Use of a Structural Deformity Index as a Predictor of Severity Among Trauma Victims in Motor Vehicle Crashes

Diez, Diego Reyero; Otano, Tomás Belzunegui; Fraile, Begoña Bermejo; Louis, Clint Jean; Ramírez, Jose Roldán; Echarri-Sucunza, Alfredo

doi:10.1016/j.jemermed.2010.01.017

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…The NMTR also includes information about trauma patients who died on the scene or while being transported to the hospital [ 15 ]. Furthermore information about the severity of the injury at the scene of a motor vehicle crash, calculated by Structural Deformity Index (SDI), is also documented in the NMTR [ 16 ]. The use of the SDI can assist prehospital and hospital health care providers if particular serious injuries are suspected and anatomical and physiological criteria are not definitive.…”

Section: Methodsmentioning

confidence: 99%

Epidemiological comparison between the Navarra Major Trauma Registry and the German Trauma Registry (TR-DGU®)

Ali

Lefering

Moral³

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundInternational benchmarking can help identify trauma system performance issues and determine the extent to which other countries also experience these. When problems are identified, countries can look to high performers for insight into possible responses. The objective of this study was to compare the treatment and outcome of severely injured patients in Germany and Navarra, Spain.MethodsData collected, from 2010 to 2013, in the Navarra Major Trauma Registry (NMTR) and the TraumaRegister DGU® (TR-DGU) were compared. Both registries followed the Utstein Trauma Template (European Core Dataset) for documentation of trauma patients. Adult patients (≥ 16 years) with New Injury Severity Score (NISS) being >15 points were included in this study. Patients who had been admitted to the hospital later than 24 h after the trauma, had been pronounced dead before hospital arrival, or had been injured by hanging, drowning or burns, were excluded.Demographic data, injury data, prehospital data, hospital treatment data, time intervals, and outcome were compared. The expected mortality was calculated using the Revised Injury Severity Classification score II (RISC II).ResultsA total of 646 and 43,110 patients were included in the outcome analysis from NMTR and TR-DGU, respectively. The difference between observed and expected mortality was −0.4% (standardized mortality ratio [SMR] 0.97; 95% CI 0.93–1.04) in Germany and 1.6% (SMR 1.08; 95% CI: 1.02–1.14) in Navarra. Differences in the characteristics of trauma patients and trauma systems between the regions were noted.ConclusionThe higher observed mortality in Navarra is consistent with the epidemiological characteristics of its population. However, to improve the quality of trauma care in the Navarra trauma system, certain improvements are necessary. There were less young adults with severe injuries in Navarra than in Germany. It is possible to compare data of severely injured patients from different countries if standardized registries are used.

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Section: Methodsmentioning

confidence: 99%

Epidemiological comparison between the Navarra Major Trauma Registry and the German Trauma Registry (TR-DGU®)

Ali

Lefering

Moral³

et al. 2017

Scand J Trauma Resusc Emerg Med

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“…Existen eventos traumáticos en los que inicialmente los criterios anatómicos y fisiológicos no muestran alteraciones, pero puede existir una lesión oculta que puede llegar a ser crítica. Los criterios cinemáticos sirven como complemento y permiten sospechar esas lesiones ocultas y actuar en consecuencia 4,5 .…”

Section: Cinemática De Los Traumatismosunclassified

“…El Índice de Deformidad Estructural (IDE), elaborado a partir de las variables señaladas, es fácil de recoger en la propia escena, "cuantifica" el intercambio de energía que sufre un ocupante de un vehículo tras una colisión y sirve como complemento a los criterios anatómicos y fisiológicos 5 . La recogida del IDE por parte policía o bomberos en la escena, permite el envío de información en tiempo real al centro coordinador, a los equipos de emergencias, y a los equipos de urgencias hospitalarios.…”

Section: Explosionesunclassified

Actualización Del Manejo Prehospitalario Del Paciente Con Trauma Grave

Louis¹,

Caminos²,

Arce³

et al. 2022

Bol Inf Farmacoter Navar

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INTRODUCCIÓN Los objetivos de la atención prehospitalaria al traumatismo grave son la detección de lesiones que comprometen la vida del paciente, la aplicación temprana de medidas terapéuticas y el traslado sin demora a un centro hospitalario apropiado. La respuesta de los servicios de emergencias implica diferentes intervinientes con variedad de circunstancias y de funcionamientos, por tanto, es imprescindible un lenguaje común, una preparación y coordinación para garantizar el cumplimiento de los objetivos y un control de calidad de la atención. OBJETIVO Actualización sobre el manejo del paciente adulto politraumatizado basado en nuevas evidencias y prácticas. MÉTODOS Revisión de la literatura buscando principalmente a través de PubMed. Búsqueda secundaria en UptoDate y las últimas ediciones de libros de referencia en trauma grave prehospitalario y avanzado, y en organismos referentes como Difficult Airway Society, Advanced Trauma Life Support, European Trauma Course, y Anesthesia, Trauma and Critical Care Course (ATACC). Búsqueda terciaria a través de las referencias en las guías de UpToDate para identificar nuevas fuentes. Los términos de búsqueda incluyeron: atención prehospitalaria, trauma grave, vía aérea difícil, hipotensión permisiva, inmovilización, tanto en castellano como en inglés. RESULTADOS El manejo de la hemorragia catastrófica ocupa el primer lugar en la evaluación primaria, porque puede causar la muerte antes que una vía aérea obstruida. El manejo de la vía aérea y la ventilación sigue siendo una prioridad. La hipotensión permisiva es cada vez más aceptada en el manejo del trauma grave con shock hipovolémicos salvo en caso de pacientes con traumatismo craneoencefálico. La prevención y control de la tríada mortal (acidosis, hipoxia e hipotermia) mejora el pronóstico. Se debe evitar un enfoque de “excesiva estabilización”, de modo que no se demore el acceso al tratamiento definitivo. CONCLUSIONES La atención prehospitalaria al trauma es necesariamente multidisciplinar y la coordinación y la comunicación entre equipos es clave para garantizar la calidad de cuidados.

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“…For example, statistical data on important factors, e.g. impact speed, angle, and mass, can be used as the basis for defining standards for impact tests, but also to develop new devices or shapes to mitigate the injuries, to improve current triage operations, to develop and validate new tools for the prediction of the severity of the injuries [19,20] and to evaluate the change produced by the countermeasures adopted.…”

Section: Introductionmentioning

confidence: 99%

Advanced accident research system based on a medical and engineering data in the metropolitan area of Florence

et al. 2013

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BackgroundIn the metropolitan area of Florence, 62% of major traumas involve powered two wheeler rider and pillion passengers, 10% cyclists, and 7% pedestrians. The urban and extra-urban areas are the most dangerous for the vulnerable road user. In-depth investigations are needed for assessing detailed information on road accidents. This type of study has been very limited in time frame in Italy, and completely absent in the Tuscan region.Consequently a study called “In-depth Study of road Accident in FlorencE” (In-SAFE) has been initiated.MethodsA network between the Department of Mechanics and Industrial Technologies (University of Florence) and the Intensive Care Unit of the Emergency Department (Careggi Teaching Hospital, Florence) was created with the aim of collecting information about the road accidents. The data collected includes: on-scene data, data coming from examination of the vehicles, kinematics and dynamic crash data, injuries, treatment, and injury mechanisms. Each injury is codified thorough the AIS score, localized by a three-dimensional human body model based on computer tomography slices, and the main scores are calculated. We then associate each injury with its cause and crash technical parameters. Finally, all the information is collected in the In-SAFE database.ResultsPatient mean age at the time of the accident was 34.6 years, and 80% were males. The ISS mean is 24.2 (SD 8.7) and the NISS mean is 33.6 (SD 10.5). The main road accident configurations are the “car-to-PTW” (25%) and “pedestrian run over” (17,9%). For the former, the main collision configuration is “head-on crash” (57%). Cyclists and PTW riders-and-pillions-passengers suffer serious injuries (AIS3+) mainly to the head and the thorax. The head (56.4%) and the lower extremities (12.7%) are the most frequently injured pedestrian body regions.ConclusionsThe aim of the project is to create an in-depth road accident study with special focus on the correlation between technical parameters and injuries. An in-depth investigation team was setup and is currently active in the metropolitan area of Florence.Twenty-eight serious road accidents involving twenty-nine ICU patients are studied. PTW users, cyclist and pedestrians are the most frequently involved in metropolitan accidents.

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Use of a Structural Deformity Index as a Predictor of Severity Among Trauma Victims in Motor Vehicle Crashes

Cited by 5 publications

References 32 publications

Epidemiological comparison between the Navarra Major Trauma Registry and the German Trauma Registry (TR-DGU®)

Epidemiological comparison between the Navarra Major Trauma Registry and the German Trauma Registry (TR-DGU®)

Actualización Del Manejo Prehospitalario Del Paciente Con Trauma Grave

Advanced accident research system based on a medical and engineering data in the metropolitan area of Florence

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