Contemporary characteristics of blunt abdominal trauma in a regional series from the UK

Pande, R; Saratzis, Athanasios; Beatty, Jasmine Winter; Doran, Catherine; Kirby, Robert; Harmston, Christopher

doi:10.1308/rcsann.2016.0223

Cited by 29 publications

(27 citation statements)

References 19 publications

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“…This percentage is not low, if one considers that approximately 20% of our trauma patients deceased either on the field or in the emergency department, before reaching the operative room. One-third of our trauma patients received SNOM rate similar to European and US trauma centers 43–46. The non-therapeutic intervention ratio (ie, negative laparotomies) was not recorded in our registry.…”

Section: Discussionmentioning

confidence: 99%

Evaluating trauma care, outcomes and costs in a system in crisis: the necessity of a Greek National Trauma Database

Prionas¹,

Tsoulfas

Tooulias

et al. 2020

Trauma Surg Acute Care Open

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BackgroundAt present there is no organized trauma system in Greece and no national trauma database. The objective of this study was to record and evaluate trauma management at our university hospital and to measure the associated healthcare costs, while laying the foundations for a national database and the organization of regional trauma networks.MethodsRetrospective study of trauma patients (n=2320) between 2014 and 2015, through our single-center registry. Demographic information, injury patterns, hospital transfer, investigations, interventions, duration of hospitalization, Injury Severity Score (ISS), outcomes, complications and cost were recorded.ResultsRoad traffic collisions (RTC) accounted for 23.2% of traumas. The proportion of patients who were transferred to the hospital by the National Emergency Medical Services decreased throughout the study (n2015=76/1192 (6.38%), n2014=109/1128 (9.7%)) (p<0.05). 1209 (52.1%) of our trauma patients did not meet the US trauma field triage algorithm criteria. Overtriage of trauma patients to our facility ranged from 90.7% to 96.7%, depending on the criteria used (clinical vs. ISS criteria). Ninety-one (3.9%) of our patients received operative management. Intensive care unit admissions were 21 (0.1%). Seventy-six (3.3%) of our patients had ISS>15 and their mortality was 31.6%. The overall non-salary cost for trauma management was €623 140. 53% of these costs were attributed to RTCs. The cost resulting from the observed overtriage ranged from €121 000 to €315 000. Patients who did not meet the US trauma triage algorithm criteria accounted for 10.5% of total expenses.DiscussionOur results suggest that RTCs pose a significant financial burden. The prehospital triage of trauma patients is ineffective. A reduction of costs could have been achieved if prehospital triage was more effective.Level of evidenceLevel IV.

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Section: Discussionmentioning

confidence: 99%

Evaluating trauma care, outcomes and costs in a system in crisis: the necessity of a Greek National Trauma Database

Prionas¹,

Tsoulfas

Tooulias

et al. 2020

Trauma Surg Acute Care Open

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“…Ainsi le taux de décès des contusions abdominales serait de 36% au Brésil (Pimentel, 2015), de 6,1% en grande Bretagne(Pande, 2017), mais de 6,1% à N'djamena au Tchad (Choua, 2019). Ces décès pour traumatisme survenaient surtout en période préhospitalière (Mock, 1998), (Pande, 2017). Pour Demetriades et al 15,8% des décès par contusion abdominale survenaient sur le lieu du traumatisme avant l'admission des patients à l'hôpital et 19% des patients qui arrivaient vivants à l'hôpital décédaient durant la 1 ère heure qui suivait la contusion abdominale à Los Angeles aux Etats Unis d'Amérique malgré son ''trauma system'' et sa réactivité moyenne de 28 minutes (Demetriades, 2005).…”

Section: Discussionunclassified

Morbi-Mortalité des Contusions Abdominales : La Face Visible de L’iceberg

Hama

Kadi

Garba

et al. 2019

ESJ

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“…Various materials are used for TAE, broadly categorized as permanent (coils or n-butyl-2-cyanoacrylate) or temporary (gelatine particles). The method of following up paediatric patients who underwent TAE is as follows: (1) an emergency physician confirmed that the patients are in a hemodynamic stability state and removed the arterial sheath after 6 or 12 hours of TAE, (2) before and after TAE, the patients, with a pressure band, rested on the bed during 6 hours, (3) an emergency physician evaluated whether the patients have complications such as puncture site hematomas, arterial embolism, or pseudo-aneurysms.…”

Section: Emergency Department Algorithm In Blunt Torso Patients With mentioning

confidence: 99%

“…Although torso trauma with excessive bleeding has been associated with significant morbidity and mortality, the selection of the therapeutic strategy for patients who are haemodynamically unstable remains a challenge [1][2][3]. Due to advances in endovascular techniques for trauma patients, the therapeutic strategy in blunt torso trauma with haemorrhage changed from operative to non-operative management in the mid-1990s [4,5].…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Arterial Embolization is an Efficient and Safe for Paediatric Blunt Torso Trauma: A Case Control Study

Gakumazawa

Toida²,

Muguruma

et al. 2020

Preprint

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Background: It remains unclear whether transcatheter arterial embolization (TAE) is as safe and effective for paediatric patients with blunt torso trauma as it is for adults in Japan, owing to few trauma cases and sporadic case reports. The study aimed to compare the efficacy and safety of TAE in paediatric patients (age ≤ 15 years) with blunt torso trauma to those of TAE in adult patients. Methods: This was a single-centre, retrospective chart review study that included blunt torso trauma patients who underwent TAE in the trauma centre from 2012 to 2017. The comparative study was carried out between a “paediatric patient group” and an “adult patient group”.The outcome measures for TAE were the success of haemorrhage control and complications and standardised mortality ratio (SMR). Results: A total of 504 patients with blunt torso trauma were transported to the trauma centre. Among them, 23% (N=114) of patients with blunt torso trauma underwent TAE, including 15 paediatric and 99 adult patients. There was no significant difference between the use of TAE in paediatric and adult patients with blunt torso trauma (29% vs. 22%, P=.221). The median age was 11 (IQR 7–14) years for paediatric patients. The predicted mortality (PMR) rate and SMR for paediatric patients were lower than that for adult patients (18.3% vs. 25.9%, P =.026, and 0.37 vs. 0.54). The rate of effective haemorrhage control without repeated TAE or additional surgical intervention was 93% in paediatric patients, which was similar to that in adult patients (88%). There were no complications in the paediatric patients at our centre. There were no significant differences in the proportion of paediatric patients that underwent surgery before TAE or urgent blood transfusion (33% vs. 26%, P =.566, or 67% vs. 85%, P =.084). Conclusions: It is possible to provide an equal level of care related to TAE for both paediatric and adult patients as it relates to TAE for blunt torso trauma with haemorrhage in the trauma centre. We should prepare alternative haemorrhage control procedures as soon as possible whenever the patients reach a hemodynamic unstable state.

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Contemporary characteristics of blunt abdominal trauma in a regional series from the UK

Cited by 29 publications

References 19 publications

Evaluating trauma care, outcomes and costs in a system in crisis: the necessity of a Greek National Trauma Database

Evaluating trauma care, outcomes and costs in a system in crisis: the necessity of a Greek National Trauma Database

Morbi-Mortalité des Contusions Abdominales : La Face Visible de L’iceberg

Transcatheter Arterial Embolization is an Efficient and Safe for Paediatric Blunt Torso Trauma: A Case Control Study

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