Assessment of mechanism, type and severity of injury in multiple trauma patients: A cross sectional study of a trauma center in Iran / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center.</p><p><b>METHODS</b>Patients with multiple traumas referring to the emergency department of Hasheminejad University Hospital in Mashhad, Iran, entered this cross sectional study from March 2013 to December 2013. All the patients with injury severity score (ISS) > 9 were included in this study. Data analysis was performed by SPSS software (Version 11.5) and P values less than 0.05 were considered as significant differences.</p><p><b>RESULTS</b>Among the 6306 hospitalized trauma patients during this period, 148 had ISS>9. The male female ratio was 80%. The mean age of the patients was (33.5 ± 19.3) years. And 71% of the patients were younger than 44 years old. There were 19 (13%) deaths from which 68.5% were older than 44 years old. The mean transfer time from the injury scene to hospital was (55 ± 26) minutes. The most frequent mechanisms of injury were motorcycle crashes and falling from height, which together included 66.2% of all the injuries. A total of 84% of hospital deaths occurred after the first 24 h of hospitalization. Head and neck were the most common body injured areas with a prevalence of 111 cases (75%).</p><p><b>CONCLUSION</b>Motorcycle crashes have high frequency in Iran. Since most victims are young males, injury prevention strategies should be considered to reduce the burden of injuries.</p>

How is the injury severity scored? a brief review of scoring systems

The management of injured patients is a critical issue in pre-hospital and emergency departments. Trauma victims are usually young and the injuries may lead to mortality or severe morbidities. The severity of injury can be estimated by observing the anatomic and physiologic evidences. Scoring systems are used to present a scale of describing the severity of the injuries in the victims. We reviewed the evidences of famous scoring systems, the history of their development, applications and their evolutions. We searched electronic database PubMed and Google scholar with keywords: [trauma OR injury] AND [severity OR intensity] AND [score OR scale]. In this paper, we are going to present a definition of scoring systems and discuss the Abbreviated Injury Scale [AIS] and Injury Severity Score [ISS], the most acceptable systems, their applications and their advantages and limitations. Several injury-scoring methods have been introduced. Each method has specific features, advantages and disadvantages. The AIS is an anatomical-based scoring system, which provides a standard numerical scale of ranking and comparing injuries. The ISS was established as a platform for trauma data registry. ISS is also an anatomically-based ordinal scale, with a range of 1-75. Several databases and studies are formed based on ISS and are available for trauma management research. Although the ISS is not perfect, it is established as the basic platform of health services and public health researches. The ISS registering system can provide many opportunities for the development of efficient data recording and statistical analyzing models

Association between serum levels of MASP-2 and neutropenic febrile attacks in children with leukemia

Infectious complications are a major etiology of morbidity and mortality in febrile neutropenic patients. Low serum man-nose-binding lectin [MBL]-associated serine protease-2 [MASP-2] concentration may represent a risk factor for infection in leukemia patients receiving chemotherapy. This study evaluates the relationship between serum levels of MASP-2 with neutropenic febrile attacks in children with leukemia. This prospective cohort study conducted between 2009-2010, we measured baseline serum MASP-2 levels by enzyme-linked immunosorbent assay [ELISA] prior to chemotherapy in leukemia patients less than 14 years of age. The relationship of febrile neutropenia [FN] episodes and duration of hospitalization with MASP-2 concentration was analyzed. We evaluated 75 children [38 girls [51%], 37 boys [49%]; mean age, 61.6 +/- 43.7 months]. There were 8 [10.7%] children with MASP-2 deficiency [< 200 ng/mL]. Mean MASP-2 was 673.2 +/- 288.7 ng/mL [range: 116-1112]. Eight patients had no FN episodes. Of the 129 FN episodes recorded, 19 [average 2.4 times] were from the MASP-2deficient group and 110 [average 1.6 times] were in the normal group. There was a significant difference between the mean MASP-2 concentration and FN episodes [P = 0.043]. There was an inverse relationship between FN episodes [r = -0.332, P = 0.004] and the duration of hospitalization [r = -0.334, P= 0.005] with MASP-2 concentration. MASP-2 deficient patients were hospitalized longer than the normal group, which was strongly significant [P < 0.001]. Our study confirmed the results of several previous studies. MASP-2 deficiency in leukemic children treated with chemotherapy was associated with an increased risk of FN episodes, prolonged cumulative duration of hospitalization, and intravenous antimicrobial therapy