ORIGINAL_ARTICLE
Cost-Effectiveness of Multifactorial Interventions in Preventing Falls among Elderly Population: A Systematic Review
Objective: To review the cost-effectiveness of multifactorial interventions preventing falls in elderly people. Methods: In this systematic review, the databases including PubMed via MEDLINE, Web of Science, Embase, Scopus, Cochrane Library and Google Scholar (from 1st January 2000 to 30th February) were used. All prereviewed articles related to cost-effectiveness analysis of multifactorial interventions to prevent falls in elderly were included in this paper and congresses abstracts were excluded. Descriptive statistics were used for quantitative data and content-analysis method to analyze qualitative data. Results: Out of the 456 articles, 19 were finally included in the study. Eighteen articles were conducted in High-Income Countries (HICs) and 16 were at the community level. Medical visits consultation and education were the most common interventions. Most studies were cost-effectiveness and using the Randomized Control Trial (RCT) methods. A fall of prevention costs ranged from $ 272 to $ 987. Incremental Cost-Effectiveness Ratio (ICER) interventions also ranged from the US $ 120,667 to the US $ 4280.9. Conclusion: The results show that despite the high effectiveness of multifactorial interventions to prevent elderly falls, the cost of the interventions are high and they are not very cost-effective. It would be better to design and implement multifactorial interventions with low cost and high effectiveness that are appropriate for each country
https://beat.sums.ac.ir/article_47520_1a3b1bdec82c89c59975b9ddae4726e5.pdf
2021-10-01
159
168
10.30476/beat.2021.84375.1068
Elderly
Falls
Cost effectiveness
Intervention
Population
Vahid
Alipour
vahid.alipoor1360@yahoo.com
1
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
AUTHOR
Saber
Azami-Aghdash
s.azami.a90@gmail.com
2
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Aziz
Rezapour
gola_7069@yahoo.com
3
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
AUTHOR
Naser
Derakhshani
derakhshani.mhc@gmail.com
4
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Akbar
Ghiasi
ghiasi@uiwtx.edu
5
Health Administration HEB School of Business & Administration, University of the Incarnate Word, Texas, USA
AUTHOR
Neghar
Yusefzadeh
jskh95@yahoo.com
6
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
AUTHOR
Sanaz
Taghizade
sanaz_taghizade@yahoo.com
7
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Sahar
Amuzadeh
mis.amuzadeh@gmail.com
8
Babol University of Medical Sciences, Babol, Iran
AUTHOR
Victorino GP, Chong TJ, Pal JD. Trauma in the elderly patient. Arch Surg. 2003;138(10):1093-8.
1
In: United Nations. Trends in contraceptive use worldwide; Economic and Social Affairs. 2015. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesa_pd_report_2015_trends_contraceptive_use.pdf.
2
In: United Nations. World Population Prospects, 2019. Available from: http://www.europeanmigrationlaw.eu/documents/UN-WorldPopulationProspects2019-Highlights.pdf.
3
Ibrahim N, Ghabrah T, Qadi M. Morbidity profile of elderly attended/admitted in Jeddah health facilities, Saudi Arabia. Bull High Inst Public Health. 2005;35:173-90.
4
Werner CA. The older population, 2010: US Department of Commerce, Economics and Statistics Administration, US …; 2011.
5
Evans D, Pester J, Vera L, Jeanmonod D, Jeanmonod R. Elderly fall patients triaged to the trauma bay: age, injury patterns, and mortality risk. Am J Emerg Med. 2015;33(11):1635-8.
6
Vincent GK. The next four decades: The older population in the United States: 2010 to 2050: US Department of Commerce, Economics and Statistics Administration, US …; 2010.
7
Blank WA, Freiberger E, Siegrist M, Landendoerfer P, Linde K, Schuster T, et al. An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls]. BMC Geriatr. 2011;11:7.
8
Labib N, Nouh T, Winocour S, Deckelbaum D, Banici L, Fata P, et al. Severely injured geriatric population: morbidity, mortality, and risk factors. J Trauma. 2011;71(6):1908-14.
9
DeMaria EJ, Kenney PR, Merriam MA, Casanova LA, Gann DS. Survival after trauma in geriatric patients. Ann Surg. 1987;206(6):738-43.
10
Champion HR, Copes WS, Buyer D, Flanagan ME, Bain L, Sacco WJ. Major trauma in geriatric patients. Am J Public Health. 1989;79(9):1278-82.
11
McCoy GF, Johnston RA, Duthie RB. Injury to the elderly in road traffic accidents. J Trauma. 1989;29(4):494-7.
12
Kuhne CA, Ruchholtz S, Kaiser GM, Nast-Kolb D; Working Group on Multiple Trauma of the German Society of Trauma. Mortality in severely injured elderly trauma patients--when does age become a risk factor? World J Surg. 2005;29(11):1476-82.
13
Ottochian M, Salim A, DuBose J, Teixeira PG, Chan LS, Margulies DR. Does age matter? The relationship between age and mortality in penetrating trauma. Injury. 2009;40(4):354-7.
14
Lustenberger T, Inaba K, Schnüriger B, Barmparas G, Eberle BM, Lam L, et al. Gunshot injuries in the elderly: patterns and outcomes. A national trauma databank analysis. World J Surg. 2011;35(3):528-34.
15
Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007;297(1):77-86.
16
Scuffham P, Chaplin S, Legood R. Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health. 2003;57(9):740-4.
17
Tinetti ME. Clinical practice. Preventing falls in elderly persons. N Engl J Med. 2003;348(1):42-9.
18
Child S, Goodwin V, Garside R, Jones-Hughes T, Boddy K, Stein K. Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies. Implement Sci. 2012;7:91.
19
Li YH, Song GX, Yu Y, Zhou de D, Zhang HW. Study on age and education level and their relationship with fall-related injuries in Shanghai, China. Biomed Environ Sci. 2013;26(2):79-86.
20
Saadat S, Hafezi-Nejad N, Ekhtiari YS, Rahimi-Movaghar A, Motevalian A, Amin-Esmaeili M, et al. Incidence of fall-related injuries in Iran: A population-based nationwide study. Injury. 2016;47(7):1404-9.
21
Sadeghi H, Amri SB, Razeghi M, Hamid TA, Abdollah MNH. Effects of Combined exergame and conventional exercise to reduce and prevent fall risk among elderly people: A Hypothesis. International Journal of Applied Exercise Physiology. 2017;6(3):80-4.
22
Schonnop R, Yang Y, Feldman F, Robinson E, Loughin M, Robinovitch SN. Prevalence of and factors associated with head impact during falls in older adults in long-term care. CMAJ. 2013;185(17):E803-10.
23
Hill KD, Suttanon P, Lin SI, Tsang WWN, Ashari A, Hamid TAA, et al. What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials. BMC Geriatr. 2018;18(1):3.
24
Kannus P, Parkkari J, Niemi S, Palvanen M. Fall-induced deaths among elderly people. Am J Public Health. 2005;95(3):422-4.
25
Larson L, Bergmann TF. Taking on the fall: The etiology and prevention of falls in the elderly. Clinical Chiropractic. 2008;11(3):148-54.
26
Gilbert R, Todd C, May M, Yardley L, Ben-Shlomo Y. Socio-demographic factors predict the likelihood of not returning home after hospital admission following a fall. J Public Health (Oxf). 2010;32(1):117-24.
27
Watson WL, Clapperton AJ, Mitchell RJ. The cost of fall-related injuries among older people in NSW, 2006-07. N S W Public Health Bull. 2011;22(3-4):55-9.
28
Watson W, Clapperton A, Mitchell R. The burden of fall-related injury among older persons in New South Wales. Aust N Z J Public Health. 2011;35(2):170-5.
29
Hsieh W-M, Chen C-C, Wang S-C, Chen Y-L, Hwang Y-S, Lai J-S. Combination of the kinect with virtual reality in balance training for the elderly. Engineering. 2013;5(10):171-5.
30
Bonne S, Schuerer DJ. Trauma in the older adult. Clinics in geriatric medicine. 2013;29(1):137-50.
31
Hester AL, Wei F. Falls in the community: state of the science. Clin Interv Aging. 2013;8:675-9.
32
Limpawattana P, Sutra S, Thavompitak Y, Chindaprasirt J, Mairieng P. Geriatric hospitalizations due to fall-related injuries. J Med Assoc Thai. 2012;95 Suppl 7:S235-9.
33
Christensen MC, Ridley S, Lecky FE, Munro V, Morris S. Outcomes and costs of blunt trauma in England and Wales. Crit Care. 2008;12(1):R23.
34
Rosendahl E, Gustafson Y, Nordin E, Lundin-Olsson L, Nyberg L. A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities. Aging Clin Exp Res. 2008;20(1):67-75.
35
Svantesson U, Babagbemi B, Foster L, Alricsson M. Influences on modern multifactorial falls prevention interventions and fear of falling in non-frail older adults: a literature review. J Clin Med Res. 2014;6(5):314-20.
36
Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gottschalk M, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331(13):821-7.
37
Isaranuwatchai W, Perdrizet J, Markle-Reid M, Hoch JS. Cost-effectiveness analysis of a multifactorial fall prevention intervention in older home care clients at risk for falling. BMC Geriatr. 2017;17(1):199.
38
Heinrich S, Rapp K, Stuhldreher N, Rissmann U, Becker C, König HH. Cost-effectiveness of a multifactorial fall prevention program in nursing homes. Osteoporos Int. 2013;24(4):1215-23.
39
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.
40
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.
41
Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes: Oxford university press; 2015.
42
Grbich C. Qualitative data analysis: An introduction: Sage; 2012.
43
Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320(7227):114-6.
44
Wu S, Keeler EB, Rubenstein LZ, Maglione MA, Shekelle PG. A cost-effectiveness analysis of a proposed national falls prevention program. Clin Geriatr Med. 2010;26(4):751-66.
45
Church JL, Haas MR, Goodall S. Cost Effectiveness of Falls and Injury Prevention Strategies for Older Adults Living in Residential Aged Care Facilities. Pharmacoeconomics. 2015;33(12):1301-10.
46
Irvine L, Conroy SP, Sach T, Gladman JR, Harwood RH, Kendrick D, et al. Cost-effectiveness of a day hospital falls prevention programme for screened community-dwelling older people at high risk of falls. Age Ageing. 2010;39(6):710-6.
47
Hendriks MR, Evers SM, Bleijlevens MH, van Haastregt JC, Crebolder HF, van Eijk JT. Cost-effectiveness of a multidisciplinary fall prevention program in community-dwelling elderly people: a randomized controlled trial (ISRCTN 64716113). Int J Technol Assess Health Care. 2008;24(2):193-202.
48
Jenkyn KB, Hoch JS, Speechley M. How much are we willing to pay to prevent a fall? Cost-effectiveness of a multifactorial falls prevention program for community-dwelling older adults. Can J Aging. 2012;31(2):121-37.
49
Peeters GM, Heymans MW, de Vries OJ, Bouter LM, Lips P, van Tulder MW. Multifactorial evaluation and treatment of persons with a high risk of recurrent falling was not cost-effective. Osteoporos Int. 2011;22(7):2187-96.
50
Salkeld G, Cumming RG, O’Neill E, Thomas M, Szonyi G, Westbury C. The cost effectiveness of a home hazard reduction program to reduce falls among older persons. Aust N Z J Public Health. 2000;24(3):265-71.
51
Church J, Goodall S, Norman R, Haas M. The cost-effectiveness of falls prevention interventions for older community-dwelling Australians. Aust N Z J Public Health. 2012;36(3):241-8.
52
Davis JC, Robertson MC, Ashe MC, Liu-Ambrose T, Khan KM, Marra CA. Does a home-based strength and balance programme in people aged > or =80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions. Br J Sports Med. 2010;44(2):80-9.
53
Church J, Goodall S, Norman R, Haas M. An economic evaluation of community and residential aged care falls prevention strategies in NSW. N S W Public Health Bull. 2011;22(3-4):60-8.
54
Farag I, Howard K, Ferreira ML, Sherrington C. Economic modelling of a public health programme for fall prevention. Age Ageing. 2015;44(3):409-14.
55
Müller D, Borsi L, Stracke C, Stock S, Stollenwerk B. Cost-effectiveness of a multifactorial fracture prevention program for elderly people admitted to nursing homes. Eur J Health Econ. 2015;16(5):517-27.
56
Patil R, Kolu P, Raitanen J, Valvanne J, Kannus P, Karinkanta S, et al. Cost-effectiveness of vitamin D supplementation and exercise in preventing injurious falls among older home-dwelling women: findings from an RCT. Osteoporos Int. 2016;27(1):193-201.
57
Campbell AJ, Robertson MC, La Grow SJ, Kerse NM, Sanderson GF, Jacobs RJ, et al. Randomised controlled trial of prevention of falls in people aged > or =75 with severe visual impairment: the VIP trial. BMJ. 2005;331(7520):817.
58
Hendriks MR, van Haastregt JC, Diederiks JP, Evers SM, Crebolder HF, van Eijk JT. Effectiveness and cost-effectiveness of a multidisciplinary intervention programme to prevent new falls and functional decline among elderly persons at risk: design of a replicated randomised controlled trial [ISRCTN64716113]. BMC Public Health. 2005;5:6.
59
Frick KD, Kung JY, Parrish JM, Narrett MJ. Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults. J Am Geriatr Soc. 2010;58(1):136-41.
60
Matchar DB, Eom K, Duncan PW, Lee M, Sim R, Sivapragasam NR, et al. A Cost-Effectiveness Analysis of a Randomized Control Trial of a Tailored, Multifactorial Program to Prevent Falls Among the Community-Dwelling Elderly. Arch Phys Med Rehabil. 2019;100(1):1-8.
61
Campbell AJ, Robertson MC. Rethinking individual and community fall prevention strategies: a meta-regression comparing single and multifactorial interventions. Age Ageing. 2007;36(6):656-62.
62
Oeppen J, Vaupel JW. Demography. Broken limits to life expectancy. Science. 2002;296(5570):1029-31.
63
Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet. 2009;374(9696):1196-208.
64
Edwards N. Falls among the elderly are a major cause of injuries and deaths in countries around the world. Int Nurs Rev. 2008;55(2):132.
65
Akyol AD. Falls in the elderly: what can be done? Int Nurs Rev. 2007;54(2):191-6.
66
Lord SR, Ward JA, Williams P, Anstey KJ. An epidemiological study of falls in older community-dwelling women: the Randwick falls and fractures study. Aust J Public Health. 1993;17(3):240-5.
67
Samper-Ternent R, Karmarkar A, Graham J, Reistetter T, Ottenbacher K. Frailty as a predictor of falls in older Mexican Americans. J Aging Health. 2012;24(4):641-53.
68
Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, et al. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2007;62(7):744-51.
69
Nelson JM, Dufraux K, Cook PF. The relationship between glycemic control and falls in older adults. J Am Geriatr Soc. 2007;55(12):2041-4.
70
Ungar A, Rafanelli M, Iacomelli I, Brunetti MA, Ceccofiglio A, Tesi F, et al. Fall prevention in the elderly. Clin Cases Miner Bone Metab. 2013;10(2):91-5.
71
Karlsson MK, Magnusson H, von Schewelov T, Rosengren BE. Prevention of falls in the elderly--a review. Osteoporos Int. 2013;24(3):747-62.
72
McKay C, Anderson KE. How to manage falls in community dwelling older adults: a review of the evidence. Postgrad Med J. 2010;86(1015):299-306.
73
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;(9):CD007146.
74
Rizzo JA, Baker DI, McAvay G, Tinetti ME. The cost-effectiveness of a multifactorial targeted prevention program for falls among community elderly persons. Med Care. 1996;34(9):954-69.
75
Robertson MC, Devlin N, Gardner MM, Campbell AJ. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial. BMJ. 2001;322(7288):697-701.
76
Vitry AI, Hoile AP, Gilbert AL, Esterman A, Luszcz MA. The risk of falls and fractures associated with persistent use of psychotropic medications in elderly people. Arch Gerontol Geriatr. 2010;50(3):e1-4.
77
Wong AK, Lord SR, Sturnieks DL, Delbaere K, Trollor JN, Close JC. Angiotensin system-blocking medications are associated with fewer falls over 12 months in community-dwelling older people. J Am Geriatr Soc. 2013;61(5):776-81.
78
Harvie P, Sloan K, Beaver RJ. Three-dimensional component alignment and functional outcome in computer-navigated total knee arthroplasty: a prospective, randomized study comparing two navigation systems. J Arthroplasty. 2011;26(8):1285-90.
79
Hill K, Vrantsidis F, Haralambous B, Fearn M, Smith R, Murray K, et al. An analysis of research on preventing falls and falls injury in older people: community, residential care and hospital settings (2004 update). Injury Prevention Section by the National Ageing Research Institute Canberra: Commonwealth of Australia; 2004.
80
Hosseini H, Hosseini N. Epidemiology and prevention of fall injuries among the elderly. Hosp Top. 2008;86(3):15-20.
81
Allen T. Preventing falls in older people: evaluating a peer education approach. Br J Community Nurs. 2004;9(5):195-200.
82
Chang JT, Morton SC, Rubenstein LZ, Mojica WA, Maglione M, Suttorp MJ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ. 2004;328(7441):680.
83
Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc. 2001;49(5):664-72.
84
Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2003;(4):CD000340.
85
Haines TP, Hill AM, Hill KD, McPhail S, Oliver D, Brauer S, et al. Patient education to prevent falls among older hospital inpatients: a randomized controlled trial. Arch Intern Med. 2011;171(6):516-24.
86
ORIGINAL_ARTICLE
Quality of Life after Motorcycle Traffic Injuries: A Cohort Study in Northwest of Iran
Objective: To investigate the quality of life (QOL) of injured motorcyclists and associated factors in a period of three months after the accident. Methods: In the present study, we were included 190 injured motorcyclists who admitted to two referral specialized hospitals (Emam Reza and Shohada) in Tabriz, between June 2018 and January 2019. All injured motorcyclists were contacted through the telephone one and 171 of them (90%) three months after their accident to complete an EQ-5D-3L questionnaire. The baseline measurements were gathered by using face to face interviews in the hospitals. The QOL score could vary between 1 and 3. The higher score showed a lower QOL. Results: The injured motorcyclist’s QOL score was relatively better in three months after the accident (mean±Standard Deviation (SD): 1.78±0.51) in comparison with their status a month after the accident (2.15±0.65) (p <0.001). The multivariable model showed that individuals with pelvis injuries (Coef: 0.29, (95% CI: 0.16, 0.42), p=0.001) and knee injuries (Coef: 0.26, (95% CI: 0.10, 0.42), p=0.001), experienced a higher QOL score. Also, those whose accident had happened in rainy weather experienced higher QOL score (Coef: 0.33, (95% CI: 0.12, 0.53), p=0.001). The patients who were in an accident with a vehicle were experienced a better QOL than others (Coef: -0.26, (95% CI: -0.43, -0.09), p=0.002). Conclusion: The assessment of three-months post-accident showed that the QOL score of the motorcyclists was reduced. It is recommended that the QOL of patients should be improved in hospital discharge victims.
https://beat.sums.ac.ir/article_47746_49e36ab8d41515c49b15f3c13440da38.pdf
2021-10-01
169
177
10.30476/beat.2021.87236.1182
Quality of life
QOL
Motorcycle
Traffic accident
Cohort study
Hospitalization
Patient discharge
Iran
Leili
Abedi Gheshlaghi
abedi.leili@gmail.com
1
Student of Epidemiology, Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
AUTHOR
Hamid
sharifi
sharifihami@gmail.com
2
HIV/STI Surveillance Research Center, and WHO Collaborating for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
LEAD_AUTHOR
Mehdi
Noroozi
noroozimehdi04@gmail.com
3
Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
AUTHOR
Mohsen
Barouni
mohsenbarooni@gmail.com
4
Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
AUTHOR
Homayoun
Sadeghi-Bazargani
homayoun.sadeghi@gmail.com
5
Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
World Health Organization. Global Status Report On Road Safety 2015. Switzerland: WHO Library Cataloguing-in-Publication Data; 2015.
1
World Health Organization. Global status report on road safety 2018. 20 Avenue Appia 1211 Geneva 27 Switzerland; 2018.
2
Sadeghi-Bazargani H, Samadirad B, Hosseinpour-Feizi H. Epidemiology of Traffic Fatalities among Motorcycle Users in East Azerbaijan, Iran. Biomed Res Int. 2018;2018:6971904.
3
Moergeli H, Wittmann L, Schnyder U. Quality of life after traumatic injury: a latent trajectory modeling approach. Psychother Psychosom. 2012;81(5):305-11.
4
Hasselberg M, Kirsebom M, Bäckström J, Berg HY, Rissanen R. I did NOT feel like this at all before the accident: do men and women report different health and life consequences of a road traffic injury? Inj Prev. 2019;25(4):307-312.
5
Olschewski M, Schulgen G, Schumacher M, Altman DG. Quality of life assessment in clinical cancer research. Br J Cancer. 1994;70(1):1-5.
6
Sprangers MA. Disregarding clinical trial-based patient-reported outcomes is unwarranted: Five advances to substantiate the scientific stringency of quality-of-life measurement. Acta Oncol. 2010;49(2):155-63.
7
Nejat S. Quality of life and its measurement. Iranian journal of epidemiology. 2008;4(2):57-62.
8
Hours M, Khati I, Charnay P, Chossegros L, Tardy H, Tournier C, et al. One year after mild injury: comparison of health status and quality of life between patients with whiplash versus other injuries. J Rheumatol. 2014;41(3):528-38.
9
Chaikoolvatana A, Sripech S. Quality of life of road accident head-injured patients after craniotomy. Southeast Asian J Trop Med Public Health. 2007;38(4):761-8.
10
Barnes J, Thomas P. Quality of life outcomes in a hospitalized sample of road users involved in crashes. Annu Proc Assoc Adv Automot Med. 2006;50:253-68.
11
Jagnoor J, De Wolf A, Nicholas M, Maher CG, Casey P, Blyth F, et al. Restriction in functioning and quality of life is common in people 2 months after compensable motor vehicle crashes: prospective cohort study. Inj Epidemiol. 2015;2(1):8.
12
Hazen A, Ehiri JE. Road traffic injuries: hidden epidemic in less developed countries. J Natl Med Assoc. 2006;98(1):73-82.
13
Gopinath B, Jagnoor J, Harris IA, Nicholas M, Casey P, Blyth F, et al. Health-related quality of life 24 months after sustaining a minor musculoskeletal injury in a road traffic crash: A prospective cohort study. Traffic Inj Prev. 2017;18(3):251-256.
14
Khati I, Hours M, Charnay P, Chossegros L, Tardy H, Nhac-Vu HT, et al. Quality of life one year after a road accident: results from the adult ESPARR cohort. J Trauma Acute Care Surg. 2013;74(1):301-11.
15
Kaske S, Lefering R, Trentzsch H, Driessen A, Bouillon B, Maegele M, et al. Quality of life two years after severe trauma: a single-centre evaluation. Injury. 2014;45 Suppl 3:S100-5.
16
Kenardy J, Heron-Delaney M, Warren J, Brown E. The effect of mental health on long-term health-related quality of life following a road traffic crash: results from the UQ SuPPORT study. Injury. 2015;46(5):883-90.
17
Gopinath B, Jagnoor J, Elbers N, Cameron ID. Overview of findings from a 2-year study of claimants who had sustained a mild or moderate injury in a road traffic crash: prospective study. BMC Res Notes. 2017;10(1):76.
18
Rissanen R, Berg HY, Hasselberg M. Quality of life following road traffic injury: A systematic literature review. Accid Anal Prev. 2017;108:308-320.
19
Mayou R, Bryant B. Consequences of road traffic accidents for different types of road user. Injury. 2003;34(3):197-202.
20
United Nations Economic Commission for Europe (UNECE). OECD Health Statistics 2019 Definitions, Sources and Methods. 2019.
21
EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199-208.
22
Sadeghi-Bazargani H, Aboubakri O, Asghari-Jafarabadi M, Alizadeh-Aghdam M, Imani A, Tabrizi JS, et al. Psychometric properties of the short and ultra-short versions of socioeconomic status assessment tool for health studies in Iran (SES-Iran). Journal of Clinical Research & Governance. 2015;4(2).
23
Mollon L, Bhattacharjee S. Health related quality of life among myocardial infarction survivors in the United States: a propensity score matched analysis. Health Qual Life Outcomes. 2017;15(1):235.
24
McCaffrey N, Kaambwa B, Currow DC, Ratcliffe J. Health-related quality of life measured using the EQ-5D-5L: South Australian population norms. Health Qual Life Outcomes. 2016;14(1):133.
25
Yao Q, Liu C, Zhang Y, Xu L. Changes in health-related quality of life of Chinese populations measured by the EQ-5D-3 L: a comparison of the 2008 and 2013 National Health Services Surveys. Health Qual Life Outcomes. 2019;17(1):43.
26
Rezaei S, Hajizadeh M, Kazemi A, Khosravipour M, Khosravi F, Rezaeian S. Determinants of health-related quality of life in Iranian adults: evidence from a cross-sectional study. Epidemiol Health. 2017;39:e2017038.
27
Nhac-Vu HT, Hours M, Charnay P, Chossegros L, Boisson D, Luauté J, et al. Predicting self-reported recovery one year after major road traffic accident trauma. J Rehabil Med. 2011;43(9):776-82.
28
Gopinath B, Harris IA, Nicholas M, Casey P, Blyth F, Maher CG, et al. A comparison of health outcomes in older versus younger adults following a road traffic crash injury: a cohort study. PLoS One. 2015;10(4):e0122732.
29
Fitzharris M, Bowman D, Ludlow K. Factors associated with return-to-work and health outcomes among survivors of road crashes in Victoria. Aust N Z J Public Health. 2010;34(2):153-9.
30
Zangooei Dovom H, Shafahi Y, Zangooei Dovom M. Fatal accident distribution by age, gender and head injury, and death probability at accident scene in Mashhad, Iran, 2006-2009. Int J Inj Contr Saf Promot. 2013;20(2):121-33.
31
Khorasani-Zavareh D, Sadeghi-Bazargani H. Epidemiological pattern of motorcycle injuries with focus on riding purpose: Experience from a middle-income country. Tabriz University of Medical Sciences; 2015.
32
Ghaffari-Fam S, Sarbazi E, Daemi A, Sarbazi MR, Nikbakht HA, Salarilak S. The Epidemilogical Characteristics of Motorcyclists Associated Injuries in Road Traffics Accidents; A Hospital-Based Study. Bull Emerg Trauma. 2016;4(4):223-229.
33
Saadat S, Mafi M, Sharif-Alhoseini M. Population based estimates of non-fatal injuries in the capital of Iran. BMC Public Health. 2011;11:608.
34
Srinivasa Kumar P, Srinivasan K. A study on environmental factors influencing road traffic accident victims in district hospital, Karimnagar. Int J Res Health Sci. 2013;1(2):80-3.
35
Potoglou D, Carlucci F, Cirà A, Restaino M. Factors associated with urban non-fatal road-accident severity. Int J Inj Contr Saf Promot. 2018;25(3):303-310.
36
Khorasani-Zavareh D, Khankeh HR, Mohammadi R, Laflamme L, Bikmoradi A, Haglund BJ. Post-crash management of road traffic injury victims in Iran. Stakeholders’ views on current barriers and potential facilitators. BMC Emerg Med. 2009;9:8.
37
Marshall RD, Cárcamo JH, Blanco C, Liebowitz M. Trauma-focused psychotherapy after a trial of medication for chronic PTSD: pilot observations. Am J Psychother. 2003;57(3):374-83.
38
ORIGINAL_ARTICLE
Characteristics and In-Hospital Outcomes of Pediatric Traumatic Spinal Injuries in A Referral Trauma Center
Objective: To evaluate the characteristics and in-hospital outcomes of traumatic spinal injuries among children admitted to a local trauma center in Iran. Methods: Patients aged 0-18 years who had been admitted to Shahid Kamyab trauma center for acute traumatic spinal injury (Mashhad, Iran) between 2011 and 2018 were evaluated retrospectively. Various demographic, clinical, radiological, and outcome variables were recorded and analyzed. Results: A total of 127,300 trauma patients were evaluated and amongst them, 61 children had spinal trauma. The mean age was 11.1 and there was no significant sex preponderance (54% males). Most of the injuries were occurred in summer (34.4%) and the most common trauma mechanism was motor vehicle accidents (55.7%) followed by falling (36.1%). Almost all patients (95.1%) had vertebral fractures, which were in the cervical, thoracic, and lumbosacral area in order to decrease incidence. 67.2% of patients were managed non-surgically. The mean hospital stay was 8.9 days and 82.0% of patients had been discharged with normal motor function. Conclusion: Pediatric spinal trauma is less studied entity in the field of traumatology due to the lower prevalence of these injuries in pediatric patients worldwide. But our study shows a higher prevalence of such injuries in the pediatric population. Although controversial, the leading cause of these injuries is motor vehicle accidents. Fortunately, short term in-hospital outcome seems to be good in such injuries.
https://beat.sums.ac.ir/article_47808_87a6d6340c967143d83a6c00b2449b19.pdf
2021-10-01
178
182
10.30476/beat.2021.91333.1275
pediatric
Spine
Trauma
Hamid
Rezaei
rezaeehm@mums.ac.ir
1
Department of Neurosurgery, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Ehsan
Keykhosravi
keykhosravie@mums.ac.ir
2
Department of Neurosurgery, Akbar children’s Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
Amin
Tavallaii
tavallaeia@mums.ac.ir
3
Department of Neurosurgery, Akbar children’s Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Derakhshanrad N, Yekaninejad MS, Vosoughi F, Sadeghi Fazel F, Saberi H. Epidemiological study of traumatic spinal cord injuries: experience from a specialized spine center in Iran. Spinal Cord. 2016;54(10):901-907.
1
Wang H, Liu X, Zhao Y, Ou L, Zhou Y, Li C, et al. Incidence and pattern of traumatic spinal fractures and associated spinal cord injury resulting from motor vehicle collisions in China over 11 years: An observational study. Medicine (Baltimore). 2016;95(43):e5220.
2
Chan M, Al-Buali W, Charyk Stewart T, Singh RN, Kornecki A, Seabrook JA, et al. Cervical spine injuries and collar complications in severely injured paediatric trauma patients. Spinal Cord. 2013;51(5):360-4.
3
Stawicki SP, Holmes JH, Kallan MJ, Nance ML. Fatal child cervical spine injuries in motor vehicle collisions: Analysis using unique linked national datasets. Injury. 2009;40(8):864-7.
4
Nitecki S, Moir CR. Predictive factors of the outcome of traumatic cervical spine fracture in children. J Pediatr Surg. 1994;29(11):1409-11.
5
Avellino AM, Mann FA, Grady MS, Chapman JR, Ellenbogen RG, Alden TD, et al. The misdiagnosis of acute cervical spine injuries and fractures in infants and children: the 12-year experience of a level I pediatric and adult trauma center. Childs Nerv Syst. 2005;21(2):122-7.
6
Hofbauer M, Jaindl M, Höchtl LL, Ostermann RC, Kdolsky R, Aldrian S. Spine injuries in polytraumatized pediatric patients: characteristics and experience from a Level I trauma center over two decades. J Trauma Acute Care Surg. 2012;73(1):156-61.
7
Galvin J, Scheinberg A, New PW. A retrospective case series of pediatric spinal cord injury and disease in Victoria, Australia. Spine (Phila Pa 1976). 2013;38(14):E878-82.
8
Özkan N, Wrede K, Ardeshiri A, Sariaslan Z, Stein KP, Dammann P, et al. Management of traumatic spinal injuries in children and young adults. Childs Nerv Syst. 2015;31(7):1139-48.
9
Saunders LL, Selassie A, Cao Y, Zebracki K, Vogel LC. Epidemiology of Pediatric Traumatic Spinal Cord Injury in a Population-Based Cohort, 1998-2012. Top Spinal Cord Inj Rehabil. 2015;21(4):325-32.
10
Álvarez-Pérez MJ, López-Llano ML. Lesion medular traumatica en la infancia y adolescencia en Asturias [Traumatic spinal cord injury in children and adolescents in Asturias]. Rev Neurol. 2015;60(9):401-7. [in Spanish]
11
Kerttula LI, Serlo WS, Tervonen OA, Pääkkö EL, Vanharanta HV. Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study. Spine (Phila Pa 1976). 2000;25(9):1104-8.
12
ORIGINAL_ARTICLE
S100 Calcium-Binding Protein B and Glial Fibrillary Acidic Protein in Patients with Mild Traumatic Brain Injury
Objective: To examine the GFAP and S100B ability in prevention unnecessary brain CT scan in mTBI and compare them with the single extremity fracture in orthopedic patients. Methods: In this prospective cohort study, two orthopedics patients’ groups and mTBI patients were studied to assess the biomarkers’ ability in prevention unnecessary brain CT scan at the emergency setting. There were 40 orthopedics’ patients with single extremity fracture and 41 mTBI patients. Brain CT scans were done for all mTBI patients. Results: Brain CT scans showed no intracranial traumatic lesions. The median levels for S100B in the mTBI group was 14.8 (4.4-335.9) ng/L, and in orthopedic patients’ group was 13.3 (5-353.10) ng/L. Statistically significant differences were observed between both groups in S100B levels (p=0.006). The median Glial Fibrillary Acidic Protein (GFAP) levels in the mTBI patients’ group were 600 (400-16300) and in the orthopedic patients’ groups was 60 ng/L (300-14900). Statistically significant differences were observed between groups in GFAP (p=0.041). Conclusion: Our results showed that S100B and GFAP serum levels were significantly higher in patients with mTBI than in patients with a single limb fracture.
https://beat.sums.ac.ir/article_47631_ff54b87a5957765a325dab67689d4bb4.pdf
2021-10-01
183
187
10.30476/beat.2021.89355.1231
Glial fibrillary acidic protein
S100B
Computed tomography scan
Traumatic brain injury
Ali
Meshkini
masmas9271@yahoo.com
1
Road Injuries Prevention Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Amir
Ghorbani
ghorbaniamir@hotmail.com
2
Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Zahra
Hasanpour Segherlou
zahra90hasanpour@yahoo.com
3
Road Injuries Prevention Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
LEAD_AUTHOR
Masoud
Nouri-Vaskeh
mnvaske@gmail.com
4
Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
Stein SC, Fabbri A, Servadei F, Glick HA. A critical comparison of clinical decision instruments for computed tomographic scanning in mild closed traumatic brain injury in adolescents and adults. Ann Emerg Med. 2009;53(2):180-8.
1
Alimohammadi H, Partovinezhad H, Aliniagerdroudbari E, Babaniamansour S, Partovinezhad E, Shojaee M. A Comparison of the Antiemetic Effect of Ondansetron and Metoclopramide in Patients with Nauseous Isolated Head Trauma: A Double-Blind Randomized Clinical Trial. Frontiers in Emergency Medicine. 2021.
2
Alexander MP. Mild traumatic brain injury: pathophysiology, natural history, and clinical management. Neurology. 1995;45(7):1253-60.
3
Barth JT, Macciocchi SN, Giordani B, Rimel R, Jane JA, Boll TJ. Neuropsychological sequelae of minor head injury. Neurosurgery. 1983;13(5):529-33.
4
Millis SR, Rosenthal M, Novack TA, Sherer M, Nick TG, Kreutzer JS, et al. Long-term neuropsychological outcome after traumatic brain injury. J Head Trauma Rehabil. 2001;16(4):343-55.
5
Rimel RW, Giordani B, Barth JT, Boll TJ, Jane JA. Disability caused by minor head injury. Neurosurgery. 1981;9(3):221-8.
6
Papa L, Ramia MM, Kelly JM, Burks SS, Pawlowicz A, Berger RP. Systematic review of clinical research on biomarkers for pediatric traumatic brain injury. J Neurotrauma. 2013;30(5):324-38.
7
Xiong H, Liang WL, Wu XR. Pathophysiological alterations in cultured astrocytes exposed to hypoxia/reoxygenation. Sheng Li Ke Xue Jin Zhan. 2000;31(3):217-21. [In Chinese]
8
Berger RP, Pierce MC, Wisniewski SR, Adelson PD, Kochanek PM. Serum S100B concentrations are increased after closed head injury in children: a preliminary study. J Neurotrauma. 2002;19(11):1405-9.
9
Jönsson H, Johnsson P, Höglund P, Alling C, Blomquist S. Elimination of S100B and renal function after cardiac surgery. J Cardiothorac Vasc Anesth. 2000;14(6):698-701.
10
Korfias S, Stranjalis G, Boviatsis E, Psachoulia C, Jullien G, Gregson B, et al. Serum S-100B protein monitoring in patients with severe traumatic brain injury. Intensive Care Med. 2007;33(2):255-60.
11
Romner B, Ingebrigtsen T, Kongstad P, Børgesen SE. Traumatic brain damage: serum S-100 protein measurements related to neuroradiological findings. J Neurotrauma. 2000;17(8):641-7.
12
Vos PE, Jacobs B, Andriessen TM, Lamers KJ, Borm GF, Beems T, et al. GFAP and S100B are biomarkers of traumatic brain injury: an observational cohort study. Neurology. 2010;75(20):1786-93.
13
Ytrebø LM, Nedredal GI, Korvald C, Holm Nielsen OJ, Ingebrigtsen T, Romner B, et al. Renal elimination of protein S-100beta in pigs with acute encephalopathy. Scand J Clin Lab Invest. 2001;61(3):217-25.
14
Eng LF, Vanderhaeghen JJ, Bignami A, Gerstl B. An acidic protein isolated from fibrous astrocytes. Brain Res. 1971;28(2):351-4.
15
Pelinka LE, Kroepfl A, Leixnering M, Buchinger W, Raabe A, Redl H. GFAP versus S100B in serum after traumatic brain injury: relationship to brain damage and outcome. J Neurotrauma. 2004;21(11):1553-61.
16
Böhmer AE, Oses JP, Schmidt AP, Perón CS, Krebs CL, Oppitz PP, et al. Neuron-specific enolase, S100B, and glial fibrillary acidic protein levels as outcome predictors in patients with severe traumatic brain injury. Neurosurgery. 2011;68(6):1624-30; discussion 1630-1.
17
Žurek J, Fedora M. The usefulness of S100B, NSE, GFAP, NF-H, secretagogin and Hsp70 as a predictive biomarker of outcome in children with traumatic brain injury. Acta Neurochir (Wien). 2012;154(1):93-103; discussion 103.
18
Honda M, Tsuruta R, Kaneko T, Kasaoka S, Yagi T, Todani M, et al. Serum glial fibrillary acidic protein is a highly specific biomarker for traumatic brain injury in humans compared with S-100B and neuron-specific enolase. J Trauma. 2010;69(1):104-9.
19
Vajtr D, Benada O, Linzer P, Sámal F, Springer D, Strejc P, et al. Immunohistochemistry and serum values of S-100B, glial fibrillary acidic protein, and hyperphosphorylated neurofilaments in brain injuries. Soud Lek. 2012;57(1):7-12.
20
Ingebrigtsen T, Romner B. Serial S-100 protein serum measurements related to early magnetic resonance imaging after minor head injury. Case report. J Neurosurg. 1996;85(5):945-8.
21
Papa L, Silvestri S, Brophy GM, Giordano P, Falk JL, Braga CF, et al. GFAP out-performs S100β in detecting traumatic intracranial lesions on computed tomography in trauma patients with mild traumatic brain injury and those with extracranial lesions. J Neurotrauma. 2014;31(22):1815-22.
22
Posti JP, Hossain I, Takala RS, Liedes H, Newcombe V, Outtrim J, et al. Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase-L1 Are Not Specific Biomarkers for Mild CT-Negative Traumatic Brain Injury. J Neurotrauma. 2017 Jan 27.
23
Undén J, Romner B. Can low serum levels of S100B predict normal CT findings after minor head injury in adults?: an evidence-based review and meta-analysis. J Head Trauma Rehabil. 2010;25(4):228-40.
24
Lee H, Wintermark M, Gean AD, Ghajar J, Manley GT, Mukherjee P. Focal lesions in acute mild traumatic brain injury and neurocognitive outcome: CT versus 3T MRI. J Neurotrauma. 2008;25(9):1049-56.
25
ORIGINAL_ARTICLE
Prospective Observational Study of Early Tracheostomy Role in Operated Severe Head Injury Patients at A Level 1 Trauma Center
Objective: To evaluate the impact of the early tracheostomy on operated patients with severe head injury. Methods: This prospective observational study was conducted at a level 1 trauma center and medical college over one-year period. The study included all surgically managed severe head injury patients without any other life-threatening major injuries. Patients who underwent tracheostomy within 7 days were classified as early tracheostomy. Results: The patient’s mean age of this cohort study was 43.4±14.5 years. Motor-vehicle accidents were being the most common cause of severe head injury. Operated patients were undergoing early tracheostomy on an average of 2.9 days. We were observed that the patients spent on a mechanical ventilation on an average 3.67±2.26 days. This was significantly lower than previous four published studies (p <0.05) which had a range of mean 9.8-15.7 days. Conclusion: We have shown that it is possible to decrease mechanical ventilation (MV) time, intensive care unit (ICU) stay and total hospital stay by doing early tracheostomy in operated severe head injury patients.
https://beat.sums.ac.ir/article_47788_3a98aa25dfee8664290b9d7ce5156e8a.pdf
2021-10-01
188
194
10.30476/beat.2021.86725.1198
Head injury
Intensive care unit
Cerebral Hypoxia
Tracheostomy
Glasgow Coma Scale
Rohit
Bharti
rohit.b.singh@gmail.com
1
Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, India
LEAD_AUTHOR
Sindhu
Sapru
sindhu.sapru@nhs.net
2
Northwick Park Hospital, London, UK
AUTHOR
Ponraj
Sundaram
ponrajks@gmail.com
3
Department of Neurosurgery, Goa Medical College, Goa, India
AUTHOR
Ganesh
Chauhan
ganeshchauhan83@gmail.com
4
Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, India
AUTHOR
Dunham CM, LaMonica C. Prolonged tracheal intubation in the trauma patient. J Trauma. 1984;24(2):120-4.
1
Marshall LF, Gautille T, Klauber MR, Eisenberg HM, Jane JA, Luerssen TG, et al. The outcome of severe closed head injury. Journal of Neurosurgery. 1991;75(Supplement):S28-S36.
2
Lannoo E, Van Rietvelde F, Colardyn F, Lemmerling M, Vandekerckhove T, Jannes C, et al. Early predictors of mortality and morbidity after severe closed head injury. J Neurotrauma. 2000;17(5):403-14.
3
Chintamani, Khanna J, Singh JP, Kulshreshtha P, Kalra P, Priyambada B, et al. Early tracheostomy in closed head injuries: experience at a tertiary center in a developing country--a prospective study. BMC Emerg Med. 2005;5:8.
4
Gurkin SA, Parikshak M, Kralovich KA, Horst HM, Agarwal V, Payne N. Indicators for tracheostomy in patients with traumatic brain injury. Am Surg. 2002;68(4):324-8; discussion 328-9.
5
De Leyn P, Bedert L, Delcroix M, Depuydt P, Lauwers G, Sokolov Y, et al. Tracheotomy: clinical review and guidelines. Eur J Cardiothorac Surg. 2007;32(3):412-21.
6
Plummer AL, Gracey DR. Consensus conference on artificial airways in patients receiving mechanical ventilation. Chest. 1989;96(1):178-80.
7
Whited RE. A prospective study of laryngotracheal sequelae in long-term intubation. Laryngoscope. 1984;94(3):367-77.
8
Huang YH, Lee TC, Liao CC, Deng YH, Kwan AL. Tracheostomy in craniectomised survivors after traumatic brain injury: a cross-sectional analytical study. Injury. 2013;44(9):1226-31.
9
Agrawal A, Joharapurkar SR, Golhar KB, Shahapurkar VV. Early tracheostomy in severe head injuries at a rural center. J Emerg Trauma Shock. 2009;2(1):56.
10
Durbin CG Jr, Perkins MP, Moores LK. Should tracheostomy be performed as early as 72 hours in patients requiring prolonged mechanical ventilation? Respir Care. 2010;55(1):76-87.
11
Opondo E, Mwangombe N. Outcome of severe traumatic brain injury at a critical care unit: a review of 87 patients. Annals of African Surgery. 2007;1.
12
Unterberg A, Stover J, Kress B, Kiening K. Edema and brain trauma. Neuroscience. 2004;129(4):1019-27.
13
Sarrafzadeh AS, Peltonen EE, Kaisers U, Küchler I, Lanksch WR, Unterberg AW. Secondary insults in severe head injury--do multiply injured patients do worse? Crit Care Med. 2001;29(6):1116-23.
14
Marmarou A, Anderson RL, Ward JD, Choi SC, Young HF, Eisenberg HM, et al. Impact of ICP instability and hypotension on outcome in patients with severe head trauma. Journal of neurosurgery. 1991;75(Supplement):S59-S66.
15
Jeremitsky E, Omert L, Dunham CM, Protetch J, Rodriguez A. Harbingers of poor outcome the day after severe brain injury: hypothermia, hypoxia, and hypoperfusion. J Trauma. 2003;54(2):312-9.
16
Jones PA, Andrews PJ, Midgley S, Anderson SI, Piper IR, Tocher JL, et al. Measuring the burden of secondary insults in head-injured patients during intensive care. J Neurosurg Anesthesiol. 1994;6(1):4-14.
17
Galgano M, Toshkezi G, Qiu X, Russell T, Chin L, Zhao LR. Traumatic Brain Injury: Current Treatment Strategies and Future Endeavors. Cell Transplant. 2017;26(7):1118-1130.
18
Heffner JE, Miller KS, Sahn SA. Tracheostomy in the intensive care unit. Part 2: Complications. Chest. 1986;90(3):430-6.
19
Koh WY, Lew TW, Chin NM, Wong MF. Tracheostomy in a neuro-intensive care setting: indications and timing. Anaesth Intensive Care. 1997;25(4):365-8.
20
Teoh WH, Goh KY, Chan C. The role of early tracheostomy in critically ill neurosurgical patients. Ann Acad Med Singap. 2001;30(3):234-8.
21
Siddiqui UT, Tahir MZ, Shamim MS, Enam SA. Clinical outcome and cost effectiveness of early tracheostomy in isolated severe head injury patients. Surg Neurol Int. 2015;23;6:65.
22
Lesnik I, Rappaport W, Fulginiti J, Witzke D. The role of early tracheostomy in blunt, multiple organ trauma. Am Surg. 1992;58(6):346-9.
23
Colice GL, Stukel TA, Dain B. Laryngeal complications of prolonged intubation. Chest. 1989;96(4):877-84.
24
Davis K Jr, Campbell RS, Johannigman JA, Valente JF, Branson RD. Changes in respiratory mechanics after tracheostomy. Arch Surg. 1999;134(1):59-62.
25
Kress JP, Pohlman AS, O’Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med. 2000;342(20):1471-7.
26
Chamoun RB, Robertson CS, Gopinath SP. Outcome in patients with blunt head trauma and a Glasgow Coma Scale score of 3 at presentation. J Neurosurg. 2009;111(4):683-7.
27
Ahmed N, Kuo YH. Early versus late tracheostomy in patients with severe traumatic head injury. Surg Infect (Larchmt). 2007;8(3):343-7.
28
Holevar M, Dunham JC, Brautigan R, Clancy TV, Como JJ, Ebert JB, et al. Practice management guidelines for timing of tracheostomy: the EAST Practice Management Guidelines Work Group. J Trauma. 2009;67(4):870-4.
29
Bouderka MA, Fakhir B, Bouaggad A, Hmamouchi B, Hamoudi D, Harti A. Early tracheostomy versus prolonged endotracheal intubation in severe head injury. J Trauma. 2004;57(2):251-4.
30
Rodriguez JL, Steinberg SM, Luchetti FA, Gibbons KJ, Taheri PA, Flint LM. Early tracheostomy for primary airway management in the surgical critical care setting. Surgery. 1990;108(4):655-9.
31
Nowak P, Cohn AM, Guidice MA. Airway complications in patients with closed-head injuries. Am J Otolaryngol. 1987;8(2):91-6.
32
Shibahashi K, Sugiyama K, Houda H, Takasu Y, Hamabe Y, Morita A. The effect of tracheostomy performed within 72 h after traumatic brain injury. Br J Neurosurg. 2017;31(5):564-568.
33
Dunham CM, Cutrona AF, Gruber BS, Calderon JE, Ransom KJ, Flowers LL. Early tracheostomy in severe traumatic brain injury: evidence for decreased mechanical ventilation and increased hospital mortality. Int J Burns Trauma. 2014;4(1):14-24.
34
McCredie VA, Alali AS, Scales DC, Adhikari NK, Rubenfeld GD, Cuthbertson BH, et al. Effect of Early Versus Late Tracheostomy or Prolonged Intubation in Critically Ill Patients with Acute Brain Injury: A Systematic Review and Meta-Analysis. Neurocrit Care. 2017;26(1):14-25.
35
Baron DM, Hochrieser H, Metnitz PG, Mauritz W. Tracheostomy is associated with decreased hospital mortality after moderate or severe isolated traumatic brain injury. Wien Klin Wochenschr. 2016;128(11-12):397-403.
36
Sheehan BM, Grigorian A, Gambhir S, Maithel S, Kuza CM, Dolich MO, et al. Early Tracheostomy for Severe Pediatric Traumatic Brain Injury is Associated with Reduced Intensive Care Unit Length of Stay and Total Ventilator Days. J Intensive Care Med. 2020;35(11):1346-1351.
37
Wang HK, Lu K, Liliang PC, Wang KW, Chen HJ, Chen TB, Liang CL. The impact of tracheostomy timing in patients with severe head injury: an observational cohort study. Injury. 2012;43(9):1432-6.
38
ORIGINAL_ARTICLE
The Epidemiology of Chemical Burns Among the Patients Referred to Burn Centers in Shiraz, Southern Iran, 2008–2018
Objective: To investigate the prevalence of chemical burns among the patients admitted to Shiraz burn treatment centers. Methods: It is a descriptive study that was conducted on 62 patients with chemical burns who were admitted between 2008 and 2018. The patients’ records were used in the research using the census sampling process. A questionnaire with questions about age, sex, the extent of the burn, the cause of the burn, duration of hospital stay, level of education, incident location, and clinical outcome was used to collect data (survival-death). The data was analyzed by using descriptive statistical methods. Results: The prevalence of chemical burns was 1% during 2008-2018. Acid and alkali burns were accounted for 93.5% and 6.5% of burns, respectively. 77.4% of patients were male, and 22.6% were female. The mean age of patients was 27 years. The average burn percentage was 16%. 70.6% of patients were illiterate or had primary education. Burns occurred at the workplace and home in 12.9% and 66.1% of cases, respectively. Moreover, Burns occurred due to accident (61%), acid attack (29%), and self-immolation (10%). The average length of hospital stay was 20 days. One patient (1.6%) died from burns. Conclusion: The study’s findings revealed that chemical burns were more common in men than women, and the majority of chemical burns occurred at home. To minimize the occurrence of chemical burns and acid attacks, teaching methods of preventing burns is important at home and work, as well as restricting nonspecialists’ access to chemicals.
https://beat.sums.ac.ir/article_47668_9f2e307aa39b11b4320781fb4d1529db.pdf
2021-10-01
195
200
10.30476/beat.2021.90754.1261
Chemical burn
Acid
Alkali
Epidemiology
Iran
Hosein
Abbasi
hoseinabbasi2006@gmail.com
1
Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Ali
Dehghani
ali.dehghani2000@yahoo.com
2
Department of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran
AUTHOR
Ali Akbar
Mohammadi
mohamadiaa1347@gmail.com
3
Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Tayyeb
Ghadimi
tayyeb.ghadimi5@gmail.com
4
Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
AUTHOR
Abdolkhalegh
Keshavarzi
iliakeshavarzi@yahoo.com
5
Department of General Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Peck MD. Epidemiology of burns throughout the world. Part I: Distribution and risk factors. Burns. 2011;37(7):1087-100.
1
In: World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization; [Accessed: October 2019]. Available from: https://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/.
2
Pasalar M, Mohammadi AA, Rajaeefard A, Neghab M, Tolidie H, Mehrabani D. Epidemiology of burns during pregnancy in southern Iran: Effect on maternal and fetal outcomes. World Appl Sci J. 2013;28(2):153-8.
3
In: World Health Organization. Burns: 2018 fact sheet. Geneva: World Health Organization; [Accessed: October 2019]. Available from: https://www.who.int/news-room/fact-sheets/detail/burns.
4
Arifi H, Ahmeti H, Zatriqi V, Buja S, Rexhaj Z, Arifi N. Epidemiology of burn injuries in Kosovo: a 10-year review. Ann Burns Fire Disasters. 2017;30(3):163-166.
5
Eser T, Kavalci C, Aydogan C, Kayipmaz AE. Epidemiological and cost analysis of burn injuries admitted to the emergency department of a tertiary burn center. Springerplus. 2016;5(1):1411.
6
Palao R, Monge I, Ruiz M, Barret JP. Chemical burns: pathophysiology and treatment. Burns. 2010;36(3):295-304.
7
Mozingo DW, Smith AA, McManus WF, Pruitt BA Jr, Mason AD Jr. Chemical burns. J Trauma. 1988;28(5):642-7.
8
Koh DH, Lee SG, Kim HC. Incidence and characteristics of chemical burns. Burns. 2017;43(3):654-664.
9
Jurkiewicz MJ. Plastic surgery: principles and practice. 1990.
10
Li W, Wu X, Gao C. Ten-year epidemiological study of chemical burns in Jinshan, Shanghai, PR China. Burns. 2013;39(7):1468-73.
11
In: American Burn Association. Burn Incidence and Treatment in the US: 2016 fact sheet. Chicago: American Burn Association; 2016 [Accessed: April 2020]. Available from: http://ameriburn.org/who-we-are/media/burn-incidence-fact-sheet/.
12
Hosseini SN, Rashtchi V, Kamali K, Moghimi MH. Epidemiology and outcome of 2,590 burned patients in Northwest Iran. Ann Burns Fire Disasters. 2017;30(2):85-90..
13
Sadeghi-Bazargani H, Mohammadi R. Epidemiology of burns in Iran during the last decade (2000-2010): review of literature and methodological considerations. Burns. 2012;38(3):319-29.
14
Akbari ME, Naghavi M, Soori H. Epidemiology of deaths from injuries in the Islamic Republic of Iran. East Mediterr Health J. 2006;12(3-4):382-90.
15
Naghavi M, Abolhassani F, Pourmalek F, Lakeh M, Jafari N, Vaseghi S, et al. The burden of disease and injury in Iran 2003. Popul Health Metr. 2009;7:9.
16
Maghsoudi H, Gabraely N. Epidemiology and outcome of 121 cases of chemical burn in East Azarbaijan province, Iran. Injury. 2008;39(9):1042-6.
17
Aghakhani K, Mehrpisheh S, Memarian A, Nikbin N. Epidemiology of caustic burns in Motahari hospital, Tehran from 2006 to 2011. Razi Journal of Medical Sciences. 2013;20(110):71-6.
18
McInnes JA, Cleland HJ, Cameron PA, Darton A, Tracy LM, Wood FM, et al. Epidemiology of burn-related fatalities in Australia and New Zealand, 2009-2015. Burns. 2019;45(7):1553-1561.
19
Ye C, Wang X, Zhang Y, Ni L, Jiang R, Liu L, et al. Ten-year epidemiology of chemical burns in western Zhejiang Province, China. Burns. 2016;42(3):668-74.
20
Dohlman CH, Cade F, Regatieri CV, Zhou C, Lei F, Crnej A, et al. Chemical Burns of the Eye: The Role of Retinal Injury and New Therapeutic Possibilities. Cornea. 2018;37(2):248-251.
21
Yano K, Hosokawa K, Kakibuchi M, Hikasa H, Hata Y. Effects of washing acid injuries to the skin with water: an experimental study using rats. Burns. 1995;21(7):500-2.
22
Patel B, Groom L, Prasad V, Kendrick D. Parental poison prevention practices and their relationship with perceived toxicity: cross-sectional study. Inj Prev. 2008;14(6):389-95.
23
Hardwicke J, Bechar J, Bella H, Moiemen N. Cutaneous chemical burns in children - a comparative study. Burns. 2013;39(8):1626-30
24
ORIGINAL_ARTICLE
Term Spontaneous Heterotopic Pregnancy (Abdominal and Intrauterine): A Case Report
Spontaneous heterotopic pregnancy is a potentially life-threatening condition rarely considered when a patient with an intrauterine pregnancy is asymptomatic or presents with complaints such as abdominal pain. An advanced abdominal pregnancy is even more unusual as the form of the ectopic component outside the context of assisted reproduction and is difficult in diagnosis with very few cases reported in the literature. We report such a case in a 31-year-old primigravida with heterotopic pregnancy which is a fetus in the uterine cavity and the other in the abdominal cavity. Her pregnancy was initially misdiagnosed and managed as a di-amniotic di-chorionic gestation. The correct diagnosis was only made after term delivery of the intrauterine pregnancy. The patient was complicated with severe bleeding which led to disseminated intravascular coagulopathy and massive transfusion. Two other operations were imposed on the patient because of bleeding. The clinical risk factor for ectopic pregnancy was only previous pelvic inflammatory disease in this woman.
https://beat.sums.ac.ir/article_47485_e353f235022b9abfd97da1006e32a64e.pdf
2021-10-01
201
203
10.30476/beat.2021.86588.1153
Heterotopic pregnancy
Abdominal pregnancy
Twin Pregnancy
term pregnancy
Mozhde
Momtahan
momtahan@sums.ac.ir
1
Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Maryam
Kasraeean
kasraeeanm@sums.ac.ir
2
Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Azam
Faraji
farajiaz@sums.ac.ir
3
Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
shaghayegh
Moradi Alamdarloo
shaghayeghmoradi84@gmail.com
4
Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Mina
Moosaie
moosaie.mina@gmail.com
5
Student research committee, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Hewlett K, Howell CM. Heterotopic pregnancy: Simultaneous viable and nonviable pregnancies. Journal of the American Academy of PAs. 2020;33(3):35-8.
1
Aziz M, Arronte J. A case of spontaneous heterotopic pregnancy in natural conception complicated with hemoperitoneum. Heliyon. 2020;6(2):e03373.
2
Lv S, Wang Z, Liu H, Peng J, Song J, Liu W, et al. Management strategies of heterotopic pregnancy following in vitro fertilization-embryo transfer. Taiwan J Obstet Gynecol. 2020;59(1):67-72.
3
Goettler S, Zanetti-Dällenbach R. Heterotopic Pregnancy. N Engl J Med. 2016;375(20):1982.
4
Nabi U, Yousaf A, Ghaffar F, Sajid S, Ahmed MMH. Heterotopic Pregnancy - A Diagnostic Challenge. Six Case Reports and Literature Review. Cureus. 2019;11(11):e6080.
5
Chen L, Wen H, Xu D, Chen LQ, He J. Management and pregnancy outcomes of heterotopic pregnancy. Zhonghua Fu Chan Ke Za Zhi. 2018;53(11):768-775. [in Chinese].
6
Chughtai F. Twin abdominal pregnancy - A rare scenario. J Pak Med Assoc. 2017;67(5):793-795.
7
Siati A, Berrada T, Baidada A, Kharbach A. Abdominal pregnancy with a healthy newborn: a new case. Pan Afr Med J. 2019;34:35.
8
ORIGINAL_ARTICLE
Sanctions or National Policies in COVID-19 Management in Iran: Which One is More Effective?!
The new corona disease (COVID-19) is very contagious and features a high risk of vast outbreak and infection. The World Health Organization (WHO) declared a global public health emergency condition on 30 January 2020 and a universal epidemic afterwards by given its rapid epidemic worldwide (1). Iran was amongst the first countries influenced by COVID-19. Iran’s health system was shocked by the fast and vast outbreak of the virus which made it impossible to take appropriate measures on the first days of COVID-19 outbreak for its management. However, Iran made maximal efforts returning to normal conditions. On the other hand, United States (US) sanctions contributed to the worsening of the conditions. The sanctions that mark the US’s economic and political war against Iran, date back to long time ago. These sanctions had indirect, adverse effects on the relief and rescue measures during the 2019 flood in Iran, as well (2). Sanctions are the perfect violation of humanitarian programs and are in conflict with the United Nations (UN) charter and the international human right declaration. Nonetheless, not only COVID-19 had no effects on the US’s perspectives and policies, but the sanctions have also been increased by the US in this period. In fact, the sanctions are the genuine manifestation of the US’s application of terrorism. These sanctions exert subtle physical, psychological, and mental effects on the people based on contribution to further spread of COVID-19.
https://beat.sums.ac.ir/article_47487_2a05f7e5b69aeec765c0279024cd3df4.pdf
2021-10-01
204
205
10.30476/beat.2021.90365.1249
COVID-19
National policies
Sanction
Health
Pandemic
Mahmoudreza
Peyravi
peyravi110@gmail.com
1
Department of Health in Disasters and Emergencies, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
AUTHOR
Milad
Ahmadi Marzaleh
miladahmadimarzaleh@yahoo.com
2
Department of Health in Disasters and Emergencies, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
LEAD_AUTHOR
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
1
Peyravi M, Ahmadi Marzaleh M. The Effect of the US Sanctions on Humanitarian Aids during the Great Flood of Iran in 2019. Prehosp Disaster Med. 2020;35(2):233-234.
2