Improving outcomes in a regional trauma system: impact of a level III trauma center

Barringer, M; Thomason, Michael; Kilgo, Patrick D.; Spallone, Linda

doi:10.1016/j.amjsurg.2005.11.006

Cited by 22 publications

(8 citation statements)

References 20 publications

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“…Unlike other studies [1,3,6,17,20], we found that burns were overrepresented among transferred patients. This can be attributed to the fact that there are three centers specialized in treating burn injuries in the whole country and they are situated in the two major cities.…”

Section: Discussioncontrasting

confidence: 99%

Interfacility transfers in a non-trauma system setting: an assessment of the Greek reality

Katsaragakis

Drimousis

Kleidi

et al. 2010

Scand J Trauma Resusc Emerg Med

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BackgroundQuality assessment of any trauma system involves the evaluation of the transferring patterns. This study aims to assess interfacility transfers in the absence of a formal trauma system setting and to estimate the benefits from implementing a more organized structure.MethodsThe 'Report of the Epidemiology and Management of Trauma in Greece' is a one year project of trauma patient reporting throughout the country. It provided data concerning the patterns of interfacility transfers. We compared the transferred patient group to the non transferred patient group. Information reviewed included patient and injury characteristics, need for an operation, Intensive Care Unit (ICU) admittance and mortality. Analysis employed descriptive statistics and Chi-square test. Interfacility transfers were then assessed according to each health care facility's availability of five requirements; Computed Tomography scanner, ICU, neurosurgeon, orthopedic and vascular surgeon.ResultsData on 8,524 patients were analyzed; 86.3% were treated at the same facility, whereas 13.7% were transferred. Transferred patients tended to be younger, male, and more severely injured than non transferred patients. Moreover, they were admitted to ICU more often, had a higher mortality rate but were less operated on compared to non transferred patients. The 34.3% of transfers was from facilities with none of the five requirements, whereas the 12.4% was from those with one requirement. Low level facilities, with up to three requirements transferred 43.2% of their transfer volume to units of equal resources.ConclusionTrauma management in Greece results in a high number of transfers. Patients are frequently transferred between low level facilities. Better coordination could lead to improved outcomes and less cost.

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Section: Discussioncontrasting

confidence: 99%

Interfacility transfers in a non-trauma system setting: an assessment of the Greek reality

Katsaragakis

Drimousis

Kleidi

et al. 2010

Scand J Trauma Resusc Emerg Med

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“…The advances in intensive care and patient management have improved short-term survival following severe injury 35, 36 however, the overall hospital mortality for trauma patients admitted to the intensive care unit remains high 15, 37 . In combat and civilian situations where care is delayed or fluid resuscitation is logistically difficult, methods to prolong life in the absence of fluid resuscitation are necessitated.…”

Section: Discussionmentioning

confidence: 99%

Mitochondrial targeting by dichloroacetate improves outcome following hemorrhagic shock

Subramani

Warren

et al. 2017

Sci Rep

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Hemorrhagic shock is a leading cause of death in people under the age of 45 and accounts for almost half of trauma-related deaths. In order to develop a treatment strategy based on potentiating mitochondrial function, we investigated the effect of the orphan drug dichloroacetate (DCA) on survival in an animal model of hemorrhagic shock in the absence of fluid resuscitation. Hemorrhagic shock was induced in rats by withdrawing 60% of the blood volume and maintaining a hypotensive state. The studies demonstrated prolonged survival of rats subjected to hemorrhagic injury (HI) when treated with DCA. In separate experiments, using a fluid resuscitation model we studied mitochondrial functional alterations and changes in metabolic networks connected to mitochondria following HI and treatment with DCA. DCA treatment restored cardiac mitochondrial membrane potential and tissue ATP in the rats following HI. Treatment with DCA resulted in normalization of several metabolic and molecular parameters including plasma lactate and p-AMPK/AMPK, as well as Ach-mediated vascular relaxation. In conclusion we demonstrate that DCA can be successfully used in the treatment of hemorrhagic shock in the absence of fluid resuscitation; therefore DCA may be a good candidate in prolonged field care following severe blood loss.

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“…Therefore, different regional management methods are carried out. [10][11][12][13][14] The current study was conducted in the rural Muş province located in the eastern part of Turkey, where there is little information available on trauma, with an aim to analyze the trauma cases, compare our results with previous literature reports, and discuss possible solutions.…”

mentioning

confidence: 99%

Analysis of trauma patients in a rural hospital in Turkey

Kahramansoy¹,

Erkol²,

Kurt³

et al. 2011

Ulus Travma Acil Cerrahi Derg

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Bu çalışmanın amacı, travma ile ilgili yeterli verinin olmadığı Türkiye'nin doğusundan epidemiyolojik veriler yanında hastaların çıkış durumlarını sunmaktadır. GEREÇ VE YÖNTEMMuş Devlet Hastanesi Acil Birimi'ne Ocak 2006 -Aralık 2007 tarihleri arasında başvuran travma hastalarının kayıtları retrospektif olarak incelendi. BULGULARToplam 6183 hastanın 5377'si (%87) erkek ve ortalama yaş 26,2±13,6 idi. Darp-şiddet 3910 (%63,2) hasta ile en sık travma nedeni idi. Ardından trafik kazası ve düşme sırasıyla %21,2, %6,5 oranlarında idi. En sık baş-boyun ve ekstremite yaralanmaları görülmüştür. Olguların %89,8'inin, darp şiddet olgularının ise %98,7'sinin acil polikliniğinde müdahale sonrası taburcu edildiği gözlendi. Konsültasyona hastaların çoğunda (%81,8) ihtiyaç duyulmadı. Yatışı yapılan 258 (%4,2) hastanın %32,6'sı trafik kazası, %19'u düşme olguları idi. Ancak ateşli silahla ve delici-kesici aletle yaralanan olguların yatış oranları (%16,7, %36,1) yüksekti. Hastaların %5,3'ü sevk edildi. Sevk edilen hastaların %41,5'i trafik kazası, %24,3'ü düşme olguları idi. Bununla birlikte yanık ve ateşli silahla yaralanma olguları arasında sevk daha yüksek oranda (%42,1, %24,1) idi. Yarısı trafik kazasından olmak üzere 48 (%0,8) hasta hayatını kaybetti. Ancak canına kastetmeye ve ateşli silahla yaralanmaya bağlı ölüm oranı (%8,3,%6) daha yüksek bulundu. SONUÇDarp şiddet olguları acil biriminde travma hastası yoğunluğuna neden olmaktadır. Yüksek darp şiddet oranı ile ilgili ileri çalışmalar gerekli gözükmektedir.

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Improving outcomes in a regional trauma system: impact of a level III trauma center

Cited by 22 publications

References 20 publications

Interfacility transfers in a non-trauma system setting: an assessment of the Greek reality

Interfacility transfers in a non-trauma system setting: an assessment of the Greek reality

Mitochondrial targeting by dichloroacetate improves outcome following hemorrhagic shock

Analysis of trauma patients in a rural hospital in Turkey

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