Background: The intent of this study was to predict conversion of laparoscopic cholecystectomy (LC) to open surgery employing artificial neural networks (ANN).

Using ANN model based on clinical and biochemical variables in patients with moderate to severe traumatic injury, resulted in satisfactory outcome prediction when applied to a test set.

Early one-stage LCBDE is an effective procedure as an initial and definite management of acute gallstone cholangitis, which prevents a second hospitalization and relapse problems.

BACKGROUND:Trauma is considered as a worldwide problem despite socio-economic development. Motor vehicle accidents (MVAs) are the most important cause of trauma. Trauma related deaths are mostly preventable. This study aimed to investigate the causes and prevention of death in trauma patients. METHODS:This retrospective, descriptive-analytic study assessed 100 trauma patients referred to our emergency department (ED) from January 2013 to Januanry 2015. The included patients were those with trauma died after arrival at our ED. Age, sex, cause of trauma, clinical causes of death, causes of death defi ned by autopsy, way of transfer to the ED, time of ambulance arrival at the scene of trauma, and time elapsed to enter the ED from the scene of trauma were studied. RESULTS:In the 100 patients, 21 (21%) patients were female and 79 (79%) male. Fortythree patients were older than 60 years. Trauma was largely due to pedestrian accidents in 31% of the patients, and 33% had a hypo-volemic shock. About 80% of deaths were due to intra-cranial hemorrhage (ICH) or intra-ventricular hemorrhage (IVH), and spinal injuries were not preventable. Autopsy revealed that 28% of the patients suffered from internal injuries. Autopsy revealed that 19% of the deaths were not preventable and 81% were considered preventable. In our patients, 76 were transferred to the hospital by emergency medicine services (EMS). Analysis of time for ambulance arrival to the scene and frequency of death revealed that 52.2% of the deaths occurred between 11 and 15 minutes. Analysis of time for admission to the ED from the scene of trauma showed that 74.6% deaths occurred between 6 and 10 minutes. CONCLUSIONS:The rate of hospital preventable deaths is about 80%, a high mortality rate, which denotes a lack of proper diagnosis and treatment. The time for arrival of EMS at the scene of trauma is longer than that in other countries.

Objective: Death from trauma is a major problem for the health system. The determination of preventable deaths is a valuable indicator of quality and efficiency in the management of trauma patients. The purpose of our study was to investigate the cause of preventable death in pre-hospital settings in the city of Tabriz. Materials and Methods:In a cross-sectional study from 2013 to 2014 in Tabriz, all traumatic patients who died at the scene of trauma or during transport and before reaching the hospital were referred to forensics for autopsy studies. For all deaths, data on demographics, mechanism and type of injury, place of death, mode of transportation, injury to the central nervous system (CNS) and results of necropsy were recorded. Preventability of death was defined upon examination of the necropsy report.Results: In this study, 160 pre-hospital deaths were studied. The commonest mechanism of injury was a vehicular traffic accident (83.8%), and blunt trauma in 98.8% was the commonest type of injury. In total, 80.6% of the deaths were at the scene of trauma and 18.8% on arrival to the hospital. CNS injury was recorded in 71.9% of the cases. The commonest cause of death from the necropsy report was CNS injury (60.6%), exsanguination or breathing problems (28.1%), and CNS injury with exsanguination or breathing problems (11.2%). In this study, death was possibly preventable in 25.6% of the cases, and 21.9% of the deaths were definitively preventable. Conclusion:Many deaths occurred at the scene of trauma, and traffic accidents are the main mechanism of injury. A high percentage of deaths as seen in the autopsy had CNS injuries, and this was the main cause of death. The high rate of preventable death in the present study compared to that in similar studies in other countries is a significant finding.