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Factors Associated with In-Patient Mortality in the Rapid Assessment of Adult Earthquake Trauma Patients. Prehosp Disaster Med 2022; 37:299-305. [PMID: 35466904 DOI: 10.1017/s1049023x22000693] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To date, there is limited evidence for health care providers regarding the determinants of early assessment of poor outcomes of adult in-patients due to earthquakes. This study aimed to explore factors related to early assessment of adult earthquake trauma patients (AETPs). METHODS The data on 29,933 AETPs in the West China Earthquake Patients Database (WCEPD) were analyzed retrospectively. Then, 37 simple variables that could be obtained rapidly upon arrival at the hospital were collected. The least absolute shrinkage and selection operator (LASSO) regression analyses were performed. A nomogram was then constructed. RESULTS Nine independent mortality-related factors that contributed to AETP in-patient mortality were identified. The variables included age (OR:1.035; 95%CI, 1.027-1.044), respiratory rate ([RR]; OR:1.091; 95%CI, 1.050-1.133), pulse rate ([PR]; OR:1.028; 95%CI, 1.020-1.036), diastolic blood pressure ([DBP]; OR:0.96; 95%CI, 0.950-0.970), Glasgow Coma Scale ([GCS]; OR:0.666; 95%CI, 0.643-0.691), crush injury (OR:3.707; 95%CI, 2.166-6.115), coronary heart disease ([CHD]; OR:4.025; 95%CI, 1.869-7.859), malignant tumor (OR:4.915; 95%CI, 2.850-8.098), and chronic kidney disease ([CKD]; OR:5.735; 95%CI, 3.209-10.019). CONCLUSIONS The nine mortality-related factors for ATEPs, including age, RR, PR, DBP, GCS, crush injury, CHD, malignant tumor, and CKD, could be quickly obtained on hospital arrival and should be the focal point of future earthquake response strategies for AETPs. Based on these factors, a nomogram was constructed to screen for AETPs with a higher risk of in-patient mortality.
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Hu H, Yao N, Lai XQ. Factors related to early and rapid assessment of in-hospital mortality among older adult trauma patients in an earthquake. World J Emerg Med 2022; 13:425-432. [PMID: 36636566 PMCID: PMC9807381 DOI: 10.5847/wjem.j.1920-8642.2022.099] [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: 12/29/2021] [Accepted: 06/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND There is limited evidence for emergency physicians and emergency trauma surgeons regarding the determinants of early and rapid assessment of older adult in-hospital mortality due to earthquakes. This study explored factors related to the early and rapid assessment of the mortality among older adult earthquake trauma patients (OAETPs) and created a screening model. METHODS Data on 7,308 OAETPs from the West China Earthquake Patients Database were analyzed retrospectively. The 35 variables that can be obtained rapidly on arrival at the hospital were collected. Least absolute shrinkage and selection operator (LASSO) regression analysis was performed. Then, the nomogram for assessing the mortality of OAETPs was constructed. RESULTS We identified 10 independent mortality-related factors that contributed to the in-hospital mortality of OAETPs. The 10 factors included age (odds ratio [OR]=1.061, 95% confidence interval [CI]:1.031-1.090), dementia (OR=5.146, 95%CI: 1.169-17.856), coronary heart disease (CHD; OR=23.441, 95%CI: 4.799-83.927), malignant tumor (OR=8.497, 95%CI: 3.583-17.967), deep vein thrombosis (DVT; OR=7.110, 95%CI: 1.369-27.168), chronic kidney disease(CKD; OR=11.783, 95%CI: 5.419-24.407), pulse rate (PR; OR=1.036, 95%CI: 1.022-1.048), mean artery pressure (MAP; OR=0.960, 95%CI: 0.945-0.975), Glasgow Coma Scale (GCS; OR=0.864, 95%CI: 0.760-0.972), and Triage Revised Trauma Score (T-RTS, OR=0.485, 95%CI: 0.351-0.696). CONCLUSION The 10 mortality-related factors could be quickly obtained on hospital arrival and should be the focal point of future earthquake response strategies regarding hospitalized older adults with trauma. A nomogram was constructed based on the factors for screening OAETPs with a higher risk of in-hospital mortality.
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Affiliation(s)
- Hai Hu
- Emergency Management Office of West China Hospital, Sichuan University, Chengdu 610041, China,China International Emergency Medical Team, Chengdu 610041, China,Sichuan University’s Emergency Medical Rescue Base, Chengdu 610041, China,Corresponding Author: Hai Hu,
| | - Ni Yao
- China International Emergency Medical Team, Chengdu 610041, China,Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China,Day Surgery Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiao-qin Lai
- China International Emergency Medical Team, Chengdu 610041, China,Day Surgery Center, West China Hospital, Sichuan University, Chengdu 610041, China,West China School of Nursing, Sichuan University, Chengdu 610041, China
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Abstract
OBJECTIVES To date, we have only limited evidence of the determinants of earthquake inpatient mortality-related factors. This study is among the first to explore related factors of inpatient deaths using data from multiple hospitals and multiple earthquakes. METHODS We included and retrospectively analyzed data on 32,976 earthquake inpatients in the West China Earthquake Patients Database. Of these, we analyzed the records of 284 patients who died during hospitalization. We collected 12 dichotomous variables with reference to previous reports: patients' age (both ≤ 15 years and ≥ 65 years), gender, prehospital treatment, intensive care unit (ICU) admission, the presence of severe traumatic brain injury (TBI), trunk injury, severe poly-trauma, crush syndrome, multiple-system organ failure (MSOF), infection, and cardiac/respiratory disease. We performed multivariate logistic regression analysis to explore independent related factors of mortality. RESULTS Ultimately, we identified severe TBI, MSOF, old age (≥ 65 years), ICU admission, crush syndrome, and cardiac/respiratory disease as independent mortality-related factors. Severe TBI was the greatest risk factor of inpatient death (ods ratio [OR], 31.913, 95% confidence interval [CI], 20.484-49.720), followed by MSOF (OR 30.905, 95% CI, 21.733-43.947). CONCLUSION To reduce earthquake inpatient mortalities, the related factors analyzed in this study should be prioritized in future inpatient earthquake response strategies.
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Zhou J, Bai Y, Jiang Y, Tarun P, Feng Y, Huang R, Fu P. Immunomodulatory role of recombinant human erythropoietin in acute kidney injury induced by crush syndrome via inhibition of the TLR4/NF-κB signaling pathway in macrophages. Immunopharmacol Immunotoxicol 2020; 42:37-47. [PMID: 31971040 DOI: 10.1080/08923973.2019.1706555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: The present study aimed to investigate whether recombinant human erythropoietin (rHuEPO) plays an immunomodulatory function by regulating the TLR4/NF-κB signaling pathway.Materials and methods: C57BL/6 mice were intraperitoneally injected with rHuEPO and, half an hour later, with 50% glycerol at the dose of 7.5 ml/kg to induce crush syndrome (CS)-acute kidney injury (AKI). The levels of TNF-α, IL-1β, IL-6, serum creatinine (Scr), and creatine kinase (CK) were measured. The kidney tissues were analyzed by HE staining, and macrophage infiltration was detected by immunohistochemistry. Double immunofluorescence staining, RT-qPCR, and western blotting were conducted to analyze TLR4/NF-κB p65 expression. Ferrous myoglobin was co-cultured with RAW264.7 cells to mimic crush injury and the production of proinflammatory cytokines. The expression levels of TLR4 and NF-κB p65 were measured.Results: In vivo study results revealed that rHuEPO ameliorated renal function, tissue damage, production of proinflammatory cytokines, and macrophage infiltration in the kidneys. The protein and mRNA expression levels of genes involved in the TLR4/NF-κB signaling pathway in CS-induced AKI mice were upregulated (p < .05). Meanwhile, the expression levels of TLR4, NF-κB p65, and proinflammatory cytokines in RAW264.7 cells were downregulated in CS-AKI mice injected with rHuEPO (p < .05).Conclusions: Our results demonstrated the immunomodulatory capacity of rHuEPO and confirmed that rHuEPO exerts protective effects against CS-induced AKI by regulating the TLR4/NF-κB signaling pathway in macrophages. Therefore, our findings highlight the therapeutic potential of rHuEPO in improving the prognosis of CS-AKI patients.
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Affiliation(s)
- Jiaojiao Zhou
- Division of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yajun Bai
- Department of Nephrology, Nanchong Central Hospital, Nanchong, Sichuan, China
| | - Yong Jiang
- Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Padamata Tarun
- West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yuying Feng
- Kidney Research Institute, Department of Internal Medicine, Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Rongshuang Huang
- Kidney Research Institute, Department of Internal Medicine, Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ping Fu
- Kidney Research Institute, Department of Internal Medicine, Division of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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Jouhari Z, Pirasteh A, Ghassemi GR, Bazrafkan L. The effects of educational program on health volunteers' knowledge regarding their approach to earthquake in health centers in Tehran. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2015; 3:56-61. [PMID: 25927068 PMCID: PMC4403565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 02/02/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION The people's mental, intellectual and physical non-readiness to confront earthquake may result in disastrous outcomes. This research aimed to study of effects of a training intervention on health connector's knowledge regarding their approach to earthquake in health-training centers in East of Tehran. METHODS This research which is a semi-experimental study was designed and executed in 2011, using a questionnaire with items based on the information of Crisis Management Org. After a pilot study and making the questionnaire valid and reliable, we determined the sample size. Then, the questionnaires were completed before and after the training program by 82 health connectors at health-treatment centers in the East of Tehran. Finally, the collected data were analyzed by SPSS 14, using paired sample t-test and Pearson's correlation coefficient. RESULTS Health connectors were women with the mean age of 43.43±8.51 years. In this research, the mean score of connectors' knowledge before and after the training was 35.15±4.3 and 43.73±2.91 out of 48, respectively. The difference was statistically significant (p=0.001). The classes were the most important source of information for the health connectors. CONCLUSION The people's knowledge to confront earthquake can be increased by holding training courses and workshops. Such training courses and workshops have an important role in data transfer and readiness of health connectors.
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Affiliation(s)
| | | | | | - Leila Bazrafkan
- Quality Improvement in Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Comparison of Injury Epidemiology Between the Wenchuan and Lushan Earthquakes in Sichuan, China. Disaster Med Public Health Prep 2014; 8:541-7. [DOI: 10.1017/dmp.2014.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveWe aimed to compare injury characteristics and the timing of admissions and surgeries in the Wenchuan earthquake in 2008 and the Lushan earthquake in 2013.MethodsWe retrospectively compared the admission and operating times and injury profiles of patients admitted to our medical center during both earthquakes. We also explored the relationship between seismic intensity and injury type.ResultsThe time from earthquake onset to the peak in patient admissions and surgeries differed between the 2 earthquakes. In the Wenchuan earthquake, injuries due to being struck by objects or being buried were more frequent than other types of injuries, and more patients suffered injuries of the extremities than thoracic injuries or brain trauma. In the Lushan earthquake, falls were the most common injury, and more patients suffered thoracic trauma or brain injuries. The types of injury seemed to vary with seismic intensity, whereas the anatomical location of the injury did not.ConclusionsGreater seismic intensity of an earthquake is associated with longer delay between the event and the peak in patient admissions and surgeries, higher frequencies of injuries due to being struck or buried, and lower frequencies of injuries due to falls and injuries to the chest and brain. These insights may prove useful for planning rescue interventions in trauma centers near the epicenter. (Disaster Med Public Health Preparedness. 2014;8:541-547)
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Regens JL, Mould N. Prevention and treatment of traumatic brain injury due to rapid-onset natural disasters. Front Public Health 2014; 2:28. [PMID: 24783188 PMCID: PMC3995068 DOI: 10.3389/fpubh.2014.00028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 03/24/2014] [Indexed: 11/13/2022] Open
Abstract
The prevention and treatment of traumatic brain injury (TBI) attributable to rapid-onset natural disasters is a major challenge confronting disaster preparedness planners and emergency medical personnel responding to those incidents. The kinetic energy released by rapid-onset natural disasters such as earthquakes, hurricanes or typhoons, and tornadoes can cause mild, moderate, or severe TBIs. As a result, neurotrauma is a major risk factor for mortality and morbidity outcomes within the spatial domain impacted by a rapid-onset natural disaster. This review article elucidates major challenges associated with immediate emergency medical response, long-term care, and prevention of post-event increases in pediatric TBIs because of child abuse when rapid-onset natural disasters occur.
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Affiliation(s)
- James L Regens
- OUHSC Center for Biosecurity Research, University of Oklahoma Health Sciences Center , Oklahoma City, OK , USA
| | - Nick Mould
- OUHSC Center for Biosecurity Research, University of Oklahoma Health Sciences Center , Oklahoma City, OK , USA
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Petrazzi L, Striuli R, Polidoro L, Petrarca M, Scipioni R, Struglia M, Giorgini P, Necozione S, Festuccia V, Ferri C. Causes of hospitalisation before and after the 2009 L'Aquila earthquake. Intern Med J 2013; 43:1031-4. [DOI: 10.1111/imj.12238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/11/2013] [Indexed: 11/28/2022]
Affiliation(s)
- L. Petrazzi
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
| | - R. Striuli
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
| | - L. Polidoro
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
| | - M. Petrarca
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
| | - R. Scipioni
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
| | - M. Struglia
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
| | - P. Giorgini
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
| | - S. Necozione
- Epidemiology Unit; University of L'Aquila; L'Aquila Italy
| | - V. Festuccia
- Division of Internal Medicine; San Salvatore Hospital; L'Aquila Italy
| | - C. Ferri
- Department of Life, Health and Environmental Sciences; University of L'Aquila; San Salvatore Hospital; L'Aquila Italy
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9
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Doocy S, Daniels A, Packer C, Dick A, Kirsch TD. The human impact of earthquakes: a historical review of events 1980-2009 and systematic literature review. PLOS CURRENTS 2013; 5. [PMID: 23857161 PMCID: PMC3644288 DOI: 10.1371/currents.dis.67bd14fe457f1db0b5433a8ee20fb833] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Introduction.
Population growth and increasing urbanization in earthquake-prone areas suggest that earthquake impacts on human populations will increase in the coming decades. Recent large earthquakes affecting large populations in Japan, Haiti, Chile and New Zealand are evidence of this trend and also illustrate significant variations in outcomes such damage and mortality levels. The objectives of this review were to describe the impact of earthquakes on human populations in terms of mortality, injury and displacement and, to the extent possible, identify risk factors associated with these outcomes. This is one of five reviews on the human impact of natural disasters.
Methods.
Data on the impact of earthquakes were compiled using two methods, a historical review from 1980 to mid 2009 of earthquake events from multiple databases and a systematic literature review of publications, ending in October 2012. Analysis included descriptive statistics and bivariate tests for associations between earthquake mortality and characteristics using STATA 11.
Findings.
From 1980 through 2009, there were a total of 372,634 deaths (range 314,634-412,599), 995,219 injuries (range: 845,345-1,145,093), and more than 61 million people affected by earthquakes, and mortality was greatest in Asia. Inconsistent reporting across data sources suggests that the numbers injured and affected are likely underestimates. Findings from a systematic review of the literature indicate that the primary cause of earthquake-related death was trauma due to building collapse and, the very young and the elderly were at increased mortality risk, while gender was not consistently associated with mortality risk.
Conclusions.
Strategies to mitigate the impact of future earthquakes should include improvements to the built environment and a focus on populations most vulnerable to mortality and injury.
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Affiliation(s)
- Shannon Doocy
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
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10
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Macintyre AG, Barbera JA, Petinaux BP. Survival Interval in Earthquake Entrapments: Research Findings Reinforced During the 2010 Haiti Earthquake Response. Disaster Med Public Health Prep 2013; 5:13-22. [PMID: 21357474 DOI: 10.1001/dmp.2011.5] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
ABSTRACTEarthquakes can result in collapsed structures with the potential to entrap individuals. In some cases, people can survive entrapment for lengthy periods. The search for and rescue of entrapped people is resource intensive and competes with other postdisaster priorities. The decision to end search and rescue activities is often difficult and in some cases protracted. Medical providers participating in response may be consulted about the probability of continued survival in undiscovered trapped individuals. Historically, many espouse a rigid time frame for viability of entrapped living people (eg, 2 days, 4 days, 14 days). The available medical and engineering data and media reports demonstrate a wide variety in survival “time to rescue,” arguing against the acceptance of a single time interval applicable to all incidents. This article presents historical evidence and reports from the 2010 Haiti earthquake. Factors that may contribute to survival after entombment are listed. Finally, a decision process for projecting viability that considers the critical factors in each incident rather than adhering to a single time frame for ceasing search and rescue activities is proposed. (Disaster Med Public Health Preparedness. 2011;5:13–22)
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Affiliation(s)
- Anthony G Macintyre
- The George Washington University, 2150 Pennsylvania Ave, NW, Suite 2B, Washington, DC 20037, USA.
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11
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Guetti C, Angeletti C, Paladini A, Varrassi G, Marinangeli F. Pain and natural disaster. Pain Pract 2012; 13:589-93. [PMID: 23241164 DOI: 10.1111/papr.12010] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 09/18/2012] [Indexed: 12/01/2022]
Abstract
The treatment for pain in emergency medicine is a matter of increasing interest. Available data indicate that in both normal conditions and during major-emergencies, the majority of healthcare providers are culturally and professionally unprepared to adequately treat acute pain conditions. In case of natural disasters, opioid drugs are often unavailable. Moreover, no guidelines or validated protocols provide adequate indications for the treatment for pain in case of massive emergencies. Training of the medical and nursing staff, in both formal and continuing, or on-the-job education is needed to adequately face a devastating emergency. Unfortunately, there is an inadequate level of training among healthcare professionals, even in highly seismic areas, and the source of aid is frequently limited, especially in the immediate aftermath of a disaster to those already present at the scene. Pain inadequately treated may modify the characteristics of the pain itself. Pain is no longer considered just a symptom, but itself becomes an autonomous pathology heavily influencing the social life and psycho-social aspects of a person. In the disastrous situation following an earthquake, an inadequate treatment of pain was the major violation of the psycho-physical integrity of individuals and a severe violation of their rights, as human beings and patients.
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Affiliation(s)
- Cristiana Guetti
- Anesthesiology, Intensive Care and Pain Medicine, Department of Health Sciences, University of L'Aquila, Italy
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Wen J, Sun X, Shi YK, Li YP, Zhao LP, Wu Q, Fei YH. Patient influx and trauma types in a front-line hospital and a secondary referral hospital after the Wenchuan earthquake: a retrospectively comparative study. Eur J Trauma Emerg Surg 2012; 38:261-7. [PMID: 26815957 DOI: 10.1007/s00068-011-0100-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 03/10/2011] [Indexed: 02/05/2023]
Abstract
PURPOSE To better understand the differences of patient influx and types of trauma between front-line and referral hospitals after the Wenchuan earthquake, so as to improve the efficiency of injury management. METHODS A retrospective and comparative study was performed in Deyang People's Hospital (a front-line hospital) and West China Hospital (a secondary referral hospital). RESULTS A total of 1,106 patients were admitted to the front-line hospital, and 1,775 to the secondary referral hospital. The patient flow peaked within 24 h after the quake, and decreased dramatically thereafter in the front-line hospital, while it peaked 2 days after the disaster in the referral one. Extremities were the most frequent location of all identified injuries (48.4% in the front-line hospital and 49.5% in the second-line hospital). Head and trunk injuries were more frequent in the front-line hospital than the referral hospital. Most of the deaths in the front-line hospital occurred within 24 h (6/8), whilst most in the referral hospital died more than 7 days (29/30) after the earthquake. While the total mortality in the front-line hospital was less than that in the referral hospital (0.7 vs 1.7%), the critical mortality in the former was higher (22.8 vs 9.4%). CONCLUSIONS There were dramatically different features in terms of quake-related patient influx and types of injury between the epicenter and less-affected hospitals.
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Affiliation(s)
- J Wen
- Department of Hospital Management & Health Policy, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - X Sun
- The Chinese Evidence-Based Medicine Center, Department of Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, 610041, China.,Department of Clinical Epidemiology and Biostatistics, McMaster University, 1200 Main Street West, Rm. 3H57, Hamilton, Ontario, L8N 3Z5, Canada
| | - Y K Shi
- Department of Thoracic & Cardiovascular Surgery, West China Hospital, Sichuan University, No.37 Guoxue Xiang, Chengdu, 610041, China.
| | - Y P Li
- The Chinese Evidence-Based Medicine Center, Department of Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - L P Zhao
- Department of Urinary Surgery, Deyang People's Hospital, Deyang, 618000, China
| | - Q Wu
- Department of Medical Quality Control and Continuing Education, Deyang People's Hospital, Deyang, 618000, China
| | - Y H Fei
- Department of Economics and Management, Deyang People's Hospital, Deyang, 618000, China
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Microbiological findings from the Haiti disaster. Travel Med Infect Dis 2012; 10:157-61. [PMID: 22521601 DOI: 10.1016/j.tmaid.2012.03.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 03/14/2012] [Accepted: 03/20/2012] [Indexed: 11/20/2022]
Abstract
There are few data regarding microbiological findings from the disaster situation in Haiti. A rapid and accurate diagnosis of infection is necessary for the optimal efficacy of antimicrobial therapy, considering the antimicrobial spectrum and the duration of treatment. Furthermore, understanding the microorganisms and their susceptibility profiles is necessary to implement appropriate infection control policies and to contain the emergence and dissemination of Gram-negative multidrug-resistant pathogens.
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Cross-sectional study of craniocerebral trauma in a tertiary hospital after 2008 Sichuan earthquake: a brief report of 242 cases and experiences from West China Hospital. THE JOURNAL OF TRAUMA 2011; 70:E108-12. [PMID: 21248645 DOI: 10.1097/ta.0b013e3181fb4976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND We aim to analyze clinical features of patients with craniocerebral trauma after 2008 Sichuan earthquake in China. METHODS Medical records of patients with craniocerebral trauma admitted to Department of Neurosurgery in West China Hospital within 30 days after earthquake were retrospectively analyzed. Demographic data, clinical diagnosis, treatment, and prognosis were reviewed. Patients' data from peripheral hospitals were also analyzed. RESULTS Two hundred forty-two patients with craniocerebral injuries were included in the study. The male to female ratio was 1.3:1, and more than half of the patients were between 20 and 60 years. Majority of patients suffered from mild to moderate injuries (88.4%). Scalp wound was the leading type, followed by skull fractures and brain contusion and laceration. Fifty patients (20.7%) underwent craniotomy. Overall mortality was 5.4% (n = 13). In survivors, 186 patients had good outcome (Glasgow Outcome Scale score ≥4, 76.9%). Staphylococcus aureus (n = 74, 44.6%), Aerobacter cloacae (n = 37, 22.3%), and Staphylococcus epidermidis (n = 33, 19.9%) were most frequently isolated bacteria in wound smear. Over 85% (n=6) of patients with infectious wound (n=7) obtained delayed first stage healing. Mortality of patients in local hospitals ranged from 3.8% to 8.9%. CONCLUSIONS Most patients admitted to tertiary hospitals are mildly or moderately injured. Cooperation among different departments is critical to shorten delay in emergency room. First stage wound healing or delayed first stage healing can be achieved in most patients after treatment. More than 76% of seismic injury patients in a tertiary medical center have good outcome.
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16
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Foran M, Levine A, Lippert S, Chan J, Aschkenasy M, Arnold K, Rosborough S. International emergency medicine: a review of the literature from 2009. Acad Emerg Med 2011; 18:86-92. [PMID: 21182567 DOI: 10.1111/j.1553-2712.2010.00961.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
As the specialty of emergency medicine evolves in countries around the world, and as interest in international emergency medicine (IEM) grows within the United States, the IEM Literature Review Group recognizes an ongoing need for a high-quality, consolidated, and easily accessible evidence base of literature. The IEM Literature Review Group produces an annual publication that strives to provide readers with access to the highest quality and most relevant IEM research from the previous year. This publication represents our fifth annual review, covering the top 24 IEM research articles published in 2009. Articles were selected for the review according to explicit, predetermined criteria that emphasize both methodologic quality and impact of the research. It is our hope that this annual review acts as a forum for disseminating best practices, while also stimulating further research in the field of IEM.
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Affiliation(s)
- Mark Foran
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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18
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Metzger JC, Eastman AL, Pepe PE. Year in review 2009: Critical Care--cardiac arrest, trauma and disasters. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2010; 14:242. [PMID: 21122166 PMCID: PMC3220035 DOI: 10.1186/cc9302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
During 2009, Critical Care published nine papers on various aspects of resuscitation, prehospital medicine, trauma care and disaster response. One article demonstrated that children as young as 9 years of age can learn cardiopulmonary resuscitation (CPR) effectively, although, depending on their size, some may have difficulty performing it. Another paper showed that while there was a trend toward mild therapeutic hypothermia reducing S-100 levels, there was no statistically significant change. Another predictor study also showed a strong link between acute kidney injury and neurologic outcome while another article described a program in which kidneys were harvested from cardiac arrest patients and showed an 89% graft survival rate. One experimental investigation indicated that when a pump-less interventional lung assist device is present, leaving the device open (unclamped) while performing CPR has no harmful effects on mean arterial pressures and it may have positive effects on blood oxygenation and CO2 clearance. One other study, conducted in the prehospital environment, found that end-tidal CO2 could be useful in diagnosing pulmonary embolism. Three articles addressed disaster medicine, the first of which described a triage system for use during pandemic influenza that demonstrated high reliability in delineating patients with a good chance of survival from those likely to die. The other two studies, both drawn from the 2008 Sichuan earthquake experience, showed success in treating crush injured patients in an on-site tent ICU and, in the second case, how the epidemiology of earthquake injuries and related factors predicted mortality.
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Affiliation(s)
- Jeffery C Metzger
- Department of Surgery/Emergency Medicine, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Mail Code 8579, Dallas, TX 75390-8579, USA.
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Mateen FJ. Neurological disorders in complex humanitarian emergencies and natural disasters. Ann Neurol 2010; 68:282-94. [PMID: 20818788 DOI: 10.1002/ana.22135] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Complex humanitarian emergencies include the relatively acute, severe, and overwhelming health consequences of armed conflict, food scarcity, mass displacement, and political strife. Neurological manifestations of complex humanitarian emergencies are important and underappreciated consequences of emergencies in populations worldwide. This review critically assesses the existing knowledge of the range of neurological disorders that accompany complex humanitarian emergencies and natural disasters in both the acute phase of crisis and the "long shadow" that follows.
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Affiliation(s)
- Farrah J Mateen
- Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA.
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Wen J, Yang CL, Shi YK, Li YP, Ji YL, Liu J. A Retrospective Study of Geriatric Trauma at a Large Teaching Hospital After the 2008 Wenchuan Earthquake. INT J GERONTOL 2010. [DOI: 10.1016/s1873-9598(10)70034-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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