Pre-hospital trauma care: a proposal for more efficient evaluation

Injury
Wouter J VlesLoek P H Leenen

Abstract

Although mortality is an important outcome parameter for pre-hospital trauma care, it is influenced by many factors other than pre-hospital trauma care alone. We therefore studied an alternative method to evaluate pre-hospital trauma care by calculating the change in probability of survival (Ps) according to the TRISS methodology, before and directly after the pre-hospital trauma care. Correlations between patient characteristics and a change in Ps were assessed. Further, required sample sizes were calculated for an 80% power to detect a hypothetical 3% reduction in mortality and the corresponding change in Ps. In 140 of 191 patients with an Injury Severity Score > or =16, the Ps did not change. In 36, the Ps increased and in 15 patients, the Ps decreased. Between these three groups, significant differences were found in Revised Trauma Score and age, but no clear differences in Injury Severity Score or mortality. A 3% difference in mortality would require 6800 patients, in contrast to 3500 when the change in Ps was the primary outcome parameter. A change in Ps is a promising outcome parameter for a more efficient evaluation of pre-hospital trauma care. A good collaboration is, however, required between ambulance services and th...Continue Reading

References

Jun 11, 1992·The Journal of Trauma·L A DurhamK L Mattox
Jan 1, 1988·Computers in Biology and Medicine·W J SaccoH R Champion
Dec 1, 1986·Annals of Emergency Medicine·P E PepeM K Copass
Dec 1, 1986·Annals of Emergency Medicine·R E Burney, R P Fischer
Jan 1, 1987·Annals of Emergency Medicine·T E AndersonM J Leicht
Jan 1, 1985·The Journal of Trauma·J P SmithC F Frey
Jul 1, 1980·American Journal of Surgery·C C BakerD D Trunkey
Jul 22, 1995·BMJ : British Medical Journal·J P NichollH A Snooks
Oct 27, 1994·The New England Journal of Medicine·W H BickellK L Mattox
Dec 30, 1993·Statistics in Medicine·J Whitehead
Sep 25, 1999·The Journal of Trauma·N C MannC N Mock
May 2, 2000·JAMA : the Journal of the American Medical Association·A B NathensR V Maier
Oct 19, 2000·The Journal of Trauma·J P HuntC C Baker
May 24, 2001·The Journal of Trauma·A C Marson, J C Thomson
Jul 11, 2001·Lancet·T J Coats, A Goode

❮ Previous
Next ❯

Citations

Nov 18, 2010·Injury·Zhao-wen ZongUNKNOWN Group for Trauma Emergency Care and Multiple Injuries, Trauma Society of Chinese Medical Association
Jul 21, 2007·Injury·Bahman S RoudsariFrederick P Rivara

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.