scholarly journals Effect of Earlier Door-to-CT and Door-to-Bleeding Control in Severe Blunt Trauma: A Retrospective Cohort Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1522
Author(s):  
Shuhei Murao ◽  
Kazuma Yamakawa ◽  
Daijiro Kabata ◽  
Takahiro Kinoshita ◽  
Yutaka Umemura ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Blunt Trauma ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Ct Scanning ◽  
Control Procedure ◽  
Bleeding Control ◽  
Cox Proportional Hazard Regression

Blunt trauma is a potentially life-threatening injury that requires prompt diagnostic examination and therapeutic intervention. Nevertheless, how impactful a rapid response time is on mortality or functional outcomes has not been well-investigated. This study aimed to evaluate effects of earlier door-to-computed tomography time (D2CT) and door-to-bleeding control time (D2BC) on clinical outcomes in severe blunt trauma. This was a single-center, retrospective cohort study of patients with severe blunt trauma (Injury Severity Score > 16). To assess the effect of earlier D2CT and D2BC on clinical outcomes, we conducted multivariable regression analyses with a consideration for nonlinear associations. Among 671 patients with severe blunt trauma who underwent CT scanning, 163 patients received an emergency bleeding control procedure. The median D2CT and D2BC were 19 min and 57 min, respectively. In a Cox proportional hazard regression model, earlier D2CT was not associated with improved 28-day mortality (p = 0.30), but it was significantly associated with decreased mortality from exsanguination (p = 0.003). Earlier D2BC was significantly associated with improved 28-day mortality (p = 0.026). In conclusion, earlier time to a hemostatic procedure was independently associated with decreased mortality. Meanwhile, time benefits of earlier CT examination were not observed for overall survival but were observed for decreased mortality from exsanguination.

scholarly journals Effect of earlier door-to-CT and door-to-bleeding control in severe blunt trauma: a retrospective cohort study

2020 ◽  
Author(s):  
Shuhei Murao ◽  
Kazuma Yamakawa ◽  
Daijiro Kabata ◽  
Takahiro Kinoshita ◽  
Yutaka Umemura ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blunt Trauma ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Ct Scanning ◽  
Whole Body ◽  
Control Procedure ◽  
Bleeding Control ◽  
Scanning Time

Abstract BackgroundBlunt trauma is a potentially life-threatening injury that requires prompt diagnostic examination and therapeutic intervention. Nevertheless, how impactful a rapid response time is on mortality or functional outcomes has not been well investigated. This study aimed to evaluate effects of earlier door-to-computed tomography time (D2CT) and door-to-bleeding control time (D2BC) on clinical outcomes in severe blunt trauma.MethodThis was a single-center, retrospective cohort study of patients with severe blunt trauma (Injury Severity Score > 16) treated between August 2007 and July 2015 in a tertiary trauma center in Japan. Patients who underwent whole-body CT scanning within 90 minutes of emergency room arrival were included. To assess the effect of earlier D2CT and D2BC on 28-day mortality, we conducted multivariable regression analyses with consideration of non-linear associations. The effects on 24-hour mortality and the Oxford Handicap Scale were also evaluated as secondary outcomes.ResultsAmong 671 patients with severe blunt trauma who underwent CT scanning, 163 patients received an emergency bleeding control procedure. The median D2CT and D2BC were 19 min (IQR 12–27) and 57 min (IQR 45–75), respectively. In a Cox proportional hazard regression model, earlier D2CT was not associated with improved 28-day mortality (p = 0.30), whereas earlier D2BC was significantly associated with improved 28-day mortality (p = 0.026). This beneficial trend of D2BC was consistently observed for the assessment of secondary outcomes.ConclusionAmong patients with severe blunt trauma undergoing CT scanning, time benefits were not observed for the CT examination itself but were for therapeutic bleeding control.

scholarly journals Clinical outcomes among COVID-19 patients managed with modern and traditional Siddha medicine -A retrospective cohort study, Chennai, Tamil Nadu, India, 2020

2021 ◽  
Author(s):  
Ramaswamy Meenakumari ◽  
Karuppiah Thangaraj ◽  
Arunachalam Sundaram ◽  
Malayappan Meenakshi Sundaram ◽  
Ponnappan Shanmugapriya ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tamil Nadu

scholarly journals Determinants of Mortality among HIV Positives after Initiating Antiretroviral Therapy in Western Ethiopia: A Hospital-Based Retrospective Cohort Study

ISRN AIDS ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Mitiku Teshome Hambisa ◽  
Ahmed Ali ◽  
Yadeta Dessie
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Incidence Density ◽  
Rank Test ◽  
Time To Death ◽  
Art Initiation ◽  
Mortality Incidence ◽  
Cox Proportional Hazard Regression ◽  
Western Ethiopia

Studies revealed that there are various determinants of mortality among HIV positives after ART initiation. These determinants are so variable with context and dynamic across time with the advancement of cares and treatments. In this study we tried to identify determinants of mortality among HIV positives after initiating ART. A retrospective cohort study was conducted among 416 ART attendees enrolled between July 2005 to January 2012 in Nekemte Referral Hospital, Western Ethiopia. Actuarial table was used to estimate survival of patients after ART initiation and log rank test was used to compare the survival curves. Cox proportional-hazard regression was applied to determine the independent determinants of time to death. The estimated mortality was 4%, 5%, 6%, 7%, and 7% at 6, 12, 24, 36 and 48 months respectively with mortality incidence density of 1.89 deaths per 100 person years (95% CI 1.74, 3.62). Forty years and above AHR = 3.055 (95% CI 1.292, 7.223), low baseline hemoglobin level (AHR = 0.523 (95% CI .335, 0.816)), and poor ART adherence (AHR 27.848 (95% CI 8.928, 86.8)) were found to be an independent determinants of mortality. These determinants of mortality have to be taken into account to enhance better clinical outcomes of ART attendees.

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