Opportunities for improvement in the management of patients who die from haemorrhage after trauma

O’Reilly, Derek; Mahendran, K; West, Anita; Shirley, Peter; Walsh, Mark; Tai, Nigel

doi:10.1002/bjs.9096

Cited by 35 publications

(29 citation statements)

References 21 publications

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“…The development of performance improvement programmes for specialist trauma services identifies opportunities for improvement and reduces preventable death rates in this setting. 31,32 Supported by these findings, the revised NHS Operating Framework for 2011-2012 stated that all regions should move towards networks for trauma. 33 The setup of a majority of regional trauma networks was already in place by April 2012.…”

Section: 13mentioning

confidence: 98%

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

O’Reilly

Bouamra

Kausar

et al. 2015

annals

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INTRODUCTION Pancreatoduodenal (PD) injury is an uncommon but serious complication of blunt and penetrating trauma, associated with high mortality. The aim of this study was to assess the incidence, mechanisms of injury, initial operation rates and outcome of patients who sustained PD trauma in the UK from a large trauma registry, over the period . METHODS The Trauma Audit and Research Network database was searched for details of any patient with blunt or penetrating trauma to the pancreas, duodenum or both. RESULTS Of 356,534 trauma cases, 1,155 (0.32%) sustained PD trauma. The median patient age was 27 years for blunt trauma and 27.5 years for penetrating trauma. The male-to-female ratio was 2.5:1. Blunt trauma was the most common type of injury seen, with a ratio of blunt-to-penetrating PD injury ratio of 3.6:1. Road traffic collision was the most common mechanism of injury, accounting for 673 cases (58.3%). The median injury severity score (ISS) was 25 (IQR: 14-35) for blunt trauma and 14 (IQR: 9-18) for penetrating trauma. The mortality rate for blunt PD trauma was 17.6%; it was 12.2% for penetrating PD trauma. Variables predicting mortality after pancreatic trauma were increasing age, ISS, haemodynamic compromise and not having undergone an operation. CONCLUSIONS Isolated pancreatic injuries are uncommon; most coexist with other injuries. In the UK, a high proportion of cases are due to blunt trauma, which differs from US and South African series. Mortality is high in the UK but comparison with other surgical series is difficult because of selection bias in their datasets.

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Section: 13mentioning

confidence: 98%

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

O’Reilly

Bouamra

Kausar

et al. 2015

annals

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show abstract

“…Le contrô le de la volé mie, le choix des soluté s de remplissage et des produits sanguins labiles ainsi que la gestion de la normothermie font l'objet de recommandations pour amé liorer la survie des patients victimes d'hé morragie, notamment durant les premiè res heures de la prise en charge [4][5][6][7][8]. L'emploi de l'acide tranexamique dans les trois premiè res heures de la prise en charge d'un patient traumatisé a dé montré son efficacité sur la ré duction de la mortalité dans l'é tude multicentrique randomisé e CRASH-2 [9].…”

Section: Introductionunclassified

Équipement des Smur pour la prise en charge préhospitalière du choc hémorragique : peut mieux faire !

Vardon¹,

Bounes²,

Ducassé³

et al. 2014

Annales Françaises d'Anesthésie et de Réanimation

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“…Quanto ao período de permanência dos pacientes no ambiente hospitalar variou de 00 a 1.111 dias, sendo que, houve predominância do período compreendido de 00 a 10 dias (57,0% (14) . Existe uma questão multifatorial (15)(16)(17) relacionada à mortalidade de pacientes vítimas de traumas tais como: a gravidade do trauma sofrido e ao estado crítico que o usuário chega à unidade hospitalar. Assim como fatores relacionados aos extremos etários; as doenças pré-existentes ao trauma, bem como as condições envolvidas no contexto extra e intra-hospitalar a saber: a espera pelo primeiro atendimento, o transporte e toda a conjuntura hospitalar, de leitos especializados e a preparação dos profissionais que prestam os cuidados críticos (15) .…”

Section: Discussionunclassified

Time of internment and outcome of trauma victims for external causes / Tempo de internamento e desfecho de vítimas de traumas por causas externas / Estancia en el hospital y desenlace de las víctimas de trauma de causas externas

et al. 2016

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Objective: To characterize patients who are victims of trauma due to external causes regarding hospitalization time and outcome of a tertiary hospital in Fortaleza / CE. Method: descriptive, quantitative, documentary and retrospective study. Sample of 151 medical records. The research took place in the period from February to September 2016, through a pre-elaborated form. The project was approved by the institution's Ethics Committee. Data later analyzed by the Statistical Package of Social Sciences (SPSS) software. Results: Most of the patients in the study are from other municipalities of Ceará. Motorcycle accidents were the main cause of hospitalizations. Regarding the time of permeation in the hospital, it was a period of 0 to 10 days, in most cases. It should be noted that this number ZERO (0) is due to the patients who are admitted to the hospital but did not complete nor 24 hours of hospitalization and died. The period varied from 0 to 1,111 days. Conclusion: The high percentage of deaths demonstrates, in part, the severity of these cases. Keywords: Emergencies; Trauma; Critical Patients. RESUMO Objetivo: Caracterizar pacientes vítimas de traumas por causas externas quanto ao tempo de internamento e desfecho de um hospital terciário de Fortaleza/CE. Método: estudo descritivo, quantitativo, documental e retrospectivo. Amostra de 151 prontuários. A pesquisa ocorreu no período de fevereiro a setembro de 2016, por meio de um formulário pré-elaborado. O projeto foi aprovado pelo Comitê de Ética da instituição. Dados posteriormente analisados pelo software Statistical Package of Social Sciences (SPSS). Resultados: A maioria dos pacientes em estudo é oriundo de outros municípios cearenses. Os acidentes de moto foram a principal causa dos internamentos. Em se tratando do tempo de permeância no hospital, tratou-se de um período de 0 a 10 dias, na maioria dos casos. Cabe ressaltar que esse número ZERO (0) se deve aos pacientes que são admitidos no hospital mas não completaram nem 24 horas de internamento e foram à óbito. Sendo que o período variou de 0 a 1.111 dias. Conclusão: O alto percentual de óbitos demonstra, em parte, a gravidade desses casos. Descritores: Emergências; Trauma; Pacientes críticos. RESUMEN Objetivo: Caracterizar los pacientes víctimas de trauma por causas externas como la duración de la estancia hospitalaria y el resultado de un hospital terciario de Fortaleza/CE. Método: Estudio descriptivo, cuantitativo, documental y retrospectivo. La muestra de 151 registros. La investigación se llevó a cabo en el período de febrero a septiembre de 2016, a través de un formulario previamente preparado. El proyecto fue aprobado por el Comité de Ética de la institución. Los datos analizados posteriormente por el software Statistical Package for the Social Sciences (SPSS). Resultados: La mayoría de los pacientes en el estudio provienen de otros municipios de Ceará. Los accidentes de motocicleta fueron la principal causa de ingresos hospitalarios. En términos de la permeancia de tiempo en el hospital, s...

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Opportunities for improvement in the management of patients who die from haemorrhage after trauma

Cited by 35 publications

References 21 publications

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

The Epidemiology of and Outcome from Pancreatoduodenal Trauma in the UK, 1989–2013

Équipement des Smur pour la prise en charge préhospitalière du choc hémorragique : peut mieux faire !

Time of internment and outcome of trauma victims for external causes / Tempo de internamento e desfecho de vítimas de traumas por causas externas / Estancia en el hospital y desenlace de las víctimas de trauma de causas externas

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