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Behzadnia MJ, Anbarlouei M, Hosseini SM, Boroumand AB. Prognostic factors in traumatic brain injuries in emergency department. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:83. [PMID: 36685030 PMCID: PMC9854932 DOI: 10.4103/jrms.jrms_290_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/28/2022] [Accepted: 06/20/2022] [Indexed: 11/27/2022]
Abstract
Background Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in young adults. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods This was a multicenter cross-sectional study conducted on 144 patients with TBI admitted at trauma emergency centers. The patients' information, including demographic characteristics, duration of hospital stay, mechanical ventilation and on-admission laboratory measurements, and on-admission vital signs, were evaluated. The patients' TBI-related symptoms and brain computed tomography (CT) scan findings were recorded. Results GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30) and within 3 months (7.58 ± 1.21) evaluations (P < 0.001). On-discharge GOSE was positively correlated with Glasgow Coma Scale (GCS)(r = 0.729, P < 0.001), motor GCS (r = 0.812, P < 0.001), Hb (r = 0.165, P = 0.048), and pH (r = 0.165, P = 0.048) and inversely with age (r = -0.261, P = 0.002), hospitalization period (r = -0.678, P < 0.001), pulse rate (r = -0.256, P = 0.002), white blood cell (WBC) (r = -0.222, P = 0.008), and triglyceride (r = -0.218, P = 0.009). In multiple linear regression analysis, the associations were significant only for GCS (B = 0.102, 95% confidence interval [CI]: 0-0.202; P = 0.05), hospitalization stay duration (B = -0.004, 95% CI: -0.005--0.003, P = 0.001), and WBC (B = 0.00001, 95% CI: 0.00000014-0.000025; P = 0.024). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) was significantly associated with GOSE at discharge in multivariable analysis. Conclusion According to the current study findings, GCS, hospitalization stay duration, WBC and among imaging signs and trauma-related symptoms ICH, IVH, SAH, SDH, and EDH are independent significant predictors of GOSE at discharge in TBI patients.
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Affiliation(s)
- Mohammad Javad Behzadnia
- Department of Emergency Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran,Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mousareza Anbarlouei
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Morteza Hosseini
- Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Bahador Boroumand
- Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Amir Bahador Boroumand, Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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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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Yamada MP, Zanei SSV, Whitaker IY. Functional Capacity Index: cultural adaptation and measurement of validity and reliability. Rev Gaucha Enferm 2021; 42:e20200091. [PMID: 34755798 DOI: 10.1590/1983-1447.2021.20200091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/02/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To carry out a cultural adaptation of the Functional Capacity Index (FCI) into Portuguese and to verify its reliability and validity in traffic accident victims. METHOD Methodological study for cultural adaptation of the FCI. Reliability and validity were verified in a convenience sample of traffic accident victims, in São Paulo city. Data from the patient's medical record were collected retrospectively in 2015. Reliability verified by Cronbach's alpha coefficient and validity by Spearman's correlation and Mann-Whitney test. RESULTS The FCI in Portuguese was applied to 50 traffic accident victims. The internal consistency reached Cronbach's alpha values >0.70. The FCI correlated with the Katz index, did not correlate with the severity of trauma and the FCI of trauma patients was higher compared to those without trauma. CONCLUSION The FCI in Portuguese showed satisfactory internal consistency, allowing the measurement of functional capacity, discriminating against people with and without traumatic injuries.
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Affiliation(s)
- Marina Peixe Yamada
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
| | - Suely Sueko Viski Zanei
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Enfermagem Clínica e Cirúrgica. São Paulo, São Paulo, Brasil
| | - Iveth Yamaguchi Whitaker
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
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Lin M, Chen J, Li S, Qin Y, Wang X, Liu Y, Zhang Q, Taha Abdullah Abdulaziz A, Zhou D, Li J. Individual prediction of motor vehicle accidents for patients with epilepsy. Epilepsy Behav 2021; 121:108046. [PMID: 34111767 DOI: 10.1016/j.yebeh.2021.108046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 02/05/2023]
Abstract
The objective of the study was to design a clinically useful tool to predict the risk of seizure-related motor vehicle accidents (MVAs) for people with epilepsy (PWE). Participants were patients who visited our epilepsy center in West China Hospital from October 2012 to October 2019 and were divided into a primary cohort and a validation cohort. Ultimately, we included 525 patients in the primary cohort and 86 patients in the validation cohort. Proportional hazard regression was performed to measure the prognostic factors of car accidents. The outcome was used to create a nomogram model. The final model had 7 factors, with a C-index of 0.85 (95% CI, 0.80-0.91), to predict the possibility of non-MVA for PWE. For the validation cohort, the C-index was 0.83 (95% CI, 0.72-0.95). This nomogram model can offer more individualized advice to PWE who are still driving by estimating the risk of car accidents.
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Affiliation(s)
- Mintao Lin
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Jiani Chen
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Sisi Li
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Yingjie Qin
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Xuruan Wang
- West China Medical School, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Yadong Liu
- West China Medical School, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Qi Zhang
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Ammar Taha Abdullah Abdulaziz
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China.
| | - Jinmei Li
- Department of Neurology, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan 610041, People's Republic of China.
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Serge A, Quiroz Montoya J, Alonso F, Montoro L. Socioeconomic Status, Health and Lifestyle Settings as Psychosocial Risk Factors for Road Crashes in Young People: Assessing the Colombian Case. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030886. [PMID: 33498569 PMCID: PMC7908603 DOI: 10.3390/ijerph18030886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/17/2022]
Abstract
The social determinants of health influence both psychosocial risks and protective factors, especially in high-demanding contexts, such as the mobility of drivers and non-drivers. Recent evidence suggests that exploring socioeconomic status (SES), health and lifestyle-related factors might contribute to a better understanding of road traffic crashes (RTCs). Thus, the aim of this study was to construct indices for the assessment of crash rates and mobility patterns among young Colombians who live in the central region of the country. The specific objectives were developing SES, health and lifestyle indices, and assessing the self-reported RTCs and mobility features depending on these indices. A sample of 561 subjects participated in this cross-sectional study. Through a reduction approach of Principal Component Analysis (PCA), three indices were constructed. Mean and frequency differences were contrasted for the self-reported mobility, crash rates, age, and gender. As a result, SES, health and lifestyle indices explained between 56.3–67.9% of the total variance. Drivers and pedestrians who suffered crashes had higher SES. A healthier lifestyle is associated with cycling, but also with suffering more bike crashes; drivers and those reporting traffic crashes have shown greater psychosocial and lifestyle-related risk factors. Regarding gender differences, men are more likely to engage in road activities, as well as to suffer more RTCs. On the other hand, women present lower healthy lifestyle-related indices and a less active implication in mobility. Protective factors such as a high SES and a healthier lifestyle are associated with RTCs suffered by young Colombian road users. Given the differences found in this regard, a gender perspective for understanding RTCs and mobility is highly suggestible, considering that socio-economic gaps seem to differentially affect mobility and crash-related patterns.
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Affiliation(s)
- Andrea Serge
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, 46022 Valencia, Spain
- Correspondence: (A.S.); (F.A.); Tel.: +34-61120-2027 (A.S. & F.A.)
| | - Johana Quiroz Montoya
- Dipartimento Scienze Statistiche, Faculty: Ingegneria Dell’informazione, Informatica e Statistica, Sapienza Università di Roma, 00185 Rome, Italy;
| | - Francisco Alonso
- DATS (Development and Advising in Traffic Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, 46022 Valencia, Spain
- Correspondence: (A.S.); (F.A.); Tel.: +34-61120-2027 (A.S. & F.A.)
| | - Luis Montoro
- FACTHUM.Lab (Human Factor and Road Safety) Research Group, INTRAS (Research Institute on Traffic and Road Safety), University of Valencia, 46022 Valencia, Spain;
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