mahnaz yadollahi; Zahra Moradi; Kazem Jamali; Maryam Fadaie Dashti
Volume 26, Issue 1 , 2024
Abstract
Background: The current study aimed to successively assess the applicability of trauma scoring systems.Objectives: To evaluate the outcomes, prognosis, and mortality in trauma patients.Methods: The present study was conducted on all 221 injured patients referred to Shahid Rajaee Hospital from January ...
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Background: The current study aimed to successively assess the applicability of trauma scoring systems.Objectives: To evaluate the outcomes, prognosis, and mortality in trauma patients.Methods: The present study was conducted on all 221 injured patients referred to Shahid Rajaee Hospital from January 2014 toDecember 2020 with International Classification of Diseases-10th Revision (ICD-10) injury mechanism codes of W32.0-34.09, indicating afirearm injury. Univariate analysis and Chi-square test were employed to discover the individual relationship between each variable andthe injury outcome. Logistic regression analysis was performed to control the confounder. Finally, the area under the Receiver OperatingCharacteristic (ROC) curve was used to compare the predictive efficiency of the injury severity scales.Results: The mortality rate of the gunshot was 15 (6.78%). The cause of the gunshot was related to assaults in 73.68% of the survivingpatients. Meanwhile, suicide attempt was the second cause of death in gunshot patients (16.67%). Most of the injuries that occurredamong 20-24-year-old patients resulted from assaults. The odds of mortality in gunshot victims increased by 4.25 times (95% CI [1.99,9.10]) for each additional unit AIS. In the random forest model, the Trauma Injury Severity Score (TRISS) was the most importantmortality predictor. The TRISS was the highest area under the ROC curve for death prediction among firearms gunshot patients.Conclusion: Injury Severity Score (ISS) had the least, and TRISS had the most area under the curve. Therefore, TRISS was found to be thebest predictor in determining the death or survival of firearms gunshot patients.
Mahnaz Yadollahi; kazem Jamali; Forough Pazhuheian; Mahmood ali Nezam eftekhari
Volume 23, Issue 5 , 2021
Abstract
Background: Simulation studies present an important statistical tool to investigate the performance, properties, and adequacy of statistical models in pre-specified situations. The proportional hazards model of survival analysis is one of the most important statistical models in medical studies. This ...
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Background: Simulation studies present an important statistical tool to investigate the performance, properties, and adequacy of statistical models in pre-specified situations. The proportional hazards model of survival analysis is one of the most important statistical models in medical studies. This study aimed to investigate the underlying one-month survival of road traffic accident (RTA) victims in a Level 1 Trauma Center in Iran using parametric and semi-parametric survival analysis models from the viewpoint of post-crash care-provider in 2017.
Materials and Methods: This retrospective cohort study (restudy) was conducted at Level-I Trauma Center of Shiraz, Iran, from January to December 2017. Considering the fact that certain covariates acting on survival may take a non-homogenous risk pattern leading to the violation of proportional hazards assumption in Cox-PH, the parametric survival modeling was employed to inspect the multiplicative effect of all covariates on the hazard. Distributions of choice were Exponential, Weibull and Lognormal. Parameters were estimated using the Akaike
Results: Survival analysis was conducted on 8,621 individuals for whom the length of stay (observation period) was between 1 and 89 days. In total, 141 death occurred during this time. The log-rank test revealed inequality of survival functions across various categories of age, injury mechanism, injured body region, injury severity score, and nosocomial infections. Although the risk level in the Cox model is almost the same as that in the results of the parametric models, the Weibull model in the multivariate analysis yields better results, according to the Akaike criterion.
Conclusion: In multivariate analysis, parametric models were more efficient than other models. Some results were similar in both parametric and semi-parametric models. In general, parametric models and among them the Weibull model was more efficient than other models.
Mahnaz Yadollahi; Ali Kashkooe; Ehsan Habibpour; Kazem Jamali
Volume 20, s1 , December 2018, , Pages 1-7
Abstract
Background: Spinal trauma is a devastating event which could disturb a person’s life. Objectives: The purpose of this study was to examine the prevalence and risk factors of spinal trauma in Rajaee Trauma Center, Shiraz, Iran.Methods: Data for this cross-sectional study were gathered from October ...
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Background: Spinal trauma is a devastating event which could disturb a person’s life. Objectives: The purpose of this study was to examine the prevalence and risk factors of spinal trauma in Rajaee Trauma Center, Shiraz, Iran.Methods: Data for this cross-sectional study were gathered from October 2009 to August 2015. The study was conducted through data extraction from the classified data of trauma patients admitted to Rajaei hospital. After performing some inclusion and ex- clusion criteria, 4630 cases were analyzed. The variables analyzed as the risk factors of spinal trauma included sex, age, cord injury, mechanism of injury, and injury severity score. Results: The prevalence of spinal trauma among traumatic patients was 7%; also, 3.7% of those with spinal trauma suffered cord injury. The mean age of the spinal traumatic patients was 38.2 ± 17.8, and male-to-female ratio was 2.394. Car accident, motorbikeaccident, and fall were the main causes of spinal trauma in this study. The lumbar region was the most common injured site in our study. Old age, cord injury, suicide, and car accident were the main risk factors of mortality among spinal traumatic patients. Risk factors of spinal trauma among traumatic patients were female gender, old age, and fall. The risk factors of cord injury in spinal traumatic patients were male gender, old age, and suicide. Conclusions: It was found that spinal trauma, spinal cord injury (SCI), and mortality among spinal traumatic patients in Iran de- pended on some risk factors, which should be reduced through eliminating such risk factors. Fall was the most prominent factor ofthe occurrence of spinal trauma. The most important factors of mortality in spinal traumatic patients were suicide and cord injury. Finally, suicide played the most important role in occurrence of SCI.
