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Treffer: Military trauma care in Birmingham: observational study of care requirements and resource utilisation.

Title:
Military trauma care in Birmingham: observational study of care requirements and resource utilisation.
Authors:
Jackson PC; Hull & East Yorkshire Hospitals, Yorkshire, United Kingdom. Electronic address: drpcjackson@gmail.com., Foster M, Fries A, Jeffery SL
Source:
Injury [Injury] 2014 Jan; Vol. 45 (1), pp. 44-9. Date of Electronic Publication: 2012 Sep 19.
Publication Type:
Journal Article; Observational Study
Language:
English
Journal Info:
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0226040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0267 (Electronic) Linking ISSN: 00201383 NLM ISO Abbreviation: Injury Subsets: MEDLINE
Imprint Name(s):
Publication: <2002->: Amsterdam : Elsevier
Original Publication: Bristol, Wright.
MeSH Terms:
Military Medicine*/economics , Military Personnel*, Blast Injuries/*surgery , Critical Care/*statistics & numerical data , Wounds, Nonpenetrating/*surgery , Wounds, Penetrating/*surgery, Adolescent ; Adult ; Blast Injuries/economics ; Blast Injuries/mortality ; Critical Care/economics ; Critical Care/organization & administration ; Female ; Health Resources/economics ; Health Resources/statistics & numerical data ; Humans ; Injury Severity Score ; Intensive Care Units/statistics & numerical data ; Length of Stay/statistics & numerical data ; Male ; Patient Admission/statistics & numerical data ; Patient Care Team/organization & administration ; Patient Transfer/statistics & numerical data ; Trauma Severity Indices ; United Kingdom/epidemiology ; Warfare ; Wounds, Nonpenetrating/economics ; Wounds, Nonpenetrating/mortality ; Wounds, Penetrating/economics ; Wounds, Penetrating/mortality
Contributed Indexing:
Keywords: CCAST; Critical Care Air Support Team; DMRC; Defence Medical Rehabilitation Centre; ICU; IED; IQR; ISS; Injury Severity Score; Injury severity; JMC; JTTR; Joint Medical Command; Joint Theatre Trauma Registry; LOS; MDT; MOF; Military trauma; Multidisciplinary Team; NBI; NISS; New Injury Severity Score; RAF; RCDM; Royal Air Force; Royal Centre for Defence Medicine; SIRS; Service provision; Surgical requirement; TMW; Tactical Medical Wing; Trauma service; UHB; University Hospitals Birmingham; improvised explosive device; intensive care unit; interquartile range; length of stay; multiple organ failure; non-battle injury; systemic inflammatory response syndrome
Entry Date(s):
Date Created: 20120925 Date Completed: 20150804 Latest Revision: 20181202
Update Code:
20250114
DOI:
10.1016/j.injury.2012.08.036
PMID:
22999185
Database:
MEDLINE

Weitere Informationen

Background: The Royal Centre for Defence Medicine is located at University Hospitals Birmingham (UHB). Since 2001 all UK military casualties injured on active duty have been repatriated here for their initial treatment. This service evaluation was performed to quantify the work undertaken, with the aim of providing a snapshot of a year's military trauma work in order to inform the delivery of trauma care in both the military and civilian setting.
Methods: Military patients admitted with traumatic injuries over a 12-month period were identified and the hospital notes and electronic records reviewed. Data were collected focusing on three areas - the details of the injury, information about the in-patient admission, and surgical interventions performed.
Results: A total of 388 patients were used in the analysis. Median total length of stay was 10.5 days (IQR: 4-26, range: 0-137 days), and a median 6.0 days (IQR: 3.0-11.0, range: 1-49 days) was spent on intensive care by 125 patients. Surgical intervention was required for 278 (71.6%) patients, with a median of 2.0 operations (IQR: 1.0-4.0, range: 1-27) or 170 min (IQR: 90.0-570.0, range 20-4735 min) operating time per patient. 77% of these patients had their first procedure within 24h of arrival. Improvised explosives accounted for 50.5% of injuries seen. Spearman rank correlation between New Injury Severity Score with length of stay demonstrated significant correlation (p<0.001), with a coefficient of 0.640. A model predicting length of stay based on New Injury Severity Score was devised for patients with battle injuries.
Conclusion: This report of 12 months work at UHB demonstrates the service commitment to these casualties, describing the burden of care and resource requirements for military trauma patients.
(Copyright © 2012 Elsevier Ltd. All rights reserved.)