Clinical efficient risks, associated with clinic-epidemiological and clinic-nosological risk-creating factors in thoraco-cranial trauma
Objective. Formulation of clinical efficient risks, associated with- clinic-epidemiological signs and clinic-nosological forms of injuries.
Materials and methods. The calculation data of clinical efficient risks, associated with clinic-epidemiological and clinic-nosological characteristics of 254 injuries are adduced, including 178 combined closed thoraco-cranial traumas and 76 isolated thoracic traumas.
Results. Using polychoric analysis, the clinical efficient risks for combined thoraco-cranial traumas and isolated closed traumas of thoracic cage were calculated. The data base was formatted in accordance to the method of irrevocable randomization of general massive of 20 592 injuries and the method of the random numbers in accordance to presence of cranial and thoracic injuries - for the main group and in accordance to signs of the isolated thoracic trauma presence - for the control one. The conducted polychoric analysis of data have permitted to establish, that in the injured men-patients with combined closed thoraco-cranial trauma between clinic-epidemiological factors and clinic-nosological signs a positive (c=0.43) , moderate (φ²=0.23) and trustworthy (χ²=29.26) association exists, and the above-mentioned establishments are localized in the trustworthiness field borders. In the injured women-patients with combined closed thoraco-cranial trauma between clinic-epidemiological factors and clinic-nosological signs a positive (c=0.3), mild (φ²=0.1) and trustworthy (χ²=4.97) association exists, but the trustworthiness degree indicates on essential impact of other factors.
Conclusion. Clinical efficient risks, associated with clinic-epidemiological and clinic-nosological risk-creating factors, are certainly trustworthy, their values are distributed from minimal to critical and owe a trustworthy association with clinic-epidemiological signs and clinic-epidemiological forms of the injuries. Occurrence of certain clinic-nosological forms of combined thoraco-cranial trauma owes strong positive and trustworthy association with clinic-epidemiological characteristics.
Gurev SO,Terentieva AV, Volyanskiy PB. Krizoviy menedzhment ta pryncipy upravlinnya ryzykamy v procesi likvidatsii medyko-sanitarnyh naslidkiv nadzvychaynyh sytuatsiy. Kyiv: Parlamentske vydavnytstvo; 2008. 148 s.[In Ukrainian].
Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003;23(3):374-8.82. PMID: 12614809. doi: 10.1016/s1010-7940(02)00813-8.
Topcu I, Ekici Z, Sakarya M. Comparison of clinical effectiveness of thoracic epidural and intravenous patient-controlled analgesia for the treatment of rib fractures pain in intensive care unit. Ulusal Travma ve Acil Cerrahi Dergisi = Turkish J Trauma & Emerg Surg: TJTES. 2007;13(3):205-10. PMID: 17978895. [In Tur].
Kieninger AN, Bair HA, Bendick PJ, Howells GA. Epidural versus intravenous pain control in elderly patients with rib fractures. Am J Surg. 2005;189(3):327-30. PMID: 15792761. doi: 10.1016/j.amjsurg.2004.11.022
Curtis K, Zou Y, Morris R, Black D. Trauma case management: improving patient outcomes. Injury. 2006;37(7):626-32. PMID: 16624316. doi: 10.1016/j.injury.2006.02.006.
Lohr KN. Rating the strength of scientific evidence: relevance for quality improvement programs. Int J Qual Health Care. 2004;16(1):9-18. PMID: 15020556. doi: 10.1093/intqhc/mzh005.
Ullman EA, Donley LP, Brady WJ. Pulmonary trauma emergency department evaluation and management. Emerg Med Clin North Am 2003;21(2):291-313. PMID: 12793615. doi: 10.1016/S0733-8627(03)00016-6.
Viano D, Lau I, Asbury C, King A, Begeman P. Biomechanics of the human chest, abdomen, and pelvis in lateral impact. Accid Anal Prev. 1989; 21(6): 553-74. PMID: 2629763. doi: 10.1016/0001-4575(89)90070-5.
Wallis L, Greaves I. Injuries associated with airbag deployment. Emerg Med J. 2002; 19(6): 490-3. PMID: 31856165 doi: 10.1136/emj.19.6.490 .
This work is licensed under a Creative Commons Attribution 4.0 International License.