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[Multiple injuries and quality control]

https://arctichealth.org/en/permalink/ahliterature11902
Source
Tidsskr Nor Laegeforen. 1992 Feb 10;112(4):485-8
Publication Type
Article
Date
Feb-10-1992
Author
J. Pillgram-Larsen
K. Solheim
S. Birkeland
Author Affiliation
Kirurgisk klinikk, Ullevål sykehus, Oslo.
Source
Tidsskr Nor Laegeforen. 1992 Feb 10;112(4):485-8
Date
Feb-10-1992
Language
Norwegian
Publication Type
Article
Keywords
Adult
Emergency Medical Services - standards
English Abstract
Female
Humans
Injury Severity Score
Male
Middle Aged
Multiple Trauma - epidemiology - etiology - mortality
Norway - epidemiology
Prognosis
Prospective Studies
Quality Control
Abstract
A prospective registration was carried out of all patients with multiple injuries who were admitted to hospital in 1990 during the first 24 hours after the accident. The total number was 441, and included 47 patients with penetrating injuries. Such patients constituted 5% of a total of 9,000 admitted patients, and 19% of a total of 2,266 injured persons. The injuries were scored using the Trauma Score and Injury Severity Score and the probability for survival was calculated by the TRISS method. 148 patients were seriously injured, having an Injury Severity Score 16 or more. Traffic accidents were more common, and were the cause of injury in more than 50% of the patients. 15% of the patients with such injuries were under the influence of alcohol and 5% were drug abusers. The percentage under the influence of alcohol was three times as high, however, among patients injured by violence. Median ISS was 26 for the whole series, and 41 for the 41 patients who died. Mortality was significantly higher in patients older than 54 years of age than among younger patients. No patients were reduced to a vegetative state, but 13% of the surviving patients were considerably disabled. Among the 41 patients who died the main cause of death was haemorrhage in 17, and airway obstruction in five. Estimation of probability of survival showed that the mortality in this series compared well with the mortality in larger series of injured persons in America. None the less, improvement is still feasible.
PubMed ID
1553698 View in PubMed
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[Triage. Initial diagnosis of life-threatening injuries based on functional state and mechanism of injury].

https://arctichealth.org/en/permalink/ahliterature229042
Source
Tidsskr Nor Laegeforen. 1990 May 20;110(13):1673-6
Publication Type
Article
Date
May-20-1990
Author
J. Pillgram-Larsen
P. Schistad
J L Svennevig
K. Solheim
H K Nordby
Author Affiliation
Kirurgisk avdeling, Ullevål sykehus, Oslo.
Source
Tidsskr Nor Laegeforen. 1990 May 20;110(13):1673-6
Date
May-20-1990
Language
Norwegian
Publication Type
Article
Keywords
Accidents, Traffic - classification
Emergency Medical Services - standards
Humans
Norway
Trauma Severity Indices
Wounds and Injuries - classification - diagnosis
Abstract
Functional status expressed as Trauma Score (TS) and mechanism of injury were evaluated as criteria for diagnosing severe trauma in 253 traffic accident victims. An Injury Severity Score (ISS) of greater than or equal to 16 was considered a severe, potentially life-threatening injury. In 67 patients with ISS greater than or equal to 16, either TS was less than or equal to 13 or the history suggested risk of high energy trauma in 72%. When one or both of these criteria were met, ISS was greater than or equal to 16 in 54%. In addition, five patients (3%) with ISS less than 16 had potentially life-threatening injuries in the abdomen or in the thorax. Of these, two had a history indicating high energy trauma. Identifying severely injured patients by assessment of function and mechanism of injury gave an overtriage of 46%, which is acceptable, and an undertriage of 12%. Caution should be exercised in excluding severe trauma on these criteria. Considered together, decreased TS and a history indicating high energy injury, gave high sensitivity (72%) and specificity (78%) for diagnosing severe trauma, ISS greater than or equal to 16.
PubMed ID
2368047 View in PubMed
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