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1. An Experience of Multiple Hematomas in a Coronavirus Disease-19 Patient Administered with ART-123 and Heparin

Author

Shiraki H, Morishita K, Kishino M, Nakatsutsumi K, Kimura K, Shirai T, Ishizuka M, Miyazaki Y, Aiboshi J, and Otomo Y

Subjects
anticoagulation, complication, covid-19, hematoma, tae, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Hideto Shiraki,1 Koji Morishita,1 Mitsuhiro Kishino,2 Keita Nakatsutsumi,1 Koichiro Kimura,2 Tsuyoshi Shirai,3 Masahiro Ishizuka,3 Yasunari Miyazaki,3 Junichi Aiboshi,1 Yasuhiro Otomo1 1Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; 2Department of Diagnostic Radiology, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan; 3Department of Respiratory Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, JapanCorrespondence: Koji MorishitaDepartment of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, JapanTel +81-3-3813-6111Fax +81-3-5803-0137Email morishita.accm@tmd.ac.jpBackground: Anticoagulant therapy for patients with severe coronavirus disease (COVID-19) pneumonia is considered to improve the hypercoagulable and inflammatory state. However, bleeding complications should also be considered.Case Presentation: A 77-year-old man with a history of falls was diagnosed with COVID-19. Owing to his severe condition, he was intubated and transferred to our hospital for intensive care. Favipiravir, tocilizumab, unfractionated heparin, and ART-123 were administered to treat COVID-19 and manage the antithrombotic prophylaxis for paroxysmal atrial fibrillation (Af). On the 6th day after admission, a hematoma was noted on the left chest wall. Computed tomography (CT) revealed multiple hematomas, including hematomas on his chest wall and obturatorius internus muscle. Emergency angiography transcatheter embolization (TAE) was performed. The patient was transferred to another hospital 23 days after TAE, without complications.Conclusion: Our findings show that anticoagulation therapy and a history of falls induced multiple hematomas in a COVID-19 patient and that the condition was managed with TAE. When anticoagulants are considered in the management of Af and COVID-19 associated coagulopathy, it is necessary to closely monitor potential bleeding complications.Keywords: anticoagulation, complication, COVID-19, hematoma, TAE

Published
2021

2. A Case of Fatal Stanford Type A Aortic Dissection Caused by a Traffic Accident with Low Energy Impact

Author

Mori S, Ai T, Morishita K, and Otomo Y

Subjects
aortic dissection, traffic accident, blunt trauma, elderly patients, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Shusuke Mori,1 Tomohiko Ai,1– 3 Koji Morishita,1,2 Yasuhiro Otomo1 1Trauma and Acute Critical Care Center, Tokyo Medical and Dental University, Tokyo, Japan; 2Emergency Department, JA Toride Medical Center, Ibaraki, Japan; 3Krannert Institute of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USACorrespondence: Shusuke MoriTrauma and Acute Critical Care Center, Tokyo Medical and Dental University, Tokyo, JapanTel +81-3-3813-6111Email shunasu@yahoo.co.jpAbstract: A seemingly healthy 84-year-old female pedestrian was mildly bumped by a car, and she hit her left shoulder, flank, and lower legs when she fell down on a street. She was conscious and stable when transferred to an emergency room. She had no sign of any major injuries except minor lacerations on her legs. Repeated evaluations including chest X-ray, ECG, and focused assessment with sonography for trauma did not reveal any abnormal findings. While waiting for discharge, she started having mild chest discomfort. Unexpectedly, the third echocardiogram showed mild pericardial effusion, and a CT with contrast showed aortic dissection in the ascending aorta and infra-left subclavian aortic dissection. She was immediately transferred by a helicopter to a tertiary trauma center for emergent repair surgery. Considering the site of dissections, progression of existing intrinsic intimal tear triggered by energy impact was suspected. However, traumatic causes could not be excluded. Extra caution and diligence should be exercised when examining elderly patients in blunt trauma.Keywords: aortic dissection, traffic accident, blunt trauma, elderly patients

Published
2020

3. Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS)

Author

Picetti, E, Demetriades, A, Catena, F, Aarabi, B, Abu-Zidan, F, Alves, O, Ansaloni, L, Armonda, R, Badenes, R, Bala, M, Balogh, Z, Barbanera, A, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Castano-Leon, A, Cerasti, D, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Costa, F, De Iure, F, Depreitere, B, Fainardi, E, Fehlings, M, Gabrovsky, N, Godoy, D, Gruen, P, Gupta, D, Hawryluk, G, Helbok, R, Hossain, I, Hutchinson, P, Iaccarino, C, Inaba, K, Ivanov, M, Kaprovoy, S, Kirkpatrick, A, Klein, S, Kolias, A, Konovalov, N, Lagares, A, Lippa, L, Loza-Gomez, A, Luoto, T, Maas, A, Maciejczak, A, Maier, R, Marklund, N, Martin, M, Melloni, I, Mendoza-Lattes, S, Meyfroidt, G, Munari, M, Napolitano, L, Okonkwo, D, Otomo, Y, Papadopoulos, M, Petr, O, Peul, W, Pudkrong, A, Qasim, Z, Rasulo, F, Reizinho, C, Ringel, F, Rizoli, S, Rostami, E, Rubiano, A, Russo, E, Sarwal, A, Schwab, J, Servadei, F, Sharma, D, Sharif, S, Shiban, E, Shutter, L, Stahel, P, Taccone, F, Terpolilli, N, Thomé, C, Toth, P, Tsitsopoulos, P, Udy, A, Vaccaro, A, Varon, A, Vavilala, M, Younsi, A, Zackova, M, Zoerle, T, Robba, C, Picetti, Edoardo, Demetriades, Andreas K., Catena, Fausto, Aarabi, Bizhan, Abu-Zidan, Fikri M., Alves, Oscar L., Ansaloni, Luca, Armonda, Rocco A., Badenes, Rafael, Bala, Miklosh, Balogh, Zsolt J., Barbanera, Andrea, Bertuccio, Alessandro, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Castano-Leon, Ana Maria, Cerasti, Davide, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Costa, Francesco, De Iure, Federico, Depreitere, Bart, Fainardi, Enrico, Fehlings, Michael J., Gabrovsky, Nikolay, Godoy, Daniel Agustin, Gruen, Peter, Gupta, Deepak, Hawryluk, Gregory W. J., Helbok, Raimund, Hossain, Iftakher, Hutchinson, Peter J., Iaccarino, Corrado, Inaba, Kenji, Ivanov, Marcel, Kaprovoy, Stanislav, Kirkpatrick, Andrew W., Klein, Sam, Kolias, Angelos, Konovalov, Nikolay A., Lagares, Alfonso, Lippa, Laura, Loza-Gomez, Angelica, Luoto, Teemu M., Maas, Andrew I. R., Maciejczak, Andrzej, Maier, Ronald V., Marklund, Niklas, Martin, Matthew J., Melloni, Ilaria, Mendoza-Lattes, Sergio, Meyfroidt, Geert, Munari, Marina, Napolitano, Lena M., Okonkwo, David O., Otomo, Yasuhiro, Papadopoulos, Marios C., Petr, Ondra, Peul, Wilco C., Pudkrong, Aichholz K., Qasim, Zaffer, Rasulo, Frank, Reizinho, Carla, Ringel, Florian, Rizoli, Sandro, Rostami, Elham, Rubiano, Andres M., Russo, Emanuele, Sarwal, Aarti, Schwab, Jan M., Servadei, Franco, Sharma, Deepak, Sharif, Salman, Shiban, Ehab, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Terpolilli, Nicole A., Thomé, Claudius, Toth, Peter, Tsitsopoulos, Parmenion P., Udy, Andrew, Vaccaro, Alexander R., Varon, Albert J., Vavilala, Monica S., Younsi, Alexander, Zackova, Monika, Zoerle, Tommaso, Robba, Chiara, Picetti, E, Demetriades, A, Catena, F, Aarabi, B, Abu-Zidan, F, Alves, O, Ansaloni, L, Armonda, R, Badenes, R, Bala, M, Balogh, Z, Barbanera, A, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Castano-Leon, A, Cerasti, D, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Costa, F, De Iure, F, Depreitere, B, Fainardi, E, Fehlings, M, Gabrovsky, N, Godoy, D, Gruen, P, Gupta, D, Hawryluk, G, Helbok, R, Hossain, I, Hutchinson, P, Iaccarino, C, Inaba, K, Ivanov, M, Kaprovoy, S, Kirkpatrick, A, Klein, S, Kolias, A, Konovalov, N, Lagares, A, Lippa, L, Loza-Gomez, A, Luoto, T, Maas, A, Maciejczak, A, Maier, R, Marklund, N, Martin, M, Melloni, I, Mendoza-Lattes, S, Meyfroidt, G, Munari, M, Napolitano, L, Okonkwo, D, Otomo, Y, Papadopoulos, M, Petr, O, Peul, W, Pudkrong, A, Qasim, Z, Rasulo, F, Reizinho, C, Ringel, F, Rizoli, S, Rostami, E, Rubiano, A, Russo, E, Sarwal, A, Schwab, J, Servadei, F, Sharma, D, Sharif, S, Shiban, E, Shutter, L, Stahel, P, Taccone, F, Terpolilli, N, Thomé, C, Toth, P, Tsitsopoulos, P, Udy, A, Vaccaro, A, Varon, A, Vavilala, M, Younsi, A, Zackova, M, Zoerle, T, Robba, C, Picetti, Edoardo, Demetriades, Andreas K., Catena, Fausto, Aarabi, Bizhan, Abu-Zidan, Fikri M., Alves, Oscar L., Ansaloni, Luca, Armonda, Rocco A., Badenes, Rafael, Bala, Miklosh, Balogh, Zsolt J., Barbanera, Andrea, Bertuccio, Alessandro, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Castano-Leon, Ana Maria, Cerasti, Davide, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Costa, Francesco, De Iure, Federico, Depreitere, Bart, Fainardi, Enrico, Fehlings, Michael J., Gabrovsky, Nikolay, Godoy, Daniel Agustin, Gruen, Peter, Gupta, Deepak, Hawryluk, Gregory W. J., Helbok, Raimund, Hossain, Iftakher, Hutchinson, Peter J., Iaccarino, Corrado, Inaba, Kenji, Ivanov, Marcel, Kaprovoy, Stanislav, Kirkpatrick, Andrew W., Klein, Sam, Kolias, Angelos, Konovalov, Nikolay A., Lagares, Alfonso, Lippa, Laura, Loza-Gomez, Angelica, Luoto, Teemu M., Maas, Andrew I. R., Maciejczak, Andrzej, Maier, Ronald V., Marklund, Niklas, Martin, Matthew J., Melloni, Ilaria, Mendoza-Lattes, Sergio, Meyfroidt, Geert, Munari, Marina, Napolitano, Lena M., Okonkwo, David O., Otomo, Yasuhiro, Papadopoulos, Marios C., Petr, Ondra, Peul, Wilco C., Pudkrong, Aichholz K., Qasim, Zaffer, Rasulo, Frank, Reizinho, Carla, Ringel, Florian, Rizoli, Sandro, Rostami, Elham, Rubiano, Andres M., Russo, Emanuele, Sarwal, Aarti, Schwab, Jan M., Servadei, Franco, Sharma, Deepak, Sharif, Salman, Shiban, Ehab, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Terpolilli, Nicole A., Thomé, Claudius, Toth, Peter, Tsitsopoulos, Parmenion P., Udy, Andrew, Vaccaro, Alexander R., Varon, Albert J., Vavilala, Monica S., Younsi, Alexander, Zackova, Monika, Zoerle, Tommaso, and Robba, Chiara

Abstract

Background: The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies. Methods: A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established. The World Society of Emergency Surgery (WSES) and the European Association of Neurosurgical Societies (EANS) endorsed the consensus, and a modified Delphi approach was adopted. Results: A total of 17 statements were proposed and discussed. A consensus was reached generating 17 recommendations (16 strong and 1 weak). Conclusions: This consensus provides practical recommendations to support a clinician’s decision making in the management of tSCI polytrauma patients.

Published
2024

5. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation

Author

Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, Coccolini F., Kluger Y., Moore E. E., Maier R. V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A. W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G. P., Otomo Y., Baiocchi G. L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J. G., Consani H., Russello D., Bortul M., Maurel T. G., Kaf H. S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C. A., Kong V., Zakaria A. D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J. G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V. M. D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A. Y. Y. M., Gonsaga R. A. T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C. G. L., Podda M., Mingoli A., Delgado R. C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K. Y. Y., Jusoh A. C., Amato B., Nita G. E., de Beaux A., Demetrashvili Z., Davies R. J., Kim J. I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F. M., Berardi L., Florio M. G., Hecker M., Dubuisson V., O'Connor D. B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W. P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L. B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L. A., Adeleye A. O., Kim D., Veroux M., Hardcastle T. C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G. M. M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C. -J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G. A. M., Santini M., Mellace L., Enoksen C. H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., Romeo L., Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, Coccolini F., Kluger Y., Moore E. E., Maier R. V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A. W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G. P., Otomo Y., Baiocchi G. L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J. G., Consani H., Russello D., Bortul M., Maurel T. G., Kaf H. S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C. A., Kong V., Zakaria A. D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J. G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V. M. D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A. Y. Y. M., Gonsaga R. A. T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C. G. L., Podda M., Mingoli A., Delgado R. C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K. Y. Y., Jusoh A. C., Amato B., Nita G. E., de Beaux A., Demetrashvili Z., Davies R. J., Kim J. I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F. M., Berardi L., Florio M. G., Hecker M., Dubuisson V., O'Connor D. B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W. P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L. B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L. A., Adeleye A. O., Kim D., Veroux M., Hardcastle T. C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G. M. M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C. -J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G. A. M., Santini M., Mellace L., Enoksen C. H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., and Romeo L.

Abstract

Introduction: Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods: A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results: An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion: Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.

Published
2021

6. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation

Author

Coccolini, F., Kluger, Y., Moore, E. E., Maier, R. V., Coimbra, R., Ordonez, C., Ivatury, R., Kirkpatrick, A. W., Biffl, W., Sartelli, M., Hecker, A., Ansaloni, L., Leppaniemi, A., Reva, V., Civil, I., Vega, F., Chiarugi, M., Chichom-Mefire, A., Sakakushev, B., Peitzman, A., Chiara, O., Abu-Zidan, F., Maegele, M., Miccoli, M., Chirica, M., Khokha, V., Sugrue, M., Fraga, G. P., Otomo, Y., Baiocchi, G. L., Catena, F., Kuliesius, Z., Conti, L., Dogjani, A., Lee, J. G., Consani, H., Russello, D., Bortul, M., Maurel, T. G., Kaf, H. S., Adamou, H., Alin, V., Robustelli, U., Sato, N., Seretis, C., Quiodettis, M., Gomes, C. A., Kong, V., Zakaria, A. D., Guner, A., Gachabayov, M., Chowdhury, S., Pata, F., Garcia, A., Rems, M., Das, K., Riedel, J. G., Lasithiotakis, K., Sydorchuk, R., Sydorchuk, L., Lostoridis, E., Buia, A., Mcfarlane, M., Ciani, R., Munoz-Cruzado, V. M. D., Tartaglia, D., Ioannidis, O., Muhrbeck, M., Reicher, M., Roscio, F., Ceresoli, M., Tsiftsis, D., Kavalakat, A., Pintar, T., Georgiou, G., Ricci, G., Mohan, R., Saar, S., Di Carlo, I., Isik, A., Ahmed, A. Y. Y. M., Gonsaga, R. A. T., Sammartano, F., Tallon-Aguilar, L., Shoko, T., Hsu, J., Kobe, Y., Romeo, C. G. L., Podda, M., Mingoli, A., Delgado, R. C., Ekwen, G., Aude, V., Olona, C., Boati, P., Magnone, S., Capaldi, M., Bala, M., Picetti, E., Negoi, I., Kok, K. Y. Y., Jusoh, A. C., Amato, B., Nita, G. E., de Beaux, A., Demetrashvili, Z., Davies, R. J., Kim, J. I., Pereira, A., Fattori, L., Paolillo, C., Ghannam, W., Rodriguez, F. M., Berardi, L., Florio, M. G., Hecker, M., Dubuisson, V., O'Connor, D. B., De'Angelis, N., Dobric, I., Massalou, D., Ortenwall, P., Pikoulis, E., Ugarte-Sierra, B., Zuidema, W. P., Kechagias, A., Marwah, S., Litvin, A., Nikolopoulos, I., Pesce, A., Uranues, S., Luppi, D., Flohe, S., Martinez-Perez, A., Lorenzo, M., Vergano, L. B., Manca, M., Malacarne, P., Kurihara, H., Widder, S., Pucciarelli, M., Monzani, F., Brambillasca, P., Corbella, D., Agresta, F., Moore, L., Buonomo, L. A., Adeleye, A. O., Kim, D., Veroux, M., Hardcastle, T. C., Di Saverio, S., Recordare, A., Rubio-Perez, I., Shlyapnikov, S., Rahim, R., Vega, G. M. M., Boris, K., Sawyer, R., Baraket, O., Soreide, K., Weber, C., Seak, C. -J., Herman, S., Gamberini, E., Costa, S., Mazzocconi, G., Lozada, E., Manatakis, D., Lohsiriwat, V., Ahmed, A., Elbery, B., Tiberio, G. A. M., Santini, M., Mellace, L., Enoksen, C. H., Major, P., Parini, D., Improta, M., Fugazzola, P., Pini, S., Liberti, G., Martino, C., Cobianchi, L., Canzi, G., Cicuttin, E., Kenig, J., Zago, M., Giannessi, S., Scaglione, M., Orsitto, E., Cioni, R., Ghiadoni, L., Menichetti, F., Agnoletti, V., Sganga, G., Prosperi, P., Roviello, F., De Paolis, P., Gordini, G., Forfori, F., Ruscelli, P., Gabrielli, F., Puglisi, A., Bertolucci, A., Marchi, S., Bellini, M., Casagli, S., De Simone, B., Carmassi, F., Marchetti, S., Accorsini, M., Cremonini, C., Morelli, F., Romeo, L., Coccolini F., Kluger Y., Moore E.E., Maier R.V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A.W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G.P., Otomo Y., Baiocchi G.L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J.G., Consani H., Russello D., Bortul M., Maurel T.G., Kaf H.S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C.A., Kong V., Zakaria A.D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J.G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V.M.D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A.Y.Y.M., Gonsaga R.A.T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C.G.L., Podda M., Mingoli A., Delgado R.C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K.Y.Y., Jusoh A.C., Amato B., Nita G.E., de Beaux A., Demetrashvili Z., Davies R.J., Kim J.I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F.M., Berardi L., Florio M.G., Hecker M., Dubuisson V., O'Connor D.B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W.P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L.B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L.A., Adeleye A.O., Kim D., Veroux M., Hardcastle T.C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G.M.M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C.-J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G.A.M., Santini M., Mellace L., Enoksen C.H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., Romeo L., Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, and HUS Abdominal Center

Subjects
System, Consensus, Internationality, Delphi Technique, Accrual, Process (engineering), media_common.quotation_subject, Performance, education, lcsh:Surgery, 030230 surgery, Analysis, Data, Morbidity, Mortality, Outcome, Planning, Product, World, 03 medical and health sciences, 0302 clinical medicine, Trauma management, Health care, Medicine, Humans, Operations management, Quality (business), Product (category theory), media_common, Quality Indicators, Health Care, Core set, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Analysi, lcsh:RD1-811, lcsh:RC86-88.9, CARE, 3126 Surgery, anesthesiology, intensive care, radiology, Core (game theory), Traumatology, Emergency Medicine, Surgery, business, Research Article
Abstract

Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.

Published
2021

9. Understanding the neuroprotective effect of tranexamic acid: an exploratory analysis of the CRASH-3 randomised trial

Author

Brenner, A., Belli, A., Chaudhri, R., Coats, T., Frimley, L., Jamaluddin, S. F., Jooma, R., Mansukhani, R., Sandercock, P., Shakur-Still, H., Shokunbi, T., Roberts, I., Aeron-Thomas, A., Chaudary, M. A., Jamaluddin, S. F. B., Javaid, K., Kayani, A., Leech, C., Mahmood, K., Noor, J. M., Mejia-Mantilla, J., Moss, P., Pott, J., Vallecilla, L., Hartzenberg, H. B., Joshipura, M., Perel, P., Clarke, M. J., Ohaegbulam, S. C., Rodgers, A., Brady, T., Dewan, Y., Edwards, P., Komolafe, E. O., Arribas, M., Austin, E., Balogun, E., Barneston, L., Barrow, C., Beaumont, D., Benyahia, M., Brooks, I., Cargill, M., Carrington, L., Cook, L., Cornu-Hewitt, B., Geer, A., Gilbert, D., Gilliam, C., Gil-Onandia, J., Hetherington, D., Howe, C., Hughes, C., I'Anson, D., Jackson, R., Joshi, M., Kansagra, S., Kawahara, T., Ker, K., Kostrov, S., Mahmood, A., Miah, H., Ndungu, B., Needham, K., Okusi, C., Outtandy, A., Pardinaz-Solis, R., Pearson, D., Pepple, T., Pisani, C., Prieto-Merino, D., Prowse, D., Quashi, N., Quinn, A., Ramos, M., Reid, M., Roukas, C., Scrapa, G., Squires, C., Tanner, J., Thayne, A., Vidaurre, L., Woods, E., Fawole, B., Adetayo, O., Okunade, O., Gogichaishvili, T., de los Angeles Munoz-Sanchez, M., Olldashi, F., Krishnan, S., Djientcheu, V., Castellanos, J. L., Rasulo, F., Hama, Q., Mulla, Y., Florian, I. S., Tobar, J., Khamis, H., Deasy, C., Wellsh, B., Williams-Johnson, J., Chandra, S., Mutiso, V., Butt, R., Nasir, M. H., Ahmad, S., Aslam, F., Ishaque, K., Usmani, F., Rizvi, S., Ali, F., Sajjad, O., Zunair, A., Rehman, L., Rizvi, R., Javeed, F., Ahmed, S., Abbas, A., Afzal, A., Mikdad, A., Bashir, A., Chaudary, A., Salahuddin, T., Ahemed, B., Aziz, A., Ashraf, N., Hussain, S., Ahmad, U., Asif, M., Adil, M., Rauf, A., Khan, R., Ahmad, B., Afzal, U., Raza, H., Ain, Q., Yaqoob, S., Waseem, Q., Nishat, M., Semvel, S., Iqbal, J., Majeed, S., Zulfiqar, S., Iqbal, M., Majeed, N., Ahmed, M., Akhtar, N., Malik, M., Shehzad, Y., Yousaf, M., Wahid, A., Samad, A., Shah, S., Ali, M., Zeb, J., Khan, A. S., Irfan, A., Sharif, S., Memon, R., Bloom, B., Harris, T., Skene, I., Bellhouse, G., Boulton, O., Ward, G., Jarvis, C., Swann, C., Ratnam, S., Carrera, R., Yakoub, K., Davies, D., Fellows, E., Jarman, H., Rounding, S., Johnson, E., Loughran, C., Lecky, F., Clayton, K., Michael, A., Coumbarides, A., Kendall, J., Faulkner, B., Worner, R., Gendall, E., Hopkins, P., Riozzi, P., Cotton, H., Astin-Chamberlain, R., Wilson, M., Bodnar, J., Williams, R., Rigoni, A., Sattout, A., Fletcher, J., Edge, C., Maryanji, N., Boyle, A., Hardwick, S., Nichols, E., Hayhurst, C., Coffey, F., Gough, C., Miller, P., Ryan, L., Darwent, M., Espinosa, A., Beer, S., Norton, J., Maguire, H., Finney, K., Kehoe, A., Squire, R., Jeffery, A., Vorwerk, C., Foord, D., Wilkinson, E., Kuhrt, A., Ramlakhan, S., Reid, S., Curran, A., Mcmullan, S., Hassan, T., Nuttall, S., Haig, S., Al-Nahhas, S., Bulters, D., Zolnourian, A., Ribbons, T., Mew, I., de Weymarn, T., Hughes, V., Mcvicar, J., Mckiernan, C., Keating, L., Reschreiter, H., Wright, J., Chan, L., Kataria, H., Ireland, A., Body, R., Corfield, A., Francis, S., Townend, W., Gagg, J., Wilson, S., Cottingham, R., Tucker, S., Sutherland, F., Mitchell, L., Parker, L., Afolabi, O., Hunter, F., Jadav, M., Adeboye, K., Grocutt, M., May, G., Watson, D., Wootten, A., Robertshaw, S., Dorrian, S., Perry, R., Choi, H., Mcgroarty, C., Shone, P., Maritz, D., Jamaluddin, S., Noor, J., Rosli, N., Xian, L. L. S., De Jun, Y., Mohamed, F., Song, C. H., Hawari, A., Chin, L. Y., Hussein, H. M., Lotfi, M., Hamid, H., Udin, N., Lian, P., Choo, S., Wong, K., Gani, F., Jusoh, M., Rajakumar, D., Yang, C. B., Dzulkiflee, N. S. B., W. C., Ky, Azman, M. A. B. M., Osman, A. B., Ahmad, A. H., Ismail, R., Lai, S. Q., Mohidin, M. A. B., Deraman, N. B., Selamat, S. B., Abidin, I., Halim, N., Bakar, Z., Ismail, Z. M., Hisham, B., Kamal, R., Effendy, Z., Ismail, M., Azleen, N., Seng, L. Y., Baharuddin, K. A., Kandasamy, R., Kamalludin, A., Asmee, S., Fadzil, M., Basitz, A., Abdullah, N., Ingorokva, G., Ingorokva, S., Agdgomelashvili, I., Mumladze, K., Maisuradze, I., Kugusheva, I., Shalamberidze, B., Tomadze, G., Fernandez-Ortega, J., Seara-Valero, R., Ibanez-Botella, G., Garcia-Martinez, V., Martul, M. G., Ramos, S. F., Preciado, G. L., Garcia-Alfaro, C., Munoz-Sanchez, A., Bellido-Alba, R., Corcobado, C., Bueno, A., Ambros, A., Jimenez, J. T., Ramirez, J. R., Martin, J., Rodriguez, L. I., Fontanals, J., Jimenez-Moragas, J. M., Berbegal, J. P., Oluwole, O., Mahmud, R., Ukwu, N., Bankole, F., Oseni, A., Adebayo, B., Malomo, A., Tiamiyu, L., Adekanmbi, A., Thanni, L., Olubodun, A., Ojeblenu, F., Uwaezuoke, M., Komolafe, E., Owagbemi, O., Ishola, F., Durodola, A., Udoffa, U., James, A., Tella, A., Dongo, A., Ekpemiro, U., Anyanwu, S., Aigoro, N., Mezue, W., Shilong, D., Azeez, A., Babalola, O., Ibrahim, M., Obande, J., Franco, A. C., Salazar, E. V., Londono, S. B., Cardona, V. M., Morales, C., Naranjo, S., Agudelo, J., Carvajal, S., Fajardo-Gaviria, Y., Roka, Y., Ghising, U., Roka, N., Shrestha, M., Devkota, U., Vaidya, B., Nepal, P., Thapa, A., Kc, B., Shrestha, A., Jha, R., Shrestha, P., Hodaj, I., Spaho, E., Selaj, A., Bendo, N., Shoko, T., Endo, H., Senda, A., Hagihara, Y., Fuse, T., Masunaga, N., Otomo, Y., Egashira, R., Ohnuki, T., Almazmi, A., Saha, S., Suvarov, A., Aung, T. L., Tun, K. M., Khaing, T. T., Maw, T., Ndome, O., Moumi, M., Mbida, A., Fondop, J., Sebastien, M., Azim, A., Adil, J., Amiry, Z., Loria-Castellanos, J., Rubio, N. G., Leon, P. O., Estrada, F., de Oca-Garcia, E. M., Sanchez, H., Soria, A., Bonucci, P., Franchi, F., Girardini, A., Hameed, H., Basim, M., Stock, S., Hourt, E., Ilunga, A., Mulenga, J., Ples, H., Danil, A., Gorgan, M., Florian, I., Vlahovic, D., French, J., East, J., Kurniawan, A., and Kiboi, J.

Subjects
medicine.medical_specialty, Tranexamic acid, Traumatic brain injury, Epidemiology, Critical Care and Intensive Care Medicine, Placebo, CRASH-3 trial, Neuroprotection, Intracranial haemorrhage, law.invention, Emergence care, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Randomised controlled trial, business.industry, Multiple Trauma, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Protective Factors, medicine.disease, Polytrauma, Antifibrinolytic Agents, 3. Good health, Neuroprotective Agents, Relative risk, Brain Injuries, business, medicine.drug
Abstract

Background The CRASH-3 trial hypothesised that timely tranexamic acid (TXA) treatment might reduce deaths from intracranial bleeding after traumatic brain injury (TBI). To explore the mechanism of action of TXA in TBI, we examined the timing of its effect on death. Methods The CRASH-3 trial randomised 9202 patients within 3 h of injury with a GCS score ≤ 12 or intracranial bleeding on CT scan and no significant extracranial bleeding to receive TXA or placebo. We conducted an exploratory analysis of the effects of TXA on all-cause mortality within 24 h of injury and within 28 days, excluding patients with a GCS score of 3 or bilateral unreactive pupils, stratified by severity and country income. We pool data from the CRASH-2 and CRASH-3 trials in a one-step fixed effects individual patient data meta-analysis. Results There were 7637 patients for analysis after excluding patients with a GCS score of 3 or bilateral unreactive pupils. Of 1112 deaths, 23.3% were within 24 h of injury (early deaths). The risk of early death was reduced with TXA (112 (2.9%) TXA group vs 147 (3.9%) placebo group; risk ratio [RR] RR 0.74, 95% CI 0.58–0.94). There was no evidence of heterogeneity by severity (p = 0.64) or country income (p = 0.68). The risk of death beyond 24 h of injury was similar in the TXA and placebo groups (432 (11.5%) TXA group vs 421 (11.7%) placebo group; RR 0.98, 95% CI 0.69–1.12). The risk of death at 28 days was 14.0% in the TXA group versus 15.1% in the placebo group (544 vs 568 events; RR 0.93, 95% CI 0.83–1.03). When the CRASH-2 and CRASH-3 trial data were pooled, TXA reduced early death (RR 0.78, 95% CI 0.70–0.87) and death within 28 days (RR 0.88, 95% CI 0.82–0.94). Conclusions Tranexamic acid reduces early deaths in non-moribund TBI patients regardless of TBI severity or country income. The effect of tranexamic acid in patients with isolated TBI is similar to that in polytrauma. Treatment is safe and even severely injured patients appear to benefit when treated soon after injury. Trial registration ISRCTN15088122, registered on 19 July 2011; NCT01402882, registered on 26 July 2011.

Published
2020

12. Splenic trauma: WSES classification and guidelines for adult and pediatric patients

Author

Coccolini, F, Montori, G, Catena, F, Kluger, Y, Biffl, W, Moore, E, Reva, V, Bing, C, Bala, M, Fugazzola, P, Bahouth, H, Marzi, I, Velmahos, G, Ivatury, R, Soreide, K, Horer, T, ten Broek, R, Pereira, B, Fraga, G, Inaba, K, Kashuk, J, Parry, N, Masiakos, P, Mylonas, K, Kirkpatrick, A, Abu-Zidan, F, Gomes, C, Benatti, S, Naidoo, N, Salvetti, F, Maccatrozzo, S, Agnoletti, V, Gamberini, E, Solaini, L, Costanzo, A, Celotti, A, Tomasoni, M, Khokha, V, Arvieux, C, Napolitano, L, Handolin, L, Pisano, M, Magnone, S, Spain, D, de Moya, M, Davis, K, De Angelis, N, Leppaniemi, A, Ferrada, P, Latifi, R, Navarro, D, Otomo, Y, Coimbra, R, Maier, R, Moore, F, Rizoli, S, Sakakushev, B, Galante, J, Chiara, O, Cimbanassi, S, Mefire, A, Weber, D, Ceresoli, M, Peitzman, A, Wehlie, L, Sartelli, M, Di Saverio, S, Ansaloni, L, Coccolini F., Montori G., Catena F., Kluger Y., Biffl W., Moore E. E., Reva V., Bing C., Bala M., Fugazzola P., Bahouth H., Marzi I., Velmahos G., Ivatury R., Soreide K., Horer T., ten Broek R., Pereira B. M., Fraga G. P., Inaba K., Kashuk J., Parry N., Masiakos P. T., Mylonas K. S., Kirkpatrick A., Abu-Zidan F., Gomes C. A., Benatti S. V., Naidoo N., Salvetti F., Maccatrozzo S., Agnoletti V., Gamberini E., Solaini L., Costanzo A., Celotti A., Tomasoni M., Khokha V., Arvieux C., Napolitano L., Handolin L., Pisano M., Magnone S., Spain D. A., de Moya M., Davis K. A., De Angelis N., Leppaniemi A., Ferrada P., Latifi R., Navarro D. C., Otomo Y., Coimbra R., Maier R. V., Moore F., Rizoli S., Sakakushev B., Galante J. M., Chiara O., Cimbanassi S., Mefire A. C., Weber D., Ceresoli M., Peitzman A. B., Wehlie L., Sartelli M., Di Saverio S., Ansaloni L., Coccolini, F, Montori, G, Catena, F, Kluger, Y, Biffl, W, Moore, E, Reva, V, Bing, C, Bala, M, Fugazzola, P, Bahouth, H, Marzi, I, Velmahos, G, Ivatury, R, Soreide, K, Horer, T, ten Broek, R, Pereira, B, Fraga, G, Inaba, K, Kashuk, J, Parry, N, Masiakos, P, Mylonas, K, Kirkpatrick, A, Abu-Zidan, F, Gomes, C, Benatti, S, Naidoo, N, Salvetti, F, Maccatrozzo, S, Agnoletti, V, Gamberini, E, Solaini, L, Costanzo, A, Celotti, A, Tomasoni, M, Khokha, V, Arvieux, C, Napolitano, L, Handolin, L, Pisano, M, Magnone, S, Spain, D, de Moya, M, Davis, K, De Angelis, N, Leppaniemi, A, Ferrada, P, Latifi, R, Navarro, D, Otomo, Y, Coimbra, R, Maier, R, Moore, F, Rizoli, S, Sakakushev, B, Galante, J, Chiara, O, Cimbanassi, S, Mefire, A, Weber, D, Ceresoli, M, Peitzman, A, Wehlie, L, Sartelli, M, Di Saverio, S, Ansaloni, L, Coccolini F., Montori G., Catena F., Kluger Y., Biffl W., Moore E. E., Reva V., Bing C., Bala M., Fugazzola P., Bahouth H., Marzi I., Velmahos G., Ivatury R., Soreide K., Horer T., ten Broek R., Pereira B. M., Fraga G. P., Inaba K., Kashuk J., Parry N., Masiakos P. T., Mylonas K. S., Kirkpatrick A., Abu-Zidan F., Gomes C. A., Benatti S. V., Naidoo N., Salvetti F., Maccatrozzo S., Agnoletti V., Gamberini E., Solaini L., Costanzo A., Celotti A., Tomasoni M., Khokha V., Arvieux C., Napolitano L., Handolin L., Pisano M., Magnone S., Spain D. A., de Moya M., Davis K. A., De Angelis N., Leppaniemi A., Ferrada P., Latifi R., Navarro D. C., Otomo Y., Coimbra R., Maier R. V., Moore F., Rizoli S., Sakakushev B., Galante J. M., Chiara O., Cimbanassi S., Mefire A. C., Weber D., Ceresoli M., Peitzman A. B., Wehlie L., Sartelli M., Di Saverio S., and Ansaloni L.

Abstract

Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.

Published
2017

15. WSES consensus conference guidelines: monitoring and management of severe adult traumatic brain injury patients with polytrauma in the first 24 hours

Author

Picetti, E, Rossi, S, Abu-Zidan, F, Ansaloni, L, Armonda, R, Baiocchi, G, Bala, M, Balogh, Z, Berardino, M, Biffl, W, Bouzat, P, Buki, A, Ceresoli, M, Chesnut, R, Chiara, O, Citerio, G, Coccolini, F, Coimbra, R, Di Saverio, S, Fraga, G, Gupta, D, Helbok, R, Hutchinson, P, Kirkpatrick, A, Kinoshita, T, Kluger, Y, Leppaniemi, A, Maas, A, Maier, R, Minardi, F, Moore, E, Myburgh, J, Okonkwo, D, Otomo, Y, Rizoli, S, Rubiano, A, Sahuquillo, J, Sartelli, M, Scalea, T, Servadei, F, Stahel, P, Stocchetti, N, Taccone, F, Tonetti, T, Velmahos, G, Weber, D, Catena, F, Picetti, Edoardo, Rossi, Sandra, Abu-Zidan, Fikri M., Ansaloni, Luca, Armonda, Rocco, Baiocchi, Gian Luca, Bala, Miklosh, Balogh, Zsolt J., Berardino, Maurizio, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Ceresoli, Marco, Chesnut, Randall M., Chiara, Osvaldo, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Fraga, Gustavo P., Gupta, Deepak, Helbok, Raimund, Hutchinson, Peter J., Kirkpatrick, Andrew W., Kinoshita, Takahiro, Kluger, Yoram, Leppaniemi, Ari, Maas, Andrew I. R., Maier, Ronald V., Minardi, Francesco, Moore, Ernest E., Myburgh, John A., Okonkwo, David O., Otomo, Yasuhiro, Rizoli, Sandro, Rubiano, Andres M., Sahuquillo, Juan, Sartelli, Massimo, Scalea, Thomas M., Servadei, Franco, Stahel, Philip F., Stocchetti, Nino, Taccone, Fabio S., Tonetti, Tommaso, Velmahos, George, Weber, Dieter, Catena, Fausto, Picetti, E, Rossi, S, Abu-Zidan, F, Ansaloni, L, Armonda, R, Baiocchi, G, Bala, M, Balogh, Z, Berardino, M, Biffl, W, Bouzat, P, Buki, A, Ceresoli, M, Chesnut, R, Chiara, O, Citerio, G, Coccolini, F, Coimbra, R, Di Saverio, S, Fraga, G, Gupta, D, Helbok, R, Hutchinson, P, Kirkpatrick, A, Kinoshita, T, Kluger, Y, Leppaniemi, A, Maas, A, Maier, R, Minardi, F, Moore, E, Myburgh, J, Okonkwo, D, Otomo, Y, Rizoli, S, Rubiano, A, Sahuquillo, J, Sartelli, M, Scalea, T, Servadei, F, Stahel, P, Stocchetti, N, Taccone, F, Tonetti, T, Velmahos, G, Weber, D, Catena, F, Picetti, Edoardo, Rossi, Sandra, Abu-Zidan, Fikri M., Ansaloni, Luca, Armonda, Rocco, Baiocchi, Gian Luca, Bala, Miklosh, Balogh, Zsolt J., Berardino, Maurizio, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Ceresoli, Marco, Chesnut, Randall M., Chiara, Osvaldo, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Fraga, Gustavo P., Gupta, Deepak, Helbok, Raimund, Hutchinson, Peter J., Kirkpatrick, Andrew W., Kinoshita, Takahiro, Kluger, Yoram, Leppaniemi, Ari, Maas, Andrew I. R., Maier, Ronald V., Minardi, Francesco, Moore, Ernest E., Myburgh, John A., Okonkwo, David O., Otomo, Yasuhiro, Rizoli, Sandro, Rubiano, Andres M., Sahuquillo, Juan, Sartelli, Massimo, Scalea, Thomas M., Servadei, Franco, Stahel, Philip F., Stocchetti, Nino, Taccone, Fabio S., Tonetti, Tommaso, Velmahos, George, Weber, Dieter, and Catena, Fausto

Abstract

The acute phase management of patients with severe traumatic brain injury (TBI) and polytrauma represents a major challenge. Guidelines for the care of these complex patients are lacking, and worldwide variability in clinical practice has been documented in recent studies. Consequently, the World Society of Emergency Surgery (WSES) decided to organize an international consensus conference regarding the monitoring and management of severe adult TBI polytrauma patients during the first 24 hours after injury. A modified Delphi approach was adopted, with an agreement cut-off of 70%. Forty experts in this field (emergency surgeons, neurosurgeons, and intensivists) participated in the online consensus process. Sixteen recommendations were generated, with the aim of promoting rational care in this difficult setting

Published
2019

16. 深度学习超越皮肤科医生

Author

Fujisawa, Y., primary, Otomo, Y., additional, Ogata, Y., additional, Nakamura, Y., additional, Fujita, R., additional, Ishitsuka, Y., additional, Watanabe, R., additional, Okiyama, N., additional, Ohara, K., additional, and Fujimoto, M., additional

Published
2019
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17. Deep learning surpasses dermatologists

Author

Fujisawa, Y., primary, Otomo, Y., additional, Ogata, Y., additional, Nakamura, Y., additional, Fujita, R., additional, Ishitsuka, Y., additional, Watanabe, R., additional, Okiyama, N., additional, Ohara, K., additional, and Fujimoto, M., additional

Published
2019
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22. Effectiveness of early administration of tranexamic acid in patients with severe trauma

Author

Shiraishi, A, primary, Kushimoto, S, additional, Otomo, Y, additional, Matsui, H, additional, Hagiwara, A, additional, Murata, K, additional, Hayakawa, M, additional, Maekawa, K, additional, Saitoh, D, additional, Ogura, H, additional, Sasaki, J, additional, Shibusawa, T, additional, Uejima, T, additional, Yaguchi, A, additional, Takeda, M, additional, Ishikura, H, additional, Nakamura, Y, additional, Kudo, D, additional, Kaneko, N, additional, Matsuoka, T, additional, Hagiwara, Y, additional, Morimura, N, additional, Furugori, S, additional, Kato, H, additional, Kanemura, T, additional, Mayama, G, additional, Kim, S, additional, Takasu, O, additional, and Nishiyama, K, additional

Published
2017
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23. Deep‐learning‐based, computer‐aided classifier developed with a small dataset of clinical images surpasses board‐certified dermatologists in skin tumour diagnosis.

Author

Fujisawa, Y., Otomo, Y., Ogata, Y., Nakamura, Y., Fujita, R., Ishitsuka, Y., Watanabe, R., Okiyama, N., Ohara, K., and Fujimoto, M.

Subjects
*SKIN cancer, *DIAGNOSTIC imaging, *DIAGNOSIS, *CANCER, *MEDICAL practice, *SKIN
Abstract

Summary: Background: Application of deep‐learning technology to skin cancer classification can potentially improve the sensitivity and specificity of skin cancer screening, but the number of training images required for such a system is thought to be extremely large. Objectives: To determine whether deep‐learning technology could be used to develop an efficient skin cancer classification system with a relatively small dataset of clinical images. Methods: A deep convolutional neural network (DCNN) was trained using a dataset of 4867 clinical images obtained from 1842 patients diagnosed with skin tumours at the University of Tsukuba Hospital from 2003 to 2016. The images consisted of 14 diagnoses, including both malignant and benign conditions. Its performance was tested against 13 board‐certified dermatologists and nine dermatology trainees. Results: The overall classification accuracy of the trained DCNN was 76·5%. The DCNN achieved 96·3% sensitivity (correctly classified malignant as malignant) and 89·5% specificity (correctly classified benign as benign). Although the accuracy of malignant or benign classification by the board‐certified dermatologists was statistically higher than that of the dermatology trainees (85·3% ± 3·7% and 74·4% ± 6·8%, P < 0·01), the DCNN achieved even greater accuracy, as high as 92·4% ± 2·1% (P < 0·001). Conclusions: We have developed an efficient skin tumour classifier using a DCNN trained on a relatively small dataset. The DCNN classified images of skin tumours more accurately than board‐certified dermatologists. Collectively, the current system may have capabilities for screening purposes in general medical practice, particularly because it requires only a single clinical image for classification. What's already known about this topic? Several computer‐aided classification systems have been introduced that achieve high sensitivity for melanoma detection; however, low specificity was a trade‐off for high sensitivity.The application of deep‐learning technology to skin cancer classification could potentially improve the sensitivity and specificity of skin cancer screening.The number of training images required for such a system is thought to be extremely large, and compiling large datasets for rare skin conditions is difficult. What does this study add? Our deep convolutional neural network (DCNN), trained on only 4867 images from 1842 patients, classified images of skin tumours into 14 different diagnoses more accurately than board‐certified dermatologists.The fluctuation range was only ± 3·2% by fivefold cross‐validation, showing the robustness of the system.Our DCNN system requires only a single image and provides 96·3% sensitivity and 89·5% specificity in the detection of skin cancer; however, it should be validated in a prospective clinical study before use for screening purposes in general medical practice. Linked Editorial:Janda and Soyer. Br J Dermatol 2019; 180:247–248. Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]

Published
2019
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25. Stabilization of poor soil by paper sludge mixing

Author

M. Otomo Y. Fujiwara, H. Shigematsu, and Y. Demura

Subjects
business.industry, Environmental engineering, Environmental science, Paper mill, business, Mixing (physics)
Abstract

物性（活性度）の全く異なる3種類の処理対象土に，2種類の製紙スラッジ（PMFおよびPS灰）を混ぜ合わせ，2つの方法でコーン指数試験を実施した．これらの実験結果から，製紙スラッジを土の安定材として用いた場合の強度維持・強度回復効果（安定処理効果）を明確にした．また，実験に用いた供試体を走査型電子顕微鏡（SEM）で観察し，製紙スラッジと土粒子のインタラクションを視覚的に捉え，それが土の安定化と密接に関連していることを明らかにした．

Published
2008

31. (P1-111) Japan Medical Association Team (JMAT)

Author

Nagata, T., primary, Ishihara, T., additional, Inasaka, H., additional, Sakamoto, T., additional, Akashi, M., additional, Otomo, Y., additional, Koriyama, K., additional, Kobayashi, H., additional, Ido, T., additional, and Ishi, S., additional

Published
2011
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