Background and Consequences of Injuries Missed when Diagnosing Severely Injured Accident Victims in Prehospital Care in Patients Transported by Ambulance to the University Medical Centre in Utrecht, 1999-2000
From: Stichting Regionale Ambulance Voorziening Utrecht, Bilthoven. r.lichtveld@ravu.nl
Nederlands tijdschrift voor geneeskunde
- Publish Date: Oct 2006
- ISSN: 0028-2162
- Volume: 150
- Issue: 40
- Pages: 2197-202
- Medium: Print
- Language:
- Citation (JAMA): Lichtveld R A, Spijkers A T E, Panhuizen I F, et al. Background and Consequences of Injuries Missed when Diagnosing Severely Injured Accident Victims in Prehospital Care in Patients Transported by Ambulance to the University Medical Centre in Utrecht, 1999-2000. Oct 2006;150:2197-202
Abstract
OBJECTIVE: To determine the background and consequences of failing to diagnose injuries in prehospital care. DESIGN: Prospective cohort study. METHOD: Data were collected from 507 trauma patients with multiple injuries, and a Hospital trauma index-injury severity score of 16 or higher, who were delivered by the emergency ambulance service to the emergency department of the University Medical Centre Utrecht, the Netherlands, in 1999-2000. RESULTS: The percentage of missed injuries varied from 9-55. For every additional year of age the risk of missing thoracic injuries was 2% higher. The risk of missing head injuries was 84% lower in people with a Triage revised trauma score (T-RTS) < 11. Initially missing an injury had no consequences for duration of stay in the ICU except in those patients with injuries to the lower extremities. A difference in quality of life was only reported for patients in whom injuries ofthe ribs, shoulder or clavicle had been missed. For every year of age, there was a 2% greater risk of dying within 1.5 years. A T-RTS < 11 resulted in a 5.6-fold greater risk of death. Failing to diagnose an injury did not in itself increase the risk of death. CONCLUSION: Frequently missing an injury prior to hospitalization did not result in a poorer chance of survival or lesser quality of life. The risk of dying was mainly related to a higher age and a poorer general condition at the scene of the accident. According to these findings there is no reason to adapt the current policy with regard to initial care and transport of trauma patients.
Mesh Headings (Keywords): Ambulances, Cohort Studies, Diagnostic Errors, Emergency Service, Hospital, First Aid, Humans, Netherlands, Patient Care Team, Prospective Studies, Quality of Health Care, Quality of Life, Risk Factors, Trauma Centers, Trauma Severity Indices, Triage, Wounds and Injuries
Check for Full Text / PubMed Unique Identifier (PMID): 17061432
This abstract is part of PubMed, a service of the U.S. National Library of Medicine. PubMed includes more than 17 million citations from MEDLINE and other life science journals for biomedical articles. See Copyright and Disclaimers.
Linked medical terms appearing on this page are added by Healia to help readers find more information and are not part of the original PubMed document.
The data herein was last updated on July 8th, 2008 and may not reflect the most current and accurate data available from NLM.