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Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/468

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Title: Is preoperative period associated with severity and unexpected death of injured patients needing emergency trauma surgery?
Authors: Ono, Yuko
Yokoyama, Hideyuki
Matsumoto, Akinori
Kumada, Yoshibumi
Shinohara, Kazuaki
Tase, Choichiro
Affiliation: 救急医療学講座
Source title: Journal of anesthesia
Volume: 28
Issue: 3
Start page: 381
End page: 389
Issue Date: Jun-2014
Abstract: Purpose: Early operative control of hemorrhage is the key to saving the lives of severe trauma patients. We investigated whether emergency room (ER) stay time (time from the ER to the operating room [OR]) is associated with trauma severity and unexpected trauma death (Trauma and Injury Severity Score [TRISS] method-based Probability of survival [Ps] ≥0.5 but died) of injured patients needing emergency trauma surgery. Methods: We performed a retrospective review of call trauma patients requiring emergency surgery and all patients with pelvic fractures requiring transcatheter arterial embolization at our hospital from January 2002 to December 2012. We analyzed the relationships among injury severity on ER admission (Injury Severity Score [ISS]; Revised Trauma Score (RTS); Ps; Shock Index (SI); American Society of Anesthesiologists Physical Status [ASA-PS]); mortality rate; unexpected trauma death rate; and ER stay time. Results: ER stay times were significantly shorter for patients with life-threating conditions (RTS <6.0 [p<0.01], Ps <0.5 [p<0.001], SI ≥1.0 [p<0.01], and ASA-PS ≥4E [p<0.001]). In particular, ER stay time was inversely related to injury severity up to 120 minutes. The risk of unexpected trauma death significantly increased as ER stay time increased over 90 minutes (p<0.01). Conclusions: Our results suggest that every medical staff should work together effectively on high-risk patients in the ER, bringing them immediately to the OR according to their level of risk. If injured patients need emergency trauma surgery, ER stay times should be kept as short as possible to reduce unexpected trauma death.
Publisher: Springer
language: eng
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/468
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/468/1/JAnesth_28_p381.pdf
ISSN: 0913-8668
DOI: 10.1007/s00540-013-1727-0
PubMed ID: 24141883
Other version: http://dx.doi.org/10.1007/s00540-013-1727-0
Rights: © Japanese Society of Anesthesiologists 2013. The final publication is available at link.springer.com
Appears in Collections:a10 学術雑誌論文等 = Journal Article

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