Trauma In Greece Research Articles

Significant Effect of the Coronavirus 2020 Lockdown on Maxillofacial Trauma in Greece

Significant Effect of the Coronavirus 2020 Lockdown on Maxillofacial Trauma in Greece

Tapping on Collective National Trauma

Tapping on Collective National Trauma

Measuring the Impact of Trauma in Greece: A Systematic Review of Greek Trauma Registries. Is Quality Improvement Achievable?

Measuring the Impact of Trauma in Greece: A Systematic Review of Greek Trauma Registries. Is Quality Improvement Achievable?

Measuring the Impact of Trauma in Greece: A Systematic Review of Greek Trauma Registries. Is Quality Improvement Achievable?

Greece currently has no national trauma registry. The primary aim of this study was to identify all the trauma registries that have been established in Greece and assess the methodology used in these registries. The secondary aim was investigation, through review of the registries, of the demographics, mechanisms of injury, severity of injuries, and mortality of Greek trauma patients. We performed a systematic review of published trauma registry literature from Greece, according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We assessed the methodology of the registries, based on the reported physical and human resources, administration strategies, processes of data collection, and analysis. SPSS was used for the synthesis of the quantitative data extracted from the registries (demographics, mechanisms of injury, injury severity score [ISS], mortality). The initial search retrieved 1,732 abstracts, after screening of which, 81 full-text articles were scrutinized for their suitability for inclusion. Finally, 14 papers from 6 registries, including a total 159,763 patients, were deemed eligible. Each registry used different inclusion criteria. Half of the publications (7/14) were derived from registries that received funding. Regarding the analysis included in the studies, epidemiological analysis was the most common (12/14), followed by comparisons (internal or external) (6/14). Quality improvement analysis was not presented in any publication. The mean age of the patients was 41±7.3 years, and 63.17% were males. Road traffic accidents (RTAs) were the most common mechanism of injury (38.19%), followed by falls (36.1%). The registries used a variety of different ISS thresholds for considering a trauma patient severely injured; the mean ISS threshold used was 12±5. The mean ISS of the entire population was 8.4±4.4 and the average mortality was 3.85%. RTAs and falls are responsible for a significant proportion of the Greek trauma burden. The small number of publications of the data from the registries and the complete absence of quality control studies indicate that trauma auditing in Greece is still in an embryonic state. There is a pressing need for national consensus on how to record and investigate trauma.

Rates of childhood trauma in a sample of university students in Greece: The Greek version of the Early Trauma Inventory-Self Report.

The self-report Early Trauma Inventory (ETI-SR-SF) was developed by Bremner et al in 2007 and has been proven a valid tool for the assessment of childhood trauma. The inventory covers four types of traumatic experiences: general trauma, physical abuse, emotional abuse and sexual abuse. The primary aim of the present study was to assess the internal consistency, test-retest reliability, convergent validity and factor structure of the Greek version of the ETI-SR-SF. The study sample consisted of 605 individuals (402 women), undergraduate and postgraduate students of Athens universities with a mean age of 24.3 years. All participants completed a questionnaire on demographic characteristics, the Greek version of the ETI-SR-SF and the Greek version of the Trauma Symptoms Checklist (TSC-40). Both ETI-SR-SF and TSC-40 were re-administered to 56 participants after three to four weeks. ETI-SR-SF was found to display high levels of internal consistency (Cronbach's α=0.91) and test-retest reliability (ICC=0.93). In addition, the internal structure of every subscale was examined by the means of factor analysis, which revealed that the items in every subscale contribute to a single factor explaining a great proportion of the variance. The correlation between total scores of ETI-SR-SF and TSC-40 was significantly strong (r=0.42, p<0.001), indicating satisfactory convergent validity. The most frequently reported type of childhood trauma was corporal punishment, at a rate of 89.9%, followed by emotional abuse (67.2%) and sexual abuse (27%). These rates are higher than those found in the international literature indicating that the various types of early traumatic experience are very common phenomena in the Greek student population. This finding should alert the experts and requires replication and further investigation by studies with larger samples. The findings of the present study suggest that the Greek version of the self-report Early Trauma Inventory (ETI-SR-SF) is a valid and reliable tool useful for future studies on childhood traumatic experiences in Greek populations. Moreover, according to our preliminary findings further investigation of the childhood trauma in Greece appears to be very much warranted.

The structure of trauma patients, its management and health care in the University Hospital of Alexandroupolis.

The present study was designed to describe the patterns of trauma patients using a newly-introduced trauma registry, as well as retrospectively assess the management and outcome facts of these patients. The study included 2346 patients (62.15% male) with a mean age of 34.06 +/- 23.77 years. Of these patients, 355 were multiple trauma patients. Privately owned vehicles were used as a mode of transportation for most of the trauma patients (96.65%). Data regarding patient demographics, arrival at the Emergency Department, mechanism of injury, injury severity, anatomical location and type of injury were collected and analyzed. Falls were the most prevalent mechanism of injury, accounting for 62.19% of the total admitted cases, with other causes (that also included occupational accidents and machinery trauma) being the second most prevalent, and MVAs--the third with a rate of 11.46%. The most commonly injured body regions were the extremities (50.26%), the head (42.50%), and the torso (19.39%). Fractures represented 11.46% of the injuries, while open wounds were much more frequent (29.41%). The mean abbreviated injury severity (AIS) score was 1.78 +/- 1.48 for all admitted patients and 3.56 +/- 1.02 for multiple trauma patients. A multi-disciplinary approach was required for 23% of the multiple trauma patients. The clinic admission rate for the whole patient sample was 13.55% and 48.96% for multiple trauma patients. The mean duration of stay for all clinic admissions was 2.7 days and 2.9 days for multiple trauma patients. With the epidemiology of trauma in Greece being rather poorly investigated, the present study manages to identify the major epidemiological patterns of trauma cases presenting to a tertiary regional hospital and addresses the need for development and implementation of injury prevention activities and policies.

Patients with pelvic fractures due to falls: A paradigm that contributed to autopsy-based audit of trauma in Greece.

BackgroundEvaluation of the pelvic fractures (PFx) population in auditing effective components of trauma care is the subject of this study.MethodsA retrospective, case-control, autopsy-based study compared a population with PFx to a control-group using a template with trauma outcome variables, which included demographics, ICD-9, intention, mechanisms, toxicology, Abbreviated Injury Scale (AIS-90), Injury Severity Score (ISS), causes of haemorrhage, comorbidity, survival time, pre-hospital response, in hospital data, location of death, and preventable deaths.ResultsOf 970 consecutive patients with fatal falls, 209 (21.5%) had PFx and constituted the PFx-group while 761 (78.5%) formed the control-group.Multivariate analysis showed that gender, age, intention, and height of fall were risk factors for PFx. A 300% higher odds of a psychiatric history was found in the PFx-group compared to the control-group (p < 0.001).The median ISS was 50 (17-75) for the PFx-group and 26 (1-75) for the control-group (p < 0.0001). There were no patients with an ISS less than 16 in the PFx group.Associated injuries were significantly more common in the PFx-group than in the control-group. Potentially preventable deaths (ISS < 75) constituted 78% (n = 163) of the PFx-group. The most common AIS3-5 injuries in the potentially preventable subset of patients were the lower extremities in 133 (81.6%), thorax in 130 (79.7%), abdomen/pelvic contents in 99 (60.7%), head in 95 (58.3%) and the spine in 26 (15.9%) patients.A subset of 126 (60.3%) potentially preventable deaths in the PFx-group had at least one AIS-90 code other than the PFx, denoting major haemorrhage. Deaths directly attributed to PFx were limited to 6 (2.9%).The median survival time was 30 minutes for the PFx-group and 20 hours for the control-group (p < 0.001). For a one-group increment in the ISS-groups, the survival rates over the post-traumatic time intervals were reduced by 57% (p < 0.0001).Pre-hospital mortality was significantly higher in the PFx-group i.e. 70.3% of the PFx-group versus 42.7% of the control-group (p < 0.001).ConclusionsThe PFx-group shared common causative risk factors, high severity and multiplicity of injuries that define the PFx-group as a paradigm of injury for audit. This reduced sample of autopsies substantially contributed to the audit of functional, infrastructural, management and prevention issues requiring transformation to reduce mortality.

Interfacility transfers in a non-trauma system setting: an assessment of the Greek reality

BackgroundQuality assessment of any trauma system involves the evaluation of the transferring patterns. This study aims to assess interfacility transfers in the absence of a formal trauma system setting and to estimate the benefits from implementing a more organized structure.MethodsThe 'Report of the Epidemiology and Management of Trauma in Greece' is a one year project of trauma patient reporting throughout the country. It provided data concerning the patterns of interfacility transfers. We compared the transferred patient group to the non transferred patient group. Information reviewed included patient and injury characteristics, need for an operation, Intensive Care Unit (ICU) admittance and mortality. Analysis employed descriptive statistics and Chi-square test. Interfacility transfers were then assessed according to each health care facility's availability of five requirements; Computed Tomography scanner, ICU, neurosurgeon, orthopedic and vascular surgeon.ResultsData on 8,524 patients were analyzed; 86.3% were treated at the same facility, whereas 13.7% were transferred. Transferred patients tended to be younger, male, and more severely injured than non transferred patients. Moreover, they were admitted to ICU more often, had a higher mortality rate but were less operated on compared to non transferred patients. The 34.3% of transfers was from facilities with none of the five requirements, whereas the 12.4% was from those with one requirement. Low level facilities, with up to three requirements transferred 43.2% of their transfer volume to units of equal resources.ConclusionTrauma management in Greece results in a high number of transfers. Patients are frequently transferred between low level facilities. Better coordination could lead to improved outcomes and less cost.

Emergency room management of trauma patients in Greece: Preliminary report of a national study

Aim of the study The aim of this study was to record and to evaluate the epidemiology of trauma in Greece and to assess the quality of management provided for trauma patients in the emergency department in Greek hospitals. Methods The Hellenic Society of Trauma and Emergency Surgery invited all the official representatives of the society throughout the country to participate in the study. The representatives that responded positively, met with the Board of the society in succeeding meetings to establish the reporting form and the inclusion criteria. Inclusion criteria were defined as trauma patients requiring admission, transfer to a higher level center or arrived dead or died in the emergency department of the reporting hospital. All reports were accumulated by the Hellenic Trauma society, imported in an electronic data base and analyzed. The design of the study was prospective and observational. Results In total 8862 patients were included in the study in 12 months time. Of them 68.7% ( n = 6084) were male, aged 41.8 ± 20.6 (mean ± S.D.) and 31.3% were female ( n = 2778), aged 52.7 ± 24.1 (mean ± S.D.). The mean duration of treatment in the emergency room department was 1 h and 28 min. Of the total number of patients, 2312 (26.1%) were initially assessed and managed by a specialist and 6249 (70.5%) were initially assessed and managed by a resident. Conclusions Data from this study show that there is substantial room for improvement in the patient care in the emergency department following trauma. Further evaluation will be required to identify particular management patterns that can be readily altered.