Impact of systolic blood pressure limits on the diagnostic value of triage algorithms

Neidel, Tobias; Salvador, N.; Heller, Axel R.

doi:10.1186/s13049-017-0461-2

Cited by 17 publications

(24 citation statements)

References 12 publications

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“…We categorized age into three groups: < 20 years, 20-64 years, and ≥ 65 years. We defined shock as a systolic blood pressure of < 80 mmHg on hospital arrival [18]. To assess concomitant injuries, we mapped AIScoded injuries to the following categories: head/neck, thorax, pelvis/extremities, and intra-abdominal organs (including the liver, spleen, pancreas, and gastrointestinal tract).…”

Section: Variablesmentioning

confidence: 99%

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Nakao

Katayama

Hirayama³

et al. 2020

World J Emerg Surg

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Background: There is a paucity of information for predicting patient outcomes other than the American Association for the Surgery of Trauma (AAST) renal injury scale. The aim of this study was to evaluate the association between the patient characteristics and outcomes of patients with blunt renal trauma using a nationwide database in Japan. Methods: We performed a retrospective analysis of the Japan Trauma Data Bank (JTDB) from 2004 to 2018. We identified patients with blunt renal trauma by AIS codes converted to AAST grades. We evaluated trends in patient characteristics and management and assessed factors associated with mortality and nephrectomy using a multivariable logistic regression analysis. Results: We identified 3550 patients with blunt renal trauma. Their median age was 43 years and 74.2% were male. Nephrectomy was performed in 3.8%, and the overall mortality rate was 9.5%. We found increasing trends in age and emergency abdominal angiography and decreasing trends in nephrectomy and mortality over the 15-year period. The following factors were associated with mortality: age ≥ 65 years (adjusted OR 3.36); pedestrian accident (adjusted OR 1.94); fall from height (adjusted OR 1.91); shock on arrival (adjusted OR 4.02); concomitant injuries to the head/neck (adjusted OR 3.14), pelvis/lower-extremity (adjusted OR 1.59), liver (adjusted OR 1.68), spleen (adjusted OR 1.45), and gastrointestinal tract (adjusted OR 1.90); AAST grades III-V (adjusted ORs 1.42, 2.16, and 5.55); and emergency abdominal angiography (adjusted OR 0.70). The following factors were associated with nephrectomy: shock on arrival (adjusted OR 1.98), concomitant injuries to the thorax (adjusted OR 0.46) and spleen (adjusted OR 2.07), AAST grades III, IV, and V (adjusted ORs 18.40, 113.89, and 468.17), and emergency abdominal angiography (adjusted OR 0.28). Conclusions: We demonstrated that the AAST grade and emergency angiography were associated with mortality and nephrectomy in blunt renal trauma in the Japanese population.

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Section: Variablesmentioning

confidence: 99%

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Nakao

Katayama

Hirayama³

et al. 2020

World J Emerg Surg

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show abstract

“…We de ned shock as a systolic blood pressure of <80 mmHg on hospital arrival. 18 To assess concomitant injuries, we mapped AIS-coded injuries to the following categories: head/neck, thorax, pelvis/extremities, and intra-abdominal organs (including the liver, spleen, pancreas, and gastrointestinal tract). Factors associated with mortality were assessed by a multivariable logistic regression analysis and adjusted odds ratios (ORs) and 95% con dence intervals (CIs) were calculated.…”

Section: Variablesmentioning

confidence: 99%

Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan

Nakao

Katayama

Hirayama

et al. 2020

Preprint

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Background There is a paucity of information for predicting patient outcomes other than the American Association for the Surgery of Trauma (AAST) renal injury scale. The aim of this study was to evaluate the association between the patient characteristics and outcomes of patients with blunt renal trauma using a nationwide database in Japan. Methods We performed a retrospective analysis of the Japan Trauma Data Bank (JTDB) from 2004 to 2018. We identified patients with blunt renal trauma by AIS codes converted to AAST grades. We evaluated trends in patient characteristics and management, and assessed factors associated with mortality and nephrectomy using a multivariable logistic regression analysis. Results We identified 3,550 patients with blunt renal trauma. Their median age was 43 years and 74.2% were male. Nephrectomy was performed in 3.8% and the overall mortality rate was 9.5%. We found increasing trends in age and emergency abdominal angiography, and decreasing trends in nephrectomy and mortality over the 15-year period. The following factors were associated with mortality: age ≥ 65 years (adjusted OR 3.36), pedestrian accident (adjusted OR 1.94), fall from height (adjusted OR 1.91), shock on arrival (adjusted OR 4.02), concomitant injuries to head/neck (adjusted OR 3.14), pelvis/lower-extremity (adjusted OR 1.59), liver (adjusted OR 1.68), spleen (adjusted OR 1.45), and gastrointestinal tract (adjusted OR 1.90), AAST grade III-V (adjusted ORs 1.42, 2.16 and 5.55), and emergency abdominal angiography (adjusted OR 0.70). The following factors were associated with nephrectomy: shock on arrival (adjusted OR 1.98), concomitant injuries to thorax (adjusted OR 0.46) and spleen (adjusted OR 2.07), AAST grade III, IV and V (adjusted ORs 18.40, 113.89, and 468.17) and emergency abdominal angiography (adjusted OR 0.28). Conclusions We demonstrated that the AAST grade and emergency angiography were associated with mortality and nephrectomy in blunt renal trauma in the Japanese population. Trial registration: Not applicable

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“…In aktuellen Studien wurde die Qualität verschiedener in Deutschland gebräuchlicher Vorsichtungsalgorithmen hinsichtlich der korrekten Identifizierung der SK I untersucht. Die Algorithmen ASAV [5] und mSTaRT [6] erzielten dabei die besten Ergebnisse hinsichtlich Sensitivität und Spezifitätalso ob möglichst alle vital bedrohten Patienten als SK I erkannt und keine leichter Verletzten als SK I triagiert wurden [7,8] Eine weitere Fehlerquelle steckt diesbezüglich im zeitigen Aussortieren der gehfähigen Patienten. Wenn gehfähige Patienten ganz am Anfang des Algorithmus als "grün" aussortiert werden, können in dieser Gruppe noch bis zu 28 % "rote" Patienten stecken.…”

Section: Qualität Verfügbarer Vorsichtungsalgorithmenunclassified

“…Wenn gehfähige Patienten ganz am Anfang des Algorithmus als "grün" aussortiert werden, können in dieser Gruppe noch bis zu 28 % "rote" Patienten stecken. Daher ist eine zeitnahe Nachsichtung der "grünen" Patienten unbedingt erforderlich [8]. Dies wird auch im aktuellen mSTaRT-Algorithmus berücksichtigt [12].…”

Section: Qualität Verfügbarer Vorsichtungsalgorithmenunclassified

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Triage beim Massenanfall von Verletzten (MANV)

Neidel¹,

Heller²

2018

Notf.med. up2date

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Impact of systolic blood pressure limits on the diagnostic value of triage algorithms

Cited by 17 publications

References 12 publications

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Trends and outcomes of blunt renal trauma management: a nationwide cohort study in Japan

Trends and outcomes of blunt renal trauma management: A nationwide cohort study in Japan

Triage beim Massenanfall von Verletzten (MANV)

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