Preventable deaths and potentially preventable deaths. What are our errors?

Montmany, Sandra; Pallisera, Anna; Rebasa, Pere; Campos, Andrea; Colilles, C.; Luna, A. Bayés de; Navarro, Salvador

doi:10.1016/j.injury.2015.11.028

Cited by 27 publications

(18 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with isolated traumatic brain injury (TBI) were excluded because the natural course of TBIs is quite different from that of from torso injuries. Preventable deaths are less common with TBIs,13 14 suggesting that treatment options and SES factors might have less potential influence on mortality. Last, only patients older than 18 years were included in the cohort.…”

Section: Materials and Methodsmentioning

confidence: 99%

Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

Kuo

Liao

et al. 2019

BMJ Open

View full text Add to dashboard Cite

ObjectivesTo assess the impact of lower socioeconomic status on the outcome of major torso trauma patients under the single-payer system by the National Health Insurance (NHI) in Taiwan.DesignA nationwide, retrospective cohort study.SettingAn observational study from the NHI Research Database (NHIRD), involving all the insurees in the NHI.ParticipantsPatients with major torso trauma (injury severity score ≥16) from 2003 to 2013 in Taiwan were included. International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify trauma patients. A total of 64 721 patients were initially identified in the NHIRD. After applying the exclusion criteria, 20 009 patients were included in our statistical analysis.Primary and secondary outcome measuresThe primary outcome measure was in-hospital mortality, and we analysed patients with different income levels and geographic regions. Multiple logistic regression was used to control for confounding variables.ResultsIn univariate analysis, geographic disparities and low-income level were both risk factors for in-hospital mortality for patients with major torso trauma (p=0.002 and <0.001, respectively). However, in multivariate analysis, only a low-income level remained an independent risk factor for increased in-hospital mortality (p<0.001).ConclusionEven with the NHI, wealth inequity still led to different outcomes for major torso trauma in Taiwan. Health policies must focus on this vulnerable group to eliminate inequality in trauma care.

show abstract

Section: Materials and Methodsmentioning

confidence: 99%

Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

Kuo

Liao

et al. 2019

BMJ Open

View full text Add to dashboard Cite

show abstract

“…Only a few studies have evaluated the potential areas for improvement during the prehospital care of severely injured patients using a standardised approached. 25 …”

Section: Reviewing Trauma Deathsmentioning

confidence: 99%

Prehospital trauma death review in the State of Victoria, Australia: a study protocol

et al. 2018

View full text Add to dashboard Cite

IntroductionRegionalised trauma systems have been shown to improve outcomes for trauma patients. However, the evaluation of these trauma systems has been oriented towards in-hospital care. Therefore, the epidemiology and care delivered to the injured patients who died in the prehospital setting remain poorly studied. This study aims to provide an overview of a methodological approach to reviewing trauma deaths in order to assess the preventability, identify areas for improvements in the system of care provided to these patients and evaluate the potential for novel interventions to improve outcomes for seriously injured trauma patients.Methods and analysisThe planned study is a retrospective review of prehospital and early in-hospital (<24 hours) deaths following traumatic out-of-hospital cardiac arrest that were attended by Ambulance Victoria between 2008 and 2014. Eligible patients will be identified from the Victorian Ambulance Cardiac Arrest Registry and linked with the National Coronial Information System. For patients who were transported to hospital, data will be linked the Victoria State Trauma Registry. The project will be undertaken in four phases: (1) survivability assessment; (2) preventability assessment; (3) identification of potential areas for improvement; and (4) identification of potentially useful novel technologies. Survivability assessment will be based on predetermined anatomical injuries considered unsurvivable. For patients with potentially survivable injuries, multidisciplinary expert panel reviews will be conducted to assess the preventability as well as the identification of potential areas for improvement and the utility of novel technologies.Ethics and disseminationThe present study was approved by the Victorian Department of Justice and Regulation HREC (CF/16/272) and the Monash University HREC (CF16/532 – 2016000259). Results of the study will be published in peer-reviewed journals and reports provided to Ambulance Victoria, the Victorian State Trauma Committee and the Victorian State Government Department of Health and Human Services.

show abstract

“…Acute hemorrhage represents the leading cause of preventable death after severe trauma [1][2][3][4]. Trauma-induced coagulopathy (TIC) occurs early after severe trauma, resulting from multiple and complex pathophysiological mechanisms [5].…”

Section: Introductionmentioning

confidence: 99%

French lyophilized plasma versus normal saline for post-traumatic coagulopathy prevention and correction: PREHO-PLYO protocol for a multicenter randomized controlled clinical trial

Jost

Lemoine

et al. 2020

Trials

View full text Add to dashboard Cite

Background: Post-trauma bleeding induces an acute deficiency in clotting factors, which promotes bleeding and hemorrhagic shock. However, early plasma administration may reduce the severity of trauma-induced coagulopathy (TIC). Unlike fresh frozen plasma, which requires specific hospital logistics, French lyophilized plasma (FLYP) is storable at room temperature and compatible with all blood types, supporting its use in prehospital emergency care. We aim to test the hypothesis that by attenuating TIC, FLYP administered by prehospital emergency physicians would benefit the severely injured civilian patient at risk for hemorrhagic shock. Methods/design: This multicenter randomized clinical trial will include adults severely injured and at risk for hemorrhagic shock, with a systolic blood pressure < 70 mmHg or a Shock Index > 1.1. Two parallel groups of 70 patients will receive either FLYP or normal saline in addition to usual treatment. The primary endpoint is the International Normalized Ratio (INR) at hospital admission. Secondary endpoints are transfusion requirement, length of stay in the intensive care unit, survival rate at day 30, usability and safety related to FLYP use, and other biological coagulation parameters. Conclusion: With this trial, we aim to confirm the efficacy of FLYP in TIC and its safety in civilian prehospital care. The study results will contribute to optimizing guidelines for treating hemorrhagic shock in civilian settings. Trial registration: ClinicalTrials.gov, NCT02736812. Registered on 13 April 2016. The trial protocol has been approved by the French ethics committee (CPP 3342) and the French Agency for the Safety of Medicines and Health Products (IDRCB 2015-A00866-43).

show abstract

Preventable deaths and potentially preventable deaths. What are our errors?

Cited by 27 publications

References 31 publications

Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database

Prehospital trauma death review in the State of Victoria, Australia: a study protocol

French lyophilized plasma versus normal saline for post-traumatic coagulopathy prevention and correction: PREHO-PLYO protocol for a multicenter randomized controlled clinical trial

Contact Info

Product

Resources

About