Injury
-
Review Comparative Study
Self harm is an independent predictor of mortality in trauma and burns patients admitted to ICU.
Patients with mental illness or depression may sustain self-inflicted injuries that require admission to an Intensive Care Unit (ICU). It is unknown whether the intent of injury leads to a greater likelihood of dying over and above the severity of the initial injury. Given the economic and societal burden of injury of self-harm, we designed this study to compare hospital outcomes of intentionally injured patients presenting to a tertiary ICU compared to unintentional injuries. ⋯ Our study is the first paper in the literature to describe an increased the risk of death within a group of patients admitted to a trauma and burns ICU following deliberate self-harm.
-
Multicenter Study
Trauma centre outcome performance: a comparison of young adults and geriatric patients in an inclusive trauma system.
Elderly trauma patients represent a unique clientele requiring specialised care but they rarely benefit from standardised care strategies within trauma systems. We aimed to evaluate whether trauma centres with lower/higher than expected mortality amongst patients <65 years of age have similar results for geriatric patients. A secondary objective was to compare transfer to level I/II trauma centres across age groups. ⋯ Trauma centres that have low risk-adjusted mortality for young adults do not necessarily do so for geriatric patients. In addition, geriatric patients with severe head injuries are less likely to be treated in neurosurgical trauma centres. Further research is needed to identify determinants of inter-hospital variation in outcome for geriatric trauma patients.
-
Despite the establishment of evidence-based guidelines for the resuscitation of critically injured patients who have sustained cardiopulmonary arrest, rapid decisions regarding patient salvageability in these situations remain difficult even for experienced physicians. Regardless, survival is limited after traumatic cardiopulmonary arrest. One applicable, well-described resuscitative technique is the emergency department thoracotomy-a procedure that, when applied correctly, is effective in saving small but significant numbers of critically injured patients. By understanding the indications, technical details, and predictors of survival along with the inherent risks and costs of emergency department thoracotomy, the physician is better equipped to make rapid futile versus salvageable decisions for this most severely injured subset of patients.
-
Comparative Study
Outcomes of trauma patients: direct transport versus transfer after stabilisation at another hospital.
In this study, we attempted to identify differences in the outcomes of patients with severe trauma who were directly transported to our hospital, and those who were stabilised initially at other hospitals in south-central Taiwan. ⋯ In trauma patients with ISS>15, there is no difference in mortality between those transferred from another hospital after initial stabilisation and those who visited our emergency department directly.
-
To compare the early health status of people who sustained injuries during road traffic crashes (RTC) in which they were at fault (AF), with people who sustained injuries in RTC in which they were not at fault (NAF). ⋯ Despite there being no difference in physical health status, the NAF group demonstrated more emotional and mental disturbance than the AF group; and this was significantly worse for females. Treatment strategies should focus on addressing early pain and disability as well as providing appropriate psychological interventions, particularly for people not at fault following RTC.