Download or read book Risk Adjustment for Swedish In Hospital Trauma Mortality using International Classification of disease Injury Severity Score ICISS written by Robert Larsen and published by Linköping University Electronic Press. This book was released on 2019-02-11 with total page 77 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction Different methods have been used to describe the epidemiology of trauma with varying results. Crude mortality outcome data differ significantly from risk-adjusted information. A previous standard method for risk-adjustment in trauma was the Injury Severity Score (ISS), although it has several shortcomings. In this thesis I examine Swedish injury statistics from an epidemiological perspective using crude and risk-adjusted mortality, and to adjust for injury I used the International Classification of disease Injury Severity Score (ICISS). The groups of most lethal injuries (fall, traffic, and assault) were examined separately using an ICISS mortality prediction model that focused particularly on the effects on the prediction of mortality by adding coexisting conditions (comorbidity) to it. Differences in mortality between the sexes and changes over time were tested separately. Material and Methods Data from all patients with ICD-10 based diagnoses of injury (ICD-10: V01 to Y36) in the Swedish National Patient Registry and Cause of Death Registry were collected from 1999 to 2012 and used for assessment of mortality and comorbidity. A subgroup (patients in hospital) from 2001-2011 were selected as the study group. Their injuries were in the subgroups of falls, traffic, and assaults, and are the focus of this thesis. Mortality within 30 days of injury was used as the endpoint. The severity of injury was adjusted for using the ICISS, which was first described by Osler et al. The model was also adjusted for age, sex, and comorbidities. Results The study group comprised 815 846 patients (of whom 17 721 died). There was a decrease over time in injuries caused by falls and traffic (coefficient -4.71, p=0.047 and coefficient -5.37, p<0.001), whereas there was no change in assault-related injuries/100 000 inhabitants. The risk-adjusted 30-day mortality showed a decrease in injuries related to traffic and assault (OR 0.95, p<0.001 and OR 0.93, p=0.022) whereas for falls it remained unchanged. There was also a risk-adjusted survival benefit for women, which increased with increasing age. Adjusting for comorbidities made the prediction of 30-day mortality by the ICISS model better (accuracy, calibration, and discrimination). However, most of this effect was found to be the result of the other characteristics of the fall related injury group (they were older, and had more coexisting conditions). Conclusion During a 10-year period, there has been a significant overall decrease in crude as well as risk-adjusted mortality for these three injury groups combined. Within these groups there is a clear, risk-adjusted, female survival advantage. The ICISS model for the prediction of mortality improves when comorbidities are added, but this effect is minor and seen mainly among the injuries caused by falls, where comorbidity is significant. The ICISS method was a valuable adjunct in the investigation of data on Swedish mortality after injury that has been gathered from health care registry data. Introduktion Olika metoder har använts för att beskriva trauma, alla med varierande resultat. Riskjusterad respektive icke-justerad data skiljer sig markant åt. En metod som oftast används för riskjustering i traumasammanhang är Injury Severity Score (ISS) som tyvärr är belastad med ett antal praktiska tillkortakommande. I denna avhandling har jag undersökt de skadade i Sverige från ett epidemiologiskt perspektiv med både justerad och icke riskjusterad mortalitet. För att kunna justera för skadan använde jag International Classification of disease Injury Severity Score (ICISS). De dödligaste skademekanismerna i Sverige (fall, trafik och övergrepp) analyserades för sig med hjälp av en mortalitetsjusterad modell baserad på ICISS som fokuserade särskilt på mortalitetseffekterna av att lägga till tidigare sjukdomar (komorbiditet) i modellen. Skillnader i dödlighet mellan de olika könen samt förändringar över tid undersöktes. Material och Metod Information om alla patienter med en skadekod från ICD-10 systemet (ICD10: V01-Y36) i slutenvårdsregistret eller dödsorsaksregistrets under åren 1999–2012 samlades in för att användas för att kunna utvärdera mortalitet och komorbiditet. En undergrupp av sjukhusinlagda patienter från 2001–2011 valdes sedan som primär studiegrupp. De som i denna grupp hade drabbats av fall-, trafik- eller övergrepps-relaterade skador är det denna avhandling fokuserar på. Som mätpunkt (endpoint) användes avliden inom 30 dagar från skadan. Skadans allvarlighetsgrad bedömdes med ICISS som Osler var först att beskriva. Modellen justerades även för ålder, kön och komorbiditet. Resultat Studiegruppen innehöll 815 846 patienter (av vilka 17 721 avled). I gruppen med falloch trafik-relaterade skador var det en ren minskning över studietiden (koefficienten -4,71 med ett p=0,047 och med en koefficient på -5,37 med ett p <0,001), medans i övergreppsrelaterade skador kunde jag inte hitta någon minskning per 100 000 invånare. Den riskjusterade 30-dagars dödligheten hade en minskning i trafik- och övergreppsrelaterade skador (OR 0,95 med ett p <0,001 respektive OR 0,93 med ett p=0,022) men ingen minskning i fallrelaterade skador sågs. Riskjusterat gick det också att hitta en överlevnadsfördel för kvinnor, vilken ökade med ålder. När jag justerade för komorbiditeter blev prediktionsmodellen för ICISS med 30-dagars dödlighet bättre (detta gällde både precision, kalibrering och diskriminering). Det bör dock nämnas att det mesta av förbättringen vid eftergranskning var beroende på fall gruppens demografi (högre ålder och mer komorbiditeter). Konklusion Under denna tio-årsperiod har dödligheten minskat för dessa grupper, både riskjusterat och icke justerat. Inom dessa grupper finns en tydlig riskjusterad överlevnadsfördel för kvinnor. ICISS-modellen blir bättre på att förutspå 30-dagars dödlighet när man lägger till komorbiditet, men effekten är att betrakta som en mindre effekt och ses tydligast i fallrelaterade skador (där ålder och komorbiditet är högre). Metoden med ICISS är en värdefull metod för att undersöka stora datamaterial och dödlighet i stora grupper i Sverige. Detta kan göras med redan insamlade data i sjukvårdsregistren.
Download or read book Injury mortality in Sweden changes over time and the effect of age and injury mechanism written by Denise Bäckström and published by Linköping University Electronic Press. This book was released on 2017-11-15 with total page 49 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Injuries are one of the most common causes of death in the world. Varying types of injuries dominate in different parts of the world, which also have separate influences mortality. In Scandinavia blunt injuries dominates and the majority of those who die do so pre hospital. Over time different injury pattern may vary and by analyzing this we can assess when, where and how preventive work can be reinforced. The aim of this thesis was to study injury epidemiology in Sweden and assess the contribution of different injury patters on mortality. Method: We used the Swedish cause of death and the national patient registries which have a complete national coverage. ICISS was calculated (based on ICD-10) in the in hospital population. We have chosen to do this investigation with a broad perspective using the term injury, which includes trauma but also other diagnoses like suffocation and drowning. Results: During the study period (1999-2012) the number of deaths because of injury was 1213, 25 388, and 18 332 among children, working age and elderly, respectively. Mortality declined in the children and in the working age but inclined in the elderly. Mortality increased with each age group except between the ages of 15–25 and 26–35 years. One thousand two hundred sixty four (97%) of those who died because of penetrating trauma (sharp objects and firearms) were killed by intentional trauma (assault and intentional self-harm). One thousand and seventeen (83%) of the children died prehospital. In the working age 22 211 (80%) of 25 388 died pre hospital. Nine thousand six hundred and eighteen (53%) of 18 332 of the elderly died prehospital. During 2001- 2011 the risk adjusted in hospital mortality decreased in traffic and assault but not in fall related injuries. Discussion: Largely, the anticipated injury mortality picture was found, with blunt injuries (traffic accidents) dominating in the working age and falls in elderly. Further a significant portion of the deaths occurred pre hospital. The intentional injuries are dominated by intentional selfharm. The decrease in child injury mortality is notable as Sweden already has one of the lowest incidences in child injury mortality in the world. The decrease in injury mortality in the working age also implies that preventive work has had an effect. The incline in injury mortality in elderly on the other hand needs to be further studied. Areas of particular importance for future preventive work is the incline in injury mortality in elderly and intentional injuries among children.
Download or read book Knee Fractures written by Marc Hanschen and published by Springer Nature. This book was released on 2021-11-30 with total page 293 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a complete overview of the various types of fractures around the knee. Each chapter addresses anatomical key features, surgical procedures, postoperative regimes and complication strategies. International knee experts discuss how to improve osteosynthesis techniques as well as pearls and pitfalls for each type of knee fracture. Current clinical outcomes are included throughout and the authors recommend their preferred therapeutic approach and salvage measures if required. Knee Fractures is an essential, go-to resource for orthopaedic surgeons dealing with the total spectrum of simple and complex knee fractures in daily clinical practice.
Download or read book Military Injury Biomechanics written by Melanie Franklyn and published by CRC Press. This book was released on 2017-06-12 with total page 431 pages. Available in PDF, EPUB and Kindle. Book excerpt: Military Injury Biomechanics: The Cause and Prevention of Impact Injuries is a reference manual where information and data from a large number of sources, focussing on injuries related to military events, has been critically reviewed and discussed. The book covers the cause and prevention of impact injuries to all the major body regions, while topics such as the historical background of military impact biomechanics, the history and use of anthropomorphic test devices for military applications and the medical management of injuries are also discussed. An international team of experts have been brought together to examine and review the topics. The book is intended for researchers, postgraduate students and others working or studying defence and impact injuries.
Download or read book Guidelines for Trauma Quality Improvement Programmes written by World Health Organization and published by Stylus Pub Llc. This book was released on 2009 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: In order to promote greater implementation of effective, affordable and sustainable trauma systems globally, the World Health Organization and the International Association for Trauma Surgery and Intensive Care have worked collaboratively to produce these guidelines on trauma quality improvement. The response to the growing problem of injury needs to include the improvement of care of the injured. Quality improvement (QI) programs offer an affordable and sustainable means to implement such improvements. These programs enable health care institutions to better monitor trauma care services, better detect problems in care, and more effectively enact and evaluate corrective measures targeted at these problems. The goal of this publication is to give guidance on ways in which health care institutions globally can implement QI programs oriented to strengthening care of the injured. This guidance is intended to be universally applicable to all countries, no matter what their economic level. These guidelines provide basic definitions and an overview of the field of QI, so that those not familiar with this field will have a working knowledge of it. Evidence of the benefit of QI in general and trauma QI in particular is then laid out. The main part of the publication reviews the most common methods of trauma QI, written in a how-do-to fashion. This covers a wide range of techniques. The first two of these are especially emphasized as ways in which to strengthen trauma QI in the setting of low-income and middle-income countries.
Download or read book Accidental Injury written by Narayan Yoganandan and published by Springer. This book was released on 2014-11-17 with total page 855 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a state-of-the-art look at the applied biomechanics of accidental injury and prevention. The editors, Drs. Narayan Yoganandan, Alan M. Nahum and John W. Melvin are recognized international leaders and researchers in injury biomechanics, prevention and trauma medicine. They have assembled renowned researchers as authors for 29 chapters to cover individual aspects of human injury assessment and prevention. This third edition is thoroughly revised and expanded with new chapters in different fields. Topics covered address automotive, aviation, military and other environments. Field data collection; injury coding/scaling; injury epidemiology; mechanisms of injury; human tolerance to injury; simulations using experimental, complex computational models (finite element modeling) and statistical processes; anthropomorphic test device design, development and validation for crashworthiness applications in topics cited above; and current regulations are covered. Risk functions and injury criteria for various body regions are included. Adult and pediatric populations are addressed. The exhaustive list of references in many areas along with the latest developments is valuable to all those involved or intend to pursue this important topic on human injury biomechanics and prevention. The expanded edition will interest a variety of scholars and professionals including physicians, biomedical researchers in many disciplines, basic scientists, attorneys and jurists involved in accidental injury cases and governmental bodies. It is hoped that this book will foster multidisciplinary collaborations by medical and engineering researchers and academicians and practicing physicians for injury assessment and prevention and stimulate more applied research, education and training in the field of accidental-injury causation and prevention.
Download or read book Hemoglobin Based Oxygen Carriers as Red Cell Substitutes and Oxygen Therapeutics written by Hae Won Kim and published by Springer Science & Business Media. This book was released on 2013-12-18 with total page 741 pages. Available in PDF, EPUB and Kindle. Book excerpt: Currently, hemoglobin (Hb)-based oxygen carriers (HBOCs) are leading candidates as red blood cell substitutes. In addition, HBOCs are also potential oxygen therapeutics for treatment of patients with critical ischemic conditions due to atherosclerosis, diabetes and other conditions. This book will provide readers a comprehensive review of topics involved in the HBOC development. It focusses on current products and clinical applications as well as on emerging technologies and future prospects.
Download or read book The African Criminal Court written by Gerhard Werle and published by Springer. This book was released on 2016-11-29 with total page 347 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book offers the first comprehensive and in-depth analysis of the provisions of the ‘Malabo Protocol’—the amendment protocol to the Statute of the African Court of Justice and Human and Peoples’ Rights—adopted by the African Union at its 2014 Summit in Malabo, Equatorial Guinea. The Annex to the protocol, once it has received the required number of ratifications, will create a new Section in the African Court of Justice and Human and Peoples’ Rights with jurisdiction over international and transnational crimes, hence an ‘African Criminal Court’. In this book, leading experts in the field of international criminal law analyze the main provisions of the Annex to the Malabo Protocol. The book provides an essential and topical source of information for scholars, practitioners and students in the field of international criminal law, and for all readers with an interest in political science and African studies. Gerhard Werle is Professor of German and Internationa l Crimina l Law, Criminal Procedure and Modern Legal History at Humboldt-Universität zu Berlin and Director of the South African-German Centre for Transnational Criminal Justice. In addition, he is an Extraordinary Professor at the University of the Western Cape and Honorary Professor at North-West University of Political Science and Law (Xi’an, China). Moritz Vormbaum received his doctoral degree in criminal law from the University of Münster (Germany) and his postdoctoral degree from Humboldt-Universität zu Berlin. He is a Senior Researcher at Humboldt-Universität, as well as a coordinator and lecturer at the South African-German Centre for Transnational Criminal Justice.
Download or read book Perioperative Care of the Orthopedic Patient written by C. Ronald MacKenzie and published by Springer. This book was released on 2014-08-01 with total page 421 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by experts at the top-ranked Hospital for Special Surgery in New York, Perioperative Care of the Orthopedic Patient is a comprehensive, multidisciplinary manual providing preoperative considerations, postoperative complications, and guidelines for the anesthetic and medical management of patients undergoing orthopedic surgery. Beginning with chapters covering preoperative evaluations and general principles and practices of perioperative medicine, the book then considers anesthesiologic management in orthopedic surgery and the role of postoperative pain management. This is followed by a section on medical management in specific clinical settings, discussing patients with connective tissue disease, cardiac disease, chronic pulmonary and renal diseases, diabetes and psychiatric and neurological diseases. A fourth section covers specific perioperative problems in orthopedic surgery, such as care of the elderly patient, venous thromboembolism, infection, nutrition, compartment syndrome, and bone health. Finally, the role of allied services, quality improvement and ethics are highlighted, and selected case studies are included to illustrate real-world perioperative issues and management strategies in orthopedic surgery. A comprehensive yet concise reference, Perioperative Care of the Orthopedic Patient will be an invaluable resource for orthopedic surgeons, sports medicine specialists and any professional involved in orthopedic surgery.
Download or read book Pockets of resistance written by Piers Robinson and published by Manchester University Press. This book was released on 2013-01-18 with total page 311 pages. Available in PDF, EPUB and Kindle. Book excerpt: For scholars of media and war, the 2003 invasion of Iraq is a compelling case to study. As part of President Bush’s ‘war on terror’, the invasion was the most controversial British foreign policy decision since Suez, and its ramifications and aftermath have rarely been far from the news. In the many political and public debates regarding this conflict, arguments over the role of the media have been omnipresent. For some, media coverage was biased against the war, for others it became a cheerleader for the invasion. Where does the truth lie? Drawing upon a uniquely-detailed and rich content and framing analysis of television and press coverage, and on interviews with some of the journalists involved, Pockets of Resistance provides an authoritative assessment of how British news media reported the 2003 Iraq invasion and also of the theoretical implications of this case for our understanding of wartime media-state relations. Pockets of Resistance examines the successes and failures of British television news as it sought to attain independence under the difficult circumstances of war, and describes and explains the emergence of some surprisingly vociferous anti-war voices within a diverse national press.
Download or read book Medical Response to Major Incidents and Disasters written by Sten Lennquist and published by Springer Science & Business Media. This book was released on 2012-01-03 with total page 428 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book, written by members of the core faculty responsible for European courses on Medical Response to Major Incidents (MRMI), is a practical guide for all medical staff on how to respond to a wide range of disaster scenarios. The entire spectrum of knowledge is covered, from command and coordination through to the management of individual casualties. Central importance is attached to the key component of decision making by explaining what needs to be done for patients in particular situations and the required order and timing of treatment measures. Simplified methods receive due attention, as it is often necessary for medical staff to administer primary treatment outside of their own specialty. This book will prove an invaluable aid to all who may be involved in the response to major accidents and disasters, including medical and nursing students, ambulance crew, and military personnel as well as medical specialists.
Download or read book Moral Dilemmas of Modern War written by Michael L. Gross and published by Cambridge University Press. This book was released on 2010 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: A practical guide for policy makers, military officers, students, and anyone else interested in asymmetric conflicts.
Download or read book Proceedings of the 21st EANN Engineering Applications of Neural Networks 2020 Conference written by Lazaros Iliadis and published by Springer Nature. This book was released on 2020-05-27 with total page 630 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book gathers the proceedings of the 21st Engineering Applications of Neural Networks Conference, which is supported by the International Neural Networks Society (INNS). Artificial Intelligence (AI) has been following a unique course, characterized by alternating growth spurts and “AI winters.” Today, AI is an essential component of the fourth industrial revolution and enjoying its heyday. Further, in specific areas, AI is catching up with or even outperforming human beings. This book offers a comprehensive guide to AI in a variety of areas, concentrating on new or hybrid AI algorithmic approaches with robust applications in diverse sectors. One of the advantages of this book is that it includes robust algorithmic approaches and applications in a broad spectrum of scientific fields, namely the use of convolutional neural networks (CNNs), deep learning and LSTM in robotics/machine vision/engineering/image processing/medical systems/the environment; machine learning and meta learning applied to neurobiological modeling/optimization; state-of-the-art hybrid systems; and the algorithmic foundations of artificial neural networks.
Download or read book The Poly Traumatized Patient with Fractures written by Hans-Christoph Pape and published by Springer. This book was released on 2015-08-28 with total page 437 pages. Available in PDF, EPUB and Kindle. Book excerpt: This guide provides practical information on the care of patients with blunt injuries that will be invaluable for emergency personnel, trauma surgeons, orthopaedic traumatologists, and anesthesiologists. The management of both truncal injuries (head, chest, abdomen) and fractures of the extremities, the pelvis, and the spine is covered in a condensed fashion, emphasizing key information. Care is taken to highlight associated injuries that may alter the decision making in patients with polytrauma. The new, revised edition takes full account of three major developments of recent years, namely the increasing economic pressure on health care systems, including trauma care, the changes in trauma systems and related education, and the improved survival of polytrauma patients. In view of the greater recognition of the physical and psychological long-term sequelae of major injuries, post-traumatic stress disorder is discussed in depth in this new edition.
Download or read book The United Nations Peace and Security written by Ramesh Thakur and published by Cambridge University Press. This book was released on 2006-06-08 with total page 380 pages. Available in PDF, EPUB and Kindle. Book excerpt: Preventing humanitarian atrocities is becoming as important for the United Nations as dealing with inter-state war. In this book, Ramesh Thakur examines the transformation in UN operations, analysing its changing role and structure. He asks why, when and how force may be used and argues that the growing gulf between legality and legitimacy is evidence of an eroded sense of international community. He considers the tension between the US, with its capacity to use force and project power, and the UN, as the centre of the international law enforcement system. He asserts the central importance of the rule of law and of a rules-based order focused on the UN as the foundation of a civilised system of international relations. This book will be of interest to students of the UN and international organisations in politics, law and international relations departments, as well as policymakers in the UN and other NGOs.
Download or read book The Post Conflict Environment written by Daniel Bertrand Monk and published by University of Michigan Press. This book was released on 2018-03-22 with total page 249 pages. Available in PDF, EPUB and Kindle. Book excerpt: In case studies focusing on contemporary crises spanning Africa, the Middle East, and Eastern Europe, the scholars in this volume examine the dominant prescriptive practices of late neoliberal post-conflict interventions—such as statebuilding, peacebuilding, transitional justice, refugee management, reconstruction, and redevelopment—and contend that the post-conflict environment is in fact created and sustained by this international technocratic paradigm of peacebuilding. Key international stakeholders—from activists to politicians, humanitarian agencies to financial institutions—characterize disparate sites as “weak,” “fragile,” or “failed” states and, as a result, prescribe peacebuilding techniques that paradoxically disable effective management of post-conflict spaces while perpetuating neoliberal political and economic conditions. Treating all efforts to represent post-conflict environments as problematic, the goal becomes understanding the underlying connection between post-conflict conditions and the actions and interventions of peacebuilding technocracies.
Download or read book The Injury Chart Book written by and published by World Health Organization. This book was released on 2002 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt: This publication seeks to provide a global overview of the nature and extent of injury mortality and morbidity in the form of user-friendly tables and charts. It is hoped that the graphical representation of the main patterns of the burden of disease due to injury will raise awareness of the importance of injuries as a public health issue and facilitate the implementation of effective prevention programs.
