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Alharbi RJ, Albargi H, Almuwallad A, Harthi N, Chowdhury S. Shifts in Paediatric Road Trauma Dynamics Pre- vs. Post-COVID-19 Lockdown: Insights from a Major Trauma Centre. J Epidemiol Glob Health 2024:10.1007/s44197-024-00295-5. [PMID: 39230862 DOI: 10.1007/s44197-024-00295-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 08/29/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has brought unprecedented changes globally, significantly affecting public health sectors, including paediatric road trauma. This study aims to explore the changes in paediatric road trauma presentations and outcomes before and after the COVID-19 lockdown. METHODS This retrospective study analysed paediatric trauma data from the Saudi TraumA Registry (STAR) from August 2017 to December 2022, comparing pre- and post-COVID-19 lockdown periods (August 2017-March 2020 and July 2020-December 2022, respectively). The study analysed demographic data, mechanism of injury, severity, ICU admissions, and mortality rates using multivariate logistic regression models. RESULTS Out of 950 paediatric trauma cases analysed, there was an 44.2 [561/389 = 1.442] % increase in the number of cases post-lockdown. A significant shift was noted in the age group of 5-9 years, with cases increasing from post-lockdown. Head injuries were the most prevalent type of injury, with their proportion slightly increasing from 163 (20.5%) pre-lockdown to 248 (23.2%) post-lockdown. The ICU admission were consistent across both periods, while the definitive care mode of arrival post-lockdown showed a notable shift towards private or government ambulances. CONCLUSION Our study provides critical insights into the significant impact of the COVID-19 on paediatric road trauma. The observed increase in trauma cases post-pandemic, particularly among younger children and a notable rise in driver-related injuries among adolescents, underscores the profound effect of lockdown measures and subsequent societal changes on paediatric health. Efforts to reduce paediatric traffic injuries require collaboration among parents, educators, healthcare professionals, policymakers, and the community at large.
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Affiliation(s)
- Rayan Jafnan Alharbi
- Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, Al Maarefah Rd, Jazan, 45142, Saudi Arabia.
| | - Hussin Albargi
- Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, Al Maarefah Rd, Jazan, 45142, Saudi Arabia
| | - Ateeq Almuwallad
- Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, Al Maarefah Rd, Jazan, 45142, Saudi Arabia
| | - Naif Harthi
- Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, Al Maarefah Rd, Jazan, 45142, Saudi Arabia
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Abu-Aiada J, Quint E, Dykman D, Czeiger D, Shaked G. Effectiveness of a two-tiered trauma team activation system at a level I trauma center. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02644-2. [PMID: 39196389 DOI: 10.1007/s00068-024-02644-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 08/13/2024] [Indexed: 08/29/2024]
Abstract
PURPOSE Many trauma patients who are transported to our level I trauma center have minor injuries that do not require full trauma team activation (FTTA). Thus, we implemented a two-tiered TTA system categorizing patients into red and yellow code alerts, indicating FTTA and Limited TTA (LTTA) requirements, respectively. This study aimed to assess the effectiveness of this triage tool by evaluating its diagnostic parameters (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), undertriage and overtriage) and comparing injury severity between the two groups. METHODS A retrospective cohort study of patients admitted to a Level I trauma center. Characteristics compared between the red and yellow code groups included demographics, injury severity, treatments, and hospital length of stay (LOS). Calculating the diagnostic parameters was based on Injury Severity Score (ISS) and the need for life-saving surgery or procedures. RESULTS Significant differences in injury severity indicators were observed between the two groups. Patients in the red code group had a higher ISS and New Injury Severity Score (NISS), a lower Glasgow Coma Score (GCS), Revised Trauma Score (RTS), and probability of survival. They had a longer hospital LOS, a higher Intensive Care Unit (ICU) admission rate and required more emergency operations. The Sensitivity of the triage tool was 85.2%, specificity was 55.6%, PPV was 74.2%, NPV was 71.5%, undertriage was 14.7%, and overtriage was 25.7%. CONCLUSION The two-tiered TTA system effectively distinguish between patients with major trauma who need FTTA and patients with minor trauma who can be managed by LTTA.
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Affiliation(s)
- Jamela Abu-Aiada
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - Elchanan Quint
- Department of General Surgery, Soroka University Medical Center, Ben- Gurion University, Beer Sheva, Israel
| | - Daniel Dykman
- Trauma Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - David Czeiger
- Department of General Surgery, Soroka University Medical Center, Ben- Gurion University, Beer Sheva, Israel
| | - Gad Shaked
- Department of General Surgery, Soroka University Medical Center, Ben- Gurion University, Beer Sheva, Israel
- Trauma Unit, Soroka University Medical Center, Beer Sheva, Israel
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Alharbi RJ, Alghamdi AS, Al-Jafar R, Almuwallad A, Chowdhury S. Identifying the key characteristics, trends, and seasonality of pedestrian traffic injury at a major trauma center in Saudi Arabia: a registry-based retrospective cohort study, 2017-2022. BMC Emerg Med 2024; 24:135. [PMID: 39075361 PMCID: PMC11287874 DOI: 10.1186/s12873-024-01051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 07/15/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Pedestrian traffic injuries are a rising public health concern worldwide. In rapidly urbanizing countries like Saudi Arabia, these injuries account for a considerable proportion of trauma cases and represent a challenge for healthcare systems. The study aims to analyze the key characteristics, seasonality, and outcomes of pedestrian traffic injuries in Riyadh, Saudi Arabia. METHODS This study was a retrospective cohort analysis of all pedestrian traffic injuries presented to King Saud Medical City, Riyadh, and included in the Saudi Trauma Registry (STAR) database between August 1, 2017, and December 31, 2022. The analysis of metric and nominal variables was reported as mean (standard deviation, SD) or median (interquartile range, IQR) and frequencies (%), respectively. A logistic regression analysis was performed to examine the influence of patients' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation and in-hospital mortality. RESULTS During the study period, 1062 pedestrian-injured patients were included in the analysis, mostly males (89.45%) with a mean (SD) age of 33.44 (17.92) years. One-third (35.88%) of the patients were Saudi nationals. Two-thirds (67.04%) of the injuries occurred from 6 p.m. until 6 a.m. Compared to other years, a smaller % of injury events (13.28%) were noticed during the COVID-19 pandemic (2020). Half (50.19%) of the patients were transported to the emergency department by the Red Crescent ambulance, and 19.68% required intubation and mechanical ventilation. Most of the patients (87.85%) were discharged home after completion of treatment, and our cohort had a 4.89% overall mortality. The logistic regression analysis showed the influence of patients' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation (Chi2 = 161.95, p < 0.001) and in-hospital mortality (Chi2 = 63.78, p < 0.001) as a whole significant. CONCLUSION This study details the demographic, temporal, and clinical trends of pedestrian traffic injuries at a major Saudi trauma center. Identifying high-risk individuals and injury timing is crucial for resource allocation, targeting road safety interventions like public awareness campaigns and regulatory reforms, and improving prehospital care and patient outcomes.
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Affiliation(s)
- Rayan Jafnan Alharbi
- Department of Emergency Medical Services, College of Applied Medical Sciences, Jazan University, Al Maarefah Rd, Jazan, 45142, Saudi Arabia.
| | - Abdulrhman Saleh Alghamdi
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Rami Al-Jafar
- Data Services Sector, Lean for Business Services, Riyadh, Saudi Arabia
- School of Public Health, Imperial College London, London, UK
| | - Ateeq Almuwallad
- Department of Emergency Medical Services, College of Applied Medical Sciences, Jazan University, Al Maarefah Rd, Jazan, 45142, Saudi Arabia
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Alharbi RJ, Al-Jafar R, Chowdhury S, Rahman MA, Almuwallad A, Alshibani A, Lewis V. Impact of easing COVID-19 lockdown restrictions on traumatic injuries in Riyadh, Saudi Arabia: one-year experience at a major trauma centre. BMC Public Health 2023; 23:22. [PMID: 36600205 PMCID: PMC9812537 DOI: 10.1186/s12889-023-14981-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/03/2023] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Lockdown restrictions due to the COVID-19 pandemic have reduced the number of injuries recorded. However, little is known about the impact of easing COVID-19 lockdown restrictions on the nature and outcome of injuries. This study aims to compare injury patterns prior to and after the easing of COVID-19 lockdown restrictions in Saudi Arabia. METHOD Data were collected retrospectively from the Saudi TraumA Registry for the period between March 25, 2019, and June 21, 2021. These data corresponded to three periods: March 2019-February 2020 (pre-restrictions, period 1), March 2020-June 2020 (lockdown, period 2), and July 2020-June 2021 (post easing of restrictions, period 3). Data related to patients' demographics, mechanism and severity of injury, and in-hospital mortality were collected and analysed. RESULTS A total of 5,147 traumatic injury patients were included in the analysis (pre-restrictions n = 2593; lockdown n = 218; post easing of lockdown restrictions n = 2336). An increase in trauma cases (by 7.6%) was seen in the 30-44 age group after easing restrictions (n = 648 vs. 762, p < 0.01). Motor vehicle crashes (MVC) were the leading cause of injury, followed by falls in all the three periods. MVC-related injuries decreased by 3.1% (n = 1068 vs. 890, p = 0.03) and pedestrian-related injuries decreased by 2.7% (n = 227 vs. 143, p < 0.01); however, burn injuries increased by 2.2% (n = 134 vs. 174, p < 0.01) and violence-related injuries increased by 0.9% (n = 45 vs. 60, p = 0.05) post easing of lockdown restrictions. We observed an increase in in-hospital mortality during the period of 12 months after easing of lockdown restrictions-4.9% (114/2336) compared to 12 months of pre-lockdown period-4.3% (113/2593). CONCLUSION This is one of the first studies to document trauma trends over a one-year period after easing lockdown restrictions. MVC continues to be the leading cause of injuries despite a slight decrease; overall injury cases rebounded towards pre-lockdown levels in Saudi Arabia. Injury prevention needs robust legislation with respect to road safety measures and law enforcement that can decrease the burden of traumatic injuries.
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Affiliation(s)
- Rayan Jafnan Alharbi
- grid.411831.e0000 0004 0398 1027Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, 45142, Al Maarefah Rd, Jazan, Saudi Arabia
| | - Rami Al-Jafar
- grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK ,Department of Data Services, Lean Business Services, Riyadh, Saudi Arabia
| | - Sharfuddin Chowdhury
- grid.415998.80000 0004 0445 6726Trauma Center, King Saud Medical City, Riyadh, Saudi Arabia
| | - Muhammad Aziz Rahman
- grid.1040.50000 0001 1091 4859School of Health, Federation University Australia, Berwick, VIC Australia
| | - Ateeq Almuwallad
- grid.411831.e0000 0004 0398 1027Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, 45142, Al Maarefah Rd, Jazan, Saudi Arabia ,grid.4868.20000 0001 2171 1133Centre for Trauma Science, Blizard Institute Queen Mary University, London, UK
| | - Abdullah Alshibani
- grid.412149.b0000 0004 0608 0662Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud bin, Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia ,grid.452607.20000 0004 0580 0891King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Virginia Lewis
- grid.1018.80000 0001 2342 0938Australia Institute for Primary Care and Ageing (AIPCA), La Trobe University, Melbourne, VIC Australia
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Ramadan M, Alnashri Y, Ilyas A, Batouk O, Alsheikh KA, Alhelabi L, Alnashri SA. Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study. Ann Saudi Med 2022; 42:366-376. [PMID: 36444923 PMCID: PMC9706711 DOI: 10.5144/0256-4947.2022.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Prescribing habits during admission have largely contributed to the opioid epidemic. Orthopedic surgeons represent the third-highest opioid-prescribing specialty. Since more than half of body fractures in Saudi Arabia have been lower extremity fractures, it is imperative to understand opioid administration patterns and correlates among opioid-naïve inpatients. OBJECTIVES Assess opioid administration patterns and correlates among opioid-naïve inpatients with lower extremity fractures. DESIGN AND SETTINGS Retrospective cohort PATIENTS AND METHODS: Opioid naïve individuals aged 18 to 64 years, admitted due to lower extremity fracture from 2016 to 2020 were included. Data was collected from health records of the Ministry of National Guard Health Affairs (MNG-HA) at five different medical centers. The high-dose (≥50 MME) patients were compared with low dose (<50 MME) patients. Any association between inpatient factors and high-dose opioid use was analyzed by multiple logistic regression. MAIN OUTCOME MEASURES Opioids taken during inpatient admission as measured by milligram morphine equivalents (MME)/per day. SAMPLE SIZE 1520 patients RESULTS: Most of the 1520 patients (88.5%) received an opioid medication, while (20.3%) received high-dose opioids at a median daily dose of 33.7 MME/per day. The proportion of patients received naloxone (20.7%) was double among high-dose opioid inpatients. High-dose opioid patients during admission were two times more likely to receive an opioid prescription after discharge (odds ratio, 2.32; 95% confidence interval, 1.53, 3.51), and three more times likely to receive ketamine during admission (odds ratio, 3.02; 95% confidence interval, 1.64, 5.54). CONCLUSION Notable variabilities exist in opioid administration patterns that were not explained by patient factors. Evidence-based opioid prescribing practices should be developed for orthopedic patients to prevent opioid overprescribing and potential opioid overdose among orthopedic patients. LIMITATIONS Retrospective, unmeasurable confounders might have biased our results. Since based on National Guard employees, results may not be generalizable. CONFLICT OF INTEREST None.
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Affiliation(s)
- Majed Ramadan
- From the Population Health, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Yahya Alnashri
- From the Department of Family and Community Medicine, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Amjad Ilyas
- From the Department of Orthopedic Surgery, Dr. Soliman Fakeeh Hospital, Makkah, Saudi Arabia
| | - Omar Batouk
- From the Department of Surgery, King Khalid National Guard Hospital, Makkah, Saudi Arabia
| | - Khalid A Alsheikh
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Laila Alhelabi
- From the Population Health, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Suliman Abdulah Alnashri
- From the Population Health, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Al-Sharydah AM. Predicting Suitable Percutaneous Endovascular Arterial Embolization for Traumatic Abdominopelvic Injuries: A Retrospective Cohort Study. Open Access Emerg Med 2022; 14:545-556. [PMID: 36212089 PMCID: PMC9534156 DOI: 10.2147/oaem.s376819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose This study evaluated the pre-procedural attributes of trauma patients to determine their suitability to undergo Percutaneous Endovascular Arterial Embolization (PEAE), and the current state of endovascular repair as an option for trauma-related injuries in traumatic abdominopelvic arterial injuries was explored. Patients and Methods We retrospectively evaluated the charts of 638 adults with traumatic abdominopelvic injuries treated from March 2011 to February 2021, extensively reviewing their pre-operative indices, pre-operative optimization requirements, and multi-modality imaging records. Results In total, 235 patients (30.63%) were “hemodynamically unstable” on admission, mainly due to hypotension (n=437 [68.5%]). Additionally, laboratory-defined acquired coagulopathies and inherited bleeding disorders were found in 268 patients (42.01%). The computerized tomography bleeding protocol was performed on 408 (63.94%) patients. Percutaneous endovascular therapy by arterial embolization was performed on 146 patients. The mean number of requested pre-intervention blood units for trauma patients significantly exceeded the number of units transfused post-intervention (P<0.0005). Apart from hemodynamics (ie heart rate, mean blood pressure); hemoglobin, and lactic acid levels were independently associated indices of PEAE outcomes (p <0.01). Conclusion Despite the recommendations from the Society of Interventional Radiology on endovascular intervention for trauma and bleeding risk, 36.84% of study patients had hemodynamic instability and other unfeasible parameters that would limit the option of minimally invasive procedures. Early recognition and consideration of suitable treatment options is essential for optimizing patient outcomes. It is imperative that standardized algorithms and management protocols based on available resources be developed.
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Affiliation(s)
- Abdulaziz Mohammad Al-Sharydah
- Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, College of Medicine, King Fahd Hospital of the University, Al-Khobar City, Eastern Province, Saudi Arabia
- Correspondence: Abdulaziz Mohammad Al-Sharydah, Diagnostic and Interventional Radiology Department, Imam Abdulrahman Bin Faisal University, College of Medicine, King Fahd Hospital of the University, PO Box: 31952, Al-Khobar City, Eastern Province, 4398, Saudi Arabia, Fax +966 013 8676697, Email
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International Perspectives of Prehospital and Hospital Trauma Services: A Literature Review. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Evidence suggests that reductions in the incidence in trauma observed in some countries are related to interventions including legislation around road and vehicle safety measures, public behaviour change campaigns, and changes in trauma response systems. This study aims to briefly review recent refereed and grey literature about prehospital and hospital trauma care services in different regions around the world and describe similarities and differences in identified systems to demonstrate the diversity of characteristics present. Methods: Articles published between 2000 and 2020 were retrieved from MEDLINE and EMBASE. Since detailed comparable information was lacking in the published literature, prehospital emergency service providers’ annual performance reports from selected example countries or regions were reviewed to obtain additional information about the performance of prehospital care. Results: The review retained 34 studies from refereed literature related to trauma systems in different regions. In the U.S. and Canada, the trauma care facilities consisted of five different levels of trauma centres ranging from Level I to Level IV and Level I to Level V, respectively. Hospital care and organisation in Japan is different from the U.S. model, with no dedicated trauma centres; however, patients with severe injury are transported to university hospitals’ emergency departments. Other similarities and differences in regional examples were observed. Conclusions: The refereed literature was dominated by research from developed countries such as Australia, Canada, and the U.S., which all have organised trauma systems. Many European countries have implemented trauma systems between the 1990s and 2000s; however, some countries, such as France and Greece, are still forming an integrated system. This review aims to encourage countries with immature trauma systems to consider the similarities and differences in approaches of other countries to implementing a trauma system.
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Designing and conducting initial application of a performance assessment model for in-hospital trauma care. BMC Health Serv Res 2022; 22:273. [PMID: 35232439 PMCID: PMC8887084 DOI: 10.1186/s12913-022-07578-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 02/01/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Trauma is a major cause of death worldwide, especially in Low and Middle-Income Countries (LMIC). The increase in health care costs and the differences in the quality of provided services indicates the need for trauma care evaluation. This study was done to develop and use a performance assessment model for in-hospital trauma care focusing on traffic injures. METHODS This multi-method study was conducted in three main phases of determining indicators, model development, and model application. Trauma care performance indicators were extracted through literature review and confirmed using a two-round Delphi survey and experts' perspectives. Two focus group discussions and 16 semi-structured interviews were conducted to design the prototype. In the next step, components and the final form of the model were confirmed following pre-determined factors, including importance and necessity, simplicity, clarity, and relevance. Finally, the model was tested by applying it in a trauma center. RESULTS A total of 50 trauma care indicators were approved after reviewing the literature and obtaining the experts' views. The final model consisted of six components of assessment level, teams, methods, scheduling, frequency, and data source. The model application revealed problems of a selected trauma center in terms of information recording, patient deposition, some clinical services, waiting time for deposit, recording medical errors and complications, patient follow-up, and patient satisfaction. CONCLUSION Performance assessment with an appropriate model can identify deficiencies and failures of services provided in trauma centers. Understanding the current situation is one of the main requirements for designing any quality improvement programs.
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Exploring Factors That Influence Injured Patients’ Outcomes following Road Traffic Crashes: A Multi-Site Feasibility Study. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Injuries arising from Road Traffic Crashes (RTCs) are a major health problem in Saudi Arabia (SA). The purpose of the study was to determine the feasibility of conducting a multi-center research study to explore factors that influence the mortality of RTC-related trauma patients in SA. Methods: A multi-center observational study was undertaken involving both prospective and retrospective data collected from three hospitals. In-hospital patient mortality thirty days post-crash was the primary outcome variable. The feasibility of the study methods including the quality of data were evaluated and pilot results pertaining to factors predicting mortality were examined. Results: The overall mortality rate (n = 572 RTC victims) was (7.5%). A logistic regression model identified four independent predictors of mortality following an RTC: treatment at a non-trauma center-based hospital, SBP ≤ 90 mmHg, GCS ≤ 8, and ISS ≥ 20. With respect to the assessment of the study method’s feasibility, missing data was problematic, especially for variables pertaining to crash characteristics and prehospital care. Conclusions: Collecting multi-center injury data in SA has logistic challenges, predominantly associated with the comparability and completeness of data sets as well as the need for manual screening and data collection at some institutions. Despite these limitations, this study has demonstrated the feasibility of a method that could be utilized in further large nationwide studies to understand and examine the factors that influence injured patients’ outcomes following RTCs.
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Kablan N, Bakhsh HR, Alammar W, Tatar Y, Ferriero G. Psychometric evaluation of the Arabic version of the Quebec user evaluation of satisfaction with assistive technology (A-QUEST 2.0) in prosthesis users. Eur J Phys Rehabil Med 2022; 58:118-126. [PMID: 34247472 PMCID: PMC9980568 DOI: 10.23736/s1973-9087.21.06880-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The evaluation of patient satisfaction and perceptions plays a vital role in determining the quality of prosthesis users' devices and the competency of healthcare services. AIM To evaluate the psychometric properties of the Arabic Quebec User Evaluation of Satisfaction with Assistive Technology (A-QUEST 2.0) with prosthetics users. DESIGN A methodological study. SETTING Saudi Arabia, Turkey. POPULATION A convenience sample of outpatient prosthesis users (N.=183). METHODS The A-QUEST 2.0 includes two subscales respectively evaluating the user's satisfaction with the device and the services provided. The data for each subscale were investigated using Rasch analysis to evaluate the item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF). RESULTS Both subscales met the Rasch criteria for the functioning of rating scale categories. All items showed an acceptable fit to the Rasch model. The person separation indices for the Device and Services subscales were 2.21 (Cronbach's α=0.90) and 1.72 (Cronbach's α=0.85), respectively. Therefore, the two subscales are sensitive enough to distinguish between at least three different levels of satisfaction. The unidimensionality of each subscale was confirmed, and none of the items displayed differential item functioning across age, gender, location of amputation, country, and duration of use. CONCLUSIONS Overall, the findings indicate the psychometric evaluation of A-QUEST 2.0 is effective with prosthesis users across different clinical contexts and cultures. Thus, the A-QUEST 2.0 allows for a comprehensive understanding of users' perceptions of prosthesis characteristics, particularly among subjects with lower limb amputations caused by traumatic injuries. CLINICAL REHABILITATION IMPACT Our paper provides clinicians dealing with Arabic patients a validated outcome measure for satisfaction with prosthesis. Besides providing information in the development of new products and service delivery. Further studies are necessary to improve the measure's metric quality in different contexts and for different prosthesis devices.
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Affiliation(s)
- Nilüfer Kablan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hadeel R Bakhsh
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia -
| | - Walaa Alammar
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Yaşar Tatar
- Faculty of Sports Sciences, Marmara University, Istanbul, Turkey
| | - Giorgio Ferriero
- Unit of Physical and Rehabilitation Medicine, Scientific Institute of Tradate, IRCCS Maugeri, Tradate, Varese, Italy.,Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
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Al-Sheikh Hassan M, De Vries K, Rutty J. Emergency trauma care during the COVID-19 pandemic: A phenomenological study of nurses’ experiences. Int Emerg Nurs 2022; 61:101147. [PMID: 35184031 PMCID: PMC8801308 DOI: 10.1016/j.ienj.2022.101147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/10/2021] [Accepted: 01/26/2022] [Indexed: 11/09/2022]
Abstract
Objective This study aimed to explore nurses’ experiences in delivering emergency trauma care during the COVID-19 pandemic at a level I trauma centre in Saudi Arabia. Methods A qualitative, descriptive phenomenological design was utilised, in which face-to-face, unstructured interviews were carried out with emergency and trauma nurses at a level I trauma centre in Saudi Arabia. The study included nine registered emergency and trauma nurses who were interviewed twice from February to April 2021. The collected data were analysed using Colaizzi’s descriptive phenomenological method. Results The analysis of the data revealed an overarching theme that was about the inevitable change on the ground due to the pandemic and two primary themes, each containing two subthemes: 1 dealing with an interrupted path of care; 1.1 experiencing additional complexity; 1.2 encountering extra demands; 2 optimising the path of care; 2.1 modifying the steps; and 2.2 transforming the system. Conclusion The COVID-19 pandemic imposed change on how trauma patients would be handled and treated. Nurses took an active and critical role in creating another form of change, which helped optimise the path of trauma care and accommodate urgent treatment needs of the injured patients.
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Bakhsh HR, Kablan N, Alammar W, Tatar Y, Ferriero G. The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation. Health Qual Life Outcomes 2021; 19:134. [PMID: 33906680 PMCID: PMC8077687 DOI: 10.1186/s12955-021-01773-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Background The Client Satisfaction with Devices (CSD) module of the Orthotics and Prosthetics Users’ Survey is an extensively used questionnaire that measures patients’ satisfaction with orthosis and prosthesis. However, the validated version for Arabic speakers (CSD-Ar) is only applicable for orthosis users. Objectives The aim of this study was to evaluate the psychometric proprieties of the CSD-Ar for prosthetics users. Methods The study used a convenience sample of prosthesis users from Saudi Arabia and Turkey (N = 183), who completed the CSD-Ar. The collected data were analysed using Rasch analysis to evaluate item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF) using WINSTEPS version 4.6.1. Results Based on the analysis, the four-response Likert-scale was acceptable, as shown by the category functioning test, All eight items did achieve a fit to the Rasch Model [(infit) and (outfit) mean-square 0.75 to 1.3]. Person separation reliability was 0.76, and item separation reliability was 0.94. A principal component analysis (PCA) showed satisfactory unidimensionality and no local item dependency. The DIF analysis showed no notable dependency among items on participant characteristics in terms of age, gender, duration of use, country, and level of amputation. Conclusion This study contributes to the confidence of using CSD-Ar to evaluate users’ satisfaction with different prostheses, affirming the need for further refinement of the quality of the outcome measure.
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Affiliation(s)
- Hadeel R Bakhsh
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nilüfer Kablan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Walaa Alammar
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Yaşar Tatar
- Faculty of Sports Sciences, Marmara Üniversity, Istanbul, Turkey
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy. .,Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
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Jifang W, Liping Y, Jing Z, Jie S. The effect of trauma care systems on the mortality of injured adult patients: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22279. [PMID: 32991428 PMCID: PMC7523867 DOI: 10.1097/md.0000000000022279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The aim of this study was to have a comprehensive evaluation of the effect of trauma care systems on the mortality of injured adult patients. MATERIALS AND METHODS This protocol established in this study has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Web of Science, PubMed, EMBASE, Scopus, and the Cochrane Library were searched for all clinical trials evaluating the effect of trauma care systems on the mortality of injured adult patients until July 31, 2020. We will use a combination of Medical Subject Heading and free-text terms with various synonyms to search based on the eligibility criteria. Two investigators independently reviewed the included studies and extracted relevant data. The odds ratio (OR) and 95% confidence intervals (CIs) were used as effect estimate. I-square (I) test, substantial heterogeneity, sensitivity analysis, and publication bias assessment will be performed accordingly. Stata 15.0 and Review Manger 5.3 are used for meta-analysis and systematic review. RESULTS The results will be published in a peer-reviewed journal. CONCLUSION The results of this review will be widely disseminated through peer-reviewed publications and conference presentations. This evidence may also provide a comprehensive evaluation of the effect of trauma care systems on the mortality of injured adult patients. REGISTRATION NUMBER INPLASY202080058.
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