scholarly journals A Comparison of the Kampala Trauma Score with the Revised Trauma Score in a Cohort of Colombian Trauma Patients

2012 ◽  
Vol 1 (3) ◽  
pp. 146-149 ◽  
Author(s):  
Colin A Clarkson ◽  
Cain Clarkson ◽  
Andres M Rubiano ◽  
Mark Borgaonkar
Keyword(s):  
Hospital Stay ◽  
Scoring System ◽  
Trauma Registry ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Revised Trauma Score ◽  
Trauma Scoring ◽  
Spss Software ◽  
Trauma Score ◽  
Better Than

ABSTRACT Introduction To date, no trauma scoring system has emerged as the gold standard for use in developing countries, where limited resources for data collection are a major issue. The purpose of this study is to compare the relatively recently developed and simply calculated KTS (Kampala Trauma Score) with the more widely used RTS (Revised Trauma Score) within a cohort of Colombian trauma patients. Materials and methods Data on over 2,200 patients was derived from a newly developed trauma registry in Colombia. A statistical analysis was done using SPSS software, and included simple linear and logistical regression as appropriate. Results Both the KTS and RTS were statistically significant in terms of their ability to predict death and length of stay in hospital with the KTS being a better predictor of both. The simplest model predicting death used only the neurologic component of the KTS. However, none of these three scores explained a very large amount of the variation in the dataset. Conclusion Although statistically significant, neither the KTS nor the RTS performed well at predicting death or length of hospital stay. However, the simpler KTS did perform somewhat better than the slightly more complex RTS. Using the extremely simple neurologic component of the KTS on its own proved to be the best predictor of length of hospital stay, and also outperformed the RTS in regards to death prediction. It is clear from this study that the optimal injury scoring system for use in under resourced environments remains allusive with further research warranted. How to cite this article Clarkson CA, Clarkson C, Rubiano AM, Borgaonkar M. A Comparison of the Kampala Trauma Score with the Revised Trauma Score in a Cohort of Colombian Trauma Patients. Panam J Trauma Critical Care Emerg Surg 2012;1(3):146-149.

Scoring acuity hours and costs of nursing for trauma care

1993 ◽  
Vol 2 (6) ◽  
pp. 436-443 ◽  
Author(s):  
AE Bond ◽  
FO Thomas ◽  
RL Menlove ◽  
P MacFarlane ◽  
P Petersen
Keyword(s):  
Resource Utilization ◽  
Injury Severity ◽  
Scoring Systems ◽  
Cost Of Care ◽  
Trauma Patients ◽  
Nursing Educators ◽  
Revised Trauma Score ◽  
Trauma Scoring ◽  
Level I ◽  
Trauma Score

OBJECTIVE: To determine nursing resource utilization (acuity hours and dollars) by trauma patients based on analysis of a nursing acuity system and five trauma scoring systems. METHODS: Retrospective review of 448 trauma patients who required transport by aircraft to a level I trauma center. Values from the institution's automated nursing acuity system were compared with the Glasgow Coma Scale score, trauma score, revised trauma score, CRAMS score and injury severity score to obtain acuity hours and financial cost of care for trauma patients. RESULTS: Consistently, analysis of scores computed by five scoring instruments confirmed that nursing resource utilization is greatest for patients who are severely injured but likely to recover. For example, patients with a trauma score of 1 required 49 (+/- 66) mean acuity hours of care; those with a trauma score of 8 needed 189 (+/- 229) mean acuity hours; and those with a trauma score of 16 used 73 (+/- 120) mean acuity hours. Mean dollar costs were $980 (+/- 1293), $3812 (+/- 4518) and $1492 (+/- 2473), respectively. CONCLUSIONS: Nursing resource utilization can be determined for trauma patients by using an automated nursing acuity system and trauma scoring systems. Data acquired in this way provide a concrete basis for healthcare and reimbursement reform, for administrators who design nursing allocations and for nursing educators who prepare graduates to meet the needs of healthcare consumers.

scholarly journals Comorbidities in Trauma Injury Severity Scoring System: Refining Current Trauma Scoring System

2019 ◽  
Vol 85 (1) ◽  
pp. 59-63
Author(s):  
Adel Elkbuli ◽  
Reed Yaras ◽  
Ahmad Elghoroury ◽  
Dessy Boneva ◽  
Shaikh Hai ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Length Of Stay ◽  
Scoring System ◽  
Injury Severity ◽  
Scoring Systems ◽  
Trauma Patients ◽  
Data Registry ◽  
Revised Trauma Score ◽  
Chi Squared ◽  
Trauma Scoring

The revised trauma score combined with the Injury Severity Score (ISS) remains the mostly commonly used system for predicting trauma mortality, but these scoring systems do not account for the patient's comorbidities. This study aims to evaluate the effect of comorbidities on ISS-related mortality and length of stay. A review of our trauma center's data registry from 2014 to 2016 was carried out. Patients were divided according to ISS into two groups: ISS ≤ 15 and ISS > 15. Each ISS group was then subdivided by number of comorbidities into two groups: 1 to 2 or ≥3 comorbidities. Demographic characteristics and outcome measures were compared. ANOVA, chi-squared, and t tests were used with significance defined as P < 0.05. A total 9845 adult trauma patients were admitted to our trauma center during the three-year study period. In the ISS ≤ 15 group, patients with <3 comorbidities had significantly higher mortality rate compared with patients with 1 to 2 comorbidities (1.50% vs 0.12%, P << 0.000007). Comparing the ISS ≤ 15 group with ≥3 comorbidities with the ISS > 15 group with 1 to 2 comorbidities, the mortality rate was significantly higher (23.40% vs 4.50%, P << 0.000002). The ICU length of stay was significantly higher in the ISS ≤ 15 groups (17 vs 10 days, P < 0.05) but similar in the ISS > 15 groups (31 vs 29 days) (P > 0.05). It was concluded that when controlling for injury severity, increased comorbidities are associated with a significantly higher mortality, indicating that they may serve as a marker of lower physiologic reserve and be an independent variable. Adding comorbidity parameters to the current trauma scoring systems can assist in predicting more accurate/reliable outcomes.

scholarly journals Laparoscopy for blunt abdominal trauma: a challenging endeavor

2018 ◽  
Vol 108 (4) ◽  
pp. 273-279 ◽  
Author(s):  
M. Z. Koto ◽  
O. Y. Matsevych ◽  
F. Mosai ◽  
S. Patel ◽  
C. Aldous ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Injury Severity ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Therapeutic Laparoscopy ◽  
The Mean ◽  
Trauma Score

Background and Aims: Laparoscopy in blunt abdominal trauma is challenging because of multiple associated injuries, higher trauma score values and higher morbidity and mortality, as compared with patients with penetrating abdominal trauma. The aim of this study was to investigate the role of laparoscopy in the management of blunt abdominal trauma patients and to highlight related challenges. Material and Methods: Over a 4-year period, patients managed laparoscopically for blunt abdominal trauma were retrospectively analyzed. Perioperative details, indications for laparoscopy and conversion, complications, and length of hospital stay were discussed. Results: A total of 35 stable patients underwent laparoscopy. The mean Injury Severity Score was 12 (4–38). Therapeutic laparoscopy was performed in 15 (56%) and diagnostic in 12 (44%) patients. Eight (23%) patients were converted to therapeutic laparotomy. Intraoperative bleeding, complex injuries, visualization problem, and equipment failure necessitated conversion. Three (30%) patients with negative computed tomography scan had therapeutic laparoscopy for mesenteric injuries. There were no missed injuries. The mean length of hospital stay was 11 days in both groups. Conclusion: Laparoscopy for stable patients is feasible and safe. Multiple injuries make laparoscopy more difficult, and advanced laparoscopic skills are required. The conversion rate is high; however, the non-therapeutic laparotomies were completely eliminated in this study.

Length of hospital stay and discharge disposition in older trauma patients

2015 ◽  
Vol 36 (2) ◽  
pp. S3-S9 ◽  
Author(s):  
Rebecca A. Brotemarkle ◽  
Barbara Resnick ◽  
Kathleen Michaels ◽  
Patricia Morton ◽  
Chris Wells
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Discharge Disposition

scholarly journals Evaluation of the Revised Trauma Score in Predicting Outcomes of Trauma Patients

2013 ◽  
Vol 20 (4) ◽  
pp. 234-239
Author(s):  
H Li ◽  
WF Shen ◽  
XJ He ◽  
JS Wu ◽  
JH Yi ◽  
...  
Keyword(s):  
Trauma Patients ◽  
Revised Trauma Score ◽  
Trauma Score

Does Alcohol Intoxication Protect Patients from Severe Injury and Reduce Hospital Mortality? The Association of Alcohol Consumption with the Severity of Injury and Survival in Trauma Patients

2013 ◽  
Vol 79 (12) ◽  
pp. 1289-1294 ◽  
Author(s):  
Chi-Hsun Hsieh ◽  
Li-Ting Su ◽  
Yu-Chun Wang ◽  
Chih-Yuan Fu ◽  
Hung-Chieh Lo ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Hospital Stay ◽  
Brain Injuries ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Prolonged Hospital Stay ◽  
Severe Injuries ◽  
Prolonged Hospital

Alcohol-related motor vehicle collisions are a major cause of mortality in trauma patients. This prospective observational study investigated the influence of antecedent alcohol use on outcomes in trauma patients who survived to reach the hospital. From 2005 to 2011, all patients who were older than 18 years and were admitted as a result of motor vehicle crashes were included. Blood alcohol concentration (BAC) was routinely measured for each patient on admission. Patients were divided into four groups based on their BAC level, which included nondrinking, BAC less than 100, BAC 100 to 200, and BAC 200 mg/dL or greater. Patient demographics, physical status and injury severity on admission, length of hospital stay, and outcome were compared between the groups. Odds ratios of having a severe injury, prolonged hospital stay, and mortality were estimated. Patients with a positive BAC had an increased risk of sustaining craniofacial and thoracoabdominal injuries. Odds ratios of having severe injuries (Injury Severity Score [ISS] 16 or greater) and a prolonged hospital stay were also increased. However, for those patients whose ISS was 16 or greater and who also had a brain injury, risk of fatality was significantly reduced if they were intoxicated (BAC 200 mg/dL or greater) before injury. Alcohol consumption does not protect patients from sustaining severe injuries nor does it shorten the length of hospital stay. However, there were potential survival benefits related to alcohol consumption for patients with brain injuries but not for those without brain injuries. Additional research is required to investigate the mechanism of this association further.

scholarly journals A Comparison of the Predictive Value of the Glasgow Coma Scale and the Kampala Trauma Score for Mortality and Length of Hospital Stay in Head Injury Patients at a Tertiary Hospital in Uganda: A Diagnostic Prospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Herbert Ariaka ◽  
Joel Kiryabwire ◽  
Ssenyonjo Hussein ◽  
Alfred Ogwal ◽  
Emmanuel Nkonge ◽  
...  
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Prospective Study ◽  
Hospital Stay ◽  
Predictive Value ◽  
Length Of Hospital Stay ◽  
Tertiary Hospital ◽  
Operating Characteristics ◽  
Coma Scale ◽  
Trauma Score

Introduction. The prevalence rates of head injury have been shown to be as high as 25% among trauma patients with severe head injury contributing to about 31% of all trauma deaths. Triage utilizes numerical cutoff points along the scores continuum to predict the greatest number of people who would have a poor outcome, “severe” patients, when scoring below the threshold and a good outcome “non severe” patients, when scoring above the cutoff or numerical threshold. This study aimed to compare the predictive value of the Glasgow Coma Scale and the Kampala Trauma Score for mortality and length of hospital stay at a tertiary hospital in Uganda. Methods. A diagnostic prospective study was conducted from January 12, 2018 to March 16, 2018. We recruited patients with head injury admitted to the accidents and emergency department who met the inclusion criteria for the study. Data on patient’s demographic characteristics, mechanisms of injury, category of road use, and classification of injury according to the GCS and KTS at initial contact and at 24 hours were collected. The receiver operating characteristics (ROC) analysis and logistic regression analysis were used for comparison. Results. The GCS predicted mortality and length of hospital stay with the GCS at admission with AUC of 0.9048 and 0.7972, respectively (KTS at admission time, AUC 0.8178 and 0.7243). The GCS predicted mortality and length of hospital stay with the GCS at 24 hours with AUC of 0.9567 and 0.8203, respectively (KTS at 24 hours, AUC 0.8531 and 0.7276). At admission, the GCS at a cutoff of 11 had a sensitivity of 83.23% and specificity of 82.61% while the KTS had 88.02% and 73.91%, respectively, at a cutoff of 13 for predicting mortality. At admission, the GCS at a cutoff of 13 had sensitivity of 70.48% and specificity of 66.67% while the KTS had 68.07% and 62.50%, respectively, at a cutoff of 14 for predicting length of hospital stay. Conclusion. Comparatively, the GCS performed better than the KTS in predicting mortality and length of hospital stay. The GCS was also more accurate at labelling the head injury patients who died as severely injured as opposed to the KTS that categorized most of them as moderately injured. In general, the two scores were sensitive at detection of mortality and length of hospital stay among the study population.

Comparison of Length of Hospital Stay Between Taipei City and Hualien County in Spinal Trauma Patients

2010 ◽  
Vol 2 (5) ◽  
pp. 239-244 ◽  
Author(s):  
Wei-Chen Lee ◽  
Wen-Ta Chiu ◽  
Shin-Han Tsai ◽  
Mau-Roung Lin ◽  
Shu-Fen Chu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Spinal Trauma ◽  
Trauma Patients ◽  
Taipei City

scholarly journals Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team

2015 ◽  
Vol 42 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Daniel Francisco Mello ◽  
José Cesar Assef ◽  
Sílvia Cristine Soldá ◽  
Américo Helene Jr
Keyword(s):  
Hospital Stay ◽  
Plastic Surgery ◽  
Skin Flap ◽  
Length Of Hospital Stay ◽  
Lower Limbs ◽  
Trauma Patients ◽  
Early Assessment ◽  
Group I ◽  
Group Ii ◽  
Degloving Injuries

<sec><title>OBJECTIVE:</title><p> to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.</p></sec><sec><title>METHODS:</title><p> we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.</p></sec><sec><title>RESULTS:</title><p> there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).</p></sec><sec><title>CONCLUSION:</title><p> based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.</p></sec>

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