Outcome after red trauma alarm at an urban Swedish hospital: implications for prevention
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Outcome after red trauma alarm at an urban Swedish hospital : implications for prevention. / Bagher, Ali; Andersson, Lina; Clinical Sciences, Malmö, Lund University, Department; Ottosson, Anders; Wangefjord, Sakarias; Acosta, Stefan.
In: Scandinavian Journal of Public Health, Vol. 43, No. 5, 07.2015, p. 506-13.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Outcome after red trauma alarm at an urban Swedish hospital
T2 - implications for prevention
AU - Bagher, Ali
AU - Andersson, Lina
AU - Clinical Sciences, Malmö, Lund University, Department
AU - Ottosson, Anders
AU - Wangefjord, Sakarias
AU - Acosta, Stefan
N1 - © 2015 the Nordic Societies of Public Health.
PY - 2015/7
Y1 - 2015/7
N2 - AIMS: We applied the new injury severity scoring system and studied mechanisms of injury and risk factors for mortality, in order to find potential preventive measures, in the present Scandinavian trauma cohort triaged through red trauma alarm according to the Medical Emergency Triage and Treatment System.METHODS: Individuals were identified in hospital and forensic records. New injury severity scoring system >15 was defined as major trauma. Inter-rater reliability of new injury severity scoring system was expressed as intra-class correlation coefficient with 95% confidence intervals.RESULTS: There were 125 major and 303 minor traumas. The intra-class correlation coefficient was 0.83 (95% confidence intervals 0.58-0.94) for major trauma and intra-class correlation coefficient was 0.96 (95% confidence intervals 0.89-0.98) for minor trauma. Traffic (37%) and fall (31%) accidents were the leading mechanisms of injury. Elderly (aged ⩾65 years) were at an increased risk of fall accidents (p<0.001). The overall 3 month mortality rate was 10.3% (2% for new injury severity scoring system 16-24, 39% for new injury severity scoring system 25-40 and 68% for new injury severity scoring system >40). A higher new injury severity scoring system score (p<0.001), higher age (p<0.001), shock at admission (p<0.001), intensive care unit stay (p<0.004) and administration of massive red blood cell transfusion (p<0.048) were associated with mortality. Thirty-three patients underwent forensic autopsy and were tested positive for one or multiple drugs in 52% and 33%, respectively.CONCLUSIONS: The high prevalence of detected drugs among those undergoing forensic toxicological examination suggests that toxicology screening should be integrated into all red trauma alarm admissions, which may have implications on prevention of future trauma morbidity and mortality.
AB - AIMS: We applied the new injury severity scoring system and studied mechanisms of injury and risk factors for mortality, in order to find potential preventive measures, in the present Scandinavian trauma cohort triaged through red trauma alarm according to the Medical Emergency Triage and Treatment System.METHODS: Individuals were identified in hospital and forensic records. New injury severity scoring system >15 was defined as major trauma. Inter-rater reliability of new injury severity scoring system was expressed as intra-class correlation coefficient with 95% confidence intervals.RESULTS: There were 125 major and 303 minor traumas. The intra-class correlation coefficient was 0.83 (95% confidence intervals 0.58-0.94) for major trauma and intra-class correlation coefficient was 0.96 (95% confidence intervals 0.89-0.98) for minor trauma. Traffic (37%) and fall (31%) accidents were the leading mechanisms of injury. Elderly (aged ⩾65 years) were at an increased risk of fall accidents (p<0.001). The overall 3 month mortality rate was 10.3% (2% for new injury severity scoring system 16-24, 39% for new injury severity scoring system 25-40 and 68% for new injury severity scoring system >40). A higher new injury severity scoring system score (p<0.001), higher age (p<0.001), shock at admission (p<0.001), intensive care unit stay (p<0.004) and administration of massive red blood cell transfusion (p<0.048) were associated with mortality. Thirty-three patients underwent forensic autopsy and were tested positive for one or multiple drugs in 52% and 33%, respectively.CONCLUSIONS: The high prevalence of detected drugs among those undergoing forensic toxicological examination suggests that toxicology screening should be integrated into all red trauma alarm admissions, which may have implications on prevention of future trauma morbidity and mortality.
KW - Forensic Toxicology
KW - Hospital Mortality
KW - Hospitals, Urban/statistics & numerical data
KW - Trauma
KW - Forensic Medicine
KW - Outcome Assessment, Health Care
KW - Risk Factors
KW - Sweden/epidemiology
KW - Trauma Severity Indices
KW - Triage/methods
KW - Wounds and Injuries/mortality
U2 - 10.1177/1403494815578322
DO - 10.1177/1403494815578322
M3 - Journal article
C2 - 25816859
VL - 43
SP - 506
EP - 513
JO - Scandinavian Journal of Public Health, Supplement
JF - Scandinavian Journal of Public Health, Supplement
SN - 1403-4956
IS - 5
ER -
ID: 364741058