1.Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic: Challenges and lessons learned
Zahra AZADMANJIR ; Moein KHORMALI ; Mohsen SADEGHI-NAINI ; Vali BAIGI ; Habibollah PIRNEJAD ; Mohammad DASHTKOOHI ; Zahra GHODSI ; Behnam Seyed JAZAYERI ; Aidin SHAKERI ; Mahdi MOHAMMADZADEH ; Laleh BAGHERI ; Mohammad-Sajjad LOTFI ; Salman DALIRI ; Amir AZARHOMAYOUN ; Homayoun SADEGHI-BAZARGANI ; Gerard O'REILLY ; Vafa RAHIMI-MOVAGHAR
Chinese Journal of Traumatology 2024;27(3):173-179
Purpose::The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.Methods::An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into 3 groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage.Results::Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% - 100%, 22% - 100% and 29% - 100% for groups 1 - 3.Conclusions::To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.
2.Risk of permanent medical impairment after road traffic crashes: A systematic review.
Mahla BABAIE ; Mohammadamin JOULANI ; Mohammad Hosein RANJBAR HAMEGHAVANDI ; Mohammad Hossein ASGARDOON ; Marzieh NOJOMI ; Gerard M O'REILLY ; Morteza GHOLAMI ; Zahra GHODSI ; Vafa RAHIMI-MOVAGHAR
Chinese Journal of Traumatology 2023;26(5):267-275
PURPOSE:
To systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding permanent impairment following road traffic crashes.
METHODS:
We conducted this systematic review according to the preferred reporting items for systematic reviews and meta-analysis statement. An extended search of the literature was carried out in 4 major electronic databases for scientific research papers published from January 1980 to February 2020. Two teams include 2 reviewers each, screened independently the titles/abstracts, and after that, reviewed the full text of the included studies. The quality of the studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. A third reviewer was assessed any discrepancy and all data of included studies were extracted. Finally, the data were systematically analyzed, and the related data were interpreted.
RESULTS:
Five out of 16 studies were evaluated as high-quality according to the STROBE checklist. Fifteen studies ranked the initial injuries according to the abbreviated injury scale 2005. Five studies reported the total risk of permanent medical impairment following RTIs which varied from 2% to 23% for car occupants and 2.8% to 46% for cyclists. Seven studies reported the risk of permanent medical impairment of the different body regions. Eleven studies stated the most common body region to develop permanent impairment, of which 6 studies demonstrated that injuries of the cervical spine and neck were at the highest risk of becoming permanent injured.
CONCLUSION
The finding of this review revealed the necessity of providing a globally validated method to evaluate permanent medical impairment following RTIs across the world. This would facilitate decision-making about traffic injuries and efficient management to reduce the financial and psychological burdens for individuals and communities.
Humans
;
Accidents, Traffic
;
Disabled Persons
;
Abbreviated Injury Scale
;
Databases, Factual
;
Wounds and Injuries/etiology*
3.National Spinal Cord Injury Registry of Iran (NSCIR-IR) - a critical appraisal of its strengths and weaknesses.
Mahdi SHARIF-ALHOSEINI ; Zahra AZADMANJIR ; Mohsen SADEGHI-NAINI ; Zahra GHODSI ; Khatereh NAGHDI ; Mahdi MOHAMMADZADEH ; Amir AZARHOMAYOUN ; Kazem ZENDEHDEL ; Moein KHORMALI ; Farideh SADEGHIAN ; Seyed Behzad JAZAYERI ; Mojtaba SEHAT ; Habibollah PIRNEJAD ; Edward C BENZEL ; Gerard O'REILLY ; Michael G FEHLINGS ; Alexander R VACCARO ; Vafa RAHIMI-MOVAGHAR
Chinese Journal of Traumatology 2019;22(5):300-303
The National Spinal Cord Injury Registry of Iran (NSCIR-IR) is a not-for-profit, hospital-based, and prospective observational registry that appraises the quality of care, long-term outcomes and the personal and psychological burden of traumatic spinal cord injury in Iran. Benchmarking validity in every registry includes rigorous attention to data quality. Data quality assurance is essential for any registry to make sure that correct patients are being enrolled and that the data being collected are valid. We reviewed strengths and weaknesses of the NSCIR-IR while considering the methodological guidelines and recommendations for efficient and rational governance of patient registries. In summary, the steering committee, funded and maintained by the Ministry of Health and Medical Education of Iran, the international collaborations, continued staff training, suitable data quality, and the ethical approval are considered to be the strengths of the registry, while limited human and financial resources, poor interoperability with other health systems, and time-consuming processes are among its main weaknesses.
4.Evaluating mechanism and severity of injuries among trauma patients admitted to Sina Hospital, the National Trauma Registry of Iran.
Mina SAEEDNEJAD ; Mohammadreza ZAFARGHANDI ; Narjes KHALILI ; Vali BAIGI ; Moein KHORMALI ; Zahra GHODSI ; Mahdi SHARIF-ALHOSEINI ; Gerard M O'REILLY ; Khatereh NAGHDI ; Melika KHALEGHI-NEKOU ; Seyed Mohammad PIRI ; Vafa RAHIMI-MOVAGHAR ; Somayeh BAHRAMI ; Marjan LAAL ; Mahdi MOHAMMADZADEH ; Esmaeil FAKHARIAN ; Habibollah PIRNEJAD ; Hamid PAHLAVANHOSSEINI ; Payman SALAMATI ; Homayoun SADEGHI-BAZARGANI
Chinese Journal of Traumatology 2021;24(3):153-158
PURPOSE:
Injuries are one of the leading causes of death and lead to a high social and financial burden. Injury patterns can vary significantly among different age groups and body regions. This study aimed to evaluate the relationship between mechanism of injury, patient comorbidities and severity of injuries.
METHODS:
The study included trauma patients from July 2016 to June 2018, who were admitted to Sina Hospital, Tehran, Iran. The inclusion criteria were all injured patients who had at least one of the following: hospital length of stay more than 24 h, death in hospital, and transfer from the intensive care unit of another hospital. Data collection was performed using the National Trauma Registry of Iran minimum dataset.
RESULTS:
The most common injury mechanism was road traffic injuries (49.0%), followed by falls (25.5%). The mean age of those who fell was significantly higher in comparison with other mechanisms (p < 0.001). Severe extremity injuries occurred more often in the fall group than in the vehicle collision group (69.0% vs. 43.5%, p < 0.001). Moreover, cases of severe multiple trauma were higher amongst vehicle collisions than injuries caused by falls (27.8% vs. 12.9%, p = 0.003).
CONCLUSION
Comparing falls with motor vehicle collisions, patients who fell were older and sustained more extremity injuries. Patients injured by motor vehicle collision were more likely to have sustained multiple trauma than those presenting with falls. Recognition of the relationship between mechanisms and consequences of injuries may lead to more effective interventions.