Injury Assessment of Individuals Wounded in the Lushan Earthquake and the Emergency Department Workload: A Corresponding Correlation Study

2020 ◽  
pp. 1-4
Author(s):  
Shiyuan Tang ◽  
Fen Ni ◽  
Hai Hu ◽  
Xiaojiong Du ◽  
Shuheng Zhu ◽  
...  
Keyword(s):  
Correlation Study ◽  
Calculation Model ◽  
Lushan Earthquake ◽  
West China Hospital ◽  
West China ◽  
Revised Trauma Score ◽  
Trauma Scoring ◽  
Injury Assessment ◽  
Trauma Score ◽  
Abdominal Movement

ABSTRACT Objective: In this study, we aimed to evaluate the correlation between the trauma score of individuals wounded in the Lushan earthquake and emergency workload for treatment. We further created a trauma score-emergency workload calculation model. Methods: We included data from patients wounded in the Lushan earthquake and treated at West China Hospital, Sichuan University. We calculated scores per the following models separately: Revised Trauma Score (RTS), Prehospital Index (PHI), Circulation Respiration Abdominal Movement Speech (CRAMS), Therapeutic Intervention Scoring System (TISS-28), and Nursing Activities Score (NAS). We assessed the association between values for CRAMS, PHI, and RTS and those for TISS-28 and NAS. Subsequently, we built a trauma score-emergency workload calculation model to quantitative workload estimation. Results: Significant correlations were observed for all pairs of trauma scoring models with emergency workload scoring models. TISS-28 score was significantly associated with PHI score and RTS; however, no significant correlation was observed between the TISS-28 score and CRAMS score. Conclusions: CRAMS, PHI, and RTS were consistent in evaluating the injury condition of wounded individuals; TISS-28 and NAS scores were consistent in evaluating the required treatment workload. Dynamic changes in emergency workload in unit time were closely associated with wounded patient visits.

Scoring acuity hours and costs of nursing for trauma care

1993 ◽  
Vol 2 (6) ◽  
pp. 436-443 ◽  
Author(s):  
AE Bond ◽  
FO Thomas ◽  
RL Menlove ◽  
P MacFarlane ◽  
P Petersen
Keyword(s):  
Resource Utilization ◽  
Injury Severity ◽  
Scoring Systems ◽  
Cost Of Care ◽  
Trauma Patients ◽  
Nursing Educators ◽  
Revised Trauma Score ◽  
Trauma Scoring ◽  
Level I ◽  
Trauma Score

OBJECTIVE: To determine nursing resource utilization (acuity hours and dollars) by trauma patients based on analysis of a nursing acuity system and five trauma scoring systems. METHODS: Retrospective review of 448 trauma patients who required transport by aircraft to a level I trauma center. Values from the institution's automated nursing acuity system were compared with the Glasgow Coma Scale score, trauma score, revised trauma score, CRAMS score and injury severity score to obtain acuity hours and financial cost of care for trauma patients. RESULTS: Consistently, analysis of scores computed by five scoring instruments confirmed that nursing resource utilization is greatest for patients who are severely injured but likely to recover. For example, patients with a trauma score of 1 required 49 (+/- 66) mean acuity hours of care; those with a trauma score of 8 needed 189 (+/- 229) mean acuity hours; and those with a trauma score of 16 used 73 (+/- 120) mean acuity hours. Mean dollar costs were $980 (+/- 1293), $3812 (+/- 4518) and $1492 (+/- 2473), respectively. CONCLUSIONS: Nursing resource utilization can be determined for trauma patients by using an automated nursing acuity system and trauma scoring systems. Data acquired in this way provide a concrete basis for healthcare and reimbursement reform, for administrators who design nursing allocations and for nursing educators who prepare graduates to meet the needs of healthcare consumers.

Abstract 200: Discordance Between Monitor-measured and EMS Documented Respiratory Rates in Major Traumatic Brain Injury: Implications for Injury Scoring Systems

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Bruce J Barnhart ◽  
Daniel W Spaite ◽  
Eric Helfenbein ◽  
Dawn Jorgenson ◽  
Saeed Babaeizadeh ◽  
...  
Keyword(s):  
Scoring Systems ◽  
Trauma Research ◽  
Non Invasive ◽  
Revised Trauma Score ◽  
Trauma Scoring ◽  
End Tidal ◽  
Trauma Score ◽  
Spontaneously Breathing ◽  
The Relationship ◽  
Monitor Data

Background: Respiratory rate (RR) is a key component in commonly-used trauma scoring systems [e.g., Revised Trauma Score (RTS), TRISS]. Imprecise documentation of RR introduces misclassification when these tools are used in trauma research. By identifying each waveform, nasal cannula end tidal CO2 (NCCO2) accurately measures RR in non-intubated patients. Objective: Evaluate the relationship between EMS-documented RR measurements in patient care records (PCRs) vs. true RR recorded by non-invasive NCCO2 monitoring in major TBI patients who were never actively ventilated. Methods: Among spontaneously-breathing, major TBI cases (moderate/severe/critical), continuous NCCO2 data (Philips MRx™) were evaluated from the EPIC Prehospital TBI Study (NIH 1R01NS071049). RR classifications for RTS/TRISS were then established for each case using both PCR-documentation and monitor data. Routine monitor data (including RR) were available to EMS providers on the display at all times during care. Results: Included: 158 cases from 7 Arizona EMS agencies [(7/13-7/17; median age 55 (range 18-94); 65% male]. The Table shows RTS/TRISS case classification by PCR and monitor RR. PCR-documented RR frequently failed to correctly classify cases: RR <6 (0/10; 0%); 6-9 (3/21; 14.3%; >29: (11/34, 32.4%), normal (67/93, 72.0%; Table). In total, PCR documentation misclassified 48.7% of cases (77/158). Conclusion: These findings identify a major contributor to inaccurate trauma scoring. Since RTS and TRISS are used widely in research, this has important implications for study enrollment, case ascertainment, confounding, and risk-adjustment in injury studies. Whenever possible, QI and research studies should utilize monitor data to identify and evaluate RR and other vitals rather than relying on PCR documentation. Future development of monitor-based, real-time feedback technology might improve trauma scoring precision and provider identification of RR abnormalities.

scholarly journals A Comparison of the Kampala Trauma Score with the Revised Trauma Score in a Cohort of Colombian Trauma Patients

2012 ◽  
Vol 1 (3) ◽  
pp. 146-149 ◽  
Author(s):  
Colin A Clarkson ◽  
Cain Clarkson ◽  
Andres M Rubiano ◽  
Mark Borgaonkar
Keyword(s):  
Hospital Stay ◽  
Scoring System ◽  
Trauma Registry ◽  
Length Of Hospital Stay ◽  
Trauma Patients ◽  
Revised Trauma Score ◽  
Trauma Scoring ◽  
Spss Software ◽  
Trauma Score ◽  
Better Than

ABSTRACT Introduction To date, no trauma scoring system has emerged as the gold standard for use in developing countries, where limited resources for data collection are a major issue. The purpose of this study is to compare the relatively recently developed and simply calculated KTS (Kampala Trauma Score) with the more widely used RTS (Revised Trauma Score) within a cohort of Colombian trauma patients. Materials and methods Data on over 2,200 patients was derived from a newly developed trauma registry in Colombia. A statistical analysis was done using SPSS software, and included simple linear and logistical regression as appropriate. Results Both the KTS and RTS were statistically significant in terms of their ability to predict death and length of stay in hospital with the KTS being a better predictor of both. The simplest model predicting death used only the neurologic component of the KTS. However, none of these three scores explained a very large amount of the variation in the dataset. Conclusion Although statistically significant, neither the KTS nor the RTS performed well at predicting death or length of hospital stay. However, the simpler KTS did perform somewhat better than the slightly more complex RTS. Using the extremely simple neurologic component of the KTS on its own proved to be the best predictor of length of hospital stay, and also outperformed the RTS in regards to death prediction. It is clear from this study that the optimal injury scoring system for use in under resourced environments remains allusive with further research warranted. How to cite this article Clarkson CA, Clarkson C, Rubiano AM, Borgaonkar M. A Comparison of the Kampala Trauma Score with the Revised Trauma Score in a Cohort of Colombian Trauma Patients. Panam J Trauma Critical Care Emerg Surg 2012;1(3):146-149.

scholarly journals Aplikasi revised trauma score, injury severity score, dan trauma and injury severity score dalam memrediksi mortalitas pada pasien multitrauma di IRDB BLU RSUP Prof. Dr. R. D. Kandou Manado

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Jassy S. R. Ranti ◽  
Heber B. Sapan ◽  
Laurens T. B. Kalesaran
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Scoring System ◽  
Traffic Accidents ◽  
Injury Severity ◽  
Scoring Systems ◽  
Correlation Study ◽  
Trauma Studies ◽  
Revised Trauma Score ◽  
Trauma Score

Abstract: Trauma is the main cause of deaths among teenagers and young adults. Most of the cases are due to traffic accidents, therefore, a scoring system that can transforms the trauma quality to numbers is very valuable. This scoring system is needed to predict mortality, compare therapeutic methods, function as a triage tool pre hospitalization and during the way to the hospital, evaluate quality improvement and prevention program, and as a tool in trauma studies. There are several available scoring systems usually used in trauma studies, as follows: Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma Related Injury Severity Score (TRISS). This study aimed to obtain the easiest applicable scoring system to multitraumatic patients in Prof. Dr. R. D. Kandou Hospital Manado. This was an observational correlation study. Evaluation of mortality was done by using the scoring systems and then was compared to the results in the field. There were 37 multitraumatic patients consisted of 30 males and 7 females. Five patients died during this study. By using RTS, of score >7 there was 1 death; of score 6-7 there were 3 deaths; and of score-5 there was 1 death. By using ISS, all dead patients had score ≥25, meanwhile by using TRISS, 2 dead patients had score 81-100,1 dead patient had score 61-80, and 2 dead patients had score 41-60. Conclusion: RTS is the easiest applicable scoring system at triage and pre-hospitalization, and is recommended to be a part of management of multitraumatic patients. Along with ISS, RTS can be used as a mortality predictor among multitraumatic patients.Keywords: trauma, RTS, ISS, TRISS, mortalityAbstrak: Trauma merupakan penyebab kematian utama pada usia remaja dan dewasa muda. Sistim penilaian (skoring) yang dapat mengubah kualitas trauma ke dalam bentuk nilai diperlukan agar dapat meramalkan mortalitas, membandingkan metode terapi, merupakan alat triase pre- dan antar rumah sakit, menilai perbaikan kualitas dan program pencegahan, serta merupakan alat dalam studi trauma. Beberapa sistem skoring yang sering digunakan dalam penelitian ialah Revised Trauma Score (RTS), Injury Severity Score (ISS), dan Trauma Related Injury Severity Score (TRISS). Penelitian ini bertujuan untuk mendapatkan pilihan sistim skoring yang paling mudah diaplikasikan pada pasien multitrauma di BLU RSUP Prof. Dr. R. D. Kandou, Manado. Jenis penelitian ialah observasional korelatif. Penilaian ini mengaplikasikan masing-masing skor terhadap angka mortalitas dan dibandingkan dengan hasil yang diperoleh di lapangan. Dalam penelitian ini terdapat 37 pasien multitrauma, terdiri dari 30 laki-laki dan 7 perempuan. Jumlah pasien yang meninggal selama penelitian ialah 5 orang. Untuk RTS, dari pasien dengan skor >7 terdapat 1 kematian; dari pasien dengan skor 6-7 terdapat 3 kematian, dan dari pasien dengan skor 5 terdapat 1 kematian. Untuk ISS, semua pasien yang meninggal memiliki skor ≥25, sedangkan untuk TRISS, 2 pasien yang meninggal dengan skor 81-100, 1 pasien dengan skore 61-80, dan 2 pasien yang meninggal dengan skor 41-60. Simpulan: RTS paling mudah diaplikasikan saat triase dan fase pre rumah sakit, serta direkomendasikan untuk menjadi bagian dari pedoman penanganan kasus multitrauma. Bersama-sama dengan ISS, RTS dapat diaplikasikan sebagai prediktor mortalitas pasien multitrauma.Kata kunci: trauma, RTS, ISS, TRISS, mortalitas

West China Hospital Back Pain Treatment Measures

2010 ◽  
Author(s):  
Ernest Volinn ◽  
Bangxiang Yang ◽  
Jing He ◽  
Xiaoming Sheng ◽  
Jian Ying ◽  
...  
Keyword(s):  
Back Pain ◽  
Pain Treatment ◽  
West China Hospital ◽  
West China ◽  
Treatment Measures

Equity in Telemedicine for Older Adults During the Covid-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Weihong Kuang ◽  
Guojun Zeng ◽  
Yunbo Nie ◽  
Yan Cai ◽  
Jin Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Paradigm Shift ◽  
Drug Prescription ◽  
Rapid Change ◽  
Policy Makers ◽  
West China Hospital ◽  
West China ◽  
Effective Strategies ◽  
Online Treatment ◽  
Treatment Disparities

UNSTRUCTURED The COVID-19 pandemic spurred unprecedented progress on a paradigm shift to telemedicine to limit exposure to the virus. Telemedicine has many benefits. In the West China Hospital of Sichuan University, we use it to do COVID-19 related tele-educations to health professionals and general population, tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, at our practices, we are noticing that many older adults could not make appointment with doctors due to their difficulty using the internet-based platform. We worried that older adults who need healthcare the most are not well prepared for this rapid change. We need to pay attention to avoid causing treatment disparities for vulnerable older adults 60 years of age and over. Researchers and policy makers should work together to study effective strategies and make proper policies to mitigate barriers older adults face when using telemedicine.

scholarly journals Severe hypernatremia in children after surgical resection of hepatic echinococcosis: a rare and potentially fatal complication

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kewei Li ◽  
Yijun Liu ◽  
Xiaolong Xie ◽  
Rongxing Zhou ◽  
Bo Xiang
Keyword(s):  
Alveolar Echinococcosis ◽  
Disease Free Survival ◽  
West China Hospital ◽  
Free Survival ◽  
West China ◽  
Neurologic Sequelae ◽  
Scolicidal Agent ◽  
Hepatic Echinococcosis ◽  
Disease Free

Abstract Background Using effective scolicidal agents intraoperatively is essential to lessen the recurrence rate of hepatic echinococcosis. However, severe hypernatremia may occur after hypertonic saline (HS) has been applied as the scolicidal agent. The aim of this study is to report on pediatric patients with severe hypernatremia after hepatic echinococcus surgery. Methods Patients who presented to West China Hospital between January 2010 and February 2017 were retrospectively analyzed. Children under 16 years with echinococcosis treated by resection were included in the study. Results A total of 26 children were enrolled in this study, including 16 boys and 10 girls with a median age of 8 (2–16). 24 (92.3 %) cases were cystic echinococcosis (CE) and two (7.7 %) were alveolar echinococcosis (AE). According to Clavien-Dindo classification of surgical complications, the complication rate of all 26 patients was 19.2 %, among which three cases belonged to Grade I, one to Grade III b and 1 to Grade IV. Two children encountered severe hypernatremia (sodium: 155.3 mmol/L and 190.0mmol/L). Data showed classic clinical features of severe hypernatremia: profound and persistent bradycardia, hypotension and coma. After treatment, they recovered well without any neurologic sequelae. All patients were followed up regularly for a median time of 38 months (range 4–89 months); the overall disease-free survival was 100.0 %. Conclusions HS irrigation of intra-abdominal echinococcosis may cause acute hypernatremia and severe consequences. Diagnostic suspicion and early intervention are vital tools for avoiding morbidity and mortality.

scholarly journals Desempenho dos ajustes do Trauma and Injury Severity Score (TRISS): revisão integrativa

2015 ◽  
Vol 49 (spe) ◽  
pp. 138-146 ◽  
Author(s):  
Cristiane de Alencar Domingues ◽  
Lilia de Souza Nogueira ◽  
Cristina Helena Costanti Settervall ◽  
Regina Marcia Cardoso de Sousa
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Revised Trauma Score ◽  
Trauma Score ◽  
Trauma And Injury

RESUMO Objetivo identificar estudos que realizaram ajustes na equação do Trauma and InjurySeverity Score (TRISS) e compararam a capacidade discriminatória da equação modificada com a original. Método Revisão integrativa de pesquisas publicadas entre 1990 e 2014 nas bases de dados LILACS, MEDLINE, PubMed e SciELO utilizando-se a palavra TRISS. Resultados foram incluídos 32 estudos na revisão. Dos 67 ajustes de equações do TRISS identificados, 35 (52,2%) resultaram em melhora na acurácia do índice para predizer a probabilidade de sobrevida de vítimas de trauma. Ajustes dos coeficientes do TRISS à população de estudo foram frequentes, mas nem sempre melhoraram a capacidade preditiva dos modelos analisados. A substituição de variáveis fisiológicas do Revised Trauma Score (RTS) e modificações do Injury Severity Score (ISS) na equação original tiveram desempenho variado. A mudança na forma de inclusão da idade na equação, assim como a inserção do gênero, comorbidades e mecanismo do trauma apresentaram tendência de melhora do desempenho do TRISS. Conclusão Diferentes propostas de ajustes no TRISS foram identificadas nesta revisão e indicaram, principalmente, fragilidades do RTS no modelo original e necessidade de alteração da forma de inclusão da idade na equação para melhora da capacidade preditiva do índice.

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