Survival times and case fatality rates of brain-injured persons

Kraus, Jess F.; Conroy, Carol; Ramstein, K.; Fife, Daniel

doi:10.3171/jns.1985.63.4.0537

Cited by 19 publications

(10 citation statements)

References 21 publications

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“…This trend is probably caused by a patient selection effect. It is reasonable to assume that a higher proportion of patients from the most distant regions die in the pre-hospital phase or at the local hospital before transfer is initiated (Kraus et al, 1985;Peng et al, 1998). We intended to study this possible bias by using the Abbreviated Injury Score (AIS; Greenspan et al, 1985) and the Revised Trauma Score (RTS; Champin et al, 1989).…”

Section: Discussionmentioning

confidence: 98%

Pre- and Inter-Hospital Transport of Severely Head-Injured Patients in Rural Northern Norway

Sollid

Munch-Ellingsen

Gilbert

et al. 2003

Journal of Neurotrauma

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The purpose of this study was to survey the time consumed during the pre- and inter-hospital transport of severely head injured patients in Northern Norway. All patients (n = 85) operated for an intracranial mass lesions within 48 h after injury during the 10-year period 1986-1995 were included in this retrospective analysis. Ambulance records, transfer notes, and hospital records were reviewed. The transport of patients was classified as either direct from the trauma scene to the University Hospital (direct admission group) or as an inter-hospital transfer (transfer group). Forty-seven (55%) patients were in the direct admission group, and 38 (45%) were transferred through another hospital. The majority of patients (81%) were transported by air ambulance. Median time from injury to arrival in the emergency room was 5 (1-44) h. Time necessary for transport was significantly (p < 0.001) shorter in the direct admission group (median 3 h) compared to the transfer group (median 8 h). The inter-hospital transfer time was < or = 3 h in 17%. Clearly, the advanced air ambulance service in Northern Norway makes rapid inter-hospital transfer possible despite extremely long geographical distances. Our findings indicate that this possibility is not always utilized.

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Section: Discussionmentioning

confidence: 98%

Pre- and Inter-Hospital Transport of Severely Head-Injured Patients in Rural Northern Norway

Sollid

Munch-Ellingsen

Gilbert

et al. 2003

Journal of Neurotrauma

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“…Literature discusses another approach to survival time estimation based on the type and extent of injury, namely the ISS-AIS scale and similar tools [33,[35][36][37][38]. Detailed explanations of score calculations on these scales can be found in numerous studies, including the works cited above [37,38].…”

Section: Application Of the Ais-iss Scalesmentioning

confidence: 99%

Evaluation of survival time and acting capability after fatal injuries based on the type and extent of injuries

Engelgardt¹,

Krzyżanowski²

2018

amsik

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StreszczenieJednym z zadań specjalisty medycyny sądowej jest próba określenia czasu pomiędzy momentem zadania śmiertelnych obrażeń a zgonem oraz ocena, czy przed śmiercią ofiara mogła być aktywna fizycznie i w jakim zakresie. Aby odpowiedzieć na te pytania, prowadzone są intensywne poszukiwania wykorzystujące badania dodatkowe (histologiczne, immunohistochemiczne i inne). Niestety aktualnie stosowane metody mają liczne ograniczenia i wymagają ulepszeń, a ponadto nie są powszechnie używane w praktyce medyczno-sądowej w Polsce. Największą trudność w ocenie czasu przeżycia i czasu aktywności sprawiają przypadki, kiedy okres ten był stosunkowo krótki (sekundy-minuty-godziny). W praktyce analiza stwierdzonych obrażeń niejednokrotnie pozostaje więc jedynym narzędziem do oceny czasu, jaki upłynął pomiędzy doznaniem śmiertelnych obrażeń a zgonem, oraz możliwości aktywności fizycznej w tym okresie. Celem niniejszej pracy jest przegląd literatury dotyczącej przedmiotowego zagadnienia w kontekście metod biologicznych, z uwzględnieniem próby wyszukania zależności między charakterem obrażeń a czasem przeżycia oraz między charakterem obrażeń a zdolnością do aktywności fizycznej. Analiza dostępnych przypadków wykazała niestety, że z uwagi na liczne ograniczenia takie podejście, poza wyjątkowymi sytuacjami, pozwala określić co najwyżej przybliżony przedział czasu, w którym ofiara mogła przeżyć i być aktywna.Słowa kluczowe: czas przeżycia, obrażenia, aktywność pourazowa. AbstractOne of the tasks of the forensic specialist is to attempt to determine the interval between fatal injuries and death, and to assess whether the victim could be physically active before death and, if so, to what extent. There is ongoing research aimed at the application of additional tests (histological, immunohistochemical and others) to answer these questions. Unfortunately, currently used methods have numerous limitations and require further improvements. Moreover, they are not commonly employed in medicolegal practice in Poland. The greatest difficulty in assessing the time of survival and activity occurs when the period is relatively short (secondsminutes-hours). Therefore, in practice, injury examination is often the only tool to assess the interval between fatal injuries and death, and the possibility of physical activity during that time. Praca poglądowa Review paper archiwum medycyny sądowej i kryminologii WstępCelem niniejszej pracy jest przegląd literatury dotyczącej przedmiotowego zagadnienia w kontekście metod biologicznych, z uwzględnieniem próby wyszukania zależności między charakterem obrażeń a czasem przeżycia oraz między charakterem obrażeń a zdolnością do aktywności fizycznej.W przypadkach, w których nie ma możliwości udzielenia profesjonalnej pomocy medycznej, za czas zgonu przyjmuje się zazwyczaj moment zatrzymania krążenia i oddechu [1][2][3]. W praktyce precyzyjne ustalenie czasu, jaki upłynął pomiędzy powstaniem obrażeń a zgonem, często jest niemożliwe, ponieważ:• w okresie bezpośrednio poprzedzającym zgon ofiara może być głęboko ni...

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“…The airway would be secured soon after the accident and fluid resusci tation initiated to avoid hypoxia and hypotension. Since 70% of trauma deaths occur before the victims reach the hospital and most deaths occur within the first 24 h [11 ]. delayed or indirect transfers are further selected to sur vive.…”

Section: Discussionmentioning

confidence: 99%

Send Severely Head-Injured Children to a Pediatric Trauma Center

Johnson

Krishnamurthy²

1996

Pediatr Neurosurg

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Between 1985 and 1988, a total of 1,320 head-injured children were seen by the neurosurgical service at the Children’s Hospital in Washington, D.C. (CHOW). This included 1,095 minor injuries, 127 moderate injuries, and 98 severe injuries. Children brought from the scene of an accident were considered direct transports, whereas those taken to another hospital prior to transfer to CHOW were indirect. Of the children that suffered severe head injuries, 56 were admitted directly to the hospital and 42 indirectly. The indirect group had a higher percentage of children with lower coma scores and abused children. The trauma score was significantly higher in the direct group (9 vs. 7). The mortality rate for severe injuries referred directly from the scene of the accident was 26.8%, and the mortality rate for children referred indirectly was 50.0%. The higher number of abused children in the indirect group did not account for the increase in mortality rate (p = 0.021) in this group. This is the first study to show that children brought directly from the scene of an accident to a well-established pediatric trauma center have a significantly better chance of survival than children transported first to the nearest available hospital.

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Survival times and case fatality rates of brain-injured persons

Cited by 19 publications

References 21 publications

Pre- and Inter-Hospital Transport of Severely Head-Injured Patients in Rural Northern Norway

Pre- and Inter-Hospital Transport of Severely Head-Injured Patients in Rural Northern Norway

Evaluation of survival time and acting capability after fatal injuries based on the type and extent of injuries

Send Severely Head-Injured Children to a Pediatric Trauma Center

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