Maxillofacial fracture is the most common trauma that happened in the developing countries. One of the methods to evaluate the severity of maxillofacial fracture is by using the Facial Injury Severity Scale (FISS) score. Maxillofacial trauma causes multiple injuries, thus resulted in various periods of hospitalization. AIM: The aim of this study is to use the employment of the FISS score to predict a patient’s length of stay. METHODS: This research was a retrospective cohort and cross-sectional study on maxillofacial fracture patients whom treated in Sanglah General Hospital, Denpasar, Bali. As much as 89 subjects were included in this study and information about their age, gender, mechanism of injury, FISS score, treatments, and length of stay was collected. The data were statistically analyzed using bivariate, receiver operating characteristics (ROC), and linear regression analysis. RESULTS: A total of 89 subjects were included in this study. Among them, 50 subjects had a high FISS score, and 39 subjects had low FISS score. The average age was 28.9 ± 13.3 years with a mean length of stay 6.39 ± 4.29 days. Bivariate analysis showed that the patients with high FISS score have 5.3 times higher risk to get a longer length of stay compared to those with low FISS score (95% CI: 2.289–12.289; p = 0.001). The mean of length of stay in subjects with a high FISS score was significantly higher compared to subjects with a low FISS score (mean for subjects with high score: 8.46 ± 4.63; mean for subjects with low score: 3.74 ± 1.46; p = 0.001) with a correlation value r = 0.718 (p = 0.001). ROC analysis represented that FISS score ˂4 was categorized as mild. The linear regression analysis showed that the length of stay for maxillofacial fracture patients was able to be predicted by LOS = 1.476 + 1.032 × FISS score. CONCLUSION: The FISS score can predict the length of stay for patients with maxillofacial fracture.

scholarly journals Relationship of the Severity of Maxillofacial Trauma Based on Facial Injury Severity Scale (FISS) Against the Severity of Head Injury

2019 ◽  
Vol 2 (1) ◽  
pp. 9-21
Author(s):  
Ary Rachmanto ◽  
Abda Arif
Keyword(s):  
Head Injury ◽  
Injury Severity ◽  
Bone Fractures ◽  
Head Injuries ◽  
Secondary Data ◽  
Maxillofacial Trauma ◽  
Trauma Patients ◽  
Facial Injury ◽  
Severity Scale ◽  
Cross Sectional

ABSTRACT Introduction. Facial bone fractures can be accompanied by life-threatening complications such as head injuries. Maxillofacial trauma increases with time. The maxillofacial facial injury severity scale (FISS) scoring system was introduced to assess the patient's severity, prognosis, and outcome. Maxillofacial FISS has predictive value on the severity of head injuries. Method. This research uses analytic observation method with cross sectional design approach. The population and sample were all maxillofacial trauma patients who had been treated at RSUP dr. Moehammad Hoesin Palembang from January-September 2018. Data is taken from secondary data, namely the patient's medical record. Results. The incidence of maxillofacial trauma at RSUP dr. Moehammad Hoesin Palembang is 95 cases. The most cases occurred in the age group <30 years (62.1%). Gender male (85.3%), the scene outside the city (52.6%). There were 21 maxillofacial trauma patients undergoing neurosurgery (22.1%). There was no relationship between FISS and the severity of head injury (p = 0.063), there was a significant relationship between FISS and neurosurgery (p = <0.001). Conclusion. There is a relationship between the severity of maxillofacial trauma based on the Facial Injury Severity Scale (FISS) score on the severity of the head injury.

scholarly journals A retrospective cohort study of 27,049 polytraumatized patients age 60 and above: identifying changes over 16 years

2021 ◽  
Author(s):  
Y. Kalbas ◽  
M. Lempert ◽  
F. Ziegenhain ◽  
J. Scherer ◽  
V. Neuhaus ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Injury Severity ◽  
Descriptive Analysis ◽  
Patient Characteristics ◽  
Severe Trauma ◽  
Diagnostic Tools ◽  
Trauma Patients ◽  
Treatment Algorithms ◽  
Injured Patients ◽  
Over Time

Abstract Purpose The number of severely injured patients exceeding the age of 60 has shown a steep increase within the last decades. These patients present with numerous co-morbidities, polypharmacy, and increased frailty requiring an adjusted treatment approach. In this study, we establish an overview of changes we observed in demographics of older severe trauma patients from 2002 to 2017. Methods A descriptive analysis of the data from the TraumaRegister DGU® (TR-DGU) was performed. Patients admitted to a level one trauma center in Germany, Austria and Switzerland between 2002 and 2017, aged 60 years or older and with an injury severity score (ISS) over 15 were included. Patients were stratified into subgroups based on the admission: 2002–2005 (1), 2006–2009 (2), 2010–2013 (3) and 2014–2017 (4). Trauma and patient characteristics, diagnostics, treatment and outcome were compared. Results In total 27,049 patients with an average age of 73.9 years met the inclusion criteria. The majority were males (64%), and the mean ISS was 27.4. The proportion of patients 60 years or older [(23% (1) to 40% (4)] rose considerably over time. Trauma mechanisms changed over time and more specifically low falls (< 3 m) rose from 17.6% (1) to 40.1% (4). Altered injury patterns were also identified. Length-of-stay decreased from 28.9 (1) to 19.5 days (4) and the length-of-stay on ICU decreased from 17.1 (1) to 12.7 days (4). Mortality decreased from 40.5% (1) to 31.8% (4). Conclusion Length of stay and mortality decreased despite an increase in patient age. We ascribe this observation mainly to increased use of diagnostic tools, improved treatment algorithms, and the implementation of specialized trauma centers for older patients allowing interdisciplinary care.

scholarly journals Does emergency medicine length of stay predict trauma outcomes at a Level 1 Trauma Center?

2015 ◽  
Vol 4 (5) ◽  
pp. 1 ◽  
Author(s):  
Erin Powers Kinney ◽  
Kamal Gursahani ◽  
Eric Armbrecht ◽  
Preeti Dalawari
Keyword(s):  
Length Of Stay ◽  
Trauma Center ◽  
Injury Severity ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Hospital Capacity ◽  
Significant Difference ◽  
Level 1 ◽  
Level 1 Trauma Center

Objective: Previous studies looking at emergency department (ED) crowding and delays of care on outcome measures for certain medical and surgical patients excluded trauma patients. The objectives of this study were to assess the relationship of trauma patients’ ED length of stay (EDLOS) on hospital length of stay (HLOS) and on mortality; and to examine the association of ED and hospital capacity on EDLOS.Methods: This was a retrospective database review of Level 1 and 2 trauma patients at a single site Level 1 Trauma Center in the Midwest over a one year period. Out of a sample of 1,492, there were 1,207 patients in the analysis after exclusions. The main outcome was the difference in hospital mortality by EDLOS group (short was less than 4 hours vs. long, greater than 4 hours). HLOS was compared by EDLOS group, stratified by Trauma Injury Severity Score (TRISS) category (< 0.5, 0.51-0.89, > 0.9) to describe the association between ED and hospital capacity on EDLOS.Results: There was no significant difference in mortality by EDLOS (4.8% short and 4% long, p = .5). There was no significant difference in HLOS between EDLOS, when adjusted for TRISS. ED census did not affect EDLOS (p = .59), however; EDLOS was longer when the percentage of staffed hospital beds available was lower (p < .001).Conclusions: While hospital overcrowding did increase EDLOS, there was no association between EDLOS and mortality or HLOS in leveled trauma patients at this institution.

scholarly journals Economical treatment-related burden assessment of maxillofacial trauma among Ukrainians patients

2020 ◽  
Vol 19 ◽  
pp. e209930
Author(s):  
Pavlo Brekhlichuk ◽  
Myroslav Goncharuk-Khomyn
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Treatment Cost ◽  
Injury Severity ◽  
Traumatic Injury ◽  
Maxillofacial Trauma ◽  
Facial Injury ◽  
Maxillofacial Injury ◽  
Duration Of Hospitalization ◽  
Dental Rehabilitation

Aim: Quantitative evaluation of prognostic correspondence between initial maxillofacial traumatic injury assessed by facial injury severity score and maxillofacial injury severity score, treatment cost and duration of hospitalization among Ukrainian patients. Methods: Design of present study was retrospective and based on the medical data of patients hospitalized with signs of maxillofacial trauma. Quantitative assessment of maxillofacial trauma was held with the use of facial injury severity score (FISS) and maxillofacial injury severity score (MFISS). Average treatment cost and hospitalization duration were used as coordinative criteria for economical treatmentrelated burden verification. Results: Levels of correlation between FISS, treatment charges and hospitalization duration were r=0.69 (р<0.05) and r=0.67 (р<0.05) respectively, while analogical correlations for MFISS were 0.74 (р<0.05) and 0.69 respectively (р<0.05). Statistical correspondence between FISS and MFISS scores among study sample reached r=0.71 (р<0.05). Cases with milder maxillofacial trauma types, characterized with initial lower levels of FISS and MFISS scores, demonstrated greater degree of FISS-to-MFISS inter-relation compare to cases with severe maxillofacial trauma. Conclusion: Even though FISS and MFISS scores both demonstrated reliable levels of correlation with hospitalization duration and cost of dental rehabilitation after maxillofacial trauma injury, but MFISS approach characterized by prognostically greater level of statistical relationship with economically related treatment derivates. Moreover, differentiation capabilities of MFISS is relative greater than FISS, since independent grading of separate functional disabilities becomes possible.

Intraabdominal Injury is Common in Blunt Trauma Patients who Sustain Spinal Cord Injury

2007 ◽  
Vol 73 (10) ◽  
pp. 1035-1038
Author(s):  
Ali Salim ◽  
Marcus Ottochian ◽  
Ryan J. Gertz ◽  
Carlos Brown ◽  
Kenji Inaba ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Length Of Stay ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Unit Length ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Cord Injury ◽  
Intraabdominal Injury

The evaluation of the abdomen in patients with spinal cord injury (SCI) is challenging for obvious reasons. There are very little data on the incidence and complications of patients who sustain SCI with concomitant intraabdominal injury (IAI). To determine the incidence and outcomes of IAI in blunt trauma patients with SCI, a trauma registry and record review was performed between January 1998 and December 2005. Baseline demographic data, Injury Severity Score, and associated IAI were collected. Two groups were established and outcomes were analyzed based on the presence or absence of IAI. Intraabdominal and hollow viscus injures were found in 15 per cent and 6 per cent, respectively, of 292 patients with blunt SCI. The presence of intraabdominal injury varied according to the level of the SCI: 10 per cent of cervical, 23 per cent of thoracic, and 18 per cent of lumbar SCI. The overall mortality was 16 per cent. The presence of intraabdominal injury was associated with longer intensive care unit length of stay (13 versus 6 days, P < 0.01), hospital length of stay (23 versus 18 days, P < 0.05), higher complication rate (46% versus 33%, P = 0.09), and higher mortality (44% versus 11%, P < 0.01) when compared with patients with SCI without IAI. Intraabdominal injuries are common in blunt SCI. Liberal evaluation with computed tomography is necessary to identify injuries early.

Placement of Surgical Feeding Tubes Among Patients With Severe Traumatic Brain Injury Requiring Exploratory Abdominal Surgery

2020 ◽  
Vol 86 (6) ◽  
pp. 635-642
Author(s):  
Peter I. Cha ◽  
Ronald M. Jou ◽  
David A. Spain ◽  
Joseph D. Forrester
Keyword(s):  
Length Of Stay ◽  
Abdominal Surgery ◽  
Injury Severity ◽  
Unit Length ◽  
Feeding Tube ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Fascial Closure ◽  
Trauma Patients ◽  
Percutaneous Endoscopic Gastrostomy Placement

Objectives The purpose of this study was to identify trauma patients who would benefit from surgical placement of an enteral feeding tube during their index abdominal trauma operation. Methods We performed a retrospective analysis of all patients admitted to 2 level I trauma centers between January 2013 and February 2018 requiring urgent exploratory abdominal surgery. Results Six-hundred and one patients required exploratory abdominal surgery within 24 hours of admission after trauma activation. Nineteen (3% of total) patients underwent placement of a feeding tube after their initial exploratory surgery. On multivariate analysis, an intracranial Abbreviated Injury Scale ≥4 (odds ratio [OR] = 9.24, 95% CI 1.09-78.26, P = .04) and a Glasgow Coma Scale ≤8 (OR = 4.39, 95% CI 1.38-13.95, P = .01) were associated with increased odds of requiring a feeding tube. All patients who required a feeding tube had an Injury Severity Score ≥15. While not statistically significant, patients with an open surgical feeding tube compared with interventional radiology/percutaneous endoscopic gastrostomy placement had lower median intensive care unit length of stay, fewer ventilator days, and shorter median total hospital length of stay. Conclusions Trauma patients with severe intracranial injury already requiring urgent exploratory abdominal surgery may benefit from early, concomitant placement of a feeding tube during the index abdominal operation, or at fascial closure.

An Objective Study of the Impact of the Electronic Medical Record on Outcomes in Trauma Patients

2012 ◽  
Vol 78 (11) ◽  
pp. 1249-1254 ◽  
Author(s):  
Paul J. Schenarts ◽  
Claudia E. Goettler ◽  
Michael A. White ◽  
Brett H. Waibel
Keyword(s):  
Length Of Stay ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Injury Severity ◽  
Unit Length ◽  
Traumatic Injury ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Delay In Diagnosis ◽  
The Impact

It is commonly believed that the electronic medical record (EMR) will improve patient outcomes. However, there is scant published literature to support this claim and no studies in any surgical population. Our hypothesis was that the EMR would not improve objective outcome measures in patients with traumatic injury. Prospectively collected data from our university-based Level I trauma center was retrospectively reviewed. Demographic, injury severity as well as outcomes and complications data were compared for all patients admitted over a 20-month period before introduction of the EMR and a 20-month period after full, hospital-wide use of the EMR. Implementation of the EMR was associated with a decreased hospital length of stay, P = 0.02; intensive care unit length of stay, P = 0.001; ventilator days, P = 0.002; acute respiratory distress syndrome, P = 0.006, pneumonia, P = 0.008; myocardial infarction, P = 0.001; line infection, P = 0.03; septicemia, P = 0.000; renal failure, P = 0.000; drug complication, P = 0.001; and delay in diagnosis, P = 0.04. There was no difference in mortality, unexpected cardiac arrest, missed injury, pulmonary embolism/deep vein thrombosis, or late urinary tract infection. This is the first study to investigate the impact of the EMR in surgical patients. Although there was an improvement in some complications, the overall impact was inconsistent.

Risk for Contrast-Induced Nephropathy in Elderly Trauma Patients

2012 ◽  
Vol 78 (10) ◽  
pp. 1114-1117 ◽  
Author(s):  
Ryan Finigan ◽  
Jacqueline Pham ◽  
Rosemarie Mendoza ◽  
Michael Lekawa ◽  
Matthew Dolich ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Injury Severity ◽  
Unit Length ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Contrast Induced Nephropathy ◽  
History Of ◽  
Elderly Trauma Patients

The objective of this study was to determine if elderly trauma patients are at risk for contrast-induced nephropathy (CIN). A retrospective study was conducted identifying 362 patients 65 years and older in our Level I trauma center who received computerized tomography (CT) scans with intravenous contrast. CIN was defined as a 25 per cent increase in serum creatinine levels or a 0.5 mg/dL increase above baseline after CT. History of diabetes mellitus, hospital length of stay, intensive care unit length of stay, Injury Severity Score (ISS), and age were recorded. Eighteen per cent (21 of 118) of the patients had a peak in creatinine, 12 per cent (14 of 118) peaked and returned to baseline, and 6 per cent (7 of 118) peaked and stayed high. Pre-CT elevated creatinine, diabetes mellitus, increased hospital length of stay, ISS, and age show little association to CIN. The data suggest that CIN in elderly trauma patients is rare, regardless of history of diabetes mellitus, age, creatinine, high ISS, or result in higher length of stay. Therefore, there is little justification for the delay in diagnosis to assess a patient's renal susceptibility.

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