Prognostic models for the early care of trauma patients: a systematic review.
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ABSTRACT:
SUBMITTER: Rehn M
PROVIDER: S-EPMC3068084 | biostudies-other | 2011
REPOSITORIES: biostudies-other
Publications
Prognostic models for the early care of trauma patients: a systematic review.
Rehn Marius M Perel Pablo P Blackhall Karen K Lossius Hans Morten HM
Scandinavian journal of trauma, resuscitation and emergency medicine 20110320
<h4>Background</h4>Early identification of major trauma may contribute to timely emergency care and rapid transport to an appropriate health-care facility. Several prognostic trauma models have been developed to improve early clinical decision-making.<h4>Methods</h4>We systematically reviewed models for the early care of trauma patients that included 2 or more predictors obtained from the evaluation of an adult trauma victim, investigated their quality and described their characteristics.<h4>Res ...[more]
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Project description:BackgroundIt is argued that many older trauma patients are under-triaged in prehospital care which may adversely affect their outcomes. This systematic review aimed to assess prehospital under-triage rates for older trauma patients, the accuracy of the triage criteria, and the impact of prehospital triage decisions on outcomes.MethodsA computerised literature search using MEDLINE, Scopus, and CINHAL databases was conducted for studies published between 1966 and 2021 using a list of predetermined index terms and their associated alternatives. Studies which met the inclusion criteria were included and critiqued using the Critical Appraisal Skills Programme tool. Due to the heterogeneity of the included studies, narrative synthesis was used in this systematic review.ResultsOf the 280 identified studies, 23 met the inclusion criteria. Current trauma triage guidelines have poor sensitivity to identify major trauma and the need for TC care for older adults. Although modified triage tools for this population have improved sensitivity, they showed significantly decreased specificity or were not applied to all older people. The issue of low rates of TC transport for positively triaged older patients is not well understood. Furthermore, the benefits of TC treatment for older patients remain uncertain.ConclusionsThis systematic review showed that under-triage is an ongoing issue for older trauma patients in prehospital care and its impact on their outcomes is still uncertain. Further high-quality prospective research is needed to assess the accuracy of prehospital triage criteria, the factors other than the triage criteria that affect transport decisions, and the impact of under-triage on outcomes.
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Project description:Physiological, anatomical, and clinical laboratory analytic scoring systems (APACHE, Injury Severity Score (ISS)) have been utilized, with limited success, to predict outcome following injury. We hypothesized that a peripheral blood leukocyte gene expression score could predict outcome, including multiple organ failure, following severe blunt trauma. Contributor: The Inflammation and the Host Response to Injury Large Scale Collaborative Research Program Keywords: expression profiles
2009-04-13 | GSE11375 | GEO
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2009-04-12 | E-GEOD-11375 | biostudies-arrayexpress