Incidence rate and risk factors of missed injuries in major trauma patients

Chao Wen Chen, Chi Ming Chu, Wen Yu Yu, Yun Ting Lou, Mau Roung Lin

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

This study was designed to determine the incidence rate and risk factors of missed injuries in major trauma patients in the emergency department (ED). Hospital records of all 976 trauma patients visiting the ED and admitted to intensive care units (ICUs) of a medical center in Taiwan from 2006 to 2007 were reviewed. Missed injuries were defined as those not identified in the ED but recognized later in the ICUs. Clinically significant injuries were those with an Abbreviated Injury Scale of ≥2. In the 2-year period, there were 133 missed injuries in 118 patients in the ED, for a prevalence of 12.1%; 87 injuries were clinically significant in 78 patients, for a prevalence of 8.0%. The estimated incidence rate per 100 person-hours was 3.2 for missed injuries and 2.1 for clinically significant missed injuries. The most commonly involved body region of missed injuries was the head/neck, followed by the chest and extremities. Results of a Cox regression analysis showed that a younger age, more-severe injury, polytrauma, and the absence of soft-tissue injuries were significantly associated with missed injuries, while younger ages, more-severe injuries, and the presence of chest and pelvic injuries were also significantly associated with clinically significant missed injuries. In conclusion, a considerable number of injuries, particularly to the head/neck, may be undetected in the ED, while young people and patients with certain injury patterns such as severity levels, polytrauma, and the presence of a chest or pelvic injury are more likely to have missed injuries and/or clinically significant missed injuries.

Original languageEnglish
Pages (from-to)823-828
Number of pages6
JournalAccident Analysis and Prevention
Volume43
Issue number3
DOIs
Publication statusPublished - May 2011

Fingerprint

Intensive care units
trauma
incidence
Incidence
Wounds and Injuries
Regression analysis
Taiwan
regression analysis
Tissue
human being
Hospital Emergency Service
Multiple Trauma
Intensive Care Units
Neck
Thorax
Abbreviated Injury Scale
Soft Tissue Injuries
Body Regions
Thoracic Injuries
Hospital Records

Keywords

  • Delayed diagnosis
  • Emergency department
  • Injury severity
  • Taiwan
  • Trauma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Safety, Risk, Reliability and Quality
  • Human Factors and Ergonomics
  • Law
  • Medicine(all)

Cite this

Incidence rate and risk factors of missed injuries in major trauma patients. / Chen, Chao Wen; Chu, Chi Ming; Yu, Wen Yu; Lou, Yun Ting; Lin, Mau Roung.

In: Accident Analysis and Prevention, Vol. 43, No. 3, 05.2011, p. 823-828.

Research output: Contribution to journalArticle

Chen, Chao Wen ; Chu, Chi Ming ; Yu, Wen Yu ; Lou, Yun Ting ; Lin, Mau Roung. / Incidence rate and risk factors of missed injuries in major trauma patients. In: Accident Analysis and Prevention. 2011 ; Vol. 43, No. 3. pp. 823-828.
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