Preventable and Potentially Preventable Traumatic Death Rates in Neurosurgery Department: A Single Center Experience

Ha, Mahnjeong; Kim, Byung Chul; Choi, Seon-Uoo; Cho, Won Ho; Choi, Hyuk Jin

doi:10.13004/kjnt.2016.12.2.67

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…Additionally, the death rate in men was significantly higher compared to women. Many findings support our data; some authors reported an increased level of mortality with age and gender; higher level in men with TBI was found [ 12 – 14 ].…”

Section: Discussionsupporting

confidence: 90%

The Influence of Heavy Metals and Trace Elements on Comatose Patients with Severe Traumatic Brain Injury in the First Week of Admission

Belatar¹,

Elabidi²,

Barkiyou³

et al. 2018

Journal of Toxicology

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Purpose The aim of this study is to investigate the possible role of heavy metals (lead and cadmium) and imbalance of trace elements (chromium, iron, zinc, copper, and manganese) in death among patients with severe traumatic brain injury. Material and Methods A case-control study was conducted with 64 comatose patients with severe TBI, in the Department of Anesthesiology and Reanimation, Ibn Sina University Hospital and Hospital of Specialties in Rabat, Morocco; 22 healthy volunteers were recruited in Blood Transfusion Center of Rabat. Blood samples were collected from TBI patients, in the first week (3h after admission and each 48h during one week) and from healthy volunteers one time. Concentration of heavy metals and trace elements in serum was determined by electrochemical atomic absorption spectrometry. Statistical analysis was performed using Statistical software (SPSS) and the cases and controls were compared using the Mann–Whitney U test and Student's t-test for cadmium according to gender and final evolution. A P-value <0.05 was considered to be statistically significant. Results Our data showed that the difference of heavy metals concentration (lead and cadmium) between patients and healthy subjects was not statistically significant. However, the difference of some trace elements concentration (iron, copper, chromium, and selenium) between patients and healthy subjects was statistically significant. According to the final evolution, the concentration of manganese was higher in dead patients and statistically significant (p = 0.04) for heavy metals; the concentration of lead was not statistically significant while the concentration in cadmium was statistically significant (p = 0.004). By sex, lead and cadmium were statistically significant, respectively p = 0.02, p = 0.001, and cadmium was higher in women, while lead was higher in men. Conclusion Among all studied heavy metals (lead and cadmium) and trace elements (iron, zinc, copper, selenium, chromium, and manganese), manganese and cadmium may play a role in the death of patients from severe traumatic brain injury.

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Section: Discussionsupporting

confidence: 90%

The Influence of Heavy Metals and Trace Elements on Comatose Patients with Severe Traumatic Brain Injury in the First Week of Admission

Belatar¹,

Elabidi²,

Barkiyou³

et al. 2018

Journal of Toxicology

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“…traumatic brain injury (TBI), and exsanguination are recognised as the most frequent time-sensitive pathologies and account for approximately 70% of all trauma-related deaths within the acute phase after impact [6,7]. Rapid exsanguination has also been identified as the most common cause of preventable death after trauma, even during the prehospital phase of care [7][8][9], and this is frequently due to a delay in treatment (52.9% of cases in one study [10]). These epidemiological data underline the important burden that trauma continues to exercise on healthcare systems, society and individuals.…”

Section: Causes Mechanisms and Timing Of Deaths In Traumamentioning

confidence: 99%

“…When in-hospital time for diagnostic procedures is added-for example, the time to access either whole body or selected computed tomography (CT)-the injured patient rarely receives interventional/surgical care before 2-3 h after the initial impact and this at best. Some of this delay is related to the fragmentation of pre-and intra-hospital care, including time-consuming and anachronistic methods and errors in communication [8,25,26].…”

Section: Efficient Management Of Severe Trauma: a Time-sensitive Approachmentioning

confidence: 99%

Streamlining pre- and intra-hospital care for patients with severe trauma: a white paper from the European Critical Care Foundation

Longrois

Maegele

Bersini

et al. 2018

Eur J Trauma Emerg Surg

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Purpose Major trauma remains a significant cause of morbidity and mortality in the developed and developing world. In 2013, nearly 5 million people worldwide died from their injuries, and almost 1 billion individuals sustained injuries that warranted some type of healthcare, accounting for around 10% of the global burden of disease in general. Behind the statistics, severe trauma takes a major toll on individuals, their families and healthcare systems. Management of the patient with severe trauma requires multiple interventions in a highly time-sensitive context and fragmentation of care, characterised by loss of information and time among disciplines, departments and individuals, both outside the hospital and within it, is frequent. Outcomes may be improved by better streamlining of pre-and intra-hospital care. Methods We describe the basis for development of a multi-stakeholder consortium by the European Critical Care Foundation working closely with a number of European Scientific Societies to address and overcome problems of fragmentation in the care of patients with severe trauma. Result The consortium will develop and introduce an information management system adapted to severe trauma, which will integrate continuous monitoring of vital parameters and point-of-care diagnostics. The key innovation of the project is to harness the power of information technologies and artificial intelligence to provide computer-enhanced clinical evaluation and decision-support to streamline the multiple points at which information and time are potentially lost. Conclusions The severe trauma management platform thus created could have multiple benefits beyond its immediate use in managing the care of injured patients.

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“…Furthermore, patients with a contralateral intracranial hemorrhage after a decompressive craniectomy have a worse prognosis than those with uneventful recoveries. 4 20 22 23) Identifying risk factors for postoperative contralateral hemorrhage (PCH) could help establish a treatment strategy and predict the prognosis of TBI patients. Therefore, the objective of this study was to identify risk factors for PCH in patients who underwent a unilateral craniectomy or craniotomy due to TBI.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Postoperative Contralateral Hemorrhage in Patients With Traumatic Brain Injury who Underwent Surgical Treatment: A Multicenter Study

Jung

Yun

Lee

2023

Korean J Neurotrauma

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Objective Patients with a contralateral intracranial hemorrhage after decompressive craniectomy have a worse prognosis than those whose recovery is uneventful. Therefore, the objective of this study was to identify risk factors for postoperative contralateral hemorrhage (PCH) in patients who underwent unilateral craniectomy or craniotomy due to a traumatic brain injury (TBI). Methods Data were obtained from the Korean Neuro-Trauma Data Bank System and retrospectively reviewed. Patients who had a unilateral craniectomy or craniotomy for acute TBI were included in this study. Clinical outcomes of a PCH group and an uneventful group were compared and the risk factors for PCH were identified using regression analysis. Results A total of 326 patients were included in this study. PCH was observed in 25 (7.7%) patients. The Glasgow coma scale (GCS) and Glasgow outcome scale extended (GOSE) scores at discharge were significantly lower in the PCH group than those in the uneventful group (GCS: 3.6 vs. 6.2, p =0.043; GOSE: 2.1 vs. 3.2, p =0.032). In the multivariable regression analysis, when the time from injury to surgery was shorter than 150 minutes, the risk of PCH was increased by 4.481 times ( p =0.005). When the intraoperative transfusion volume was more than 1.5 L, the risk of PCH was increased by 4.843 times ( p =0.003). Conclusion The risk of PCH is increased when the time from injury to surgery is shorter than 150 minutes and when the intraoperative transfusion volume is greater than 1.5 L. Neurosurgeons must predict and be prepared for the development of PCH in high-risk patients.

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Preventable and Potentially Preventable Traumatic Death Rates in Neurosurgery Department: A Single Center Experience

Cited by 4 publications

References 14 publications

The Influence of Heavy Metals and Trace Elements on Comatose Patients with Severe Traumatic Brain Injury in the First Week of Admission

The Influence of Heavy Metals and Trace Elements on Comatose Patients with Severe Traumatic Brain Injury in the First Week of Admission

Streamlining pre- and intra-hospital care for patients with severe trauma: a white paper from the European Critical Care Foundation

Risk Factors for Postoperative Contralateral Hemorrhage in Patients With Traumatic Brain Injury who Underwent Surgical Treatment: A Multicenter Study

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