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Asim M, El-Menyar A, Abdelrahman H, Consunji R, Siddiqui T, Kanbar A, Taha I, Rizoli S, Al-Thani H. Time and Risk Factors of Trauma-Related Mortality: A 5-Year Retrospective Analysis From a National Level I Trauma Center. J Intensive Care Med 2024; 39:672-682. [PMID: 38193211 DOI: 10.1177/08850666231225607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Background: We aimed to analyze in-hospital timing and risk factors for mortality in a level 1 trauma center. Methods: This is a retrospective analysis of all trauma-related mortality between 2013 and 2018. Patients were divided and analyzed based on the time of mortality (early (≤48 h) vs late (>48 h)), and within different age groups. Multivariate regression analysis was performed to predict in-hospital mortality. Results: 8624 trauma admissions and 677 trauma-related deaths occurred (47.7% at the scene and 52.3% in-hospital). Among in-hospital mortality, the majority were males, with a mean age of 35.8 ± 17.2 years. Most deaths occurred within 3-7 days (35%), followed by 33% after 1 week, 20% on the first day, and 12% on the second day of admission. Patients with early mortality were more likely to have a lower Glasgow coma scale, a higher shock index, a higher chest and abdominal abbreviated injury score, and frequently required exploratory laparotomy and massive blood transfusion (P < .005). The injury severity scores and proportions of head injuries were higher in the late mortality group than in the early group. The severity of injuries, blood transfusion, in-hospital complications, and length of intensive care unit stay were comparable among the age groups, whereas mortality was higher in the age group of 19 to 44. The higher proportions of early and late in-hospital deaths were evident in the age group of 24 to 29. In multivariate analysis, the shock index (OR 2.26; 95%CI 1.04-4.925; P = .04) was an independent predictor of early death, whereas head injury was a predictor of late death (OR 4.54; 95%CI 1.92-11.11; P = .001). Conclusion: One-third of trauma-related mortalities occur early after injury. The initial shock index appears to be a reliable hemodynamic indicator for predicting early mortality. Therefore, timely hemostatic resuscitation and appropriate interventions for bleeding control may prevent early mortality.
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Affiliation(s)
- Mohammad Asim
- Clinical Research, Trauma Surgery Section, Department of Surgery, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Ayman El-Menyar
- Clinical Research, Trauma Surgery Section, Department of Surgery, Hamad Medical Corporation (HMC), Doha, Qatar
- Clinical Medicine, Weill Cornell Medicine, Doha, Qatar
| | | | - Rafael Consunji
- Hamad Injury Prevention Program, Trauma Surgery Section, Department of Surgery, HMC, Doha, Qatar
| | - Tariq Siddiqui
- Trauma Surgery Section, Department of Surgery, HMC, Doha, Qatar
| | - Ahad Kanbar
- Trauma Surgery Section, Department of Surgery, HMC, Doha, Qatar
| | - Ibrahim Taha
- Trauma Surgery Section, Department of Surgery, HMC, Doha, Qatar
| | - Sandro Rizoli
- Trauma Surgery Section, Department of Surgery, HMC, Doha, Qatar
| | - Hassan Al-Thani
- Trauma Surgery Section, Department of Surgery, HMC, Doha, Qatar
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Almarhabi M, Cornish J, Raleigh M, Philippou J. In-service education in trauma care for intensive care unit nurses: An exploratory multiple case study. Nurse Educ Pract 2023; 72:103752. [PMID: 37619286 DOI: 10.1016/j.nepr.2023.103752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/25/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
AIM This study explores the perceptions of intensive care units (ICUs) nurses with different educational backgrounds regarding their abilities in trauma care and the in-service education they receive to support it. BACKGROUND The advanced care of patients with traumatic injuries in ICU environments requires skilled and knowledgeable nurses, who need continuing and in-service education to provide the best care. Therefore, it is essential to understand the competencies and educational support these nurses may need in the ICUs to ensure safe and effective care delivery. DESIGN An exploratory multiple case study design was used, comprising three hospitals located in two different regions of Saudi Arabia. METHODS The study was conducted between October 2021 and March 2022. A total of forty ICU clinical staff, twelve managers, nine leaders and seven clinical educators participated in semi-structured interviews, which were complemented by a review of available documents on the trauma care in-service education syllabi, competencies and protocols. Interview data were analysed according to the Framework analysis approach, while documents were reviewed using qualitative content analysis. FINDINGS The data analysis revealed two interrelated categories relevant to trauma care: (i) care practice and (ii) education practice. The trauma care practice category highlighted the limited competencies and education in trauma care, as well as the perceived challenges and educational needs of nurses. The education practice category described the staff learning behaviours, supervision practices and in-service education systems in the participants' settings. CONCLUSIONS The study concludes that there is a lack of trauma care education at the examined sites. It suggests the need for further research to develop a theoretical foundation for trauma care education that can meet ICU nurses' educational needs while this being feasible to implement in the specific ICU context and practice.
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Affiliation(s)
- Maha Almarhabi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK; Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Jocelyn Cornish
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Mary Raleigh
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
| | - Julia Philippou
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, UK
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Mamo DE, Abebe A, Beyene T, Alemu F, Bereka B. Road traffic accident clinical pattern and management outcomes at JUMC Emergency Department; Ethiopia. Afr J Emerg Med 2023; 13:1-5. [PMID: 36582970 PMCID: PMC9792392 DOI: 10.1016/j.afjem.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 11/10/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Background Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. Objective To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Methods Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. Results About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Conclusion Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.
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Affiliation(s)
- Dereje Endale Mamo
- Department of Nursing, College of Health Sciences, Dilla University, Southern Nations, Nationalities and Peoples (SNNP), Ethiopia,Corresponding author.
| | - Asmamaw Abebe
- Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Temesgen Beyene
- Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Filipos Alemu
- Department of Nursing, College of Health Sciences, Dilla University, Southern Nations, Nationalities and Peoples (SNNP), Ethiopia
| | - Bayisa Bereka
- School of Nursing, Institute of health, Jimma University, Jimma, Ethiopia
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Alghnam S, Alghamdi M, Alzahrani S, Alzomai S, Alghannam A, Albabtain I, Alsheikh K, Bajowaiber M, Alghamdi A, Alibrahim F, Aldibasi O. The prevalence of long-term rehabilitation following motor-vehicle crashes in Saudi Arabia: a multicenter study. BMC Musculoskelet Disord 2022; 23:202. [PMID: 35241048 PMCID: PMC8895876 DOI: 10.1186/s12891-022-05153-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction In Saudi Arabia, motor-vehicle crashes (MVC) are the leading cause of disability-adjusted life years (DALYs). There is limited information locally on the magnitude and need for rehabilitation following MVC. This study examined the prevalence of MVC patients requiring long-term rehabilitation and the epidemiology of associated injuries. Methods A retrospective study was conducted at four hospitals of the National Guard Hospitals Affairs from January 2016 to March 2019. The study used data from an institutional trauma registry of all MVC admissions. Chi-square tests, bivariate and multivariate analyses were conducted to compare patients requiring long-term and short-term rehabilitation. Results The study included 506 patients. The study population was relatively young, with an average age was 32.8 ± 15.5 years, and the majority were males. Over two-thirds (71.3%) of patients required long-term rehabilitation. Half the patients sustained multiple fractures, and 17.0% sustained traumatic brain injuries. Overall, 53.1 and 61.8% of patients required occupational and physiotherapy, respectively. Those admitted to the intensive care unit were four times more likely to need long-term rehabilitation. Conclusions We found a significant burden of long-term rehabilitation following MVC. Patients were relatively young, thus posing a significant burden on future healthcare utilization. Policymakers should use these findings to guide primary, secondary, and tertiary prevention to improve health outcomes.
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Affiliation(s)
- Suliman Alghnam
- Population Health Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Mashael Alghamdi
- Population Health Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sarah Alzahrani
- Population Health Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sufyan Alzomai
- Population Health Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulah Alghannam
- Lifestyle and Health Research Center, Health Sciences Research Center , Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ibrahim Albabtain
- Department of Surgery, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khalid Alsheikh
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Orthopedics, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia
| | - Miasem Bajowaiber
- National Center for Road Safety, Ministry of Transportation, Riyadh, Saudi Arabia
| | - Ali Alghamdi
- National Center for Road Safety, Ministry of Transportation, Riyadh, Saudi Arabia
| | | | - Omar Aldibasi
- Biostatistics Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Chowdhury S, Parameaswari PJ, Leenen L. Outcomes of Trauma Patients Present to the Emergency Department with a Shock Index of ≥1.0. J Emerg Trauma Shock 2022; 15:17-22. [PMID: 35431481 PMCID: PMC9006726 DOI: 10.4103/jets.jets_86_21] [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: 06/28/2021] [Revised: 11/11/2021] [Accepted: 11/23/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction The study aimed primarily to evaluate the association between the initial shock index (SI) ≥1.0 with blood transfusion requirement in the emergency department (ED) after acute trauma. The study's secondary aim was to look at the outcomes regarding patients' disposition from ED, intensive care unit (ICU) and hospital length of stay, and deaths. Methods It was a retrospective, cross-sectional study and utilized secondary data from the Saudi Trauma Registry (STAR) between September 2017 and August 2020. We extracted the data related to patient demographics, mechanism of injuries, the intent of injuries, mode of arrival at the hospital, characteristics on presentation to ED, length of stay, and deaths from the database and compared between two groups of SI <1.0 and SI ≥1.0. A P < 0.05 was statistically considered significant. Results Of 6667 patients in STAR, 908 (13.6%) had SI ≥1.0. With SI ≥1.0, there was a significantly higher incidence of blood transfusion in ED compared to SI <1.0 (8.9% vs. 2.4%, P < 0.001). Furthermore, SI ≥ 1.0 was associated with significant ICU admission (26.4% vs. 12.3%, P < 0.001), emergency surgical intervention (8.5% vs. 2.8%, P < 0.001), longer ICU stay (5.0 ± 0.36 vs. 2.2 ± 0.11days, P < 0.001), longer hospital stays (14.8 ± 0.61 vs. 13.3 ± 0.24 days, P < 0.001), and higher deaths (8.4% vs. 2.8%, P < 0.001) compared to the patient with SI <1.0. Conclusions In our cohort, a SI ≥ 1.0 on the presentation at the ED carried significantly worse outcomes. This simple calculation based on initial vital signs may be used as a screening tool and therefore incorporated into initial assessment protocols to manage trauma patients.
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Affiliation(s)
| | - P J Parameaswari
- Research and Innovation Center, King Saud Medical City, Riyadh, Saudi Arabia
| | - Luke Leenen
- Department of Trauma, University Medical Center Utrecht, Utrecht, Netherlands
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Juhani WSA, Alanazi AM, Aldusari RS. Epidemiological characteristics of traumatic musculoskeletal injuries during the COVID-19 pandemic at a single tertiary hospital. J Family Med Prim Care 2021; 10:3882-3887. [PMID: 34934696 PMCID: PMC8653492 DOI: 10.4103/jfmpc.jfmpc_2463_20] [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: 12/15/2020] [Revised: 02/28/2021] [Accepted: 05/03/2021] [Indexed: 11/04/2022] Open
Abstract
Background Musculoskeletal (MSK) injuries are common but can lead to devastating outcomes. During the COVID-19 pandemic in Saudi Arabia, it is thought that the burden of traumatic MSK injuries is minimized. Objective This study aimed to assess the epidemiological characteristics of traumatic MSK injuries during the lockdown period in Saudi Arabia. Materials and Methods This retrospective descriptive study included all patients who were admitted to the orthopedic department at a single tertiary hospital level 1 trauma center due to traumatic injuries from March 23 to June 21, 2020. Results The study included 92 patients. The majority were male (68.5%). The most common comorbidity was hypertension (30.4%). Falls were the most common mechanism of injury (47%). The most common sites to be fractured were the proximal femur (22.8%) followed by the distal tibia/fibula (14%). Skull fractures (12%), rib fractures (6.5%), and pneumothorax (6.5%) were the most common associated injuries. Age and the number of injuries were significant predictors of increased length of hospital stay. Conclusions Major considerations for primary prevention must be taken into account during long periods of time with no direct patient interaction. Patient education is important to help avoid any burden that might be caused by otherwise preventable injuries. Further studies should be conducted to assess this phenomenon more in depth and to establish the appropriate method of educating patients on primary prevention.
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Affiliation(s)
- Wazzan S Al Juhani
- Department of Surgery, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah M Alanazi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rakan S Aldusari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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AbdelRazik M, Alquwaiz IA, Khojah AA, Alshahrani AY, Aldakkan OZ, Alhumaydani NK, Alqahtani FT. Clinical and epidemiological characteristics of road traffic accidents patients received at 2 intensive care units in Saudi Arabia-A cross-sectional study. J Family Med Prim Care 2021; 10:3863-3868. [PMID: 34934693 PMCID: PMC8653438 DOI: 10.4103/jfmpc.jfmpc_879_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/09/2021] [Accepted: 07/23/2021] [Indexed: 11/04/2022] Open
Abstract
Background Road traffic accidents (RTAs) lead to major trauma, which is the greatest cause of morbidity and mortality worldwide. The purpose of the study was to determine the clinical epidemiological profiles of the patients received in intensive care units (ICU) with road traffic injuries (RTIs). Methods The study, which included 300 patients, was conducted at emergency departments and two reference ICUs in Saudi Arabia. The patients were of varying ages and genders from different demographic backgrounds with different modes of injuries, varying degrees of shock, and multiple types of injury. Study variables included demographics, clinical presentations, and the types of fractures and lacerations. Results Most of our study population was male (n = 273; 91%). Car accidents were found to be the prevalent cause of injury (n = 267; 89.0% cases). Only 21.7% of the study population (n = 65) needed ICU admission compared to non-ICU patients (n = 235; 78.3%). Injuries to the chest (P = 0.0001), abdomen (P = 0.0001), upper limbs (P = 0.022), and spine (P = 0.001) significantly contributed to ICU admissions. Conclusion The burden on ICUs due to RTIs can be reduced in Saudi Arabia by adopting strict preventive measures against RTAs.
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Affiliation(s)
- Mohamed AbdelRazik
- Department of General Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | | | | | | | - Osamah Zeid Aldakkan
- College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Current changes in the epidemiology of fall-related injuries in Al Ain City, United Arab Emirates. PLoS One 2021; 16:e0257398. [PMID: 34529683 PMCID: PMC8445427 DOI: 10.1371/journal.pone.0257398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/01/2021] [Indexed: 12/03/2022] Open
Abstract
Background Falls in the Gulf countries are the second most common cause of injuries. The United Arab Emirates government implemented various preventive measures to decrease injuries in the country. We aimed to evaluate the changes in the epidemiology of fall-related injuries in Al-Ain City over the last decade. Methods Data of hospitalized patients who presented with fall-related injuries to the Al-Ain Hospital during the two periods of March 2003 to March 2006 and January 2014 to December 2017 were compared. This included patients’ demographics, mechanism, location, anatomical distribution and parameters related to injury severity. Non-parametric tests were used for the statistical analysis. Results 882 in the first and 1358 patients in the second period were studied. The incidence of falls decreased by 30.5% over ten years. The number of elderly, female patients, and UAE nationals increased, (p < 0.001, p = 0.004, and p < 0.001). Falls from height decreased by 32.5% (p < 0.001) while fall on the same level increased by 22.5% (p < 0.001). Fall-related injuries at home have increased significantly by 22.6% (p <0.001), while falls in workplaces decreased by 24.4% (p <0.001). Conclusions Our study showed that the overall incidence of falls decreased compared to a decade ago. The preventive measures were effective in reducing falls from height and workplace injuries. Future preventive measures should target falls at the same level and homes.
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Alsenani M, A Alaklobi F, Ford J, Earnest A, Hashem W, Chowdhury S, Alenezi A, Fitzgerald M, Cameron P. Comparison of trauma management between two major trauma services in Riyadh, Kingdom of Saudi Arabia and Melbourne, Australia. BMJ Open 2021; 11:e045902. [PMID: 34006550 PMCID: PMC8137252 DOI: 10.1136/bmjopen-2020-045902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The burden of injury in the Kingdom of Saudi Arabia (KSA) has increased in recent years, but the country has lacked a consistent methodology for collecting injury data. A trauma registry has been established at a large public hospital in Riyadh from which these data are now available. OBJECTIVES We aimed to provide an overview of trauma epidemiology by reviewing the first calendar year of data collection for the registry. Risk-adjusted analyses were performed to benchmark outcomes with a large Australian major trauma service in Melbourne. The findings are the first to report the trauma profile from a centre in the KSA and compare outcomes with an international level I trauma centre. METHODS This was an observational study using records with injury dates in 2018 from the registries at both hospitals. Demographics, processes and outcomes were extracted, as were baseline characteristics. Risk-adjusted endpoints were inpatient mortality and length of stay. Binary logistic regression was used to measure the association between site and inpatient mortality. RESULTS A total of 2436 and 4069 records were registered on the Riyadh and Melbourne databases, respectively. There were proportionally more men in the Saudi cohort than the Australian cohort (86% to 69%). The Saudi cohort was younger, the median age being 36 years compared with 50 years, with 51% of injuries caused by road traffic incidents. The risk-adjusted length of stay was 4.4 days less at the Melbourne hospital (95% CI 3.95 days to 4.86 days, p<0.001). The odds of in-hospital death were also less (OR 0.25; 95% CI 0.15 to 0.43, p<0.001). CONCLUSIONS This is the first hospital-based study of trauma in the kingdom that benchmarks with an individual international centre. There are limitations to interpreting the comparisons, however the findings have established a baseline for measuring continuous improvement in outcomes for KSA trauma services.
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Affiliation(s)
| | | | - Jane Ford
- Alfred Health Trauma Registry, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Arul Earnest
- Department of Epidemiology and Preventive Medicine, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Waleed Hashem
- Centre of Excellence, King Saud Medical City, Riyadh, Saudi Arabia
| | | | - Ahmed Alenezi
- Executive Office, King Saud Medical City, Riyadh, Saudi Arabia
| | - Mark Fitzgerald
- National Trauma Research Institute, Alfred Hospital, Melbourne, Victoria, Australia
| | - Peter Cameron
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Fransvea P, Costa G, Serao A, Cortese F, Balducci G, Sganga G, Marini P. Laparoscopic splenectomy after trauma: Who, when and how. A systematic review. J Minim Access Surg 2021; 17:141-146. [PMID: 31670290 PMCID: PMC8083752 DOI: 10.4103/jmas.jmas_149_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Importance: A deep knowledge of the indication for laparoscopic splenectomy (LS) in trauma case can lead trauma surgeon to offer in a wider number of situations a minimally invasive approach to a common injuries. Objective: To present and review the advantages and disadvantages of laparoscopic approach for spleen trauma and to identify patient whose can benefit from a minimally invasive approach versus patient that need open surgery to assess the whole severity of trauma. Evidence Review: A systematic review was performed according to the PRISMA statement in order to identify articles reporting LS after trauma. A literature search was performed through MEDLINE (through PubMed), Embase and Google Scholar from January 1990 to December 2018. Studies conducted on animals were not considered. All other laparoscopic procedures for spleen trauma were excluded. Results: Nineteen articles were included in this study, reporting 212 LS after trauma. The most study includes blunt trauma patient. All LS were performed in haemodynamically stable patient. Post-operative complications were reported in all articles with a median post-operative morbidity rate of 30 patients (14.01%), including 16 (7.5%) post-operative deaths. Conclusions and Relevance: This article reports the feasibility and safety of a minimally invasive approach for common trauma injuries which can help non-advanced laparoscopic skill trauma surgeon to develop the best indication to when to adopt this kind of approach.
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Affiliation(s)
- Pietro Fransvea
- Division of Emergency Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, Rome, Italy
| | - Gianluca Costa
- Department of Translational Medicine, Sant' Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy
| | - Angelo Serao
- Department of General Surgery, Ospedale Dei Castelli, Ariccia, Rome, Italy
| | - Francesco Cortese
- Emergency Surgery and Trauma Care Unit, St Filippo Neri Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Translational Medicine, Sant' Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy
| | - Gabriele Sganga
- Division of Emergency Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, Rome, Italy
| | - Pierluigi Marini
- Department of General and Emergency Surgery, St. Camillo Forlanini's Hospital, Rome, Italy
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Alhumaid FA, Alturki ST, Alshareef SH, Alobaidan OS, Alhuwaymil AA, Alohaideb NS, Bhatti AZ. Epidemiology of hand fractures at a tertiary care setting in Saudi Arabia. Saudi Med J 2019; 40:732-736. [PMID: 31287136 PMCID: PMC6757210 DOI: 10.15537/smj.2019.7.24286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To examine the epidemiology of hand fractures including common bones affected, causes, interventions, outcomes, and complications. Methods: This retrospective records-based study included patients who were admitted to King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, with traumatic metacarpal or phalangeal fractures between January 2016 and September 2017. Carpal fractures, wrist fractures, and all pathological fractures were excluded. Results: A total of 82 patients (90.2% of them men with an average age of 27.6±13.4 years) with 101 fractures were included. The fifth (25.5%) and first (24.5%) rays were the most commonly affected ones. The fifth finger (27.8%) and first metacarpal (28.9%) were the most commonly affected finger and metacarpal bone. Approximately 32.7% of the fractures were open fractures. The most frequent causes of hand fractures included falls (40.5%), road traffic accidents (20.3%), crushing injuries (9.5%), and machinery injuries (9.5%). Approximately 90.1% of the patients underwent operative interventions including open reduction (50.5%) and closed reduction (34.3%). The majority of fractures (79.2%) healed, and only 14.7% of fractures developed complications. Conclusion: In this study of hand fractures, patients were predominantly males and the main causes of fractures were falls and road traffic accidents.
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Affiliation(s)
- Fahad A Alhumaid
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Alghnam S, Alsulaim HA, BinMuneif YA, Al-Zamil A, Alahmari A, Alshafi A, Alsaif A, Albabtain I. Injuries following motorcycle crashes at a level-1 trauma center in Riyadh. Ann Saudi Med 2019; 39:185-191. [PMID: 31215223 PMCID: PMC6832331 DOI: 10.5144/0256-4947.2019.185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 04/02/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Motor vehicle crashes are the third leading cause of death in Saudi Arabia. Motorcycle riders, in particular, are considered more vulnerable than occupants, yet there are no previous studies that have examined the epidemiology of their injuries and outcomes in the country. Better understanding is needed to inform policymakers and guide future prevention programs. OBJECTIVE Describe patterns of injury among conscious and unconscious patients injured in motorcycle crashes. DESIGN Retrospective chart review. SETTINGS Level 1 trauma center in Riyadh. PATIENTS AND METHODS This retrospective study included all patients involved in motorcycle crashes who were admitted between 2001 and 2017. Medical records were reviewed, and data about injury characteristics, outcomes and healthcare utilization were ascertained. MAIN OUTCOME MEASURES Injury site and mortality rate. SAMPLE SIZE AND CHARACTERISTICS 572 patients included 488 males (85.3%) and 232 <18 years of age (40.5%), mean (SD) age 21.1 (11.6) years. RESULTS About 3% of patients died either before or after admission. Extremity injuries (356, 62.2%) were most common followed by head injuries (229, 40%). Fifty-six (9%) suffered amputation, mostly to a lower limb. CONCLUSION This study underscores the significant burden of motorcycle-related injuries on population health of Saudi Arabia. The number of amputations due to motorcycle injuries is striking. Therefore, we need to increase enforcement of safety measures during recreational use of motorcycles and to raise awareness about the dangers of motorcycle crashes to improve traffic safety and ultimately population health. LIMITATIONS The study was conducted at a single hospital which may affect the generalizability of the data to the Saudi population. CONFLICT OF INTEREST None.
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Affiliation(s)
- Suliman Alghnam
- From the Department of Population Helath, King Abdullah International Research Center, Riyadh, Saudi Arabia
| | - Hatim A. Alsulaim
- From the Department of Surgery, Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia
| | | | - Abdulmohsen Al-Zamil
- From the College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah Alahmari
- From the College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Abdullah Alshafi
- From the College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmad Alsaif
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ibrahim Albabtain
- From the Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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