Pelvic trauma mortality reduced by integrated trauma care

Fitzgerald, Mark; Esser, Max; Russ, Matthias; Mathew, Joseph; Varma, Dinesh; Wilkinson, A; Mannambeth, Rejith V; Smit, Devilliers; Bernard, Stephen; Mitra, Biswadev

doi:10.1111/1742-6723.12820

Cited by 10 publications

(6 citation statements)

References 25 publications

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“…Furthermore, computer-aided diagnosis systems can be applied in institutes lacking specialists or can even be used in prehospital settings 34 . Evidence shows that early treatment for hip and pelvic fractures can reduce morbidity and mortality [3][4][5][35][36][37] . Rapid diagnosis is the key to achieving early damage control and providing definite treatment.…”

Section: Discussionmentioning

confidence: 99%

A scalable physician-level deep learning algorithm detects universal trauma on pelvic radiographs

Cheng

Wang²,

Chen

et al. 2021

Nat Commun

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Pelvic radiograph (PXR) is essential for detecting proximal femur and pelvis injuries in trauma patients, which is also the key component for trauma survey. None of the currently available algorithms can accurately detect all kinds of trauma-related radiographic findings on PXRs. Here, we show a universal algorithm can detect most types of trauma-related radiographic findings on PXRs. We develop a multiscale deep learning algorithm called PelviXNet trained with 5204 PXRs with weakly supervised point annotation. PelviXNet yields an area under the receiver operating characteristic curve (AUROC) of 0.973 (95% CI, 0.960–0.983) and an area under the precision-recall curve (AUPRC) of 0.963 (95% CI, 0.948–0.974) in the clinical population test set of 1888 PXRs. The accuracy, sensitivity, and specificity at the cutoff value are 0.924 (95% CI, 0.912–0.936), 0.908 (95% CI, 0.885–0.908), and 0.932 (95% CI, 0.919–0.946), respectively. PelviXNet demonstrates comparable performance with radiologists and orthopedics in detecting pelvic and hip fractures.

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Section: Discussionmentioning

confidence: 99%

A scalable physician-level deep learning algorithm detects universal trauma on pelvic radiographs

Cheng

Wang²,

Chen

et al. 2021

Nat Commun

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“…In Australia, they evaluated the effectiveness of holistic plans for pelvis trauma patients by comparing the prevalence and reported a change in the mortality figure from 20% to 7.7%. [20] Similarly, a 1-year prospective monocentric study suggested that prevention programs should be directed toward a specific population of men to prevent fractures in young individuals and women to prevent injuries in those above the age of sixty. [21] In Edmonton, a 5-year study evaluated the effectiveness of seatbelt legislation, which showed a reduction in the incidence and severity of AF.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of pelvis and acetabular fractures in Kuwait

Alhadhoud

Alsiri²,

Agamia

2021

JMSR

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Objectives: Pelvis fractures (PF) and acetabular fractures (AF) are major challenges in orthopedics. Epidemiological figures are not available for Kuwait, making it difficult to evaluate the success of future plans. This study aimed to analyze the epidemiology of pelvis and AF in Kuwait. Methods: A retrospective cross-sectional design was used by reviewing the Database of PF and AF of level II trauma center, Kuwait. Results: From October 2018 to September 2019, 2046 patients were admitted to the orthopedic wards of our hospital. PF prevalence was 3.66%; mean age (standard deviation) was 37.56 (18.09) years, and 74.5% were men. AF prevalence was 1.71%; mean age was 28.08 (17.77) years, and 71.6% were men. The most frequent mechanism of injury was motor vehicle accidents. Using the OTA/AO classification, the most frequent fracture of the PF was B1.1 fractures at 60.7%, and A1 fractures for AF at 80.0%. PF and AF were associated with other injuries in 54.4% and 38.2%, respectively. In terms of management, 24.3% of the patients with PF were managed operatively and the reported complications were metal failure (2.7%), post-operative infection (1.4%), and wound dehiscence (1.4%). The management of AF was operative in 54.3%, and the identified complication was only metal failure (2.9%). The mortality of PF was 2.7% and 0.0% for AF. Variables related to the ICU length of stay, mortality, and postoperative complications were explored. Conclusion: The epidemiological figures explored could help determine PF and AF’s burden in Kuwait and direct future management and preventive plans.

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“…The patient group considered most likely to benefit were those with pelvic fractures and shock. However, since the introduction of pelvic fracture guidelines, the widespread use of pelvic binders and pre‐hospital transfusion of blood on Ambulance Victoria helicopters (but not road ambulances), few of these patients arrived shocked . The impact of sophisticated pre‐hospital shock management for a predominantly blunt trauma cohort was demonstrated by the relatively low incidence, on hospital arrival, of haemodynamic instability among the severely injured, blunt trauma patients in this study.…”

Section: Discussionmentioning

confidence: 74%

Feasibility study for implementation of resuscitative balloon occlusion of the aorta in peri‐arrest, exsanguinating trauma at an adult level 1 Australian trauma centre

Fitzgerald

Lendrum

Bernard

et al. 2019

Emerg Medicine Australasia

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Objective: This prospective, observational, interventional study sought to determine if the introduction of resuscitative balloon occlusion of the aorta (REBOA) at an Australian adult major trauma centre would improve survival for major trauma patients. Methods: Patients aged 18-60 years, transported directly from scene with exsanguinating, sub-diaphragmatic haemorrhage and hypovolaemic shock (systolic BP <70 mmHg or

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Pelvic trauma mortality reduced by integrated trauma care

Cited by 10 publications

References 25 publications

A scalable physician-level deep learning algorithm detects universal trauma on pelvic radiographs

A scalable physician-level deep learning algorithm detects universal trauma on pelvic radiographs

The epidemiology of pelvis and acetabular fractures in Kuwait

Feasibility study for implementation of resuscitative balloon occlusion of the aorta in peri‐arrest, exsanguinating trauma at an adult level 1 Australian trauma centre

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