1.Comparison of epidemiologic features between upper and lower limb injuries and risk factors for intensive care unit admission in a university hospital affiliated with the National Trauma Registry of Iran
Pouya Sharif MAHDAVI ; Mohsen MERATI ; Vali BAIGI ; Mohammadreza ZAFARGHANDI ; Vafa RAHIMI-MOVAGHAR ; Moein KHORMALI ; Marjan LAAL ; Payman SALAMATI
Chinese Journal of Traumatology 2024;27(6):389-394
Purpose::Upper extremity injuries (UEIs) and lower extremity injuries (LEIs) constitute a considerable component of traumas. However, their epidemiologic differences and short-term in-hospital outcomes are not fully elucidated. This study aims to compare such discrepancies in a large-scale study.Methods::In this retrospective study, all patients with UEIs and/or LEIs hospitalized from 24th July 2016 to 16th May 2020 in Sina Hospital, Tehran, Iran, and registered at the National Trauma Registry of Iran were enrolled in the study. Relevant demographic and clinical characteristics were extracted from the National Trauma Registry of Iran database. Patients were grouped into either UEI or LEI. For those with concomitant UEIs and LEIs, the more severe one based on the abbreviated injury scale was defined as the principal diagnosis. In addition, cases with the abbreviated injury scale > 3 for both UEI and LEI or concomitant injuries to body areas other than the limbs were excluded. Independent samples t-test, Mann-Whitney U test, Chi-square test, quintile regression models, and logistic regression models with "margins" command were used for statistical analyses, as indicated. Results::In this research, 3170 eligible cases were identified. For the LEI group, there was a much higher proportion of male patients (86.7% vs. 82.0%) and higher mean age (years, 42.9 vs. 35.3) compared to the UEI group (both p < 0.001). Patients with an injury severity score (ISS) of 9 -15 were outnumbered in the LEI group (22.9% vs. 1.6%, p < 0.001), while the proportion of those with an ISS < 9 was higher in the UEI group (98.1% vs. 76.8%, p < 0.001). The multiple logistic regression model showed a statistically significant association between intensive care unit (ICU) admission and ISS (odds ratio ( OR)=4.01 for ISS 9 -15 vs. ISS < 9, 95% confidence interval ( CI)): 3.01 -5.35; OR =17.65 for ISS ≥ 16 vs. ISS < 9, 95% CI: 4.03 -77.27), age ( OR =1.02, 95% CI: 1.01 -1.03), cause of injury ( OR =0.27 for blunt trauma vs. road traffic crash, 95% CI: 0.08 -0.90; OR =0.49 for cut/stab injuries vs. road traffic crash, 95% CI: 0.28 -0.84) and body region ( OR=1.65 for lower extremity, 95% CI: 1.19 -2.29). Having adjusted for other covariates, the odds of ICU admission in patients with LEIs was 1.65 times the odds in patients with UEIs. Conclusions::Patients with LEIs were older and suffered from more severe injuries. In addition, the age-and ISS-adjusted ICU admission and length of hospital stay were significantly higher in LEI patients. The chance of ICU admission was associated with age, cause of injury, ISS, and body region. The findings of this study can aid in the meticulous selection of ICU-candidate patients. In addition, the role of factors other than ISS and age in ICU admission and prolongation of hospitalization should be addressed by prospective studies.
2.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.