Reza Eshraghi; Sina Shamsi; Masoumeh safaee
Articles in Press, Accepted Manuscript, Available Online from 18 March 2024
Abstract
Backgrounds and aims: Considering the immunological function of the spleen, the complications, and the risk of infections and thrombocytosis following splenectomy, today's efforts are more towards preserving the spleen instead of splenectomy in splenic injury. This study aimed to evaluate the outcome ...
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Backgrounds and aims: Considering the immunological function of the spleen, the complications, and the risk of infections and thrombocytosis following splenectomy, today's efforts are more towards preserving the spleen instead of splenectomy in splenic injury. This study aimed to evaluate the outcome and risk factors in operative and non-operative management of splenic injury.Methods: This retrospective study was conducted on traumatic splenic injury patients hospitalized in Isfahan's Kashani hospital from 2017 to 2019. Studied variables were extracted from medical records of enrolled participants. Outcome (mortality and complications) and risk factors were compared based on treatment methods.Results: A total of 240 patients were investigated. The mean (SD) age of the patients was 29.8 (12.2), and 180 (77.5%) were men. 154 (64.2%) patients underwent operative treatment. Mortality rate was 18.9% and 4.6% among operative and non-operative groups (P<0.001). Complications were observed in 11.5% and 46.1% of non-operative and operative groups (P<0.001). Operative treatment inversely correlated with mortality (P<0.001) and complications (P<0.05). Splenic injury severity correlated positively with mortality (P<0.001) and negatively with complications (P<0.001). Unstable hemodynamic status was positively correlated with complications (P<0.001). Age had a positive correlation with mortality (P<0.001) and complications (P<0.001). Male sex was inversely correlated with complications (P<0.001). GCS score and on admission was positively correlated with mortality (P<0.001). No statistically significant correlation was found between associated injuries and outcome (P≥0.05).Conclusion: Rates of mortality and complications were higher among patients who underwent surgery; however, considering the role of confounders, operative treatment was inversely associated with mortality and complications.
Leila Mohsenian; Mohamad Karim Khoramian; Sara Sadat Mazloom
Volume 6, Issue 4 , October 2018, , Pages 318-324
Abstract
Objective: To evaluate the prognostic value of arterial blood gas (ABG) indices, especially base excess (BE), regarding the severity of traumatic injury.Methods: A total number of 96 trauma patients with fractures of femur and pelvis were included in this study. Demographic characteristics and clinical ...
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Objective: To evaluate the prognostic value of arterial blood gas (ABG) indices, especially base excess (BE), regarding the severity of traumatic injury.Methods: A total number of 96 trauma patients with fractures of femur and pelvis were included in this study. Demographic characteristics and clinical information of samples were recorded. The results of ABG test and hemoglobin (Hb) were evaluated at two time intervals (on admission and 6 hours later). The outcome of the patients was evaluated at the end of the study (dead or alive). The ABG indices included O2 saturation (O2Sat), PH, PO2, PCO2, bicarbonate (HCO3) and base excess (BE). The mean of the hemodynamic and ABG indices were compared between those who were discharged and mortality cases. The confounders were compensated using a multivariate logistic regression model.Results: Overall 94 trauma patients with long and pelvic fractures were included. There were 69 (73.4%) men and 25 (26.6%) women among the patients with mean age of 37.43 ± 20.07 years. The mortality rate was 10 (10.6%). The most common mechanism of injury was motorcycle accident in 41 (43.6%) and car collision in 43 (45.7%) patients. We found that mortality was significantly associated with amount of FFP transfusion (p=0.005), but was not associated with amount of transfused packed cells (p=0.113). We also found that mortality was associated with lower BP after 6 hours of admission (p=0.001), higher HR on admission (p=0.036), lower HR after 6 hours (p=0.017), lower O2Sat on admission (p<0.001), higher PCO2 after 6 hours and lower BE on admission (p=0.025). Conclusion: The ABG indices including O2Sat, BE and PCO2 are considered prognostic determinants of outcome in trauma patients with long and pelvic fractures. These findings can be considered as fundamental studies to achieve new diagnostic methods.
Robab Mehdizadeh Esfanjani; Homayoun Sadeghi-Bazargani; Mina Goletsani; Reza Mohammadi
Volume 5, Issue 4 , October 2017, , Pages 280-284
Abstract
Objective: To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.Methods: Injury data were derived from a national-based injury supervision system during 2000–2002. This registry involved all of home-related injuries ...
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Objective: To investigate epidemiological aspects of injuries among Iranian children under 7 years of age using obtained data from a national registry.Methods: Injury data were derived from a national-based injury supervision system during 2000–2002. This registry involved all of home-related injuries for children less than 7 years of age that treated in health or emergency centers. The study population included 25% of Iranian people. The descriptive statistical methods were used for representing the distribution of the variables like age, sex, injury mechanisms, types of injuries, etc. Data were presented as mean ± SD and proportions as appropriate.Results: Of the total 307,064 domestic injuries registered during 2000–2002, 77,500 cases (25.2%) were children. 70% of these children (54581 cases) were in age group of 1-5 years.The large fraction (58.8%) of injuries among children under 7 years of age went back to burn injuries. Cuts and lacerations were at the second level with 17.4%. 51% of injuries had contact with hot liquids. Of all children under 7 years of age injuries, 282 died, 86 were disabled, while the rest improved or being under treatment when recording data.Conclusion: Injuries, particularly burns (especially those who had contact with hot liquids that led into scald), are major public health problem that children under 7 years of age encounter. Therefore, it seems necessary to provide adequate plans to promote children under 7 years of age safety issues.
Adeyi A. Adoga; Daniel D. Kokong; Kenneth N. Ozoilo
Volume 5, Issue 3 , July 2017, , Pages 206-211
Abstract
Objectives: To report the incidence, socio-demographic characteristics, otorhinolaryngological presentations and outcomes of management of patients at the Jos University Teaching Hospital following terror attacks.Methods: A prospective descriptive hospital based study of consecutive patients presenting ...
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Objectives: To report the incidence, socio-demographic characteristics, otorhinolaryngological presentations and outcomes of management of patients at the Jos University Teaching Hospital following terror attacks.Methods: A prospective descriptive hospital based study of consecutive patients presenting with ear, nose and throat injuries as a result of bomb blasts and ethno-religious crises within a six-year period and managed at the Jos University Teaching Hospital were studied for age, gender, ear, nose and throat presentations, injury mechanism, interventions and outcome of interventions. A designed proforma was used for data collection.Results: There were 107 ear, nose and throat injuries from a total 468 terror-related injuries consisting of 66 (61.7%) males and 41 (38.3%) females (M:F ratio of 1.6:1), aged between 5 and 77 years (mean= 36.7 years; SD= +/- 16.2). Two peak age incidences of injuries in the first and third decades were recorded. The commonest source of injuries was bomb blasts in 47 (44%) patients. Multiple facial fractures with soft tissue injuries were the commonest seen in 78 (72.9%) patients. The commonest associated injuries were head injuries (n= 36). Ninety-four (87.9%) patients presented via the Accident and Emergency department, 16 (15%) received pre-hospital care. Patients with multiple injuries stayed longer in the hospital (p-value= 0.028). Complications were recorded in 19 (17.8%) patients. A case fatality rate of 5.6% was recorded.Conclusion: Bomb blasts were the major form of terror attacks in our region. The presence of multiple injuries is a significant negative predictor of patient outcomes.
Eduardo Smith Singares
Volume 5, Issue 3 , July 2017, , Pages 219-220
Nasrin Mehri; Homayoun Sadeghi-Bazargani; Abdolrasoul Safaiean
Volume 5, Issue 1 , January 2017, , Pages 42-46
Abstract
Objective: To determine the epidemiological and clinical characteristics of hand and finger amputations in patients referring to a single center in northern Iran.Methods: This was a cross-sectional study conducted on 200 traumatic hand amputees hospitalized in Shohada Hospital in Tabriz, Northwestern ...
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Objective: To determine the epidemiological and clinical characteristics of hand and finger amputations in patients referring to a single center in northern Iran.Methods: This was a cross-sectional study conducted on 200 traumatic hand amputees hospitalized in Shohada Hospital in Tabriz, Northwestern Iran during a 1-year period in 2014. Data were collected through prospective interviews for variables such as demographic characteristics, accident time; exact anatomical site of amputation; reasons for amputation; amputation mechanism; and having attention deficit symptoms as well as activities causing attention deficit prior to the accident.Results: The vast majority of cases were men and women accounted for only 7.5% of injured cases. In 60.5% of cases, the accident occurred on the fingers of their active hand and fingers accounted for almost 95% of accidents. 85.8% of accidents occurred at work. 63.7% of accidents occurred in the evening. 63.67% of accidents occurred in the evening. Among hazardous occupations, agricultural occupations ranked the first followed by sugar cut and pressing jobs. It was found that 10% of the victims were injured while responding a mobile phone call and 3% of the victims reported that they were listening to music through headphones before the accident. Five percent of the participants reported a quarrel with a colleague and 11.5 % of them reported a quarrel with their employer prior to the accident.Conclusion: Amputations are of much importance in men working in given jobs such as agricultural and pressing. Distraction caused by mobiles, music and personal relations with others is considered of importance to be prevented during job. Risk levels for potential risk indicators need to be assessed through controlled studies.
Pallavi Sarji Uthkarsh; Gopalkrishna Gururaj; Sai Sabharish Reddy; Mandya Siddalingaiah Rajanna
Volume 4, Issue 2 , April 2016, , Pages 93-100
Abstract
Objective: To assess the availability of trauma care services in a district referral hospital of Southern India.Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed ...
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Objective: To assess the availability of trauma care services in a district referral hospital of Southern India.Methods: This was a cross-sectional study being performed during 2013 in a tertiary healthcare centre in Southern Indian. A detailed assessment of trauma care services was done in a 400 bed speciality hospital which is an apex referral hospital in the public health system using a check list based on WHO guidelines for evaluation of essential trauma care services, along with in-depth interviews of hospital stake holders and key informants.Results: The hospital had physical infrastructure in terms of emergency room, inpatient wards, operation theatres, intensive care unit and blood bank facilities. The recently constructed designated building for trauma care services was not operational and existing facilities were used beyond capacity. A designated trauma team was lacking and speciality services for managing polytrauma were deficient and thus, existing personnel were performing multiple tasks. Neurosurgeons and rehabilitative nursing staff were unavailable, and a radiographer was not available on a 24/7 basis. Existing nursing personnel had not received any formal training in trauma care and standard operating protocols were not available for trauma care. Resources for acute resuscitation were partially adequate. The hospital lacked adequate resources to manage head, abdomen, chest and spine injuries, and most of the polytrauma cases were referred to nearby city hospitals.Conclusion: District hospital, the only referral hospital in public health system for trauma victims of that region, had inadequate resources to manage trauma victims, which was probably responsible for delay in trauma care, improper referrals, high cost of care and poor outcomes.
Shahram Paydar; Golnar Sabetian; Zahra Ghahramani; Seyed Mohsen Mousavi; Hosseinali Khalili; Hamid Reza Abbasi; Shahram Bolandparvaz
Volume 3, Issue 4 , October 2015, , Pages 118-121