The impact of specialist trauma service on major trauma mortality

Wong, Ting Hway; Lumsdaine, William; Hardy, Benjamin; Lee, Keegan; Balogh, Zsolt J.

doi:10.1097/ta.0b013e3182826d5f

Cited by 33 publications

(23 citation statements)

References 17 publications

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“…This approach is supported by the fact that similar parameters as used in the current setup have been successful in predicting outcome 12,16 and by other groups that studied the risk of adverse effects during the hospital course. 9,19 3. A priori selection of mortality rates to identify patients in a lifethreatening condition should not have been performed.…”

Section: Discussionmentioning

confidence: 99%

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The definition of polytrauma revisited

Pape

Lefering

Butcher

et al. 2014

Journal of Trauma and Acute Care Surgery

285

137

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Based on several consensus meetings and a database analysis, the expert panel proposes the following parameters for a definition of "polytrauma": significant injuries of three or more points in two or more different anatomic AIS regions in conjunction with one or more additional variables from the five physiologic parameters. Further validation of this proposal should occur, favorably by mutivariate analyses of these parameters in a separate data set.

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Section: Discussionmentioning

confidence: 99%

“…1,6 Today, it is considered to be considerably lower and ranges between 9% and 15%. 19 Based on this information, the panel unanimously agreed that an expected mortality rate of approximately 15% should be used as threshold level.…”

Section: Threshold Levels Of Mortalitymentioning

confidence: 99%

The definition of polytrauma revisited

Pape

Lefering

Butcher

et al. 2014

Journal of Trauma and Acute Care Surgery

285

137

View full text Add to dashboard Cite

show abstract

“…It has been shown that being treated in a unit with an onsite HPB service increases survival, with improvements seen with factors such as early consultant input, frequency and timing of computed tomography scanning, and use of tranexamic acid . Similarly, the introduction of a specialist trauma service decreased the overall mortality from 12.4% to 9.3% in patients with severe injury in Australia . There have also been significant changes in the approach to the management of liver trauma over time, with a shift from aggressive surgical treatment to conservative non‐operative management including angioembolization and, when laparotomy was performed, damage control strategies including perihepatic packing …”

Section: Discussionmentioning

confidence: 99%

International publication trends in hepato‐pancreato‐biliary surgery: emergency compared to oncology

Liang

Lo‐Cao

Punch

et al. 2018

ANZ Journal of Surgery

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Background: There is growing interest in publishing trends given the increasing amount of research publication across various specialities. Studies relating to hepato-pancreato-biliary (HPB) surgery show an oncological focus compared to benign, emergency and trauma. Methods: Analysis of ISI JCR impact factors in the Web of Knowledge and the Scimago Journal Rank through Scopus was performed to select four readily available, relevant and frequently read journals from the surgery category. A total of 5265 articles between 2012 and 2016 were categorized relating to emergency or oncology topics. A secondary analysis of PubMed MeSH term was performed to scrutinize trends of publishing over the period 1960-2016. Results: Of the 5265 articles screened, 2062 related to HPB surgery. Of these, 49% (1007 of 2062) were oncology related. This trend towards oncology-related topics is continued in HPB subspecialty journals where 51% (679 of 1320) of articles are oncology related. Emergency-and trauma-related topics accounted 10% (198 of 2062) overall, whereas in subspecialty journals, they account for 8% (111 of 1320). Secondary analysis of MeSH term trends demonstrated a now stable trend over the last 20 years of liver and pancreatic trauma to oncology ratio of 1:10 publications, and biliary trauma to oncology publishing ratio of 1:5. Conclusions: Quantitatively oncology topics are published favourably, whereas emergency-and trauma-related HPB articles appear static. This is in keeping with baseline trends over the last five decades. Further analysis could delineate whether publishing in trauma subspecialty journals compensate for this trend.

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“…Wong et al studied the impact of experienced multi-specialist trauma service on complex vascular injury and demonstrated that specialist trauma service decreased the mortality of cases and overall hospital stay. 23…”

Section: Original Research Articlementioning

confidence: 99%

Analysis of Consecutive Cases of Vascular Injury in Tertiary Level Hospital in Central Nepal

Sah¹,

Shrestha

Tiwari

et al. 2017

J Coll Med Sci-Nepal

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Background & Objectives:Vascular injury diagnosis and management can be challenging and need expert clinical judgments. The current study aims to present diagnostic methods and management outcome in vascular injury patients attending our centre.Materials & Methods: The study is a prospective study conducted during the study period of one and half years (From January 2015 to June 2016). Diagnosis of vascular injury was done by clinical examination, hand Doppler or in conjugation with duplex scan/CT Angiography. Primary vascular repair with end to end anastomosis was carried out whenever technically feasible; however, if it was not possible interposition reversed saphenous graft (SVG) was used to complete the repair.Results:Out of hundred cases of vascular injury, 77% were male and 23% female with a mean age of 35.18± 16.93 years. The majority of the cases 53% were diagnosed by duplex study followed by additional imaging by CT angiography in 30% cases and 17% cases were diagnosed only on clinical judgment. The main type of vascular injury was a complete transaction in 62% of cases followed by complex wall defect in 22%. The most common type of vascular reconstruction was end-end anastomosis in 76% of cases followed by ligation and haemostasis in 13% and reverse SVG graft repair in six percent of cases.Conclusion:The study concluded with the observation that early presentation, diagnosis and management including initial resuscitation and definitive multi-specialist surgical approach are paramount for excellent outcome after vascular injury.

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The impact of specialist trauma service on major trauma mortality

Abstract: Epidemiologic study, level III.

Cited by 33 publications

References 17 publications

The definition of polytrauma revisited

The definition of polytrauma revisited

International publication trends in hepato‐pancreato‐biliary surgery: emergency compared to oncology

Analysis of Consecutive Cases of Vascular Injury in Tertiary Level Hospital in Central Nepal

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