Differences in Characteristics and Outcome of Patients with Penetrating Injuries in the USA and the Netherlands: A Multi‐institutional Comparison

Dijkink, Suzan; Krijnen, Pieta; Hage, Aglaia; Wilden, Gwendolyn M. van der; Kasotakis, George; Hartog, Dennis den; Salim, Ali; Goslings, J. C.; Bloemers, Frank W.; Rhemrev, Steven J.; King, David R.; Velmahos, George C.; Schipper, Inger B.

doi:10.1007/s00268-018-4669-8

Cited by 35 publications

(24 citation statements)

References 42 publications

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“…Blunt injuries were common in our study population, especially in SII. This contrasts with studies from level 1 trauma centers in Western settings where penetrating injuries especially gunshots were more common [22]. In addition to the differences in geographical, cultural and religious backgrounds in the Middle Eastern settings, factors such as urbanization, crime rates, and legislation concerning rearm use could contribute to these existing variations.…”

Section: Discussionmentioning

confidence: 76%

Violence–related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center

Mollazehi

El‐Menyar

Mekkodathil

et al. 2020

Preprint

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Background: Violence is a global public health problem leading to injuries, long-term physical, sexual or mental health problems and mortality. The burden of violence-related injuries remains understudied in the Arabian Gulf region. The present study aimed to describe the epidemiology of hospitalized violence-related injuries in Qatar.Methods: A retrospective analysis of trauma registry data from a level 1 trauma center was conducted by including all patients admitted to the hospital for violence-related injuries between June 2010 and June 2017. We analyzed and compared the hospitalized interpersonal and self-inflicted violence groups.Results: The hospitalization rate of violence-related injuries was 4.6 per 100,000 population per year; it was significantly higher in males (5.5/100,000 males/year vs. 1.8/100,000 females/year) and in younger populations, specifically in the 25-34 years age-group (41%). South Asians constituted 55% of the affected study population. Interpersonal violence (76.7%) was the most common mechanism of injury. Significant differences between interpersonal and self-inflicted violence were evident, especially for the type of trauma (i.e. blunt or penetrating), injured body regions, alcohol use, injury severity, need for intubation and psychiatric referral (p<0.05). Overall, in-hospital mortality was 6.4%; with a significantly higher rate in females (16% vs.5%, p=0.001). Outcomes, including length of hospital stay and mortality, were comparable in the two types of violence. Multivariate analysis showed that male gender and alcohol use were predictors for interpersonal violence whereas a high Injury Severity Score and a low Glasgow Coma Scale were predictors of hospital mortality.Conclusions: The rate of hospitalization for violence-related injuries in Qatar is low; however, its burden on the trauma system is of concern. Although it comprised only 9.6% of the study population, females are more likely to get hospitalized following self-inflicted injuries when compared to interpersonal violence. Disproportionate burden of violence in the South Asians and young population warrants an evidence-based public health approach in violence prevention to well address the risk factors.

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Section: Discussionmentioning

confidence: 76%

Violence–related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center

Mollazehi

El‐Menyar

Mekkodathil

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Blunt injuries were common in our study population, especially SII. This contrasts with studies from level 1 trauma centers in Western settings where penetrating injuries especially gunshots were more common [22]. In addition to the differences in geographical, cultural and religious backgrounds in the Middle Eastern settings, factors such as urbanization, crime rates, and legislation concerning rearm use could contribute to these existing variations.…”

Section: Discussionmentioning

confidence: 76%

“…In addition to the differences in geographical, cultural and religious backgrounds in the Middle Eastern settings, factors such as urbanization, crime rates, and legislation concerning rearm use could contribute to these existing variations. Dijkink et al, demonstrated that the proportion of admitted patients with gunshot wounds was almost twice as high in level 1 trauma centers in the United States when compared to level 1 trauma centers in Netherlands, even though the geographical areas in both countries had comparable urbanization and violence crime rates [22].…”

Section: Discussionmentioning

confidence: 99%

Violence –related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center

Mollazehi

El‐Menyar

Mekkodathil

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Violence is a global public health problem leading to injuries, long-term physical, sexual or mental health problems and even mortality. The burden of violence-related injuries on hospital systems remains understudied in the Arabian Gulf region. The present study aimed to describe the epidemiology of hospitalized violence-related injuries in Qatar. Methods: A retrospective analysis of trauma registry data from a level 1 trauma center was conducted to retrieve data related to all patients admitted to the hospital for violence-related injuries between June 2010 and June 2017. Analyzed data was used to compare the hospitalized interpersonal and self-inflicted violence groups.Results: The hospitalization rate of violence-related injuries was 4.6 per 100,000 population per year; it was significantly higher in males (5.5/100,000 males/year vs. 1.8/100,000 females/year) and in younger populations, specifically in the 25-34 years age-group (41%). South Asians constituted 55% of the affected study population. Interpersonal violence (76.7%) was the most common mechanism of injury. Significant differences between interpersonal and self-inflicted violence were evident, especially for the type of trauma (i.e. blunt or penetrating), injured body regions, alcohol use, injury severity, need for intubation and psychiatric referral (p<0.05). Overall, in-hospital mortality was 6.4%; with a significantly higher rate in females (16% vs.5%, p=0.001). Outcomes, including length of hospital stay and mortality, were comparable in the two study groups. Multivariate analysis showed that male gender and alcohol use were predictors for interpersonal violence whereas a high Injury Severity Score and a low Glasgow Coma Scale were predictors of hospital mortality.Conclusions: The rate of hospitalization for violence-related injuries in Qatar is low; however, its burden on the trauma system is of concern. Although it comprised only 9.6% of the study population, females are more likely to get hospitalized following self-inflicted injuries when compared to interpersonal violence. The disproportionate burden of violence among South Asian and young populations warrants an evidence-based public health approach to best address the risk factors and set appropriate prevention programs.

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“…Another confounder is the trauma mechanism. While in Europe most patients suffer from blunt injuries, penetrating injuries are leading in the United States [29]. Fractures of extremities are a well-known risk factor for venous thromboembolism.…”

Section: Discussionmentioning

confidence: 99%

Impact of a goal-directed factor-based coagulation management on thromboembolic events following major trauma

Stein

Rössler

Braun

et al. 2019

Scand J Trauma Resusc Emerg Med

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Background: A factor-based coagulation management following major trauma is recommended as standard of care by the European Trauma Treatment Guidelines. However, concerns about the thromboembolic risk of this approach are still prevalent. Our study therefore aims to assess if such a haemostatic management is associated with an increased risk for thromboembolic events. Methods: In this retrospective observational study carried out at the University Hospital Zurich we compared two three-year periods before (period 1: 2005-2007) and after (period 2: 2012-2014) implementation of a factor-based coagulation algorithm. We included all adult patients following major trauma primarily admitted to the University Hospital Zurich. Thromboembolic events were defined as a new in-hospital appearance of any peripheral thrombosis, arterial embolism, pulmonary embolism, stroke or myocardial infarction. A logistic regression was performed to investigate the association of thromboembolic events with possible confounders such as age, sex, specific Abbreviated Injury Scale (AIS) subgroups, allogeneic blood products, and the coagulation management. Results: Out of 1138 patients, 772 met the inclusion criteria: 344 patients in period 1 and 428 patients in period 2. Thromboembolic events were present in 25 patients (7.3%) of period 1 and in 42 patients (9.8%) of period 2 (raw OR 1.39, 95% CI 0.83 to 2.33, p = 0.21). Only AIS extremities (adjusted OR 1.26, 95% CI 1.05 to 1.52, p = 0.015) and exposure to allogeneic blood products (adjusted OR 2.39, 95% CI 1.33 to 4.30, p = 0.004) were independently associated with thromboembolic events in the logistic regression, but the factor-based coagulation management was not (adjusted OR 1.60, 95% CI 0.90-2.86, p = 0.11). Conclusion: There is no evidence that a goal-directed, factor-based coagulation management is associated with an increased risk for thromboembolic events following major trauma.

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Differences in Characteristics and Outcome of Patients with Penetrating Injuries in the USA and the Netherlands: A Multi‐institutional Comparison

Cited by 35 publications

References 42 publications

Violence–related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center

Violence–related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center

Violence –related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center

Impact of a goal-directed factor-based coagulation management on thromboembolic events following major trauma

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