The State of Global Trauma and Acute Care Surgery/Surgical Critical Care

Soni, Kapil Dev; Bansal, Varun; Arora, Harshit; Verma, Shailendra Kumar; Wärnberg, Martin Gerdin; Roy, Nobhojit

doi:10.1016/j.ccc.2022.06.011

Cited by 7 publications

(4 citation statements)

References 60 publications

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“…Differing resources and capabilities for trauma care at different hospital levels have been well documented in many LMICs. [4][5][6][7][8] Planning for such differing levels of resources is an important component of trauma system planning in many countries. 9,10 The effect of these variations on the achievement of KPIs at different hospital levels has not been adequately addressed.…”

Section: Introductionmentioning

confidence: 99%

“…Measures to assure quality may need to be implemented differently at different levels. Differing resources and capabilities for trauma care at different hospital levels have been well documented in many LMICs 4–8 . Planning for such differing levels of resources is an important component of trauma system planning in many countries 9,10 .…”

Section: Introductionmentioning

confidence: 99%

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Differences in trauma care between district and regional hospitals and impact of a trauma intake form with decision support prompts in Ghana: A stepped‐wedge cluster randomized trial

Gyedu,

Amponsah‐Manu,

Awuku

et al. 2024

World j. surg.

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BackgroundWe sought to determine the achievement of key performance indicators (KPIs) of initial trauma care at district (first‐level) and regional (second‐level) hospitals in Ghana and to assess the effectiveness of a standardized trauma intake form (TIF) to improve care.MethodsA stepped‐wedge cluster randomized trial was performed with direct observations of trauma management before and after introducing the TIF at emergency units of eight hospitals for 17.5 months. Differences in KPIs were assessed using multivariable logistic regression and generalized linear mixed regression.ResultsManagement of 4077 patients was observed; 30% at regional and 70% at district hospitals. Eight of 20 KPIs were performed significantly more often at regional hospitals. TIF improved care at both levels. Fourteen KPIs improved significantly at district and eight KPIs improved significantly at regional hospitals. After TIF, regional hospitals still performed better with 18 KPIs being performed significantly more often than district hospitals. After TIF, all KPIs were performed in >90% of patients at regional hospitals. Examples of KPIs for which regional performed better than district hospitals after TIF included: assessment for oxygen saturation (83% vs. 98%) and evaluation for intra‐abdominal bleeding (82% vs. 99%, all p < 0.001). Mortality decreased among seriously injured patients (injury severity score ≥9) at both district (15% before vs. 8% after, p = 0.04) and regional (23% vs. 7%, p = 0.004) hospitals.ConclusionsTIF improved care and lowered mortality at both hospital levels, but KPIs remained lower at district hospitals. Further measures are needed to improve initial trauma care at this level.Clinical trials registrationClinicaltrials.gov (NCT04547192).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differences in trauma care between district and regional hospitals and impact of a trauma intake form with decision support prompts in Ghana: A stepped‐wedge cluster randomized trial

Gyedu,

Amponsah‐Manu,

Awuku

et al. 2024

World j. surg.

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“…Trauma is the main global public health burden that is associated with high morbidity and mortality rates [ 1 , 2 ]. In China, there has been a surge in traumatic injuries with the rapid advancement of modern society, resulting in more than 700 thousand deaths each year in the mainland of China [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Psychological resilience in the relationship between family function and illness uncertainty among family members of trauma patients in the intensive care unit

Yu,

Zhang,

et al. 2024

BMC Psychiatry

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Background Severe trauma accounts for a main factor inducing mortality for individuals aged < 45 years in China, which requires admission to intensive care unit (ICU) to receive comprehensive treatment. Family members of patients with unanticipated and life-threatening trauma during their ICU stays often experience psychosocial distress due to illness uncertainty. Previous research has shown that family function and psychological resilience are associated with illness uncertainty, respectively. However, little is known about the current situation and interacting mechanism between family function, psychological resilience, and illness uncertainty of family members for ICU trauma patients. Therefore, this study focused on exploring the current situation and relationships between these three factors in family members for ICU trauma patients. Methods The convenience sampling approach was adopted in the present cross-sectional survey, which involved 230 family members for ICU trauma patients from 34 hospitals in Chongqing, China. Related data were extracted with self-reporting questionnaires, which included sociodemographic characteristic questionnaire, the Family Adaptability, Partnership, Growth, Affection and Resolve Scale (APGAR), the 10-item Connor-Davidson Resilience Scale (10-CD-RISC) and the Mishel’s Illness Uncertainty Scale for Family Members (MUIS-FM). Pearson correlation analysis was conducted to examine the correlations between various variables. Additionally, a structural equation model was adopted to assess the mediating effect of psychological resilience on family function and illness uncertainty. Results According to our results, family members for ICU trauma patients experienced high illness uncertainty with moderate family dysfunction and low psychological resilience. Family function directly affected illness uncertainty and indirectly affected illness uncertainty through psychological resilience in family members of ICU trauma patients. Conclusions Family function and psychological resilience are the protective factors for reducing illness uncertainty. Healthcare providers should take effective measures, including family-functioning improvement and resilience-focused interventions, for alleviating illness uncertainty in family members of ICU trauma patients.

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“…Trauma accounts for 4.3 million annual deaths globally, with road traffic injuries prevailing among adolescents and young adults, while falls predominate among the elderly [3].…”

Section: Introductionmentioning

confidence: 99%

The Role of Cold Atmospheric Plasma in Wound Healing Processes in Critically Ill Patients

Bolgeo

Maconi

Gardalini

et al. 2023

JPM

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Critically ill patients are at risk of skin wounds, which reduce their quality of life, complicate their pharmacological regimens, and prolong their hospital stays in intensive care units (ICUs), while also increasing overall mortality and morbidity rates. Cold atmospheric plasma (CAP) has been proposed as a viable option for many biological and medical applications, given its capacity to reduce wound bacterial contamination and promote wound healing. The aim of this narrative review is to describe how CAP works and its operating mechanisms, as well as reporting its possible applications in critical care settings. The success of CAP in the treatment of wounds, in particular, bedsores or pressure sores, presents an innovative path in the prevention of nosocomial infections and an opportunity of reducing the negative implications of these diseases for the NHS. This narrative review of the literature was conducted following the ‘Scale for the Assessment of Narrative Review Articles’ (SANRA) methodology. Previous literature highlights three biological effects of plasma: inactivation of a wide range of microorganisms, including those that are multi-drug-resistant; increased cell proliferation and angiogenesis with a shorter period of plasma treatment; and apoptosis stimulation with a longer and more intensive treatment. CAP is effective in many areas of the medical field, with no significant adverse effects on healthy cells. However, its use can produce potentially serious side effects and should, therefore, be used under expert supervision and in appropriate doses.

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The State of Global Trauma and Acute Care Surgery/Surgical Critical Care

Cited by 7 publications

References 60 publications

Differences in trauma care between district and regional hospitals and impact of a trauma intake form with decision support prompts in Ghana: A stepped‐wedge cluster randomized trial

Differences in trauma care between district and regional hospitals and impact of a trauma intake form with decision support prompts in Ghana: A stepped‐wedge cluster randomized trial

Psychological resilience in the relationship between family function and illness uncertainty among family members of trauma patients in the intensive care unit

The Role of Cold Atmospheric Plasma in Wound Healing Processes in Critically Ill Patients

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