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  1. Article ; Online: Epidemiology of severe trauma in Navarra for 10 years: out-of-hospital/ in-hospital deaths and survivors.

    Arbizu-Fernández, Eider / Echarri-Sucunza, Alfredo / Galbete, Arkaitz / Fortún-Moral, Mariano / Belzunegui-Otano, Tomas

    BMC emergency medicine

    2023  Volume 23, Issue 1, Page(s) 54

    Abstract: Background: Major trauma is a leading cause of death. Due to the difficulties to keep a registry of these cases, few studies include all subjects, because they exclude out-of-hospital deaths. The purpose of this work was to compare the epidemiological ... ...

    Abstract Background: Major trauma is a leading cause of death. Due to the difficulties to keep a registry of these cases, few studies include all subjects, because they exclude out-of-hospital deaths. The purpose of this work was to compare the epidemiological profiles of out-of-hospital deaths, in-hospital deaths, and survivors over a 10-year period (2010-2019) of patients who had been treated by Navarre´s Health Service (Spain).
    Methods: Retrospective longitudinal cohort study using data of patients injured by an external physical force of any intentionality and with a New Injury Severity Score above 15. Hangings, drownings, burns, and chokings were excluded. Intergroup differences of demographic and clinical variables were analysed using the Kruskal Wallis test, chi-squared test, or Fisher´s exact test.
    Results: Data from 2,610 patients were analysed; 624 died out-of-hospital, 439 in-hospital, and 1,547 survived. Trauma incidences remained moderately stable over the 10-year period analysed, with a slight decrease in out-of-hospital deaths and a slight increase in in-hospital deaths. Patients of the out-of-hospital deaths group were younger (50.9 years) in comparison to in-hospital deaths and survivors. Death victims were predominantly male in all study groups. Intergroup differences regarding prior comorbidities and predominant type of injury were observed.
    Conclusions: There are significant differences among the three study groups. More than half of the deaths occur out-of-hospital and the causative mechanisms differ in each of them. Thus, when designing strategies, preventive measures were considered for each group on a case-by-case basis.
    MeSH term(s) Humans ; Male ; Female ; Hospital Mortality ; Longitudinal Studies ; Retrospective Studies ; Survivors ; Hospitals
    Language English
    Publishing date 2023-05-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050431-7
    ISSN 1471-227X ; 1471-227X
    ISSN (online) 1471-227X
    ISSN 1471-227X
    DOI 10.1186/s12873-023-00818-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Mortality in severe trauma patients attended by emergency services in Navarre, Spain: validation of a new prediction model and comparison with the Revised Injury Severity Classification Score II.

    Ali Ali, Bismil / Lefering, Rolf / Fortún Moral, Mariano / Belzunegui Otano, Tomás

    Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

    2018  Volume 30, Issue 2, Page(s) 98–104

    Abstract: Objectives: To validate the Mortality Prediction Model of Navarre (MPMN) to predict death after severe trauma and compare it to the Revised Injury Severity Classification Score II (RISCII).: Material and methods: Retrospective analysis of a cohort of ...

    Title translation Validación del Modelo de Predicción de Mortalidad de Navarra y comparación con el Revised Injury Severity Classification Score II en los pacientes con traumatismo grave atendidos por el Sistema de Emergencias de Navarra.
    Abstract Objectives: To validate the Mortality Prediction Model of Navarre (MPMN) to predict death after severe trauma and compare it to the Revised Injury Severity Classification Score II (RISCII).
    Material and methods: Retrospective analysis of a cohort of severe trauma patients (New Injury Severity Score >15) who were attended by emergency services in the Spanish autonomous community of Navarre between 2013 and 2015. The outcome variable was 30-day all-cause mortality. Risk was calculated with the MPMN and the RISCII. The performance of each model was assessed with the area under the receiver operating characteristic (ROC) curve and precision with respect to observed mortality. Calibration was assessed with the Hosmer-Lemeshow test.
    Results: We included 516 patients. The mean (SD) age was 56 (23) years, and 363 (70%) were males. Ninety patients (17.4%) died within 30 days. The 30-day mortality rates predicted by the MPMN and RISCII were 16.4% and 15.4%, respectively. The areas under the ROC curves were 0.925 (95% CI, 0.902-0.952) for the MPMN and 0.941 (95% CI, 0.921-0.962) for the RISCII (P=0.269, DeLong test). Calibration statistics were 13.6 (P=.09) for the MPMN and 8.9 (P=.35) for the RISCII.
    Conclusion: Both the MPMN and the RISCII show good ability to discriminate risk and predict 30-day all-cause mortality in severe trauma patients.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Cause of Death ; Emergency Medical Services/statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; ROC Curve ; Risk ; Spain/epidemiology ; Trauma Severity Indices ; Wounds and Injuries/mortality ; Young Adult
    Language Spanish
    Publishing date 2018-03-15
    Publishing country Spain
    Document type Comparative Study ; Journal Article ; Validation Studies
    ZDB-ID 2127173-2
    ISSN 2386-5857 ; 1137-6821
    ISSN (online) 2386-5857
    ISSN 1137-6821
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Cambios durante la última década en la incidencia y las características de los pacientes politraumatizados en Navarra.

    Gradin Purroy, Carlos / Belzunegui Otano, Tomás / Bermejo Fraile, Begoña / Teijeira, Rafael / Fortún Moral, Mariano / Reyero Díez, Diego

    Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

    2017  Volume 27, Issue 3, Page(s) 174–180

    Abstract: Objectives: To compare morbidity and mortality rates, the epidemiologic profile, and survival of patients with multiple injuries attended by the emergency services in the Navarre autonomous community in Spain in the periods of 2002-2003 and 2010-2012.!## ...

    Title translation Changes in the characteristics and incidence of multiple-injury accidents in the Navarre community over a 10-year period.
    Abstract Objectives: To compare morbidity and mortality rates, the epidemiologic profile, and survival of patients with multiple injuries attended by the emergency services in the Navarre autonomous community in Spain in the periods of 2002-2003 and 2010-2012.
    Material and methods: Observational analysis of 2 cohorts of accident patients with Injury Severity Scores of 15 points or more. Logistic regression was used to identify variables related to mortality.
    Results: A total of 651 patients were attended in the first period; 626 were attended in the second. The annual multiple-injury incidence rate decreased from 58.1 per 100 000 population in the first period to 33.5 per 100 000 population in the second; mortality decreased from 30.3 to 15.3 per 100 000 population. The mean (SD) age was 45 (22) years in the first cohort and 52 (23) years in the second. The gender distribution (75% male) did not change. The percentage injured in traffic accidents decreased from 44% to 24%; the percentage of elderly patients hurt in falls increased from 9% to 26%.
    Conclusion: The problem of the number of young people injured in accidents in our community has been brought under control, but the proportion of older patients injured in falls has risen. This change may slow the effort to improve mortality rates in patients with multiple injuries and it obliges us to introduce measures to prevent falls in the elderly.
    Language Spanish
    Publishing date 2017-10-26
    Publishing country Spain
    Document type English Abstract ; Journal Article
    ZDB-ID 2127173-2
    ISSN 2386-5857 ; 2386-5857
    ISSN (online) 2386-5857
    ISSN 2386-5857
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: La importancia de incluir las muertes prehospitalarias en los registros de traumatismo grave y su relación con la letalidad y la capacidad de predicción de la supervivencia.

    Fortún Moral, Mariano / Ali Ali, Bismil / Montes Fernández, Luisa M / Rey Pecharroman, José Miguel / Teijeira Álvarez, Rafael / Belzunegui Otano, Tomás

    Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias

    2016  Volume 28, Issue 3, Page(s) 173–178

    Abstract: Objectives: To compare the frequency and characteristics of prehospital and hospital deaths and assess whether injury severity and age can predict mortality when prehospital deaths are included or excluded from total mortality.: Material and methods: ...

    Title translation Inclusion of prehospital mortality statistics in severe trauma registries: a study of the influence of inclusion on trauma lethality rates and survival prediction.
    Abstract Objectives: To compare the frequency and characteristics of prehospital and hospital deaths and assess whether injury severity and age can predict mortality when prehospital deaths are included or excluded from total mortality.
    Material and methods: Descriptive analysis of a retrospective cohort of 918 patients with multiple injuries attended by emergency medical services in Navarre, Spain, in 2010-2013. We analyzed prehospital and hospital deaths by cause of injuries and developed and compared the precision of logistic regression models to predict mortality.
    Results: Most deaths occurred before arrival at a hospital. Three quarters of prehospital deaths occurred in patients under the age of 65 years. When prehospital deaths were included in the analysis, the lethality rate after traffic accidents rose from 16% to 42%; lethality from firearm injuries rose from 13% to 70%. When the model using the new injury severity score and age as independent variables was asked to predict survival with and without data for deaths at the scene or during transfer to a hospital, the model's performance differed only slightly.
    Conclusion: Most deaths from injuries occur before patients reach a hospital. The main characteristics of prehospital and hospital deaths differ. Including data for prehospital deaths in regression models does not change survival prediction based on injury severity and age.
    Language Spanish
    Publishing date 2016-06
    Publishing country Spain
    Document type English Abstract ; Journal Article
    ZDB-ID 2127173-2
    ISSN 2386-5857 ; 1137-6821
    ISSN (online) 2386-5857
    ISSN 1137-6821
    Database MEDical Literature Analysis and Retrieval System OnLINE

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