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Quiroga-Centeno AC, Serrano-Pastrana JP, Neira-Triana KA, Valencia-Ángel LI, Jaimes-Sanabria MZ, Quiroga-Centeno CA, Gómez-Ochoa SA. Epidemiología del trauma en Bucaramanga, Colombia: análisis del registro institucional de trauma en el Hospital Universitario de Santander. REVISTA COLOMBIANA DE CIRUGÍA 2022. [DOI: 10.30944/20117582.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introducción. El trauma es una de las principales causas de mortalidad a nivel mundial y representa un problema de salud pública. En Latinoamérica y particularmente en Colombia, son escasos los registros de trauma que se han desarrollado satisfactoriamente. El objetivo del presente estudio fue describir la epidemiología del trauma en el Hospital Universitario de Santander, en el primer año de implementación del registro de trauma institucional.
Métodos. Personal del Departamento de Cirugía General de la Universidad Industrial de Santander y el Hospital Universitario de Santander, iniciaron el diseño del registro de trauma en el año 2020. Se incluyeron todos los pacientes que ingresaron al hospital, incluso los que fallecieron en el servicio de urgencias. La implementación del registro se inició el 1 de agosto de 2020, previa realización de una prueba piloto. Los informes se recogieron automáticamente y se exportaron a una base de datos electrónica no identificada.
Resultados. Se evaluaron 3114 pacientes, el 78,1 % de ellos hombres, con una mediana de edad de 31 años. La mediana de tiempo prehospitalario fue de tres horas y lo más frecuente fue el ingreso por propios medios (51,2 %). El mecanismo de trauma más frecuente fue el penetrante (41,8 %), siendo la mayoría de heridas por arma cortopunzante (24,9 %). El trauma cerrado se presentó en el 41,7 % de los pacientes evaluados y el 14,4 % de la población se encontraba bajo el efecto de sustancias psicoactivas. El servicio de Cirugía general fue el más interconsultado (26,9 %), seguido del servicio de cirugía plástica (21,8 %). La mediana de estancia hospitalaria fue de dos días (Q1:0; Q3:4) y 75 pacientes (2,4 %) fallecieron durante su hospitalización.
Conclusión. El registro de trauma de nuestra institución se presenta como una plataforma propicia para el análisis de la atención prehospitalaria e institucional del trauma, y el desarrollo de planes de mejora en este contexto. Este registro constituye una herramienta sólida para la ejecución de nuevos de proyectos de investigación en esta área.
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Dasari M, Johnson ED, Montenegro JH, Griswold DP, Jiménez MF, Puyana JC, Rubiano AM. A consensus statement for trauma surgery capacity building in Latin America. World J Emerg Surg 2021; 16:4. [PMID: 33516227 PMCID: PMC7847173 DOI: 10.1186/s13017-021-00347-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 01/18/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Trauma is a significant public health problem in Latin America (LA), contributing to substantial death and disability in the region. Several LA countries have implemented trauma registries and injury surveillance systems. However, the region lacks an integrated trauma system. The consensus conference's goal was to integrate existing LA trauma data collection efforts into a regional trauma program and encourage the use of the data to inform health policy. METHODS We created a consensus group of 25 experts in trauma and emergency care with previous data collection and injury surveillance experience in the LA. region. Experts participated in a consensus conference to discuss the state of trauma data collection in LA. We utilized the Delphi method to build consensus around strategic steps for trauma data management in the region. Consensus was defined as the agreement of ≥ 70% among the expert panel. RESULTS The consensus conference determined that action was necessary from academic bodies, scientific societies, and ministries of health to encourage a culture of collection and use of health data in trauma. The panel developed a set of recommendations for these groups to encourage the development and use of robust trauma information systems in LA. Consensus was achieved in one Delphi round. CONCLUSIONS The expert group successfully reached a consensus on recommendations to key stakeholders in trauma information systems in LA. These recommendations may be used to encourage capacity building in trauma research and trauma health policy in the region.
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Affiliation(s)
- Mohini Dasari
- University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | | | | | - Dylan P. Griswold
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital & University of Cambridge, Cambridge, UK
- Stanford School of Medicine, Stanford, CA USA
| | | | - Juan Carlos Puyana
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Andres M. Rubiano
- MEDITECH Foundation, Santiago de Cali, Valle de Cauca, Colombia
- Institute of Neuroscience, Universidad El Bosque, Bogotá, Colombia
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Orlas CP, Herrera-Escobar JP, Zogg CK, Serna JJ, Meléndez JJ, Gómez A, Martínez D, Parra MW, García AF, Rosso F, Pino LF, Gonzalez A, Ordoñez CA. Chest Trauma Outcomes: Public Versus Private Level I Trauma Centers. World J Surg 2021; 44:1824-1834. [PMID: 31993723 DOI: 10.1007/s00268-020-05400-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The goal of our study was to evaluate the differences in care and clinical outcomes of patients with chest trauma between two hospitals, including one public trauma center (Pu-TC) and one private trauma center (Pri-TC). METHODS Patients with thoracic trauma admitted from January 2012 to December 2018 at two level I trauma centers (Pu-TC: Hospital Universitario del Valle, Pri-TC: Fundación Valle del Lili) in Cali, Colombia, were included. Multivariable logistic regression was used to assess for differences in in-hospital mortality, adjusting for relevant demographic and clinical characteristics. RESULTS A total of 482 patients were identified; 300 (62.2%) at the Pri-TC and 182 (37.8%) at the Pu-TC. Median age was 27 years (IQR 21-36) and median Injury Severity Score was 25 (IQR 16-26). 456 patients (94.6%) were male, and the majority had penetrating trauma [total 465 (96.5%); Pri-TC 287 (95.7%), Pu-TC 179 (98.4%), p 0.08]. All patients arrived at the emergency room with unstable hemodynamics. There were no statistically significant differences in post-operative complications, including retained hemothorax [Pri-TC 19 vs. Pu-TC 18], pneumonia [Pri-TC 14 vs. Pu-TC 14], empyema [Pri-TC 13 vs. Pu-TC 13] and mediastinitis [Pri-TC 6 vs. Pu-TC 2]. Logistic regression did, however, show a higher odds of mortality when patients were treated at the Pu-TC [OR 2.27 (95% CI 1.34-3.87, p < 0.001]. CONCLUSIONS Our study found significant statistical differences in clinical outcomes between patients treated at a Pu-TC and Pri-TC. The results are intended to stimulate discussions to better understand reasons for outcome variability and ways to reduce it.
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Affiliation(s)
- Claudia P Orlas
- Center for Surgery and Public Health, Department of Surgery, Brigham & Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health, Boston, USA.
- Clinical Research Center, Fundación Valle del Lili, Carrera 98, #18-49, Cali, Colombia.
| | - Juan Pablo Herrera-Escobar
- Center for Surgery and Public Health, Department of Surgery, Brigham & Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health, Boston, USA
| | - Cheryl K Zogg
- Center for Surgery and Public Health, Department of Surgery, Brigham & Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health, Boston, USA
| | - José J Serna
- Seccion de Cirugia de Trauma y Emergencias, Universidad del Valle - Hospital Universitario del Valle, Cali, Colombia
- Fundación Valle del Lili, Departamento de Cirugia de Trauma y Emergencias, Cali, Colombia
| | - Juan J Meléndez
- Seccion de Cirugia de Trauma y Emergencias, Universidad del Valle - Hospital Universitario del Valle, Cali, Colombia
| | - Alexandra Gómez
- Facultad de ciencias de la salud, Universidad del Valle, Cali, Colombia
| | - Diana Martínez
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia
| | - Michael W Parra
- Department of Trauma Critical Care, Broward General Level I Trauma Center, Fort Lauderdale, FL, USA
| | - Alberto F García
- Seccion de Cirugia de Trauma y Emergencias, Universidad del Valle - Hospital Universitario del Valle, Cali, Colombia
- Fundación Valle del Lili, Departamento de Cirugia de Trauma y Emergencias, Cali, Colombia
| | - Fernando Rosso
- Fundación Valle del Lili, Departamento de Infectologia, Universidad Icesi, Cali, Colombia
| | - Luis Fernando Pino
- Seccion de Cirugia de Trauma y Emergencias, Universidad del Valle - Hospital Universitario del Valle, Cali, Colombia
| | - Adolfo Gonzalez
- Seccion de Cirugia de Trauma y Emergencias, Universidad del Valle - Hospital Universitario del Valle, Cali, Colombia
| | - Carlos A Ordoñez
- Seccion de Cirugia de Trauma y Emergencias, Universidad del Valle - Hospital Universitario del Valle, Cali, Colombia.
- Fundación Valle del Lili, Departamento de Cirugia de Trauma y Emergencias, Cali, Colombia.
- Clinical Research Center, Fundación Valle del Lili, Carrera 98, #18-49, Cali, Colombia.
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Gonzalez-Hadad A, García AF, Serna JJ, Herrera MA, Morales M, Manzano-Nunez R. The Role of Ultrasound for Detecting Occult Penetrating Cardiac Wounds in Hemodynamically Stable Patients. World J Surg 2021; 44:1673-1680. [PMID: 31933039 DOI: 10.1007/s00268-020-05376-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is evidence in favor of using the ultrasound as the primary screening tool in looking for an occult cardiac injury. We report on a prospective single-center study to determine the diagnostic accuracy of chest ultrasound for the diagnosis of occult penetrating cardiac wounds in a low-resource hospital from a middle-income country. METHODS Data were collected prospectively. We included all consecutive patients 14 years and older who presented to the Emergency Trauma Unit with (1) penetrating injuries to the precordial area and (2) a systolic blood pressure ≥ 90 mmHg (hemodynamically stable). The main outcome measures were sensitivity, specificity, and positive and negative predictive values of ultrasound compared with those of the pericardial window, which was the standard test. RESULTS A total of 141 patients met the inclusion criteria. Our results showed that for diagnosing an occult cardiac injury, the sensitivity of the chest ultrasonography was 79.31%, and the specificity was 92.86%. Of the 110 patients with a normal or negative ultrasound, six had a positive pericardial window. All of these patients had left hemothoraces. None of them required further cardiac surgical interventions. CONCLUSION We found that ultrasound was 79% sensitive and 92% specific for the diagnosis of occult penetrating cardiac wounds. However, it should be used with caution in patients with injuries to the cardiac zone and simultaneous left hemothorax.
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Affiliation(s)
| | - Alberto F García
- Department of Surgery, Universidad del Valle, Cali, Colombia.,Department of Surgery and Clinical Research Center, Fundacion Valle del Lili, Cali, Colombia
| | - Jose J Serna
- Department of Surgery, Universidad del Valle, Cali, Colombia
| | | | - Monica Morales
- Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Ramiro Manzano-Nunez
- Department of Surgery and Clinical Research Center, Fundacion Valle del Lili, Cali, Colombia.
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Franco J, Vizcaya D. Availability of secondary healthcare data for conducting pharmacoepidemiology studies in Colombia: A systematic review. Pharmacol Res Perspect 2020; 8:e00661. [PMID: 32965783 PMCID: PMC7510335 DOI: 10.1002/prp2.661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022] Open
Abstract
Real-world evidence (RWE) is emerging as a fundamental component of the post-marketing evaluation of medicinal products. Even though the focus on RWE studies has increased in Colombia, the availability of secondary data sources to perform this type of research is not well documented. Thus, we aimed at identifying and characterizing secondary data sources available in Colombia. We performed a systematic literature review on PubMed, EMBASE, and VHL using a combination of controlled vocabulary and keywords for the concepts of electronic health records, epidemiologic studies and Colombia. A total of 323 publications were included. These comprised 123 identified secondary data sources including pharmacy dispensing databases, government datasets, disease registries, insurance databases, and electronic heath records, among others. These data sources were mostly used for cross-sectional studies focused on disease epidemiology in a specific population. Almost all databases (95%) contained demographic information, followed by pharmacological treatment (44%) and diagnostic tests (39%). Even though the database owner was identifiable in 94%, access information was only available in 44% of the articles. Only a pharmacy-dispensing database, local cancer registries, and government databases included a description regarding the quality of the information available. The diversity of databases identified shows that Colombia has a high potential to continue enhancing its RWE strategy. Greater efforts are required to improve data quality and accessibility. The linkage between databases will expand data pooling and integration to boost the translational potential of RWE.
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Cariello AN, Perrin PB, Rodríguez-Agudelo Y, Olivera Plaza SL, Quijano-Martinez MC, Arango-Lasprilla JC. A Multi-Site Study of Traumatic Brain Injury in Mexico and Colombia: Longitudinal Mediational and Cross-Lagged Models of Family Dynamics, Coping, and Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176045. [PMID: 32825253 PMCID: PMC7504148 DOI: 10.3390/ijerph17176045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 01/01/2023]
Abstract
Latin America has high rates of traumatic brain injury (TBI), yet reduced mental and physical health outcomes due to limited rehabilitation services. To understand the psychosocial adjustment process in TBI patients in Latin America, the incorporation of cultural values including family-based variables is imperative. The current study examined relations among healthy family dynamics, coping, and mental and physical health related quality of life (HRQL) among a sample of TBI patients across three sites and two countries over the first 4 months post-injury. A sample of 109 acute TBI patients from Mexico and Colombia were recruited, and a series of longitudinal mediation and cross-lag panel analyses were run. Mental and physical HRQL were positively associated with each other, as well as healthy family dynamics and coping. Coping partially mediated the effects of healthy family dynamics on both mental and physical HRQL. Family dynamics showed the strongest cross-lag relationships with coping going from 2 months to 4 months. Similarly, coping showed the strongest cross-lag relationships with both mental and physical HRQL going from baseline to 2 months. Results provide empirical support for the importance of a rehabilitation workforce that has been trained in and can effectively implement family-based interventions for individuals with TBI in Latin America.
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Affiliation(s)
- Annahir N. Cariello
- Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA 23284, USA; (A.N.C.); (P.B.P.)
| | - Paul B. Perrin
- Virginia Commonwealth University, 907 Floyd Ave, Richmond, VA 23284, USA; (A.N.C.); (P.B.P.)
| | - Yaneth Rodríguez-Agudelo
- Neuropsychology Department, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico;
| | | | | | - Juan Carlos Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute, Cruces University Hospital Barakaldo, 48903 Barakaldo, Spain
- IKERBASQUE, Basque Foundation for Science, 48013 Bilbao, Spain
- Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), 48940 Leioa, Biscay, Spain
- Correspondence:
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Association of resuscitative endovascular balloon occlusion of the aorta (REBOA) and mortality in penetrating trauma patients. Eur J Trauma Emerg Surg 2020; 47:1779-1785. [PMID: 32300850 DOI: 10.1007/s00068-020-01370-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to examine the association of REBOA and mortality in a group of patients with penetrating trauma to the torso, treated in a level-I trauma center from Colombia. METHODS In a retrospective cohort study, patients with penetrating trauma, requiring emergency surgery, and treated between 2014 and 2018, were included. The decision to use or not use REBOA during emergent surgery was based on individual surgeon's opinion. A propensity score (PS) was calculated after adjusting for age, clinical signs on admission (systolic blood pressure, cardiac rate, Glasgow coma scale), severe trauma in thorax and abdomen, and the presence of non-compressive torso hemorrhage. Subsequently, logistic regression for mortality was adjusted for the number of red blood cells (RBC) transfused within the first six hours after admission, injury severity score (ISS), and quintiles of PS. RESULTS We included 345 patients; 28 of them (8.1%) were treated with REBOA. Crude mortality rates were 17.9% (5 patients) in REBOA group and 15.3% (48 patients) in control group (p = 0.7). After controlling for RBC transfused, ISS, and the PS, the odds of death in REBOA group was 78% lower than that in the control group (odds ratio [OR] 0.20, 95% confidence interval [95%CI] 0.05-0.77, p = 0.01). CONCLUSION We found that, when compared to no REBOA use, patients treated with REBOA had lower risk-adjusted odds of mortality. These findings should be interpreted with caution and confirmed in future comparative studies, if possible.
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Garcia AF, Manzano-Nunez R, Bayona JG, Millan M, Puyana JC. A clinical series of packing the wound tract for arresting traumatic hemorrhage from injuries of the lung parenchyma as a feasible damage control technique. World J Emerg Surg 2019; 14:52. [PMID: 31798672 PMCID: PMC6883594 DOI: 10.1186/s13017-019-0273-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/17/2019] [Indexed: 12/18/2022] Open
Abstract
Background Tractotomy has become the standard of care for transfixing through-and-through lung injuries as it can be performed quickly with little blood loss and a low risk of complications. However, packing with laparotomy pads could be a feasible alternative to tractotomy on selected patients. We describe a series of four patients with lung trauma in which packing of the pulmonary wound tract was used as the primary and unique surgical strategy for arresting hemorrhage from injuries of the lung parenchyma. Methods Packing of the traumatic tract is achieved by gently pulling a laparotomy pad with a Rochester clamp and adjusting it to the cavity to stop the bleeding. The pack is removed in a subsequent surgery by moistening and tractioning it softly to avoid additional damage. The operation is completed by manual compression of the wounded lobe. We present a case series of our experience with this approach. Results From 2012 to 2016, we treated four patients with the described method. The mechanism was penetrating in all them. The clinical condition was of exsanguinations with multiple sources of hemorrhage. There were three patients with peripheral injuries to the lung and one with a central injury to the pulmonary parenchyma. Bleeding was stopped in all the cases. Three patients survived. A patient had recurrent pneumothorax which was resolved with a second chest tube. Conclusion Packing of the traumatic tract allowed rapid and safe treatment of transfixing through-and-through pulmonary wounds in exsanguinating patients under damage control from several bleeding sources.
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Affiliation(s)
- Alberto F Garcia
- 1Department of Surgery, Fundación Valle del Lili, Cali, Colombia.,3CISALVA Institute and Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Ramiro Manzano-Nunez
- 1Department of Surgery, Fundación Valle del Lili, Cali, Colombia.,2Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
| | | | - Mauricio Millan
- 1Department of Surgery, Fundación Valle del Lili, Cali, Colombia
| | - Juan C Puyana
- 4Department of Surgery, University of Pittsburgh, Pittsburgh, PA USA
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Ordoñez CA, Manzano-Nunez R, Naranjo MP, Foianini E, Cevallos C, Londoño MA, Sanchez Ortiz AI, García AF, Moore EE. Casualties of peace: an analysis of casualties admitted to the intensive care unit during the negotiation of the comprehensive Colombian process of peace. World J Emerg Surg 2018; 13:2. [PMID: 29371879 PMCID: PMC5769432 DOI: 10.1186/s13017-017-0161-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/18/2017] [Indexed: 01/22/2023] Open
Abstract
Background After 52 years of war in 2012, the Colombian government began the negotiation of a process of peace, and by November 2012, a truce was agreed. We sought to analyze casualties who were admitted to the intensive care unit (ICU) before and during the period of the negotiation of the comprehensive Colombian process of peace. Methods Retrospective study of hostile casualties admitted to the ICU at a Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (November 2012-December 2016). Patients were compared with respect to time periods. Results Four hundred forty-eight male patients were admitted to the emergency room. Of these, 94 required ICU care. Sixty-five casualties presented before the truce and 29 during the negotiation period. Median injury severity score was significantly higher before the truce. Furthermore, the odds of presenting with severe trauma (ISS > 15) were significantly higher before the truce (OR, 5.4; (95% CI, 2.0-14.2); p < 0.01). There was a gradual decrease in the admissions to the ICU, and the performance of medical and operative procedures during the period observed. Conclusion We describe a series of war casualties that required ICU care in a period of peace negotiation. Despite our limitations, our study presents a decline in the occurrence, severity, and consequences of war injuries probably as a result in part of the negotiation of the process of peace. The hysteresis of these results should only be interpreted for their implications in the understanding of the peace-health relationship and must not be overinterpreted and used for any political end.
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Affiliation(s)
- Carlos A. Ordoñez
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
- Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Ramiro Manzano-Nunez
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
| | - Maria Paula Naranjo
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
| | - Esteban Foianini
- Department of Surgery, Clinica Foianini, Santacruz de la Sierra, Bolivia
| | | | | | - Alvaro I. Sanchez Ortiz
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
- Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
| | - Alberto F. García
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
- Department of Surgery, Universidad del Valle, Cali, Colombia
| | - Ernest E. Moore
- Department of Surgery, Trauma Research Center, University of Colorado, Denver, CO USA
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Scientific Integrity Issues to Discuss. World J Surg 2017; 42:306-307. [PMID: 28717909 DOI: 10.1007/s00268-017-4117-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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