Epidemiology of trauma admissions in a level 1 trauma center in Northern Italy: a nine-year study

Difino, Margherita; Bini, Roberto; Reitano, Elisa; Faccincani, Roberto; Sammartano, Fabrizio; Briani, Laura; Cimbanassi, Stefania; Chiara, Osvaldo

doi:10.1007/s13304-021-00991-y

Cited by 18 publications

(15 citation statements)

References 29 publications

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“…In contrast with North American Literature [ 7 , 20 ], GSW and SW represented a minor cause of death in our sample: penetrating injuries represented only approximately 8% of all injuries, and most GSWs were self-inflicted in male patients > 40 years of age. These results were in line with the overall trauma trends, as the incidence of this type of MOIs is higher in North America than in Europe [ 11 , 20 ]. Our study was conducted in a high-flow Level One trauma center and showed, for the first time in Italy, the potential role of a specialized and trained Trauma Team in reducing mortality.…”

Section: Discussionsupporting

confidence: 82%

“…In addition, the study was a retrospective analysis of a nine-year cohort of trauma patients transported and treated in a level one trauma center: a high-flow trauma center with a surgical leadership in trauma management and a staff specifically trained on trauma management and damage-control procedures [ 11 , 21 ]. Although it represented the first Italian report on the topic, it cannot reflect the overall mortality distribution of trauma patients in all the country, as there are differences in trauma management according to the center.…”

Section: Discussionmentioning

confidence: 99%

“…The development of damage control techniques, specific guidelines in massive transfusion protocols, and the implementation of modern technologies in intensive care has decreased the mortality of trauma patients [ 5 , 6 ], leading to a bimodal distribution of trauma mortality [ 7 , 8 ]. The increase in the age of the trauma population, as well as the presence of comorbidities and the predominance of some mechanisms of injury (MOIs), contributed to the change in the epidemiology of trauma related deaths over the past decade [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy

et al. 2022

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Trauma is the leading cause of death in young people with a considerable socio-economic impact worldwide. A trimodal distribution of trauma mortality was described in the past, but recently different studies underlined a progressive change in trauma mortality distribution linked to improvement in trauma care. This study aimed to analyze the mortality trends in a Level-One Trauma Center in Italy. Data on 6065 patients consecutively admitted to the Trauma Center between 2011 and 2020 were selected and retrospectively analyzed. Causes of Death (CODs) and time of death were stratified in four main groups and the patient sample was further divided into five age groups. Multivariate regression models were then performed to identify independent predictors of mortality. The most common COD in all age groups was Central Nervous System injuries. Immediate deaths (in ED) affected mostly patients over 75 years of age (34.3%). Deaths caused by massive hemorrhage occurred soon upon arrival in the ED, whereas deaths due to other causes (e.g. sepsis, MOF) after the first week. Patients’ characteristics, the need for emergency procedures and high trauma severity scores were independent predictors of deaths. This study represented the first analysis on trauma mortality distribution in Italy over a nine-year period. The trimodal distribution described in the past seems to be no longer present in Italy, due to improvements in trauma systems and critical care. However, the high number of immediate and acute deaths underlies a persisting need for efforts in injury prevention and control .

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy

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“…(69.5%) and followed by falls (12.3%) [ 15 ]. The study of Pogorzelski et al, in Brazilian people pointed out that 60.4% of trauma patients suffered RTAs (52% motorcycle), and 31.2% were violence victims [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological pattern of trauma patients based on the mechanisms of trauma: trends of a regional trauma center in Midwest of Iran

et al. 2022

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Introduction Trauma is one of the important issues in public health because it is responsible for 90% of mortality in Low and Middle-Income Countries (LIMCs). The present study aimed to determine the epidemiological pattern of trauma patients in a regional trauma center in the Midwest of Iran from 2014 to 2020. Methods This study was a retrospective study that was performed on 29,804 trauma patients admitted to Be′sat Hospital in Hamadan from January 2014 to December 2020. Data was collected using Health Information Management (HIM) Center of the Be′sat Hospital. For investigating the relationship of the characteristics of trauma patients and the mechanisms of trauma, Multiple Multinomial Logistic Regression (MMNLR) model was used. All statistical analyses were performed using the IBM SPSS Statistics version 24. Results The mean age of all patients was 35.4 (SD = 21.9) years. Most of them were men (71.7%). The most common mechanism of trauma was road traffic accidents (RTAs) (39.6%) followed by falls (30.2%), other (19.7%), violence (6.2%), and burn (4.4%). 1.5% of the trauma patients expired. The results of multiple multinomial logistic regression indicated that significant affected factor on odds referring because of RTAs compared to other mechanism were: season and hospital length of stay (LOS); in falls and violence: age, sex, season, and LOS; and in burn: age, sex, season, evening time, and LOS (p < 0.05). Conclusion Based on the investigation of 29,804 trauma patients, in Iran as a developing country, RTAs and falls were two common mechanisms of trauma. It seems that as a short-term plan, it is possible to focus on road safety, to improve the quality of vehicles, to hold training courses for drivers. Also, as a long-term goal, considering that the elderly population in Iran is increasing, it is necessary to pay attention to fall reduction programs.

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“…Chest trauma represents one of the leading causes of morbidity and the second cause of death in patients with multiple trauma, followed only by head injuries [ 1 ]. The correct in-hospital management of chest trauma seems to be of paramount importance to improve patients’ outcomes and decrease the length of stay (LOS) [ 2 ]. The proper use of ventilation supports plays a fundamental role in patient management, ensuring the appropriate thoracic expansion and potentially avoiding the development of respiratory complications [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study

Reitano

Gavelli

Iannantuoni

et al. 2023

JCM

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Chest trauma management often requires the use of invasive and non-invasive ventilation. To date, only a few studies investigated the predictors of the need for ventilatory support. Data on 1080 patients with chest trauma managed in two different centers were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the predictors of tracheal intubation (TI), non-invasive mechanical ventilation (NIMV), and mortality. Rib fractures (p = 0.0001) fracture of the scapula, clavicle, or sternum (p = 0.045), hemothorax (p = 0.0035) pulmonary contusion (p = 0.0241), and a high Injury Severity Score (ISS) (p ≤ 0001) emerged as independent predictors of the need of TI. Rib fractures (p = 0.0009) hemothorax (p = 0.0027), pulmonary contusion (p = 0.0160) and a high ISS (p = 0.0001) were independent predictors of NIMV. The center of trauma care (p = 0.0279), age (p < 0.0001) peripheral oxygen saturation in the emergency department (p = 0.0010), ISS (p < 0.0001), and Revised Trauma Score (RTS) (p < 0.0001) were independent predictors of outcome. In conclusion, patients who do not require TI, while mandating ventilatory support with selected types of injuries and severity scores, are more likely to be subjected to NIMV. Trauma team expertise and the level of the trauma center could influence patient outcomes.

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Epidemiology of trauma admissions in a level 1 trauma center in Northern Italy: a nine-year study

Cited by 18 publications

References 29 publications

Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy

Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy

Epidemiological pattern of trauma patients based on the mechanisms of trauma: trends of a regional trauma center in Midwest of Iran

In-Hospital Predictors of Need for Ventilatory Support and Mortality in Chest Trauma: A Multicenter Retrospective Study

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