Time‐Based Trauma‐Related Mortality Patterns in a Newly Created Trauma System

Abdelrahman, Husham; El‐Menyar, Ayman; Al-Thani, Hassan; Consunji, Rafael; Zarour, Ahmad; Peralta, Rubén; Parchani, Ashok; Latifi, Rifat

doi:10.1007/s00268-014-2705-x

Cited by 28 publications

(58 citation statements)

References 52 publications

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“…In our center, 53.5% of mortalities occurred within 48 h of admission (early death). This is in agreement with findings of other studies 23, 29. From 2011 to 2014, the proportion of deaths occurring within 48 h of admission increased significantly from 50% to 57%.…”

Section: Discussionsupporting

confidence: 93%

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Yadollahi

Ghiassee

Anvar

et al. 2017

Chinese Journal of Traumatology

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PurposeThe administrative data from trauma centers could serve as potential sources of invaluable information while studying epidemiologic features of car accidents. In this cross-sectional analysis of Shahid Rajaee hospital administrative data, we aimed to evaluate patients injured in car accidents in terms of age, gender, injury severity, injured body regions and hospitalization outcome in the recent four years (2011–2014).MethodsThe hospital registry was accessed at Shiraz Trauma Research Center (Shiraz, Iran) and the admission's unit data were merged with the information gathered upon discharge. A total number of 27,222 car accident patients aged over 15 years with International Classification of Diseases 10th revision (ICD-10) external causes of injury codes (V40.9-V49.9) were analyzed. Injury severity score and injured body regions were determined based on converting ICD-10 injury codes to Abbreviated Injury Scale (AIS-98) severity codes using a domestically developed electronic algorithm. A binary logistic regression model was applied to the data to examine the contribution of all independent variables to in-hospital mortality.ResultsMen accounted for 68.9% of the injuries and the male to female ratio was 2.2:1. The age of the studied population was (34 ± 15) years, with more than 77.2% of the population located in the 15–45 years old age group. Head and neck was the most commonly injured body region (39.0%) followed by extremities (27.2%). Injury severity score (ISS) was calculated for 13,152 (48.3%) patients, of whom, 80.9% had severity scores less than 9. There were 332 patients (1.2%) admitted to the intensive care units and 422 in-hospital fatalities (1.5%) were recorded during the study period. Age above 65 years [OR = 7.4, 95% CI (5.0–10.9)], ISS above 16 [OR = 9.1, 95% CI (5.5–14.9)], sustaining a thoracic injury [OR = 7.4, 95% CI (4.6–11.9)] and head injury [OR = 4.9, 95% CI (3.1–7.6)] were the most important independent predictors of death following car accidents.ConclusionHospital administrative databases of this hospital could be used as reliable sources of information in providing epidemiologic reports of car accidents in terms of severity and outcomes. Improving the quality of recordings at hospital databases is an important initial step towards more comprehensive injury surveillance in Fars, Iran.

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Section: Discussionsupporting

confidence: 93%

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Yadollahi

Ghiassee

Anvar

et al. 2017

Chinese Journal of Traumatology

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“…Advancements in pre-hospital and in-hospital quality of care and prevention of septic complications in prolonged hospitalizations have led to a steady decrease in late hospital deaths over time. The trimodal distribution of deaths, therefore, has changed to bimodal distribution in the western world (36,41) and even in high-income neighboring countries (42). In Iran, however, late in-hospital death caused by septic complications remains a considerable concern.…”

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confidence: 99%

Logistic Regression Modeling for Evaluation of Factors Affecting Trauma Outcome in a Level I Trauma Center in Shiraz

Yadollahi

Anvar

Ghaem

et al. 2016

Iran Red Crescent Med J

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Background: Since injury-related mortality is preventable, identifying factors that inversely affect trauma outcome are important initial steps towards reducing injury burden. Objectives: This study aims to determine independent risk factors of early/late in-hospital mortality among adult trauma victims with equal injury characteristics and severity at Shahid Rajaee (Emtiaz) Hospital during 2013 and 2014.

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“…Trauma 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).…”

Section: Introductionmentioning

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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Time‐Based Trauma‐Related Mortality Patterns in a Newly Created Trauma System

Abstract: The distribution of mortality shows a bimodal pattern. The high rate of death at the scene highlights the importance of pre-hospital care and the need for injury prevention programs.

Cited by 28 publications

References 52 publications

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Logistic Regression Modeling for Evaluation of Factors Affecting Trauma Outcome in a Level I Trauma Center in Shiraz

Blunt Thoracic Injury Mortality and Clinical Presentation

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