Maryam Hosseini; Leila Shayan; Mahnaz Yadollahi; Mehrdad Karajizadeh
Volume 11, Issue 3 , July 2023, , Pages 132-137
Abstract
Objective: To identify the distinctive features of acutely injured patients who were presented to the emergency department (ED) and their association with mortality and surgical intervention outcomes.Methods: This cross-sectional study was conducted on all trauma patients resuscitated in the ED of ShahidRajaee ...
Read More
Objective: To identify the distinctive features of acutely injured patients who were presented to the emergency department (ED) and their association with mortality and surgical intervention outcomes.Methods: This cross-sectional study was conducted on all trauma patients resuscitated in the ED of ShahidRajaee (Emtiaz) Trauma Hospital (Shiraz, Iran) from May 2018 to June 2019. Demographic information, themechanism of trauma, trauma type, injured body regions, criteria of abbreviated injury scale (AIS) score,injury severity score (ISS), and surgical intervention was all taken into consideration. The items related to themortality and surgical performance outcomes among the patients were analyzed.Results: Of all 1281 cases, 82.9% were men, and the mean age of the patients was 37.9±19.1 years. The mostcommon mechanism of injury was a car accident, and the thorax was the most prevalent injured area of thebody. The majority of the patients had moderate blunt trauma. The mechanism of trauma, ISS, and the severityof head trauma were all significantly correlated with operation interventions. Moreover, age, the mechanismand type of trauma, ISS, and the necessity for the surgery were significantly associated with death occurrence.Additionally, head, thorax, and abdomen trauma were significantly related to a high mortality rate.Conclusion: Age, trauma mechanism and type, ISS, and the necessity for surgery were significantly associatedwith the mortality rate of injured patients. The severity of the trauma, particularly head injuries and themechanism of damage were important determinants in concern for surgery the necessity.
Mahnaz Yadollahi; Ali Kashkooe; Reza Rezaiee; Kazem Jamali; Mohammad Hadi Niakan
Volume 8, Issue 1 , January 2020, , Pages 27-33
Abstract
Objective: To compare the injury severity scales as predictors of mortality in trauma patients to search for the best scale.Methods: In a prospective cohort study and systematical random sampling conducted from March to September 2017, trauma patients over the age of 13 years were enrolled. ...
Read More
Objective: To compare the injury severity scales as predictors of mortality in trauma patients to search for the best scale.Methods: In a prospective cohort study and systematical random sampling conducted from March to September 2017, trauma patients over the age of 13 years were enrolled. The investigated variables were age, gender, systolic blood pressure, heart rate, respiratory rate, injured body region, Glasgow Coma Scale (GCS), injury severity score (ISS), revised trauma score (RTS), trauma injury severity score (TRISS) and the outcome.Results: Totally, 1410 trauma patients were followed up, out of which 68.5% were male. The participants’ mean age was 43.5±20.88 years. After adjusting the confounding effects, age over 60 years (OR=7.38, CI [3.91-13.93]), GCSthan 5.5.Conclusion: Our results showed that TRISS, RTS, GCS, and ISS were all very effective approaches for evaluating prognosis, mortality and probable complications in trauma patients; thus, these systems of injury evaluation and scoring are recommended to facilitate treatment. TRISS, RTS, and ISS had almost the same sensitivity that was higher than GCS, but GCS had the most specificity. Finally, TRISS was selected as the most efficient scale for predicting mortality.
Mahnaz Yadollahi; Saeid Gholamzadeh
Volume 7, Issue 4 , October 2019, , Pages 373-380
Abstract
Objective: The aim of study was to conduct a time-based analysis to utilize the obtained knowledge for forecasting the trend of accidents in the future. Methods: The present study, which was conducted as a cross-sectional research, investigated deaths from traffic accidents in Fars Province during a ...
Read More
Objective: The aim of study was to conduct a time-based analysis to utilize the obtained knowledge for forecasting the trend of accidents in the future. Methods: The present study, which was conducted as a cross-sectional research, investigated deaths from traffic accidents in Fars Province during a five-year period from 2013 to 2018. The pseudo-regression model of Spline was used to predict the increase in mortality rate by 2021. Results: The forecasted values indicated a decline in deaths from traffic accidents by 2021. A total of 8020 records of accidents leading to death were included in the study. The mean mortality rate from traffic accidents in the province was approximately estimated to be 33.7 per 100,000 populations. More than half of the people who died (52.36%) were in a car, 25.57% were motorcycle riders, and 19.93% were pedestrians. The highest rate of deaths was observed in the age group of 16 to 25 years old (21.5%). The data indicated a reduction in the rate of death among car riders and pedestrians and an increase in the number of deaths among motorcycle riders. The trend of deaths occurred outside the city had been increasing while the trend of deaths occurred inside the city had been decreasing. Conclusion: The present regulations are only able to reduce a small number of deaths each year. In order to achieve a downward trend in mortality with a steeper pace, it is necessary to design and implement more intelligent standards, not merely the stricter ones. This project has been approved by the research ethic committee, as well as, supported with grant number of 97-01-38-17825 by Shiraz University of Medical Sciences in Shiraz, Iran.
Mahnaz Yadollahi; Mojgan Behzadi Seyf-abadi; Forough Pazhuheian
Volume 7, Issue 2 , April 2019, , Pages 176-182
Abstract
Objective: To investigate the severity of injuries and the pattern of jaw and facial injuries in trauma patients and also to determine the predictors of the outcome in these patients.Methods: This cross-sectional study was conducted on 2697 patients with facial trauma who referred to trauma center in ...
Read More
Objective: To investigate the severity of injuries and the pattern of jaw and facial injuries in trauma patients and also to determine the predictors of the outcome in these patients.Methods: This cross-sectional study was conducted on 2697 patients with facial trauma who referred to trauma center in Shahid Rajaee (Emtiaz) Hospital, Shiraz, Iran during 2010-2015. Injury severity score was determined through the conversion of injury codes of the International Classification of Diseases, tenth revision (ICD-10). Binary logistic regression by backward method was used to determine the partial effects of independent risk factors on death odds ratio.Results: The mean age of patients with maxillofacial injuries was 31.96 ± 15.80 years. The mean injury severity score (ISS) was 4.3 ± 4.4 and about 80% of the patients had an ISS between 1 and 8. Mandible fracture and ear injuries, respectively, were the most and the least prevalent types of maxillofacial injury. The odds ratio of death by motorcycle accident was 1.7 times higher than falling down in maxillofacial patients.Conclusion: Age, gender (male), ISS, and mechanism of injury were the significant predictors of mortality in the facial trauma patients. Mandible fracture and ear injury, respectively, were the most and the least prevalent types of maxillofacial injury. Our findings demonstrate the need for referral to the maxillofacial surgeon and maxillofacial surgery should be in connected with neurosurgical centers.
Mahnaz Yadollahi; Narges Rahmanian; Kazem Jamali
Volume 6, Issue 4 , October 2018, , Pages 349-354
Abstract
Objective: To determine the indicators predicting the hospital mortality in pedestrian injured patients admitted to a level I trauma center in Southern Iran.Methods: This case control study was conducted in a Level-I trauma hospital in Shiraz. We selected all survived pedestrians who were admitted in ...
Read More
Objective: To determine the indicators predicting the hospital mortality in pedestrian injured patients admitted to a level I trauma center in Southern Iran.Methods: This case control study was conducted in a Level-I trauma hospital in Shiraz. We selected all survived pedestrians who were admitted in the hospital with duration of admission more than 24 hours in one year from March 2016 to February 2017 as control group and compared with all non-survived pedestrian patients who expired in the hospital according to clinical from March 2012 to February 2017. Multiple logistic regression was performed to identify factors of hospital effect on pedestrian mortality and results expressed by Odds Ratios and their confidence intervals (CI) of 95%.Results: A total of 424 survived pedestrian injured patients were compare to 117 non-survived one. Their mean of survived and non-survived patients were 43.79 ± 19.37 and 56.76 ± 18.55 years respectively of which 361 (66.7%) and 180 (33.3%) were men and women, respectively. We found that the gender does not have any relation with hospital mortality (p=0.275). Followed by, age is in relevance with mortality. Glasgow Coma Scale(GCS), Injury Severity Score (ISS), blood urea nitrogen (BUN), platelet (PLT), potassium (K) and hemoglobin (Hb) are significant factor which are associated with mortality. According to logistic analysis GCS ≤8 (p
Haleh Ghaem; Maryam Soltani; Mahnaz Yadollahi; Tanaz Valad Beigi; Atousa Fakherpour
Volume 5, Issue 4 , October 2017, , Pages 273-279
Abstract
Objective: To epidemiologically assess the accidents and incidents in the injured pedestrians referred to Shahid Rajaee Hospital, Shiraz in order to provide basic preventive strategies and reduce injuries and fatalities caused by traffic accidents in pedestrians.Methods: This cross-sectional study was ...
Read More
Objective: To epidemiologically assess the accidents and incidents in the injured pedestrians referred to Shahid Rajaee Hospital, Shiraz in order to provide basic preventive strategies and reduce injuries and fatalities caused by traffic accidents in pedestrians.Methods: This cross-sectional study was conducted on 5840 injured pedestrians referred to Shahid Rajaee Hospital, Shiraz from 2009 to 2014. The baseline characteristic including the demographic and clinical information, the mechanism of injury, injury severity score (ISS) and outcome determinants. We also recorded the outcome measures and the mortality. Multivariate logistic regression analysis was performed to investigate the factors related to mortality rate and Length of Stay (LOS) in hospital.Results: In our study, the history of 5840 injured pedestrians was analyzed. The mean age of the patients was 41.32±19.21 years. Multivariate logistic regression indicated that mortality increased with age. Moreover, the odds of mortality was more in patients with Injury Severity Score (ISS) between 16 and 24 [OR: 12.94, 95% CI (3.78-32.66), p=0.001] and injuries in the head and neck [OR: 7.92, 95% CI (4.18-14.99), p=0.020]. LOS in hospital was also higher in patients with ISS > 25 [OR: 16.65, 95%CI (10.68-25.96), p=0.001].Conclusion: Pedestrians have always been one of the most vulnerable road users. Our study indicated that the adverse consequences and mortalities in pedestrians increased with age. Hence, approaches are required to improve primary prevention programs and reduce deaths and injuries due to this major public health problem.
Mahnaz Yadollahi; Narges Shamseddini; Leila Shayan; Abbas Rezaianzadeh; Shahram Bolandparvaz
Volume 2, Issue 1 , January 2014, , Pages 44-51
Abstract
Objective: To compare and evaluation of scores of trauma research center of Shiraz University of Medical Sciences in Iran with other trauma research centers in Iran.Methods: The assessment scores of each center were gathered from Iran medical research and Ministry of Health and Medical Education website. ...
Read More
Objective: To compare and evaluation of scores of trauma research center of Shiraz University of Medical Sciences in Iran with other trauma research centers in Iran.Methods: The assessment scores of each center were gathered from Iran medical research and Ministry of Health and Medical Education website. Each score is recorded in helical year which is defined from the 21th of March of every year until the 20th of March of the next. They are ranked and scored by knowledge production, capacity development, and research projects.Results: The total evaluation scores of the trauma research center of Iran's Universities of Medical Sciences have increased from establishment. The highest increase in assessment scores was related to Tehran Trauma Research Center. An upward trend was observed in the total indicators of knowledge production index of all the trauma research centers from 2001/2002 to 2011/2012. An ascending trend was showed in the published articles score of Shiraz and Kashan Trauma Research Centers through the recent years.Conclusion: The increasing trend in scores of trauma research centers in Iran indicated a significant role in the knowledge production but it is need to find barriers of research and doing interventional projects to promote trauma care and prevention.
Mohammad Farahmand; Siamak Farahangiz; Mahnaz Yadollahi
Volume 1, Issue 4 , October 2013, , Pages 147-151
Abstract
Objectives: To determine the diagnostic accuracy of magnetic resonance angiography (MRA) compared to intra-arterial digital subtraction angiography (DSA) in detection of intracranial aneurysms in those suffering from acute subarachnoid hemorrhage (SAH).Methods: This observational diagnostic study was ...
Read More
Objectives: To determine the diagnostic accuracy of magnetic resonance angiography (MRA) compared to intra-arterial digital subtraction angiography (DSA) in detection of intracranial aneurysms in those suffering from acute subarachnoid hemorrhage (SAH).Methods: This observational diagnostic study was performed at a tertiary teaching hospital and reference center in Shiraz, Iran. We included 55 patients who presented to our center with the diagnosis of acute SAH. All the patients underwent MRA and DSA during their hospital course in order to detect the intracranial aneurysms. The time-of-flight MRA protocol was used and the results were compared to the results of DSA as the gold standard test. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for MRA.Results: The mean age of the patients was 46.3 ± 7.9 including 26 (47.3%%) men and 29 (52.7%) women. In46 patients, 51 intracranial aneurysms were diagnosed by DSA (5 patients had two aneurysms). No evidence of intracranial aneurysm was found in 9 patients with subarachnoid hemorrhage. MRA correctly identified 42 of the 51 aneurysms (sensitivity 82%) and missed 9 small aneurysms (less than 10 mm). MRA revealed one false- positive finding, resulting in a specificity of 88.8%. The PPC and NPV for MRA were 97% and 47%, respectively. The diagnostic accuracy per aneurysm was 0.83 for MRA.Conclusion: High sensitivity and specificity of MRA compared to DSA in diagnosis of intracranial aneurysms in those with acute SAH indicate that MRA could be reliably used as a diagnostic tool for this purpose. However we cannot recommend it as a routine substitute for DSA before surgery.
