Injury patterns and outcomes of trauma in the geriatric population presenting to the emergency department in a tertiary care hospital of South India

Abhilash, Kundavaram Paul Prabhakar; Tephilah, R; Pradeeptha, Sharon; Gunasekaran, Karthik; Chandy, Gina Maryann

doi:10.4103/jets.jets_79_18

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…During the development phase of this study, we analysed the variables used in the existing severity scales or potential prognostic indicators that had been independently assessed in trauma patients [19–23]. Considering that this process satisfied pathophysiological plausibility and was predicated by previous studies, we believe that our novel scoring index can be adopted across trauma centres in different countries for the benefit of MVC victims and patients.…”

Section: Discussionmentioning

confidence: 99%

“…The primary outcome was entered in the model as a dependent variable and potential predictive variables were selected from known survival predictors in trauma victims and other clinical variables relevant to MVC [11–13,19–22]. Owing to clinical plausibility and practicality, age and vital signs were transformed to binary variables as follows: age (< 80 or ≥80 years) [23], GCS(≤13 or ≥14), systolic blood pressure (sBP; <110 or ≥110 mmHg) [22], heart rate (HR; <100 or ≥100 bpm), respiratory rate (RR; <22 or ≥22 /min).…”

Section: Methodsmentioning

confidence: 99%

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A novel scoring system to predict the requirement for surgical intervention in victims of motor vehicle crashes: Development and validation using independent cohorts

2019

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BackgroundGiven that there are still considerable number of facilities which lack surgical specialists round the clock across the world, the ability to estimate the requirement for emergency surgery in victims of motor vehicle crashes (MVCs) can ensure appropriate resource allocation. In this study, a surgical intervention in victims of MVC (SIM) score was developed and validated, using independent patient cohorts.MethodsWe retrospectively identified MVC victims in a nationwide trauma registry (2004–2016). Adults ≥ 15 years who presented with palpable pulse were included. Patients with missing data on the type/date of surgery were excluded. Patient were allocated to development or validation cohorts based on the date of injury. After missing values were imputed, predictors of the need for emergency thoracotomy and/or laparotomy were identified with multivariate logistic regression, and scores were then assigned using odds ratios. The SIM score was validated with area under the receiver operating characteristic curve (AUROC) and calibration plots of SIM score-derived probability and observed rates of emergency surgery.ResultsWe assigned 13,328 and 12,348 patients to the development and validation cohorts, respectively. Age, motor vehicle collision and vital signs on hospital arrival were identified as independent predictors for emergency thoracotomy and/or laparotomy, and SIM score was developed as 0–9 scales. The score has a good discriminatory power (AUROC = 0.79; 95% confidence interval = 0.77–0.81), and both estimated and observed rates of emergency surgery increased stepwise from 1% at a score ≤ 1 to almost 40% at a score ≥ 8 with linear calibration plots.ConclusionsThe SIM score was developed and validated to accurately estimate the need for emergent thoracotomy and/or laparotomy in MVC victims.

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Section: Discussionmentioning

confidence: 99%