1
|
Gohy B, Opava CH, von Schreeb J, Van den Bergh R, Brus A, Fouda Mbarga N, Ouamba JP, Mafuko JM, Mulombwe Musambi I, Rougeon D, Côté Grenier E, Gaspar Fernandes L, Van Hulse J, Weerts E, Brodin N. Assessing independence in mobility activities in trauma care: Validity and reliability of the Activity Independence Measure-Trauma (AIM-T) in humanitarian settings. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001723. [PMID: 37695762 PMCID: PMC10495016 DOI: 10.1371/journal.pgph.0001723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/17/2023] [Indexed: 09/13/2023]
Abstract
The importance of measuring outcomes after injury beyond mortality and morbidity is increasingly recognized, though underreported in humanitarian settings. To address shortcomings of existing outcome measures in humanitarian settings, the Activity Independence Measure-Trauma (AIM-T) was developed, and is structured in three subscales (i.e., core, lower limb, and upper limb). This study aimed to assess the AIM-T construct validity (structural validity and hypothesis testing) and reliability (internal consistency, inter-rater reliability and measurement error) in four humanitarian settings (Burundi, Iraq, Cameroon and Central African Republic). Patients with acute injury (n = 195) were assessed using the AIM-T, the Barthel Index (BI), and two pain scores. Structural validity was assessed through confirmatory factor analysis. Hypotheses were tested regarding correlations with BI and pain scores using Pearson correlation coefficient (PCC) and differences in AIM-T scores between patients' subgroups, using standardized effect size Cohen's d (d). Internal consistency was assessed with Cronbach's alpha (α). AIM-T was reassessed by a second rater in 77 participants to test inter-rater reliability using intraclass correlation coefficient (ICC). The results showed that the AIM-T structure in three subscales had an acceptable fit. The AIM-T showed an inverse weak to moderate correlation with both pain scores (PCC<0.7, p≤0.05), positive strong correlation with BI (PCC≥0.7, p≤0.05), and differed between all subgroups (d≥0.5, p≤0.05). The inter-rater reliability in the (sub)scales was good to excellent (ICC 0.86-0.91) and the three subscales' internal consistency was adequate (α≥0.7). In conclusion, this study supports the AIM-T validity in measuring independence in mobility activities and its reliability in humanitarian settings, as well as it informs on its interpretability. Thus, the AIM-T could be a valuable measure to assess outcomes after injury in humanitarian settings.
Collapse
Affiliation(s)
- Bérangère Gohy
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Humanity & Inclusion, Rehabilitation Technical Direction, Brussels, Belgium
| | - Christina H. Opava
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Johan von Schreeb
- Department of Global Public Health, Karolinska Institutet, Stockholm Sweden
| | | | - Aude Brus
- Humanity & Inclusion, Innovation, Impact & Information Division, Brussels, Belgium
| | - Nicole Fouda Mbarga
- Médecins Sans Frontières, Operational Center Geneva, YaoundeYaounde, Cameroon
| | - Jean Patrick Ouamba
- Médecins Sans Frontières, Operational Center Geneva, YaoundeYaounde, Cameroon
| | - Jean-Marie Mafuko
- Médecins Sans Frontières, Operational Center Brussels, Bujumbura, Burundi
| | - Irene Mulombwe Musambi
- Médecins Sans Frontières, Operational Center Paris, Bangui, Central African Republic, Baghdad, Iraq
| | - Delphine Rougeon
- Médecins Sans Frontières, Operational Center Paris, Bangui, Central African Republic, Baghdad, Iraq
| | | | | | | | - Eric Weerts
- Humanity & Inclusion, Rehabilitation Technical Direction, Brussels, Belgium
| | - The AIM-T Study Group
- Médecins Sans Frontières, Operational Center Brussels, Brussels, Belgium
- Médecins Sans Frontières, Operational Center Geneva, YaoundeYaounde, Cameroon
- Médecins Sans Frontières, Operational Center Brussels, Bujumbura, Burundi
- Médecins Sans Frontières, Operational Center Paris, Bangui, Central African Republic, Baghdad, Iraq
- Médecins Sans Frontières, Operational Center Paris, Baghdad, Iraq
- Médecins Sans Frontières, Operational Center Paris, France
| | - Nina Brodin
- Department of Neurobiology, Division of Physiotherapy, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Orthopaedics, Danderyd Hospital Corp., Division of Physiotherapy, Danderyd, Sweden
| |
Collapse
|
2
|
Fusario D, Neri A, Carbone L, Resca L, Marano L, Gassi G, Calomino N, Verre L, Roviello F, Marrelli D. The Emergency Surgery Frailty Index (EmSFI) in Elderly Patients with Acute Appendicitis: An External Validation of Prognostic Score. World J Surg 2023; 47:1713-1720. [PMID: 36947203 PMCID: PMC10229705 DOI: 10.1007/s00268-023-06975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Identification of reliable risk-stratification tools is critical for surgical decision making, particularly in frail and elderly. The aim of the study is to validate the Emergency Surgery Frailty Index (EmSFI), in over 65 years old patients operated on for acute appendicitis. METHODS An observational study was conducted enrolling elderly patients with diagnosis of acute appendicitis who underwent emergency appendicectomy or right colectomy, between 2016 and 2021. All patients were treated according to the last SIFIPAC/WSES/SICG/SIMEU guidelines. RESULTS Overall, 61 patients were analyzed. Complication rate was higher for patients in the second EmSFI risk Class. Moreover, ROC analyses identified 3 as the best cutoff value in predicting risk of adverse postoperative events. Complication rate was higher in oldest elderly patients-over 80 years-(42.9 vs 22.5%; p 0.05) and was mainly related to medical complications (42.9 vs 12.5%, p 0.007). However, intestinal obstruction, peri-appendicular abscess on preoperative CT, peritonitis and a longer duration of surgery are related with increased risk of complications in the group of patients under 80 years. CONCLUSION The EmSFI score results a valid prognostic marker for frailty status, and it may support the surgeon in emergency setting for acute appendicitis. Patients aged 80 years or older have a higher risk of complications, independent from those factors which relate to increased morbidity in younger elderly patients. Age alone is not a reliable indicator of the real surgical risk, but it must encourage the adoption of multidisciplinary collaborative models of care for this group of patients.
Collapse
Affiliation(s)
- Daniele Fusario
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Alessandro Neri
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Ludovico Carbone
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy.
| | - Luca Resca
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Luigi Marano
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Giulia Gassi
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Natale Calomino
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Luigi Verre
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Franco Roviello
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Daniele Marrelli
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| |
Collapse
|
3
|
Gohy B, Opava CH, von Schreeb J, Van den Bergh R, Brus A, El Hamid Qaradaya A, Mafuko JM, Al-Abbasi O, Cherestal S, Fernandes L, Da Silva Frois A, Weerts E, Brodin N. Monitoring independence in daily life activities after trauma in humanitarian settings: Item reduction and assessment of content validity of the Activity Independence Measure-Trauma (AIM-T). PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001334. [PMID: 36962914 PMCID: PMC10021394 DOI: 10.1371/journal.pgph.0001334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
A standardized set of measures to assess functioning after trauma in humanitarian settings has been called for. The Activity Independence Measure for Trauma (AIM-T) is a clinician-rated measure of independence in 20 daily activities among patients after trauma. Designed in Afghanistan, it has since been used in other contexts. Before recommending the AIM-T for wider use, its measurement properties required confirmation. This study aims at item reduction followed by content validity assessment of the AIM-T. Using a two-step revision process, first, routinely collected data from 635 patients at five facilities managing patients after trauma in Haiti, Burundi, Yemen, and Iraq were used for item reduction. This was performed by analyzing inter-item redundancy and distribution of the first version of the AIM-T (AIM-T1) item scores, resulting in a shortened version (AIM-T2). Second, content validity of the AIM-T2 was assessed by item content validity indices (I-CVI, 0-1) based on structured interviews with 23 health care professionals and 60 patients in Haiti, Burundi, and Iraq. Through the analyses, nine pairs of redundant items (r≥0.90) were identified in the AIM-T1, leading to the removal of nine items, and resulting in AIM-T2. All remaining items were judged highly relevant, appropriate, clear, feasible and representative by most of participants (I-CVI>0.5). Ten items with I-CVI 0.5-0.85 were revised to improve their cultural relevance or appropriateness and one item was added, resulting in the AIM-T3. In conclusion, the proposed 12-item AIM-T3 is overall relevant, clear, and representative of independence in daily activity after trauma and it includes items appropriate and feasible to be observed by clinicians across different humanitarian settings. While some additional measurement properties remain to be evaluated, the present version already has the potential to serve as a routine measure to assess patients after trauma in humanitarian settings.
Collapse
Affiliation(s)
- Bérangère Gohy
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Humanity & Inclusion, Rehabilitation technical direction, Brussels, Belgium
| | - Christina H. Opava
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Johan von Schreeb
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Aude Brus
- Impact & Information Division, Humanity & Inclusion, Innovation, Brussels, Belgium
| | | | - Jean-Marie Mafuko
- Médecins Sans Frontières, Operational Center Brussels, Bujumbura, Burundi
| | - Omar Al-Abbasi
- Médecins Sans Frontières, Operational Center Brussels, Erbil, Iraq
| | - Sophia Cherestal
- Médecins Sans Frontières, Operational Center Brussels, Port-au-Prince, Haiti
| | - Livia Fernandes
- Médecins Sans Frontières, Operational Center Paris, Baghdad, Iraq
| | | | - Eric Weerts
- Humanity & Inclusion, Rehabilitation technical direction, Brussels, Belgium
| | - The AIM-T Study Group
- Médecins Sans Frontières, Operational Center Brussels, Brussels, Belgium
- Médecins Sans Frontières, Operational Center Paris, Gaza, Palestinian territories
- Médecins Sans Frontières, Operational Center Brussels, Bujumbura, Burundi
- Médecins Sans Frontières, Operational Center Brussels, Port-au-Prince, Haiti
- Médecins Sans Frontières, Operational Center Paris, Baghdad, Iraq
- Médecins Sans Frontières, Operational Center Paris, Paris, France
- Médecins Sans Frontières, Operational Center Paris, Aden, Yemen
- Humanity & Inclusion, Bujumbura, Burundi
| | - Nina Brodin
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Division of Physiotherapy, Department of Orthopaedics, Danderyd Hospital Corp., Danderyd, Sweden
| |
Collapse
|
4
|
Spagnolello O, Gatti S, Shahir MAA, Afzali MF, Portella G, Baiardo Redaelli M. Civilian war victims in Afghanistan: five-year report from the Kabul EMERGENCY NGO hospital. Eur J Trauma Emerg Surg 2022; 49:1401-1405. [DOI: 10.1007/s00068-022-02137-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/10/2022] [Indexed: 12/05/2022]
|
5
|
Daebes HL, Tounsi LL, Nerlander M, Gerdin Wärnberg M, Jaweed M, Mamozai BA, Nasim M, Trelles M, von Schreeb J. Association between triage level and outcomes at Médecins Sans Frontières trauma hospital in Kunduz, Afghanistan, 2015. Emerg Med J 2021; 39:628-633. [PMID: 34759014 PMCID: PMC9304096 DOI: 10.1136/emermed-2020-209470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 10/25/2021] [Indexed: 11/22/2022]
Abstract
Background Five million people die annually due to injuries; an increasing part is due to armed conflict in low-income and middle-income countries, demanding resolute emergency trauma care. In Afghanistan, a low-income country that has experienced conflict for over 35 years, conflict related trauma is a significant public health problem. To address this, the non-governmental organisation Médecins Sans Frontières (MSF) set up a trauma centre in Kunduz (Kunduz Trauma Centre (KTC)). MSF’s standardised emergency operating procedures include the South African Triage Scale (SATS). To date, there are few studies that assess how triage levels correspond with outcome in low-resource conflict settings Aim This study aims to assess to what extent SATS triage levels correlated to outcomes in terms of hospital admission, intensive care unit (ICU) admission and mortality for patients treated at KTC. Method and materials This retrospective study used routinely collected data from KTC registries. A total of 17 970 patients were included. The outcomes were hospital admission, ICU admission and mortality. The explanatory variable was triage level. Covariates including age, gender and delay to arrival were used. Logistic regression was used to study the correlation between triage level and outcomes. Results Out of all patients seeking care, 28.7% were triaged as red or orange. The overall mortality was 0.6%. In total, 90% of those that died and 79% of ICU-admitted patients were triaged as red. Conclusion The risk of positive and negative outcomes correlated with triage level. None of the patients triaged as green died or were admitted to the ICU whereas 90% of patients who died were triaged as red.
Collapse
Affiliation(s)
- Hadjer Latif Daebes
- Center for Research on Health Care in Disasters, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Linnea Latifa Tounsi
- Center for Research on Health Care in Disasters, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Maximilian Nerlander
- Center for Research on Health Care in Disasters, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Martin Gerdin Wärnberg
- Center for Research on Health Care in Disasters, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Solna, Sweden
| | - Momer Jaweed
- Medical Department, Médecins Sans Frontières, Kunduz, Afghanistan
| | | | - Masood Nasim
- Medical Coordination, Médecins Sans Frontières, Kabul, Afghanistan
| | - Miguel Trelles
- Medical Department, Operational Centre Brussels, Doctors without Borders, Bruxelles, Belgium
| | - Johan von Schreeb
- Center for Research on Health Care in Disasters, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
6
|
Trauma Bay Time Clocks: Influence on Emergency Department Length of Stay. J Trauma Nurs 2021; 28:269-274. [PMID: 34210948 DOI: 10.1097/jtn.0000000000000596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND To monitor the time elapsed since patient arrival in the emergency department, Trauma Services at the study institution installed a large digital stopwatch timer placed at the head of each trauma bay on June 5, 2017. This quality improvement endeavor became an essential component of performance evaluation. OBJECTIVE The purpose of the study is to measure the impact of trauma bay time clocks on emergency department length of stay. METHODS This is a retrospective before-and-after study of trauma activation patients between June 2015 and May 2019. Two 24-month intervals were compared before and after installation of time clocks. RESULTS In full activation patients, outcomes of emergency department length of stay ≤50 min (39.2% vs. 61.7%, p < .001) and time to transfer to intensive care unit ≤56 min (45.3% vs. 55.1%, p = .002) were significantly favorable in the postimplementation phase. Time to first computed tomography scan and time to first operating room from arrival to the emergency department were comparable between both phases. For limited activation patients, positive changes were noted in emergency department length of stay ≤87 min (41.4% vs. 60.6%, p < .001), time to first computed tomography scan ≤32 min (47.7% vs. 53.0%, p = .015), and time to transfer to intensive care unit ≤74 min (50.2% vs. 57.2%, p = .008). Time to first operating room remained comparable between two periods. CONCLUSIONS The study institution improved their provision of immediate care by using time clocks in trauma bays. This is a simple and cost-effective intervention and may benefit similar institutions.
Collapse
|
7
|
Villalobos MIDOEB, Santos AS, Horta MCR, Miranda GE, Bastos JV, Côrtes MIDSG. Prevalence of traumatic orofacial and dental injury in unidentified bodies—Data from a forensic medicine institute in Brazil. Dent Traumatol 2019; 36:161-166. [PMID: 31519035 DOI: 10.1111/edt.12514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 12/16/2022]
Affiliation(s)
| | - Alyssa Sales Santos
- Graduate Program in Dentistry Pontifícia Universidade Católica de Minas Gerais Belo Horizonte Brazil
| | | | | | | | | |
Collapse
|
8
|
The Golden Hour After Injury Among Civilians Caught in Conflict Zones. Disaster Med Public Health Prep 2019; 13:1074-1082. [DOI: 10.1017/dmp.2019.42] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTIntroduction:The term “golden hour” describes the first 60 minutes after patients sustain injury. In resource-available settings, rapid transport to trauma centers within this time period is standard-of-care. We compared transport times of injured civilians in modern conflict zones to assess the degree to which injured civilians are transported within the golden hour in these environments.Methods:We evaluated PubMed, Ovid, and Web of Science databases for manuscripts describing transport time after trauma among civilian victims of trauma from January 1990 to November 2017.Results:The initial database search identified 2704 abstracts. Twenty-nine studies met inclusion and exclusion criteria. Conflicts in Yugoslavia/Bosnia/Herzegovina, Syria, Afghanistan, Iraq, Israel, Cambodia, Somalia, Georgia, Lebanon, Nigeria, Democratic Republic of Congo, and Turkey were represented, describing 47 273 patients. Only 7 (24%) manuscripts described transport times under 1 hour. Transport typically required several hours to days.Conclusion:Anticipated transport times have important implications for field triage of injured persons in civilian conflict settings because existing overburdened civilian health care systems may become further overwhelmed if in-hospital health capacity is unable to keep pace with inflow of the severely wounded.
Collapse
|
9
|
Tounsi LL, Daebes HL, Gerdin Wärnberg M, Nerlander M, Jaweed M, Mamozai BA, Nasim M, Drevin G, Trelles M, von Schreeb J. Association Between Gender, Surgery and Mortality for Patients Treated at Médecins Sans Frontières Trauma Centre in Kunduz, Afghanistan. World J Surg 2019; 43:2123-2130. [PMID: 31065777 DOI: 10.1007/s00268-019-05015-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION There is paucity of literature describing type of injury and care for females in conflicts. This study aimed to describe the injury pattern and outcome in terms of surgery and mortality for female patients presenting to Médecins Sans Frontières Trauma Centre in Kunduz, Afghanistan, and compare them with males. MATERIALS AND METHODS This study retrospectively analysed patient data from 17,916 patients treated at the emergency department in Kunduz between January and September 2015, before its destruction by aerial bombing in October the same year. Routinely collected data on patient characteristics, injury patterns, triage category, time to arrival and outcome were retrieved and analysed. Comparative analyses were conducted using logistic regression. RESULTS Females constituted 23.6% of patients. Burns and back injuries were more common among females (1.4% and 3.3%) than among males (0.6% and 2.0%). In contrast, open wounds and thoracic injuries were more common among males (10.1% and 0.6%) than among females (5.2% and 0.2%). Females were less likely to undergo surgery (OR 0.60, CI 0.528-0.688), and this remained significant after adjustment for age, nature of injury, triage category, multiple injuries and delay to arrival (OR 0.80, CI 0.690-0.926). Females also had lower unadjusted odds of mortality (OR 0.49, CI 0.277-0.874), but this was not significant in the adjusted analysis (OR 0.81, CI 0.446-1.453). CONCLUSION Our main findings suggest that females seeking care at Kunduz Trauma Centre arrived later, had different injury patterns and were less likely to undergo surgery as compared to males.
Collapse
Affiliation(s)
- Linnea Latifa Tounsi
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Hadjer Latif Daebes
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | | | - Maximilian Nerlander
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Momer Jaweed
- Kunduz Trauma Centre, Médecins Sans Frontières, Kunduz, Afghanistan
| | | | - Masood Nasim
- Kabul Medical Coordination, Médecins Sans Frontières, Kabul, Afghanistan
| | - Gustaf Drevin
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Miguel Trelles
- Medical Department - Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
| | - Johan von Schreeb
- Department of Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden.
| |
Collapse
|
10
|
Hardcastle TC, David SD. Lessons from the frontline: using experiences from conflict zones to improve trauma care and outcomes. Int Health 2016; 8:372-373. [PMID: 27821501 DOI: 10.1093/inthealth/ihw048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/04/2016] [Accepted: 10/14/2016] [Indexed: 11/13/2022] Open
Abstract
Over the years healthcare services during conflict have informed healthcare practice especially in trauma care. Conflict zones have constraints not very different from low-resource settings specifically in dealing with urban violence. Yet, there is limited in-depth study on conflict medicine. This is being slowly recognised in health literature. Two recent papers in International Health have indicated that trauma care packages in conflict settings could be adapted in low-resource settings. There is a need to overview and audit healthcare services in conflict zones further to identify more areas of overlap and possible lessons it holds for improving trauma outcomes in other settings.
Collapse
Affiliation(s)
- Timothy C Hardcastle
- Trauma Service, Inkosi Albert Luthuli Central Hospital & Trauma Training Unit, Nelson R Mandela School of Clinical Medicine, Department of Surgical Sciences, University of KwaZulu-Natal, South Africa
| | - Siddarth D David
- Implementing Lancet Commission on Global Surgery in India (iLCoGS-India), India .,Environmental Health Resource Hub, School of Habitat Studies, Tata Institute of Social Sciences, India
| |
Collapse
|