Predictors for Survival of Penetrating Trauma Using Emergency Department Thoracotomy in an Urban Trauma Center: The Cardiac Instability Score
Background Emergency department thoracotomy (EDT) is a procedure used in an attempt to save lives of patients in extremis. This study aims to determine predictors of survival and futility by proposing a scoring scale that measures cardiac instability and its use in predicting survival of victims of...
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| Veröffentlicht in: | Journal of the National Medical Association 2010-02, Vol.102 (2), p.126-131 |
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| creator | Siram, Suryanarayana, MD Oyetunji, Tolulope, MD,MPH Johnson, Shaneeta M., MD Khoury, Amal L., MD White, Patricia M., RN Chang, David C Greene, Wendy R., MD Frederick, Wayne A.I., MD |
| description | Background Emergency department thoracotomy (EDT) is a procedure used in an attempt to save lives of patients in extremis. This study aims to determine predictors of survival and futility by proposing a scoring scale that measures cardiac instability and its use in predicting survival of victims of penetrating trauma undergoing EDT. Methods This retrospective study analyzes patients who underwent EDT during a 45-month period at Howard University Hospital, Washington, DC. Vital signs and Glasgow Coma scale (GCS) scores were analyzed at the scene and in the emergency department. A cardiac instability score (CIS) was devised to assign values to vital signs, and the GCS was based on scores from the emergency department. Results Emergency department vital signs, female gender, absence of cardiopulmonary resuscitation (CPR), and high CIS were found to be statistically significant predictors of survival. Conclusions The CIS correlated with survival of patients who underwent EDT and was found to be statistically significant in determining the outcome of an EDT. |
| doi_str_mv | 10.1016/S0027-9684(15)30500-9 |
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This study aims to determine predictors of survival and futility by proposing a scoring scale that measures cardiac instability and its use in predicting survival of victims of penetrating trauma undergoing EDT. Methods This retrospective study analyzes patients who underwent EDT during a 45-month period at Howard University Hospital, Washington, DC. Vital signs and Glasgow Coma scale (GCS) scores were analyzed at the scene and in the emergency department. A cardiac instability score (CIS) was devised to assign values to vital signs, and the GCS was based on scores from the emergency department. Results Emergency department vital signs, female gender, absence of cardiopulmonary resuscitation (CPR), and high CIS were found to be statistically significant predictors of survival. Conclusions The CIS correlated with survival of patients who underwent EDT and was found to be statistically significant in determining the outcome of an EDT.</description><identifier>ISSN: 0027-9684</identifier><identifier>EISSN: 1943-4693</identifier><identifier>DOI: 10.1016/S0027-9684(15)30500-9</identifier><identifier>PMID: 20191925</identifier><identifier>CODEN: JNMAAE</identifier><language>eng</language><publisher>Washington, DC: Elsevier Inc</publisher><subject>Biological and medical sciences ; emergency care ; Emergency Service, Hospital ; General aspects ; Glasgow Coma Scale ; Health Status Indicators ; Humans ; Internal Medicine ; Medical sciences ; predictor ; Prognosis ; Retrospective Studies ; surgery ; survival ; Thoracotomy - mortality ; Urban Population - statistics & numerical data ; Wounds, Penetrating - mortality</subject><ispartof>Journal of the National Medical Association, 2010-02, Vol.102 (2), p.126-131</ispartof><rights>National Medical Association</rights><rights>2010 National Medical Association</rights><rights>2015 INIST-CNRS</rights><rights>Copyright National Medical Association Feb 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-bb448189f462736aaebf13fe3fb9c0b929df7b91bf21967e1eaf8c00adcec1663</citedby><cites>FETCH-LOGICAL-c476t-bb448189f462736aaebf13fe3fb9c0b929df7b91bf21967e1eaf8c00adcec1663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22423156$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20191925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Siram, Suryanarayana, MD</creatorcontrib><creatorcontrib>Oyetunji, Tolulope, MD,MPH</creatorcontrib><creatorcontrib>Johnson, Shaneeta M., MD</creatorcontrib><creatorcontrib>Khoury, Amal L., MD</creatorcontrib><creatorcontrib>White, Patricia M., RN</creatorcontrib><creatorcontrib>Chang, David C</creatorcontrib><creatorcontrib>Greene, Wendy R., MD</creatorcontrib><creatorcontrib>Frederick, Wayne A.I., MD</creatorcontrib><title>Predictors for Survival of Penetrating Trauma Using Emergency Department Thoracotomy in an Urban Trauma Center: The Cardiac Instability Score</title><title>Journal of the National Medical Association</title><addtitle>J Natl Med Assoc</addtitle><description>Background Emergency department thoracotomy (EDT) is a procedure used in an attempt to save lives of patients in extremis. This study aims to determine predictors of survival and futility by proposing a scoring scale that measures cardiac instability and its use in predicting survival of victims of penetrating trauma undergoing EDT. Methods This retrospective study analyzes patients who underwent EDT during a 45-month period at Howard University Hospital, Washington, DC. Vital signs and Glasgow Coma scale (GCS) scores were analyzed at the scene and in the emergency department. A cardiac instability score (CIS) was devised to assign values to vital signs, and the GCS was based on scores from the emergency department. Results Emergency department vital signs, female gender, absence of cardiopulmonary resuscitation (CPR), and high CIS were found to be statistically significant predictors of survival. Conclusions The CIS correlated with survival of patients who underwent EDT and was found to be statistically significant in determining the outcome of an EDT.</description><subject>Biological and medical sciences</subject><subject>emergency care</subject><subject>Emergency Service, Hospital</subject><subject>General aspects</subject><subject>Glasgow Coma Scale</subject><subject>Health Status Indicators</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Medical sciences</subject><subject>predictor</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>surgery</subject><subject>survival</subject><subject>Thoracotomy - mortality</subject><subject>Urban Population - statistics & numerical data</subject><subject>Wounds, Penetrating - mortality</subject><issn>0027-9684</issn><issn>1943-4693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkd2KEzEYhgdR3Lp6CUoQRD0Yzc_8xQNF6qoLCy60PQ6ZzJc160zSTTKFuQjv2UxbK-yJJwmB53vzJk-WPSf4HcGker_CmNY5r5riDSnfMlxinPMH2YLwguVFxdnDbHFCzrInIdxijBtelo-zM4oJJ5yWi-z3tYfOqOh8QNp5tBr9zuxkj5xG12AhehmNvUFrL8dBok2YDxcD-BuwakJfYCt9HMBGtP7pvFQuumFCxiJp0ca3aT1OLhMD_kPCAC2l74xU6NKGKFvTmzihlXIenmaPtOwDPDvu59nm68V6-T2_-vHtcvn5KldFXcW8bYuiIQ3XRUVrVkkJrSZMA9MtV7jllHe6bjlpNSW8qoGA1I3CWHYKFKkqdp69PuRuvbsbIUQxmKCg76UFNwZRM9YQUpGZfHmPvHWjt6mcoKTAjDY1TVB5gJR3IXjQYuvNIP0kCBazLbG3JWYVgpRib0vwNPfiGD62A3Snqb96EvDqCMigZK-9tMqEfxwtKCPl3PLTgYP0aTsDXgRlkqCk1oOKonPmv1U-3ktQvbEmXfoLJginRxMRqMCHkDmDlPsEzv4AjLvHtg</recordid><startdate>20100201</startdate><enddate>20100201</enddate><creator>Siram, Suryanarayana, MD</creator><creator>Oyetunji, Tolulope, MD,MPH</creator><creator>Johnson, Shaneeta M., MD</creator><creator>Khoury, Amal L., MD</creator><creator>White, Patricia M., RN</creator><creator>Chang, David C</creator><creator>Greene, Wendy R., MD</creator><creator>Frederick, Wayne A.I., MD</creator><general>Elsevier Inc</general><general>National Medical Association</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20100201</creationdate><title>Predictors for Survival of Penetrating Trauma Using Emergency Department Thoracotomy in an Urban Trauma Center: The Cardiac Instability Score</title><author>Siram, Suryanarayana, MD ; Oyetunji, Tolulope, MD,MPH ; Johnson, Shaneeta M., MD ; Khoury, Amal L., MD ; White, Patricia M., RN ; Chang, David C ; Greene, Wendy R., MD ; Frederick, Wayne A.I., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-bb448189f462736aaebf13fe3fb9c0b929df7b91bf21967e1eaf8c00adcec1663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Biological and medical sciences</topic><topic>emergency care</topic><topic>Emergency Service, Hospital</topic><topic>General aspects</topic><topic>Glasgow Coma Scale</topic><topic>Health Status Indicators</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Medical sciences</topic><topic>predictor</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>surgery</topic><topic>survival</topic><topic>Thoracotomy - mortality</topic><topic>Urban Population - statistics & numerical data</topic><topic>Wounds, Penetrating - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Siram, Suryanarayana, MD</creatorcontrib><creatorcontrib>Oyetunji, Tolulope, MD,MPH</creatorcontrib><creatorcontrib>Johnson, Shaneeta M., MD</creatorcontrib><creatorcontrib>Khoury, Amal L., MD</creatorcontrib><creatorcontrib>White, Patricia M., RN</creatorcontrib><creatorcontrib>Chang, David C</creatorcontrib><creatorcontrib>Greene, Wendy R., MD</creatorcontrib><creatorcontrib>Frederick, Wayne A.I., MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the National Medical Association</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Siram, Suryanarayana, MD</au><au>Oyetunji, Tolulope, MD,MPH</au><au>Johnson, Shaneeta M., MD</au><au>Khoury, Amal L., MD</au><au>White, Patricia M., RN</au><au>Chang, David C</au><au>Greene, Wendy R., MD</au><au>Frederick, Wayne A.I., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors for Survival of Penetrating Trauma Using Emergency Department Thoracotomy in an Urban Trauma Center: The Cardiac Instability Score</atitle><jtitle>Journal of the National Medical Association</jtitle><addtitle>J Natl Med Assoc</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>102</volume><issue>2</issue><spage>126</spage><epage>131</epage><pages>126-131</pages><issn>0027-9684</issn><eissn>1943-4693</eissn><coden>JNMAAE</coden><abstract>Background Emergency department thoracotomy (EDT) is a procedure used in an attempt to save lives of patients in extremis. This study aims to determine predictors of survival and futility by proposing a scoring scale that measures cardiac instability and its use in predicting survival of victims of penetrating trauma undergoing EDT. Methods This retrospective study analyzes patients who underwent EDT during a 45-month period at Howard University Hospital, Washington, DC. Vital signs and Glasgow Coma scale (GCS) scores were analyzed at the scene and in the emergency department. A cardiac instability score (CIS) was devised to assign values to vital signs, and the GCS was based on scores from the emergency department. Results Emergency department vital signs, female gender, absence of cardiopulmonary resuscitation (CPR), and high CIS were found to be statistically significant predictors of survival. Conclusions The CIS correlated with survival of patients who underwent EDT and was found to be statistically significant in determining the outcome of an EDT.</abstract><cop>Washington, DC</cop><pub>Elsevier Inc</pub><pmid>20191925</pmid><doi>10.1016/S0027-9684(15)30500-9</doi><tpages>6</tpages></addata></record> |
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| subjects | Biological and medical sciences emergency care Emergency Service, Hospital General aspects Glasgow Coma Scale Health Status Indicators Humans Internal Medicine Medical sciences predictor Prognosis Retrospective Studies surgery survival Thoracotomy - mortality Urban Population - statistics & numerical data Wounds, Penetrating - mortality |
| title | Predictors for Survival of Penetrating Trauma Using Emergency Department Thoracotomy in an Urban Trauma Center: The Cardiac Instability Score |
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