Is trauma in Switzerland any different? Epidemiology and patterns of injury in major trauma – a 5-year review from a Swiss trauma centre

Heim, Catherine; Bosisio, Francesca; Roth, Audrey J.; Bloch, Jocelyne; Borens, Olivier; Daniel, Roy Thomas; Denys, Alban; Oddo, Mauro; Pasquier, Mathieu; Schmidt, Sabine; Schoettker, Patrick; Zingg, Tobias; Jb, Wasserfallen

doi:10.4414/smw.2014.13958

Cited by 43 publications

(50 citation statements)

References 37 publications

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“…Catherine Heim et al found that the main traumatic mechanism was 40.4% of road accidents motivating this difference from the other studies, due to the fact that the hospital in which the study was conducted was located in the proximity of one of Switzerland's most circulated motorways [8,32,29].…”

Section: Resultscontrasting

confidence: 50%

Clinical diagnosis versus autopsy diagnosis in head trauma

Velnic¹,

Hanganu²,

Ciudin³

et al. 2017

Romanian Neurosurgery

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Abstract:The correct and complete diagnosis is essential for the adequate care and the favourable clinical evolution of the patients with head trauma. Purpose: To identify the error rate in the clinical diagnosis of head injuries as shown in comparison with the autopsy diagnosis and to identify the most common sources of error. Material and method: We performed a retrospective study based on data from the medical files and the autopsy reports of patients with head trauma who died in the hospital and underwent forensic autopsy. We collected: demographic data, clinical and laboratory data and autopsy findings. To quantify the concordance rate between the clinical diagnosis of death and the autopsy diagnosis we used a 4 classes classification, which ranged from 100% concordance (C1) to total discordance (C4) and two classes of partial discordance: C2 (partial discordance in favour of the clinical diagnosis-missing injuries in the autopsy reports) and C3 (partial discordance in favor of the necroptic diagnosis-missing injuries in the medical files). Data were analyzed with SPSS version 20.0. Results: We analyzed 194 cases of death due to head injuries. We found a total concordance between the clinical death diagnosis and autopsy diagnosis in 30.4% of cases and at least one discrepancy in 69.6% of cases. Increasing the duration of hospitalization directly correlates with the amount of the imaging investigations and these in turn correlates with an increased rate of diagnosis concordance. Among the patients with stage 3 coma who associated a spinal cord injury, we found a partial diagnosis discordance in 50% of cases and a total discordance in 50% of cases, possibly due to the need for conducting emergency imaging investigation and the need for surgical treatment. In cases with partial and total discordant diagnosis, at least one lesion was omitted in 45.1% of the cases. The most commonly omitted injuries in C2 cases were subdural hematoma, intracerebral hematoma and ventricular hemorrhage (21.6%). In C3 cases the most frequently omitted injuries were subarachnoidian hemorrhage and skull base fractures autopsy diagnosis. Autopsy may identify the inconsistencies in diagnosis, the injuries frequently skipped and the factors favoring the discordance rate between the clinical death diagnosis and the autopsy diagnosis, making it a valuable tool for improving the clinical care of the patients with head trauma.

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Section: Resultscontrasting

confidence: 50%

Clinical diagnosis versus autopsy diagnosis in head trauma

Velnic¹,

Hanganu²,

Ciudin³

et al. 2017

Romanian Neurosurgery

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“…The results of the present study and other studies indicate that blunt chest trauma commonly occurs in young males. Heim et al performed an epidemiological study, indicating that the patients' mean age was 41.4 years and that they were predominantly male (23). The high prevalence of traumatic injuries in young males can be due to the increased use of cars or motorcycles as the means of transportation.…”

Section: Discussionmentioning

confidence: 99%

Blunt Thoracic Injury Mortality and Clinical Presentation

Yadollahi¹,

Arabi²,

Mahmoudi³

et al. 2018

Trauma Mon

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Background: Blunt thoracic trauma is the third most common injury in poly-trauma patients following head and extremities injuries; this study aimed at investigating the prevalence of blunt chest trauma and its injury pattern, mechanism of injury, length of hospital stay, treatment period, and risk factors. Methods: In this cross-sectional study, 7,410 patients, who referred to Shahid Rajaee hospital, during years 2010 to 2014 were selected through census sampling. The participants' demographic data, mechanism of injury, type of thoracic injury, location of fracture, length of stay, and injury severity scores (ISS) were recorded.Results: Most patients were male (5498, 74.2%), 63.3% were 15 to 40 years old, and their mean age was 37.53 ± 0.21 years. The most commonly reported mechanism of injury was car accident (2,999, 40.5%) followed by falls (1,529,20.6%, and motorbike accidents (964, 13.1%). Head, neck and thorax injuries were most common comorbidities in thorax trauma patients. The mortality rate was 1.5%. Indeed, the patients, who had rib fracture (P = 0.01) (OR3.66, CI [1.36 -9.82]), and multiple injuries of thorax (P < 0.001) (OR 8.10,.73]), had a higher mortality risk. Conclusions:The risk of blunt thoracic injuries was higher among specific types of injuries. Additionally, patients with blunt chest trauma, who had the risk factors of mortality required preventative measures and careful management in order to prevent traumarelated deaths.Keywords: Thoracic Injuries, Trauma, Blunt BackgroundTrauma is the leading cause of death in patients under 40 years of age (1) and the fourth leading cause of death globally (2, 3). World health organization (WHO) announced in 2004 that trauma was the fourth main cause of death in Iran, and would turn into the third cause of death by 2020 (4).With regards to the prevalence of thoracic trauma compared to other types of trauma, it is an important cause of morbidity and mortality, which has led to approximately 25% of trauma-related deaths in the United States (5). Thoracic trauma is the third most frequent injury after head and extremities in patients with multiple trauma (5). In addition, approximately 0.06% of disability cases per year are caused by chest trauma (6). Blunt thoracic injuries are the third most common injury in poly-trauma patients following head and extremities trauma (7). Blunt chest trauma is directly responsible for 25% of all trauma deaths (8).Generally, more than 50% of blunt chest trauma cases occur in fatal accidents and a large number of them are caused by motor vehicle crashes (63% to 78%), followed by falls, blows from blunt objects, or explosive devices (10% to 17%) (9).Blunt traumatic injuries (BTI) represent a high incidence of morbidity and mortality worldwide (10). The most common mechanisms of blunt trauma are road traffic accidents (RTAs), falls, and being struck by heavy objects (11,12).Patients with blunt chest trauma may be at a significant risk of developing respiratory failure (13). Some studies have also reported that up to ...

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“…Traumatic injury is life threatening and it is the fourth leading cause of death in high-income countries [1, 2]. Trauma-induced coagulopathy (TIC) is recognized as an early hypocoagulable state leading to exacerbation of bleeding and associated with fourfold-increased mortality among severely injured patients [3].…”

Section: Introductionmentioning

confidence: 99%

Overexpression of miR-24 Is Involved in the Formation of Hypocoagulation State after Severe Trauma by Inhibiting the Synthesis of Coagulation Factor X

et al. 2017

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Background Dysregulation of microRNAs may contribute to the progression of trauma-induced coagulopathy (TIC). We aimed to explore the biological function that miRNA-24-3p (miR-24) might have in coagulation factor deficiency after major trauma and TIC. Methods 15 healthy volunteers and 36 severe trauma patients (Injury Severity Score ≥ 16 were enrolled. TIC was determined as the initial international normalized ratio >1.5. The miR-24 expression and concentrations of factor X (FX) and factor XII in plasma were measured. In vitro study was conducted on L02 cell line. Results The plasma miR-24 expression was significantly elevated by 3.17-fold (P = 0.043) in major trauma patients and reduced after 3 days (P < 0.01). The expression level was significantly higher in TIC than in non-TIC patients (P = 0.040). Multivariate analysis showed that the higher miR-24 expression was associated with TIC. The plasma concentration of FX in TIC patients was significantly lower than in the non-TIC ones (P = 0.030) and controls (P < 0.01). A negative correlation was observed between miR-24 and FX. miR-24 transduction significantly reduced the FX level in the supernatant of L02 cells (P = 0.030). Conclusions miR-24 was overexpressed in major trauma and TIC patients. The negative correlation of miR-24 with FX suggested the possibility that miR-24 might inhibit the synthesis of FX during TIC.

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Is trauma in Switzerland any different? Epidemiology and patterns of injury in major trauma – a 5-year review from a Swiss trauma centre

Cited by 43 publications

References 37 publications

Clinical diagnosis versus autopsy diagnosis in head trauma

Clinical diagnosis versus autopsy diagnosis in head trauma

Blunt Thoracic Injury Mortality and Clinical Presentation

Overexpression of miR-24 Is Involved in the Formation of Hypocoagulation State after Severe Trauma by Inhibiting the Synthesis of Coagulation Factor X

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