Pattern and spectrum of tornado injury and its geographical information system distribution in Yancheng, China: a cross-sectional study

Deng, Qiangyu; Lv, Yipeng; Xue, Chen; Kang, Pengde; Dong, Junqiang; Zhang, Lulu

doi:10.1136/bmjopen-2018-021552

Cited by 10 publications

(10 citation statements)

References 34 publications

(41 reference statements)

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“…We have conducted our simulations with respect to different distributions of AIS grades reported in the literature. In addition to the distribution for victims of motor vehicles accidents, reported by Baker et al [ 1 ] and reproduced in Table 1 , we consider the distributions of AIS grades for 174 adult victims of fall accidents reported by Lopes et al in [ 21 ], 451 patients with tornado-related injuries reported by Deng et al in [ 22 ] 2 , and 278 victims of traumatic maternal injuries reported by Awoleke et al in [ 23 ]. The details of each distribution are reproduced in Table 10 and the code in Appendix A .…”

Section: Resultsmentioning

confidence: 99%

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The injury severity score: an operations perspective

Dehouche

2022

BMC Med Res Methodol

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Background The statistical evaluation of aggregation functions for trauma grades, such as the Injury Severity Score (ISS), is largely based on measurements of their Pearson product-moment correlation with mortality. However, correlation analysis makes assumptions about the nature of the involved random variables (cardinality) and their relationship (linearity) that may not be applicable to ordinal scores such as the ISS. Moreover, using correlation as a sole evaluation criterion neglects the dynamic properties of these aggregation functions scores. Methods We analyze the domain and ordinal properties of the ISS comparatively to arbitrary linear and cubic aggregation functions. Moreover, we investigate the axiomatic properties of the ISS as a multicriteria aggregation procedure. Finally, we use a queuing simulation with various empirical distributions of Abbreviated Injury Scale (AIS) grades reported in the literature, to evaluate the queuing performance of the three aggregation functions. Results We show that the assumptions required for the computation of Pearson’s product-moment correlation coefficients are not applicable to the analysis of the association between the ISS and mortality. We suggest the use of Mutual Information, a information-theoretic statistic that is able to assess general dependence rather than a specialized, linear view based on curve-fitting. Using this metric on the same data set as the seminal study that introduced the ISS, we show that the sum of cubes conveys more information on mortality than the ISS. Moreover, we highlight some unintended, undesirable axiomatic properties of the ISS that can lead to bias in its use as a patient triage criterion. Lastly, our queuing simulation highlights the sensitivity of the queuing performance of different aggregation procedures to the underlying distribution of AIS grades among patients. Conclusions Viewing the ISS, and other possible aggregation functions for multiple AIS scores, as mere operational indicators of the priority of care, rather than cardinal measures of the response of the human body to multiple injuries (as was conjectured in the seminal study introducing the ISS) offers a perspective for their construction and evaluation on more robust grounds than the correlation coefficient. In this regard, Mutual Information appears as a more appropriate measure for the study of the association between injury severity and mortality, and queuing simulations as an actionable way to adapt the choice of an aggregation function to the underlying distribution of AIS scores.

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Section: Resultsmentioning

confidence: 99%

“…The data used in the current study are available in references [ 1 ], [ 21 ], [ 22 ], and [ 23 ]. The source code for the queuing simulation is provided in the R language, in Appendix A .…”

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confidence: 99%

The injury severity score: an operations perspective

Dehouche

2022

BMC Med Res Methodol

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“…The severity of the tornado caused a large number of tornado-related deaths in China. 5,6 After the tornado, a large number of patients were sent to the hospital within a short period of time, placing great demands on medical resources. Injuries to the thorax during the tornado were common and presented a major challenge to the emergency medical staff.…”

Section: Discussionmentioning

confidence: 99%

Profile of Chest Injuries and Oxygen Therapy in Trauma Patients with Acute Respiratory Failure after the Jiangsu Tornado in China: A Retrospective Study

et al. 2020

Prehosp. Disaster med.

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Background:The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.Methods:The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.Results:Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.Conclusions:Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.

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“…In total, 29,371 houses, 2 primary schools, and 8 factories were damaged; more than 50,000 people were directly affected by the tornado [4]. This tornado was one of the largest disasters in recent decades in Jiangsu Province, and the deadliest tornado in China in nearly half a century [2, 5]. In the afternoon on August 11, 2017, a Fujita 3 (F-3, which is similar to EF-3) [6] tornado hit Keshiketeng County and Wengniute County in Chifeng City, Inner Mongolia (Fig.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with injuries among tornado victims in Yancheng and Chifeng, China

Deng¹,

Lv²,

Zhao

et al. 2019

BMC Public Health

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BackgroundAs extremely violent meteorological disasters, tornadoes often cause serious casualties. The study aims to analyze the characteristics and causes of tornado injuries in China under certain humanistic and geographical conditions.MethodsA random sampling questionnaire survey was developed and distributed to tornado victims from two separate occurrences: an Enhanced Fujita 4 tornado in Yancheng, and a Fujita 3 tornado in Chifeng. The information of demographic characteristics, disaster environment, and individual behaviors in victims was collected. Chi-square test and binary logistic regression were used to analyze influencing factor of injuries.ResultsA total of 94 valid questionnaires (participation rate 95.9%) were finally collected in Yancheng tornado and 67 valid questionnaires (participation rate 93.1%) in Chifeng tornado. Residents’ annual income (OR = 0.10, 95% CI 0.02–0.50, P = 0.005), degree of house collapse (OR = 183.12, 95% CI 8.04–4173.34, P = 0.001) have a significant impact on the probability of injury. Differences in tornado disaster drill awareness (P = 0.009), individual behaviors (P = 0.011) and fear level (P = 0.011) significantly affected the incidence of trauma. Whether victims were indoors or not has no statistical difference on injuries in China.ConclusionsOur study clarifies risk factors and is conducive to the expansion of the investigation in tornado casualties. The government should improve the wind-resistance of residential buildings. Victims should participate in disaster prevention drills to take effective disaster avoidance actions.

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Pattern and spectrum of tornado injury and its geographical information system distribution in Yancheng, China: a cross-sectional study

Cited by 10 publications

References 34 publications

The injury severity score: an operations perspective

The injury severity score: an operations perspective

Profile of Chest Injuries and Oxygen Therapy in Trauma Patients with Acute Respiratory Failure after the Jiangsu Tornado in China: A Retrospective Study

Factors associated with injuries among tornado victims in Yancheng and Chifeng, China

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