Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients

Javali, Rameshbabu Homanna; Krishnamoorthy,; Patil, Akkamahadevi; Srinivasarangan, Madhu; Suraj, Suraj; Sriharsha,

doi:10.5005/jp-journals-10071-23120

Cited by 116 publications

(86 citation statements)

References 22 publications

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“…However, the AIS-head did not show a statistically significant difference (p = 0.437) between the groups, which means we dealt with similar groups of head-injury patients in both rehab strategies. With comparable AIS, the higher ISS in the AITR group indicates more polytrauma [ 14 – 16 ]. On the other hand, with more polytrauma, the AITR group had a significantly lower length of hospital stay (38.7 days vs. 52.4 days; p < 0.001), which favored the success of the AITR program.…”

Section: Discussionmentioning

confidence: 99%

Does access to acute intensive trauma rehabilitation (AITR) programs affect the disposition of brain injury patients?

Chowdhury

Leenen

2021

PLoS ONE

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Early incorporation of rehabilitation services for severe traumatic brain injury (TBI) patients is expected to improve outcomes and quality of life. This study aimed to compare the outcomes regarding the discharge destination and length of hospital stay of selected TBI patients before and after launching an acute intensive trauma rehabilitation (AITR) program at King Saud Medical City. It was a retrospective observational before-and-after study of TBI patients who were selected and received AITR between December 2018 and December 2019. Participants’ demographics, mechanisms of injury, baseline characteristics, and outcomes were compared with TBI patients who were selected for rehabilitation care in the pre-AITR period between August 2017 and November 2018. A total of 108 and 111 patients were managed before and after the introduction of the AITR program, respectively. In the pre-AITR period, 63 (58.3%) patients were discharged home, compared to 87 (78.4%) patients after AITR (p = 0.001, chi-squared 10.2). The pre-AITR group’s time to discharge from hospital was 52.4 (SD 30.4) days, which improved to 38.7 (SD 23.2) days in the AITR (p < 0.001; 95% CI 6.6–20.9) group. The early integration of AITR significantly reduced the percentage of patients referred to another rehabilitation or long-term facility. We also emphasize the importance of physical medicine and rehabilitation (PM&R) specialists as the coordinators of structured, comprehensive, and holistic rehabilitation programs delivered by the multi-professional team working in an interdisciplinary way. The leadership and coordination of the PM&R physicians are likely to be effective, especially for those with severe disabilities after brain injury.

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Section: Discussionmentioning

confidence: 99%

Does access to acute intensive trauma rehabilitation (AITR) programs affect the disposition of brain injury patients?

Chowdhury

Leenen

2021

PLoS ONE

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“…The demographic characteristics and injury data were evaluated regarding age, Injury Severity Score (ISS), injury location, injury type and mechanism, accompanying traumas, and operations. The ISS is a scoring system based on anatomical regions that are used for assessing trauma severity in patients with multiple injuries [ 11 ]. Scores of <9 represent mild injuries, 9-15 moderate, 16-24 severe, and ≥25 profound.…”

Section: Methodsmentioning

confidence: 99%

Depression, Anxiety, and Post-Traumatic Stress Disorder Following Orthopedic War Injuries

Biçen¹,

Akdemir²,

Gülveren³

et al. 2021

Cureus

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Introduction There are ongoing wars worldwide, during which significant numbers of people are injured. Several studies have indicated that high rates of depression and anxiety are seen in war-injured patients. Methods Eighty-one male patients treated between November 2019 and January 2021 far from home in a Turkish hospital due to war injuries that happened in the Libyan Civil War were investigated. Demographic characteristics and injury data of the patients were evaluated regarding age, Injury Severity Score (ISS), location of injuries, type and mechanism of injuries, operations, and accompanying traumas. The psychological statuses of the patients were evaluated with the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and post-traumatic stress disorder (PTSD) records filled out at the first admission to the hospital. Results The mean age of the patients was 29.8±7.7 (19-56) years. While 59 patients had fractures, 22 patients had only soft tissue injuries. Eighteen patients suffered from other accompanying injuries. While 85.2% of the patients showed symptoms of depression, 82.7% of the patients suffered from anxiety and PTSD symptoms were seen in 86.4% of the patients. Statistical analysis was performed to investigate the effects of injury severity, duration of hospitalization, number of operations, and age on depression, anxiety, and PTSD among these patients with war injuries. The results did not indicate any significant effect of injury severity, hospitalization duration, or operations. Conclusion Depression, anxiety, and PTSD are common in patients injured in wars. Injury severity does not seem to affect depression, anxiety, or PTSD in these patients.

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“…The sum of the squares of the highest AIS scores for the three most severely injured body regions equals the ISS. The ISS ranges from 1 to 75 and correlates most closely with morbidity and mortality [19]. The mechanism of injuries were also evaluated to compare GTPs to octogenarians, including falls, motor vehicle collisions (MVCs), pedestrian accidents, and motorcycle collisions (MCCs).…”

Section: Methodsmentioning

confidence: 99%

Octogenarians with blunt splenic injury: not all geriatrics are the same

et al. 2020

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Geriatric trauma patients (GTP) (age ≥ 65 years) with blunt splenic injury (BSI) have up to a 6% failure rate of non-operative management (NOM). GTPs failing NOM have a similar mortality rate compared to GTPs managed successfully with NOM. However, it is unclear if this remains true in octogenarians (aged 80-89 years). We hypothesized that the failure rate for NOM in octogenarians would be similar to their younger geriatric cohort, patients aged 65-79 years; however risk of mortality in octogenarians who fail NOM would be higher than that of octogenarians managed successfully with NOM. The Trauma Quality Improvement Program (2010-2016) was queried for patients with BSI. Those undergoing splenectomy within 6 h were excluded to select for patients undergoing NOM. Patients aged 65-79 years (young GTPs) were compared to octogenarians. A multivariable logistic regression model was used to determine the risk for failed NOM and mortality. From 43,041 BSI patients undergoing NOM, 3660 (8.5%) were aged 65-79 years and 1236 (2.9%) were octogenarians. Both groups had a similar median Injury Severity Score (ISS) (p = 0.10) and failure rate of NOM (6.6% young GTPs vs. 6.8% octogenarians p = 0.82). From those failing NOM, octogenarians had similar units of blood products transfused (p > 0.05) and a higher mortality rate (40.5% vs. 18.2%, p < 0.001), compared to young GTPs. Independent risk factors for failing NOM in octogenarians included ≥ 1 unit of packed red blood cells (PRBC) (p = 0.039) within 24 h of admission. Octogenarians who failed NOM had a higher mortality rate compared to octogenarians managed successfully with NOM (40.5% vs 23.6% p = 0.001), which persisted in a multivariable logistic regression analysis (OR 2.25, CI 1.37-3.70, p < 0.001). Late failure of NOM ≥ 24 h (vs. early failure) was not associated with increased risk of mortality (p = 0.88), but ≥ 1 unit of PRBC transfused had higher risk (OR 1.88, CI 1.20-2.95, p = 0.006). Compared to young GTPs with BSI, octogenarians have a similar rate of failed NOM. Octogenarians with BSI who fail NOM have over a twofold higher risk of mortality compared to those managed successfully with NOM. PRBC transfusion increases risk for mortality. Therefore, clinicians should consider failure of NOM earlier in the octogenarian population to mitigate the risk of increased mortality.

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Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients

Cited by 116 publications

References 22 publications

Does access to acute intensive trauma rehabilitation (AITR) programs affect the disposition of brain injury patients?

Does access to acute intensive trauma rehabilitation (AITR) programs affect the disposition of brain injury patients?

Depression, Anxiety, and Post-Traumatic Stress Disorder Following Orthopedic War Injuries

Octogenarians with blunt splenic injury: not all geriatrics are the same

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