This study aimed to evaluate non-survivors who were admitted to a level I trauma center but later died, in terms of predicting who would expire early vs late. This is a single-center study of Trauma Registry data, from July 3, 2016, to February 24, 2022. The inclusion criteria were based upon age (≥18 years) and in-hospital mortality. 546 patients (mean age 58) were included in the analysis. Trauma patients who may experience an earlier death were those with increasing injury severity scores, activation of massive transfusion protocol, comorbid advanced directive limiting care, COPD, personality disorder, and ED death location. Patients were more likely to experience later in-hospital mortality, including those with increasing ICU stays, and comorbid dementia.
This research aims to evaluate the specific effects of end-stage renal disease on acutely injured trauma patients. This is a single-center study of Trauma Registry data, inclusive years July 1, 2016 to February 28, 2021. Patients were grouped by pre-existing comorbidity of chronic kidney disease (CKD) and those without. Overall, 7261 elderly trauma patients were included in the analysis; stratified groups identified 197 with CKD (3%) and 7064 without (97%). The Injury Severity Scores (ISSs) between the two groups were not significantly different. Elderly trauma patients with CKD typically stayed in the ICU and hospital longer with discharge to hospice, rehab, experienced an in-hospital mortality, and most likely experienced an in-hospital complication. For CKD and non-CKD cohorts, ISSs were similar. However, outcomes for the CKD cohort in the trauma setting were significantly worse, particularly in elderly patients with fall trauma and lower extremity fractures.
The leading cause of preventable traumatic death is uncontrolled bleeding. This study aimed to better identify those most likely to experience in-hospital mortality with increasing injury severity scoring (ISS). This is a single-center study of Trauma Registry data, from July 3, 2016, to February 24, 2022. The inclusion criteria were based upon age (≥18 years) and in-hospital mortality. 546 patients (mean age 58) were included in the analysis. There were several significant associations with increasing ISS among those who experienced in-hospital mortality, which included a rising shock index ratio, activation of the massive transfusion protocol, and, most notably, motorcycle trauma. This research reiterates the importance of the “Stop the Bleed” campaign as vital for training laypersons in the life-saving technique for hemorrhage control.
The leading cause of preventable traumatic death is uncontrolled bleeding. This study aimed to better identify those most likely to experience in-hospital mortality with increasing injury severity scoring (ISS). This is a single-center study of Trauma Registry data, from July 3, 2016, to February 24, 2022. The inclusion criteria were based upon age (≥18 years) and in-hospital mortality. 546 patients (mean age 58) were included in the analysis. There were several significant associations with increasing ISS among those who experienced in-hospital mortality, which included a rising shock index ratio, activation of the massive transfusion protocol, and, most notably, motorcycle trauma. This research reiterates the importance of the “Stop the Bleed” campaign as vital for training laypersons in the life-saving technique for hemorrhage control.
Background In the United States, healthcare organizations utilize helicopter emergency medical services (HEMS), which are well-established and integral to trauma and emergency medical transport. HEMS expedites critical resources to trauma patients at the initial scene of the accident, which typically falls outside of the effective service area of ground transportation. Methods This is a single-center study of trauma registry data, inclusive years July 1, 2016, to September 26, 2021. The inclusion criteria were all adult ICU patients (≥18 years) traveling by air. An initial bivariate analysis was used to describe differences in HEMS vs rendezvous (ground + HEMS) mode of arrival. A multivariate linear regression was calculated to predict elapsed transport times on predictor variables to determine the clinical impact of prolonged transport times. Results There were 242 patients identified in the analysis, with 87 (36%) traveling by HEMS and 155 (64%) traveling by rendezvous. A significant regression equation was found (F(29,198) = 2.39, P < .01), with an R2 of .26. As the transport time increased by 10.67 minutes, the shock index ratio (SIR) increased by one unit ( P = .04). Conversely, for each unit increase in Glasgow Coma Scores (GCS), flight time decreased by 1.03 minutes ( P < .01). Rendezvous transport times were on average eight minutes longer than HEMS alone ( P < .01). Conclusions Those with prolonged travel times were likely to travel by rendezvous with presentation of lower GCS and higher SIR upon arrival, despite equivocal injury patterns and severity. This research highlights the need for a helicopter auto-launch program to expedite helicopter travel times in distant locations to the only Level I trauma center in the region.
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