Evaluating mechanism and severity of injuries among trauma patients admitted to Sina Hospital, the National Trauma Registry of Iran.

PURPOSE: Injuries are one of the leading causes of death and lead to a high social and financial burden. Injury patterns can vary significantly among different age groups and body regions. This study aimed to evaluate the relationship between mechanism of injury, patient comorbidities and severity of injuries. METHODS: The study included trauma patients from July 2016 to June 2018, who were admitted to Sina Hospital, Tehran, Iran. The inclusion criteria were all injured patients who had at least one of the following: hospital length of stay more than 24 h, death in hospital, and transfer from the intensive care unit of another hospital. Data collection was performed using the National Trauma Registry of Iran minimum dataset. RESULTS: The most common injury mechanism was road traffic injuries (49.0%), followed by falls (25.5%). The mean age of those who fell was significantly higher in comparison with other mechanisms (p < 0.001). Severe extremity injuries occurred more often in the fall group than in the vehicle collision group (69.0% vs. 43.5%, p < 0.001). Moreover, cases of severe multiple trauma were higher amongst vehicle collisions than injuries caused by falls (27.8% vs. 12.9%, p = 0.003). CONCLUSION: Comparing falls with motor vehicle collisions, patients who fell were older and sustained more extremity injuries. Patients injured by motor vehicle collision were more likely to have sustained multiple trauma than those presenting with falls. Recognition of the relationship between mechanisms and consequences of injuries may lead to more effective interventions.

The Impact of Psychological First aid Training on the Providers: A Systematic Review.

OBJECTIVE: The consensus is that psychological first aid is a practical, early psychosocial intervention to mitigate the distress caused by disasters. This review aimed to investigate PFA training's efficacy in the existing studies and evaluate these programs' impact on trainees. METHODS: MEDLINE (National Library of Medicine, Bethesda, MD), EMBASE (Elsevier, Amsterdam, Netherlands), PsycInfo (American Psychological Association, Washington, DC), and Cochrane Library (John Wiley & Sons, Hobken, NJ, USA) were searched on August 1, 2020 without language and date limitation. The Cochrane Risk of Bias tool for randomized controlled trials and the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) (Cochrane, London, UK) were used to assess the quality of the studies included. SPSS (IBM Corp., Endicott, NY, USA) was used for descriptive, comparative, and correlational summaries. RESULTS: From 376 articles, only 9 studies met the criteria and were included after screening. The most common outcome was knowledge improvement, followed by increased confidence, and competence. Other outcomes encompassed Attitude, preparedness, and therapeutic engagement. CONCLUSION: PFA is the most suggested early intervention aftermath and could be acquired by professionals and non-professionals in the mental health area. Nonetheless, to obtain the desired outcome, PFA training programs' quality is vital. This review revealed that most training programs' duration was short, without scenario-based interactions and post-training supervisions. More controlled trials are required to measure the effectiveness of PFA training on the providers.

How Can Policymakers be Encouraged to Support People With Spinal Cord Injury-Scoping Review.

STUDY DESIGN: Scoping review. OBJECTIVE: Regarding that inappropriate medical care approaches, absence of rehabilitation services, and existing barriers in physical, social, and policy environments lead to poor outcomes in individuals with spinal cord injury (SCI) and provision for appropriate interventions and care must be created by health policymakers, we conducted this scoping review to investigate how policymakers can be persuaded to set new plans for individuals with SCI. METHODS: This review was performed according to Arksey and O'Malley's framework. PubMed was searched in February2019 without language limitation. We looked for other potential gray literature sources and some professional websites. References sections of selected articles were also scanned for other relevant literature. RESULTS: We included literature that met inclusion criteria to answer our research question. The literature was divided into 3 categories. The first category included economic impact of SCI. The second category included the role of research and developing research strategy. The third category included effective interaction and communication with policymakers. CONCLUSION: It is essential to consider multiple factors for influencing policymakers' decisions. These factors include knowing how to communicate with policymakers and presenting constructive ideas, providing a source of valid, reliable, and consistent data, considering the role of patients' advocacy groups and Non-Governmental Organizations (NGOs), and presentation of the importance of early intervention in reducing healthcare system costs. Ultimately, the goal is to have a comprehensive and flexible plan for influencing policymakers.

National Trauma Registry of Iran: A Pilot Phase at a Major Trauma Center in Tehran.

BACKGROUND: The main objective was to describe the results of the pilot phase of the national trauma registry of Iran (NTRI) at a referral university trauma center in Tehran. METHODS: The study was performed at Sina Hospital in Tehran, Iran from August 1 to September 30, 2016. Patients who had the NTRI criteria were included. 109 data variables were analyzed including demographics, medical care information, injury characteristics, and outcomes. RESULTS: Over 2 months, 171 patients, predominantly males (87.1%) with an average age of 37.2 (±19.5) years were registered. The most common mechanism of injury was road traffic crash (RTC) (53.2%), followed by fall (21.1%) and penetrating injuries (18.7%). RTC represented a remarkable proportion of the injuries with higher injury severity score (ISS) (P = 0.046). The mean hospital length of stay (LOS) was 9.8 (±12.2) days. There were significant relationships between Glasgow Coma Scale (GCS) (P = 0.03), drug abuse (P = 0.05), and ISS (P = 0.008) as independent variables and LOS. 21.6% of the patients were admitted to ICU, with a larger proportion of fall injuries (44.4%) (P = 0.002). Eight patients (4.7%) died during hospitalization, of which 7 cases were male. There was significant association between increasing age and ISS with death outcome. CONCLUSION: After successful implementation of NTRI at a major trauma center in Tehran, RTC was identified as the main cause of admission. Most patients were young men. The mean time interval between injury occurrence and hospital admission was too long. These findings could be used to improve quality of trauma care and formulate targeted preventive strategies.