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Alsulami M, Almukhlifi Y, Alsulami A, Al Nufaiei ZF, Alruwaili A, Alanazy A. Implementing Prehospital Ultrasound at the Saudi Red Crescent Authority: Perceived Barriers and Training Needs. J Multidiscip Healthc 2024; 17:2871-2878. [PMID: 38881755 PMCID: PMC11180463 DOI: 10.2147/jmdh.s457429] [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: 02/16/2024] [Accepted: 06/03/2024] [Indexed: 06/18/2024] Open
Abstract
Objective This study examines the inherent barriers to implementing prehospital ultrasound within the Saudi Red Crescent Authority (SRCA) in Saudi Arabia. Methods A qualitative study was conducted to explore the perceived barriers, mode of transportation, ultrasound familiarity, and self-efficacy level of relevant stakeholders in implementing the prehospital ultrasound in SRCA. Data was collected via surveys and interviews with 24 SRCA paramedics/EMTs, 4 SRCA station administrators, and two hospital physicians to further examine the inherent barriers of implementing the prehospital ultrasound. Results Thematic analysis revealed the main barriers were costs of ultrasound equipment, environmental factors affecting image capture, and lack of training in ultrasound skills and interpretation. Administrators and physicians also noted concerns about machine portability and technical maintenance. Stakeholders agreed ultrasound could improve trauma diagnosis if barriers were addressed through extensive training and protocols. In prehospital care setting, the two main modes of transportation are "stay and play", involving on-scene interventions before transport, and "load and go", prioritizing rapid transport to the hospital, with the choice depending on various factors. An overwhelming 96% of paramedics/EMTs preferred a 'stay and play' approach to stabilize patients before transport, while 75% of administrators preferred 'load and go' for rapid transport to hospitals. 62.5% of paramedics were familiar with ultrasound, but only 20.8% had previously used it. Conclusion This study provides important insights into stakeholder perspectives on the implementation of prehospital ultrasound within the Saudi Red Crescent Authority. The findings can guide efforts to implement appropriate ultrasound use through tailored training programs and enhanced coordination across groups, aimed at improving trauma outcomes.
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Affiliation(s)
- Maher Alsulami
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Educational Leadership Program, School of Education, Duquesne University, Pittsburgh, PA, USA
| | - Yasir Almukhlifi
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Adnan Alsulami
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ziyad F Al Nufaiei
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah Alruwaili
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Al-Ahsa, Saudi Arabia
- King Abdullah International Medical Research Center, Al-Ahsa, Saudi Arabia
| | - Ahmed Alanazy
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Al-Ahsa, Saudi Arabia
- King Abdullah International Medical Research Center, Al-Ahsa, Saudi Arabia
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2
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Buh FC, Taiwe GS, Maas AI, Motah M, Youm E, Wanyu BY, Wang KW, Hutchinson PJ, Sumbele IUN. Demographics, Causes, and Outcome of Traumatic Brain Injury among Trauma Cases in Cameroon: A Multi-Center Five Year's Retrospective Study. Neurotrauma Rep 2022; 3:569-583. [PMID: 36711440 PMCID: PMC9879018 DOI: 10.1089/neur.2022.0053] [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] [Indexed: 12/29/2022] Open
Abstract
Traumatic brain injury (TBI) is a huge public health challenge worldwide. Epidemiological monitoring is important to inform healthcare policy. We aimed at determining the prevalence, outcome, and causes of TBI in Cameroon by conducting a 5-year retrospective study in three referral trauma centers. Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were recorded. Comparisons between two categorical variables were done using Pearson's chi-square test or Fisher's exact test. A total of 6248 cases of TBI were identified of 18,151 trauma cases, yielding a prevalence of 34%. The number of TBI cases increased across the years (915 in 2016, 1406 in 2020). Demographic data and causes of TBI were available for 6248 subjects and detailed data on clinical characteristics on 2178 subjects. Median age was 30.0 (24.0, 41.0) years. Males were more affected (80%). Road traffic incidents (RTIs; 75%) was the main cause of TBI, with professional bike riders being more affected (17%). Computed tomography (CT) imaging was performed in 67.7% of cases. Of the 597 (27.4%) cases who did not undergo neuroimaging, 311 (52.1%) did not have neuroimaging performed because of financial constraints, among which 7% were severe TBI cases. A total of 341 (19.6%) patients were discharged against medical advice, of which 83% had financial limitations. Mortality was 10.3% (225 of 2178) in the overall population, but disproportionately high in patients with severe TBI (55%) compared to those in high-income settings (27%). TBI occurrence is high in Cameroon, and RTIs are the main causes. Disparities in care provision were identified as attributable to financial constraints regarding CT scanning and continuation of care. The data presented can inform preventive interventions to improve care provision and transport policies. Implementation of a universal health insurance may be expected to improve hospital care and reduce the adverse effects of TBI among Cameroonians.
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Affiliation(s)
- Franklin Chu Buh
- Department of Animal Biology and Conservation, Faculty of Science, University of Buea, Buea, Cameroon
- Panafrican Hospital Center-Douala, Buea, Cameroon
| | - Germain Sotoing Taiwe
- Department of Animal Biology and Conservation, Faculty of Science, University of Buea, Buea, Cameroon
| | - Andrew I.R. Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Mathieu Motah
- Department of Surgery, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | | | - Bertrand Yuwong Wanyu
- Department of Animal Biology and Conservation, Faculty of Science, University of Buea, Buea, Cameroon
| | - Kevin W. Wang
- Department of Emergency Medicine, University of Florida, Gainesville, Florida, USA
| | - Peter J.A. Hutchinson
- Department of Clinical Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Irene Ule Ngole Sumbele
- Department of Animal Biology and Conservation, Faculty of Science, University of Buea, Buea, Cameroon
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Clinical profile and outcomes of trauma patients visiting the emergency department of a trauma center Addis Ababa, Ethiopia. Afr J Emerg Med 2022; 12:478-483. [DOI: 10.1016/j.afjem.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
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Al-Shareef AS, Thaqafi MA, Alzahrani M, Samman AM, AlShareef A, Alzahrani A, Alzahrani A, Rio A, Hariri B, Ramadan M. Traumatic Brain Injury Cases' Mortality Predictors, Association, and Outcomes in the Emergency Department at a Tertiary Healthcare Center in Saudi Arabia. Asian J Neurosurg 2022; 17:416-422. [DOI: 10.1055/s-0042-1750786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Abstract
Aim Incidence of traumatic brain injury (TBI) in Saudi Arabia has been estimated to be 116 per 1,00,000 population as incidence of TBI continues to rise in our region. We aim to study the demographics, mortality predictors, and factors influencing the outcome of TBI cases in a tertiary care center in Jeddah, Saudi Arabia.
Materials and Methods We retrospectively collected data from all consecutive patients treated at the Emergency Department of King Abdulaziz Medical City including all acute TBI adult cases (>18 years) from 2016 to 2019. Logistic regression models were used to identify significant predictors of mortality. A total of 423 individuals with TBI were enrolled in the study. Nearly, half of them were in age group of 18 to 29 (40.77). Most patients were males (76.83%).
Results Injuries were most commonly mild-to-moderate TBI (73.83%). Road traffic accident was the most common mechanism of injury (49.7%) followed by fall (39.5%). Most common mode of transportation was private cars (47.57%). Most patient required less than or equal to24hours of admission (61.23%). A total of 30 (7%) died in the hospital all of which were male with no death cases reported among females.
Conclusion In conclusion, this study reports a mortality rate related to TBI that is among the lowest in the region. Injuries were male predominant with more balanced male to female ratio. Patients who were delivered to the hospital via private cars had an improved survival. These finding should be interpreted in the context of retrospective noncontrolled study design, and further future studies are encouraged to consolidate these findings.
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Affiliation(s)
- Ali S. Al-Shareef
- King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Majid Al Thaqafi
- King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Moajeb Alzahrani
- King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Afnan M. Samman
- King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdullah AlShareef
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ahmad Alzahrani
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ali Alzahrani
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ali Rio
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Bassam Hariri
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Majed Ramadan
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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Hakeem FF, Alshahrani SM, Ghobain MA, Albabtain I, Aldibasi O, Alghnam S. The Impact of COVID-19 Lockdown on Injuries in Saudi Arabia: Results From a Level-I Trauma Center. Front Public Health 2021; 9:704294. [PMID: 34327189 PMCID: PMC8315266 DOI: 10.3389/fpubh.2021.704294] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/18/2021] [Indexed: 01/21/2023] Open
Abstract
Background: The COVID-19 pandemic has placed an enormous strain on global health. Due to precautionary measures, the epidemiology of health conditions may have been affected. Saudi Arabia imposed a lockdown order on March 25, 2020. This study investigated the impact of the pandemic lockdown on injuries in a level-I trauma center in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: This retrospective study identified all injured patients seeking emergency care during the lockdown period (March 25-June 21, 2020) and a similar period in two previous year (March 25-June 21) 2018 and 2019. The collected data included patients' demographics, injury types, mechanisms, and health outcomes. Results: Two hundred sixty nine injured patients sought emergency care during the lockdown, while 626 and 696 patients were treated in the same period of 2018 and 2019, respectively. There was a significant reduction in motor vehicle crashes (OR: 0.47; 95% CI: 0.31-0.73) and burns (OR: 0.24; 95% CI: 0.08-0.66), coupled with a significant increase in assault injuries (OR: 2.20; 95% CI: 1.30-3.74) in the lockdown period compared to 2019. Apart from the intensive care unit (ICU) admission and hospital length of stay, there were no differences between the two periods in the health outcomes. ICU admission was significantly reduced by 57% during the lockdown period (OR: 0.43; 95% CI: 0.22-0.83). Mechanisms of injuries were not significant predictors of deaths or ICU admission or both in the lockdown period. Conclusion: The COVID-19 lockdown had a clear impact on the volume and mechanisms of injuries. The findings highlight that injury risk factors are modifiable and emphasize the importance of public health measures for preventing injuries and the significance of maintaining trauma services capacity during pandemics.
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Affiliation(s)
- Faisal F Hakeem
- Department of Preventive Dental Sciences, Taibah University Dental College & Hospital, Madinah, Saudi Arabia
| | - Saeed Mastour Alshahrani
- Basic Medical Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mohammed Al Ghobain
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ibrahim Albabtain
- Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Omar Aldibasi
- Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Population Health Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Nasser AAH, Khouli Y. The Impact of Prehospital Transport Mode on Mortality of Penetrating Trauma Patients. Air Med J 2020; 39:502-505. [PMID: 33228903 DOI: 10.1016/j.amj.2020.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/10/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The optimal mode of transport of trauma patients from the scene to the hospital remains unknown. We aimed to study the impact of different prehospital modes of transport of penetrating trauma patients on hospital mortality. METHODS Using the Trauma Quality Improvement Program 2010 to 2016 database, we identified all adults with a penetrating injury. Univariate then multivariable logistic regression analyses were performed to study the correlation between the mode of transport and in-hospital mortality, adjusting for several covariates. RESULTS A total of 92,427 subjects were included. The overall mean transport time for patients transported by a ground ambulance, helicopter, fixed wing ambulance, and police/private vehicle were 32.2, 61.2, 68.9, and 28.2 minutes, respectively. Multivariable analyses revealed that compared with ground ambulance, helicopter transport was associated with a 34% decrease in the odds of mortality (odds ratio = 0.66, P < .0001), whereas police transport and private vehicle transport were associated with a 52% decrease in the odds of mortality (odds ratio = 0.48, P < .0001). CONCLUSION Helicopter, police, and private vehicle transports are associated with a decreased odds of mortality compared with ground ambulance. Further research should examine the variation in levels of care within different modes of prehospital transport.
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Affiliation(s)
- Ahmed A H Nasser
- Trauma and Orthopaedics Department, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Isleworth, United Kingdom.
| | - Yousef Khouli
- General Surgery Department, Broomfield Hospital, Mid Essex Hospitals NHS Trust, Broomfield, United Kingdom
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7
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Alharbi RJ, Lewis V, Mosley I, Miller C. Current trauma care system in Saudi Arabia: A scoping literature review. ACCIDENT; ANALYSIS AND PREVENTION 2020; 144:105653. [PMID: 32629227 DOI: 10.1016/j.aap.2020.105653] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 05/04/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Trauma is one of the leading causes of death worldwide with millions of people dying each year, particularly in low or middle-income countries. This paper describes and evaluates the current trauma system (TS) in Saudi Arabia (SA). METHODS A scoping literature review was performed, incorporating an extensive search of Medline and Embase databases for refereed literature, as well as a search of grey literature to locate unpublished articles or reports in English or Arabic. All publications were assessed against the World Health Organization (WHO) Trauma System Maturity Index (TSMI) and American College of Surgeon's (ACS) criteria. RESULTS Despite local injury prevention efforts, Motor Vehicle Crashes (MVC) remain the primary cause of injuries in SA. Prehospital trauma care in SA aligns with level III care as described in the WHO TSMI classification system, based on the presence of formal emergency medical services and universal access to care. With respect to the ACS classification, no clear written guidelines, either for field triage or trauma destination protocols such as trauma bypass, were identified in prehospital trauma care. The role of secondary and tertiary facilities in treating trauma patients is unclear, with no clear referral linkages, suggesting a level I to III grading of SA's trauma care facilities. Currently, there is no national or regional electronic trauma registry, no quality assurance program, and active involvement in research projects related to injuries is limited. CONCLUSION The current SA TS has strengths but there are key features missing in comparison to other systems globally. As MVCs remain a leading cause of death/ disability, efforts to reduce the prevalence and impact of MVC burden in SA through development of a stronger national TS are warranted.
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Affiliation(s)
- Rayan Jafnan Alharbi
- Alfred Health Clinical School, La Trobe University, Prahran, Victoria, Australia; Department of Emergency Medical Service, Jazan University, Jazan, Saudi Arabia.
| | - Virginia Lewis
- Australian Institute for Primary Care and Ageing, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Ian Mosley
- School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Charne Miller
- Alfred Health Clinical School, La Trobe University, Prahran, Victoria, Australia
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Abujaber A, Fadlalla A, Gammoh D, Abdelrahman H, Mollazehi M, El-Menyar A. Prediction of in-hospital mortality in patients with post traumatic brain injury using National Trauma Registry and Machine Learning Approach. Scand J Trauma Resusc Emerg Med 2020; 28:44. [PMID: 32460867 PMCID: PMC7251921 DOI: 10.1186/s13049-020-00738-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/15/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The use of machine learning techniques to predict diseases outcomes has grown significantly in the last decade. Several studies prove that the machine learning predictive techniques outperform the classical multivariate techniques. We aimed to build a machine learning predictive model to predict the in-hospital mortality for patients who sustained Traumatic Brain Injury (TBI). METHODS Adult patients with TBI who were hospitalized in the level 1 trauma center in the period from January 2014 to February 2019 were included in this study. Patients' demographics, injury characteristics and CT findings were used as predictors. The predictive performance of Artificial Neural Networks (ANN) and Support Vector Machines (SVM) was evaluated in terms of accuracy, Area Under the Curve (AUC), sensitivity, precision, Negative Predictive Value (NPV), specificity and F-score. RESULTS A total of 1620 eligible patients were included in the study (1417 survival and 203 non-survivals). Both models achieved accuracy over 91% and AUC over 93%. SVM achieved the optimal performance with accuracy 95.6% and AUC 96%. CONCLUSIONS for prediction of mortality in patients with TBI, SVM outperformed the well-known classical models that utilized the conventional multivariate analytical techniques.
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Affiliation(s)
- Ahmad Abujaber
- Assistant Executive Director of Nursing, Hamad Medical Corporation, Doha, Qatar
| | - Adam Fadlalla
- College of Business and Economics, Management Information Systems, Qatar University, Doha, Qatar
| | - Diala Gammoh
- Industrial Engineering, University of Central Florida, Orlando, USA
| | - Husham Abdelrahman
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Monira Mollazehi
- Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Ayman El-Menyar
- Department of Surgery, Trauma Surgery, Clinical Research, Hamad Medical Corporation, Doha, Qatar. .,Department of Clinical Medicine, Weill Cornell Medical College Hamad General Hospital, Doha, Qatar.
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Alharbi R, Miller C, Lewis V. Protocol for a feasibility exploratory multicentre study of factors influencing trauma patients' outcomes of traffic crashes in Saudi Arabia. BMJ Open 2019; 9:e032046. [PMID: 31594903 PMCID: PMC6797312 DOI: 10.1136/bmjopen-2019-032046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Road traffic injury is a leading cause of death for people of all ages. The burden of road traffic injuries is well established in developed countries. However, there has been limited investigation of the incidence and burden of road traffic injury in low/middle-income countries. With a proportionally high number of road users, there is a need to explore the factors in prehospital and hospital care in Saudi Arabia (SA) that are associated with mortality for adult trauma patients following road traffic crashes (RTCs). This paper outlines the method for the planned research. METHODS AND ANALYSIS A feasibility exploratory multicentre study will be conducted at three purposefully selected hospitals with different trauma care resources in differing geographic locations of SA. The study sample will include all adult trauma patients who are involved in RTCs in SA and have been admitted to a study site in a 3-month period from May to July 2019. Data regarding the characteristics of the crashes and prehospital health care factors will be extracted from hospital databases where it is available. Information will be collected from patients or carers and hospital records in the two sites that do not have a registry. Patient status at 30 days post-injury, particularly mortality, will be assessed through hospital records. The relative contribution of a range of factors to predicting mortality will be explored using logistic regression analysis. ETHICS AND DISSEMINATION This study was approved by the Institutional Review Board Committee at King Saud Medical City (H-01-R-053), the General Department of Research and Studies at the Ministry of Health in SA (1440-1249939) and (1440-1398648), and the La Trobe University Human Research Ethics Committee (HEC19095). The results will be reported in a thesis and in peer-reviewed journal articles and conference presentations.
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Affiliation(s)
- Rayan Alharbi
- Australian Institute for Primary Care and Ageing, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
- Department of Emergency Medical Service, Jazan University, Jazan, Saudi Arabia
| | - Charne Miller
- La Trobe Alfred Health Clinical School, La Trobe University, Prahran, Victoria, Australia
| | - Virginia Lewis
- Australian Institute for Primary Care and Ageing, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
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Alghnam S, Towhari JA, Al Babtain I, Al Nahdi M, Aldebasi MH, Alyami M, Alkhalaf H. The associations between injury mechanism and extended hospital stay among pediatric patients: findings from a trauma Center in Saudi Arabia. BMC Pediatr 2019; 19:177. [PMID: 31159773 PMCID: PMC6545720 DOI: 10.1186/s12887-019-1559-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 05/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A hospitalized patient's length of stay (LOS) can have a significant impact on the performance and operating costs of a healthcare facility. Among pediatric patients, traumatic injuries are common causes of emergency room visits and hospitalizations. In Saudi Arabia, little is known about the burden of pediatric traumas on population health and the healthcare facilities. Therefore, the aim of this study was to investigate the associations between traumatic pediatric injury mechanisms and extended LOS in a trauma center. METHODS Data was obtained from the trauma registry. From 2001 to 2018, trauma patients between the ages of 0 and 18 years old with LOSs of > 0 days were analyzed. The independent variable was the injury mechanism, which was classified as follows: falls, burns, drowning, motor vehicle collisions, motorcycle collisions, pedestrian, and intentional injuries. The dependent variable was an extended LOS defined as ≥21 days. A multivariate logistic regression analysis was used to evaluate the associations between the injury mechanisms and an extended LOS. RESULTS A total of 5563 pediatric patients were included in this study. Of those, 774 (14%) had extended LOSs. Those patients with extended LOSs suffered more severe injuries than those with short hospital stays as measured by the Injury Severity Score (mean scores: 15.4 vs. 6.8, p < 0.01), the Glasgow Coma Scale score (mean scores: 10.4 vs, 14.0, p < 0.01), and the Revised Trauma Score (mean scores: 9.9 vs. 11.0, p < 0.01). Approximately one half of the patients with extended LOSs were admitted due to motor vehicle injuries. In addition, those patients were almost five times more likely to have extended LOSs than the patients who suffered fall injuries (odds ratio: 4.8, 95% confidence interval: 3.2-7.1). CONCLUSIONS Based on the study results, motor vehicle injuries were significantly associated with extended hospitalizations. Prevention is instrumental for reducing healthcare utilization; therefore, these findings call for public health professionals and policymakers to plan, design, and implement preventive measures to reduce the traffic injury burden. In addition, increased traffic law enforcement, such as the use of car restraints, is warranted to reduce the preventable injuries and improve the overall population health.
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Affiliation(s)
- Suliman Alghnam
- Population Health Section-King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia.
| | - Jawaher Ali Towhari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ibrahim Al Babtain
- General Surgery Trauma and Acute Care Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Muhannad Al Nahdi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed Hamad Aldebasi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Mahna Alyami
- Health Education Department, Saudi German Hospital, Riyadh, Saudi Arabia
| | - Hamad Alkhalaf
- General Pediatrics and Complex Care, King Abdullah Specialized Children's Hospital, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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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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