Mehdi Torabi; Zahra-Sadat Amiri; Moghaddameh Mirzaee
Volume 11, Issue 2 , April 2023, , Pages 83-89
Abstract
Objective: This study aimed to investigate blood glucose levels in patients with brain injury caused by mildtraumatic brain injury (TBI) as a foundation for determining whether these patients need a brain CT scan ornot.Methods: This cross-sectional study was conducted on patients with mild TBI, who were ...
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Objective: This study aimed to investigate blood glucose levels in patients with brain injury caused by mildtraumatic brain injury (TBI) as a foundation for determining whether these patients need a brain CT scan ornot.Methods: This cross-sectional study was conducted on patients with mild TBI, who were referred to theemergency department from March 1, 2022, to September 1, 2022. After the confirmation of mild TBI by anemergency medicine specialist, blood samples were taken from the patients to measure blood glucose levels.Then a brain CT scan was performed, and blood glucose levels were compared between patients with andwithout CT indications of brain injury. A checklist was used to collect data, and the data were analyzed usingSPSS software (version 23).Results: In the CT scans of the 157 patients included in the study, 30 patients (19.2%) had a brain injury inthe CT scan. The mean blood glucose level was significantly higher in patients with brain injury, especially inthe presence of vertigo and ataxia, than patients without brain injury in the CT scan (p<0.0001). There was asignificant positive correlation between age and blood glucose level (r=0.315, p<0.0001).Conclusion: Patients with mild TBI who had signs of brain injury in the CT scan had significantly higher bloodglucose levels than patients with normal CT scan findings. Although indications for performing a brain CTscan are usually based on clinical criteria, blood glucose levels can be helpful in determining the requirementfor a brain CT scan in patients with mild TBI.
Mehdi Torabi
Volume 10, Issue 2 , April 2022, , Pages 92-94
Abstract
Endotracheal intubation is more commonly performed in the right main bronchus; however, it may rarely be performed in the left side. A 52-years-old man was brought to the emergency department by emergency medical services (EMS) after multiple trauma injury. There was a decrease in the right lung’s ...
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Endotracheal intubation is more commonly performed in the right main bronchus; however, it may rarely be performed in the left side. A 52-years-old man was brought to the emergency department by emergency medical services (EMS) after multiple trauma injury. There was a decrease in the right lung’s sound. Lung computed tomography (CT) scan revealed total pulmonary atelectasis. This scan was at the time that patient did not mention any recent history or complaint of pulmonary problems or diseases. In CT scan, we observed the white lung in the right side, the trachea which was deviated to the right, and the collapse-consolidation of the right lung was seen. The endotracheal tube image was observed in the left main bronchus which is a rare phenomenon. Decreasing of the right lung sound may not always be due to pneumothorax or hemothorax in trauma patients. In these patients, the rare phenomenon of left lung intubation should be considered as well. Left lung intubation may occur because of the lesion presence in the right lung.
Elham Safari; Mehdi Torabi
Volume 8, Issue 2 , April 2020, , Pages 83-88
Abstract
Objective: To investigate the relationship between end-tidal CO2 (ETCO2) and serum lactate and their predictive role in hospital mortality of intubated multiple trauma patients. Methods: In a cohort study, intubated multiple trauma patients who referred to the emergency department for two years were ...
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Objective: To investigate the relationship between end-tidal CO2 (ETCO2) and serum lactate and their predictive role in hospital mortality of intubated multiple trauma patients. Methods: In a cohort study, intubated multiple trauma patients who referred to the emergency department for two years were enrolled. After orotracheal intubation using Rapid Sequence Intubation (RSI) method, ETCO2 was immediately measured by capnography. Blood samples for serum lactate measurements were sent to the laboratory, immediately after intubation. Data collection was done using the questionnaire, and the patients were followed using their medical records. Results: Totally, 250 patients were included with hospital mortality of 14.8% (n=37). Using Pearson correlation, an inverse relationship was noticed between serum lactate and ETCO2, immediately (p<0.0001, r=-0.65). In adjusted multivariate analysis, three variables including heart rate (HR), serum lactate and ETCO2 showed a significant relationship with hospital mortality, respectively (p=0.007, p=0.009, p=0.023, respectively). Receiver operating characteristic curve illustrated an area under the curve (AUC) of 0.93, 0.96, and 0.97 for HR, lactate, and ETCO2, respectively. Conclusion: ETCO2 post-intubation and serum lactate may be considered as prognostic factors for intubated multiple trauma patients referring to the emergency department, which can give the clinician an important clue in early prediction of the hospital mortality.
Hamidreza Habibpour; Mehdi Torabi; Moghaddameh Mirzaee
Volume 7, Issue 1 , January 2019, , Pages 55-59
Abstract
Objective: To investigate the role of red cell distribution width (RDW) in comparison with Trauma-Associated Severe Hemorrhage (TASH) system in predicting the mortality of multiple trauma patients, referred to the hospital emergency department.Methods: This follow-up study was conducted on multiple trauma ...
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Objective: To investigate the role of red cell distribution width (RDW) in comparison with Trauma-Associated Severe Hemorrhage (TASH) system in predicting the mortality of multiple trauma patients, referred to the hospital emergency department.Methods: This follow-up study was conducted on multiple trauma patients (age ≥ 18 years) with Injury Severity Scores (ISS) of ≥ 16, who were referred to the emergency department from March 1, 2017, to December 1, 2017. First, all patients were evaluated based on the Advanced Trauma Life Support (ATLS) guidelines, and then, their blood samples were sent for RDW measurements at baseline and 24 hours after admission. The ISS, Revised Trauma Score (RTS), and TASH were measured in the follow-ups and recorded by third-year emergency medicine residents. Hospital mortality was considered as the outcome of the study.Results: In this study, 200 out of 535 multiple trauma patients were recruited. The frequency of hospital mortality was 19 (9.5%). In the univariate analysis, there was no significant relationship between hospital mortality and RDW at baseline, RDW on the first day, and ΔRDW (RDW at baseline - RDW on the first day), unlike ISS, RTS, TASH (p=0.97, P= 0.28, and p=0.24, respectively). On the other hand, in the multivariate analysis, ISS, RTS, and TASH showed a significant relationship with hospital mortality. The greatest area under the ROC curve (AUC) was attributed to TASH and RTS systems (0.94 and 0.93, respectively).Conclusion: TASH scoring system, which was mainly designed to predict the need for massive transfusion, may be of prognostic value for hospital mortality in multiple trauma patients, similar to ISS and RTS scoring systems.