Objective： Among the injury types, sports ones constitute a considerable proportion of patients who refer to the medical centers. This research was conducted to examine the frequency of sports- related injuries refer...Objective： Among the injury types, sports ones constitute a considerable proportion of patients who refer to the medical centers. This research was conducted to examine the frequency of sports- related injuries referring to Kashan University of Medical Sciences Trauma Research Center from 2005 to 2011. Methods： This was a retrospective research in which existing data from the data bank of Kashan University of Medical Sciences Trauma Research Center were employed. The data were extracted from the main source by SPSS version 16.0. Variables such as age, education, occupation and gender were analyzed. Results： The highest proportion of injuries was observed in students （59.4%） followed by workers （11.8%）. Upper and lower extremities were most commonly injured. The most frequent injury was strain （35.4%）, followed by sprain （27.7%）. Conclusion： The results of this research showed that the majority of the sports trauma occurrs in students; therefore, they need more attention in regard to sports injuries. Preventive measures such as informing the coaches and teachers as well as increasing the students＇ awareness about the injury risk can decrease the incidences of sports injuries.展开更多
Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post...Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post trauma. Materials and Methods: This is a longitudinal study in which 257 patients having inclusion criteria were enrolled. Neuropsychological tasks including logical memory, verbal paired associates, visual memory, verbal expression, auditory comprehension, semantic judgment and semantic categories were implemented. The appearance of psychiatric disorder, Agnosia, Apraxia, Dysarthria and pragmatic linguistic disorder post trauma were evaluated at discharge. QOL was studied 6 months after injury by filling SF-36 questionnaire via phone interview with patients. Results: Appearance of some post-traumatic disorders including agnosia, pragmatic linguistic disorder and psychiatric disorder were significantly correlated to poor QOL. The final step of logistic regression model showed that TBI severity, verbal memory, auditory comprehension and semantic acceptability scores were predictors of unfavorable mental QOL as well as TBI severity, injury severity scale (ISS) score and multifocal lesions for unfavorable physical QOL. Discussion: Thus, it is recommended that clinicians choose medical therapeutic priorities to improve the verbal neuropsychological sequela and provide preliminaries for a chronic favorable mental QOL. Furthermore, to prevent of chronic unfavorable physical QOL, early care of organic injuries should be considered especially in patients with severe and multifocal TBI.展开更多
BACKGROUND Osteoarthritis(OA)involves low-grade inflammation.The neutrophil-to-lym-phocyte ratio(NLR)may serve as a simple biomarker,but its role in OA remains unclear.AIM To review the existing scientific literature ...BACKGROUND Osteoarthritis(OA)involves low-grade inflammation.The neutrophil-to-lym-phocyte ratio(NLR)may serve as a simple biomarker,but its role in OA remains unclear.AIM To review the existing scientific literature on the role of NLR in OA,a classic age-related disorder,to perform a meta-analysis of the available data.METHODS The electronic databases PubMed,ProQuest,and Scopus were systematically searched from inception to March 1,2024.The inclusion criteria were retro-spective and prospective case-control studies involving human subjects with OA and healthy controls.The included studies needed to provide NLR levels for both OA patients and healthy controls and perform a comparative analysis of NLR levels between these groups.RESULTS According to the PRISMA guidelines,fifteen articles were included in the meta-analysis after multiple screenings.The pooled results demonstrated a significant overall elevation of NLR in OA patients compared to healthy controls.(standardized mean difference=0.39,95%confidence interval:0.03-0.75,P=0.03).However,the subgroup analysis shows no significant differences in NLR levels when considering study design(retrospective vs prospective)and OA severity(severe vs mild-moderate).This suggests variability and potential limitations in using NLR as a consistent marker across different study types and OA severity.CONCLUSION Our study found that OA patients have higher NLR than healthy individuals.However,NLR did not significantly differ by study type or disease severity,suggesting its limited use in indicating OA severity.展开更多
Objective:To determine the causes of COVID-19 deaths at home.Methods:This descriptive cross-sectional study was conducted on confirmed COVID-19 deaths,which were confirmed to occur at home using the“Electronic Death ...Objective:To determine the causes of COVID-19 deaths at home.Methods:This descriptive cross-sectional study was conducted on confirmed COVID-19 deaths,which were confirmed to occur at home using the“Electronic Death Registration System(EDRS)”database,from February 20,2020,to September 23,2021,in the Fars province,south of Iran.A semi-structured,face-to-face survey consisting of 29 items was filled by the family caregivers,and the information was confirmed based on medical records.Results:One hundred and ninety-three deaths were included,with 60.1%male and 39.9%female.More than 75%of cases had at least one comorbid condition.Death was unexpected for 65.8%of the families and 45.1%of the deceased cases had been medically managed at home during the disease.According to the family caregivers’opinion,the most frequent causes of death at home in their COVID-19 patients were early discharge/release from the hospital(28.5%),physician's reassurance to continue home quarantine/supportive care(14.5%),hopeless/oldest-old patient(11.9%),and family/relative recommendation to not to hospitalize their patient due to fears,myths,etc.(8.8%).Conclusions:In family caregivers’belief,deaths at home might be related to healthcare system preparedness,physicians’knowledge,and public education and empowerment.展开更多
Purpose: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patien...Purpose: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran.Methods: This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each co- variate on trauma hospitalization (≥3 days as longer stay).Results: This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical inter- vention and infection in a patient had the greatest impact on prolonged LOS.Conclusion: This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors.展开更多
Purpose:Trauma is well known as one of the main causes of death and disability throughout the world.Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patie...Purpose:Trauma is well known as one of the main causes of death and disability throughout the world.Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patient outcomes,as well as reducing mortality rates.Methods:In this retrospective cohort study,systematic randomization was used to select 849 patients referred to the main trauma center of south of Iran during a period of six months(February 2017-July 2017);the patients case files were evaluated in terms of demographic information,pre-and post-accident conditions,clinical conditions at the time of admission and finally,accident outcomes.A logistic regression model was used to analyze the role of factors affecting mortality among subjects.Results:Among subjects,60.4%were in the age-group of 15-39 years.There was a 10.4%mortality rate among patients and motor-vehicle accide nts were the most comm on mecha nism of injury(66.7%).Aging led to in creased risk of fatality in this study.For each urHt increase in Glasgow coma scale(GCS),risk of death decreased by about 40%(odds ratio(OR)=0.63,95%confidence interval(CI):0.59—0.67).For each unit increase in injury severe score(ISS),risk of death increased by 10%(OR=1.11%,95%Cl:1.08-1.14)and for each unit in crease in trauma revised injury severity score(TRISS),there was 18%decrease in the risk of fatality(OR=0.82,95%CI:0.71-0.88).Conclusion:The most common cause of trauma and the most common cause of death from trauma was traffic accidents.It was also found that an increase in the ISS index increases the risk of death in trauma patients,but the increase in GCS,revised trauma score(RTS)and TRISS indices reduces the risk of death in trauma patients.The TRISS indicator is better predictor of traumatic death than other indicators.展开更多
Purpose： Trauma-related injuries are the leading cause of death worldwide. Some risk factors make trau- matic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hos- pita...Purpose： Trauma-related injuries are the leading cause of death worldwide. Some risk factors make trau- matic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hos- pitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran. Methods： This prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran. Centers for Disease Control and Prevention/National Healthcare Safety Network surveil- lance system criteria were applied to define 5 types of nosocomial infections. The variables analyzed as the risk factors of infection and mortality included sex, age, mechanism of injury, site of injury, injury severity score （ISS）, surgical intervention, length of hospitalization, intensive care unit （ICU） admission, and type of pathogen. Then, the incidence of nosocomial infection and also risk factors of mortality in traumatic patients were evaluated. All data analyses were performed using the statistical package for social sciences, version 15 （SPSS Inc., Chicago） and p 〈 0.05 is considered to be statistically significant. Results： The incidence of nosocomial infection was 7.2% （p 〈 0.001）. Pneumonia was the most common type of infection detected in our study. Infection led to a 7.8-fold increase in mortality of the traumatic patients （p 〈 O.001 ）. Admission in intensive care units and old age were the main risk factors of mortality in infected traumatic patients. Old age, gunshot and motor vehicle accidents, trauma to extremities and abdomen, higher injury severity score, and prolonged hospitalization, made the traumatic patients more susceptible to infection.展开更多
文摘Objective： Among the injury types, sports ones constitute a considerable proportion of patients who refer to the medical centers. This research was conducted to examine the frequency of sports- related injuries referring to Kashan University of Medical Sciences Trauma Research Center from 2005 to 2011. Methods： This was a retrospective research in which existing data from the data bank of Kashan University of Medical Sciences Trauma Research Center were employed. The data were extracted from the main source by SPSS version 16.0. Variables such as age, education, occupation and gender were analyzed. Results： The highest proportion of injuries was observed in students （59.4%） followed by workers （11.8%）. Upper and lower extremities were most commonly injured. The most frequent injury was strain （35.4%）, followed by sprain （27.7%）. Conclusion： The results of this research showed that the majority of the sports trauma occurrs in students; therefore, they need more attention in regard to sports injuries. Preventive measures such as informing the coaches and teachers as well as increasing the students＇ awareness about the injury risk can decrease the incidences of sports injuries.
文摘Objective and Background: This study aimed at determining the predictors of chronic physical and mental quality of life (QOL) in patients with traumatic brain injury (TBI) focusing on neuropsychological functions post trauma. Materials and Methods: This is a longitudinal study in which 257 patients having inclusion criteria were enrolled. Neuropsychological tasks including logical memory, verbal paired associates, visual memory, verbal expression, auditory comprehension, semantic judgment and semantic categories were implemented. The appearance of psychiatric disorder, Agnosia, Apraxia, Dysarthria and pragmatic linguistic disorder post trauma were evaluated at discharge. QOL was studied 6 months after injury by filling SF-36 questionnaire via phone interview with patients. Results: Appearance of some post-traumatic disorders including agnosia, pragmatic linguistic disorder and psychiatric disorder were significantly correlated to poor QOL. The final step of logistic regression model showed that TBI severity, verbal memory, auditory comprehension and semantic acceptability scores were predictors of unfavorable mental QOL as well as TBI severity, injury severity scale (ISS) score and multifocal lesions for unfavorable physical QOL. Discussion: Thus, it is recommended that clinicians choose medical therapeutic priorities to improve the verbal neuropsychological sequela and provide preliminaries for a chronic favorable mental QOL. Furthermore, to prevent of chronic unfavorable physical QOL, early care of organic injuries should be considered especially in patients with severe and multifocal TBI.
文摘BACKGROUND Osteoarthritis(OA)involves low-grade inflammation.The neutrophil-to-lym-phocyte ratio(NLR)may serve as a simple biomarker,but its role in OA remains unclear.AIM To review the existing scientific literature on the role of NLR in OA,a classic age-related disorder,to perform a meta-analysis of the available data.METHODS The electronic databases PubMed,ProQuest,and Scopus were systematically searched from inception to March 1,2024.The inclusion criteria were retro-spective and prospective case-control studies involving human subjects with OA and healthy controls.The included studies needed to provide NLR levels for both OA patients and healthy controls and perform a comparative analysis of NLR levels between these groups.RESULTS According to the PRISMA guidelines,fifteen articles were included in the meta-analysis after multiple screenings.The pooled results demonstrated a significant overall elevation of NLR in OA patients compared to healthy controls.(standardized mean difference=0.39,95%confidence interval:0.03-0.75,P=0.03).However,the subgroup analysis shows no significant differences in NLR levels when considering study design(retrospective vs prospective)and OA severity(severe vs mild-moderate).This suggests variability and potential limitations in using NLR as a consistent marker across different study types and OA severity.CONCLUSION Our study found that OA patients have higher NLR than healthy individuals.However,NLR did not significantly differ by study type or disease severity,suggesting its limited use in indicating OA severity.
文摘Objective:To determine the causes of COVID-19 deaths at home.Methods:This descriptive cross-sectional study was conducted on confirmed COVID-19 deaths,which were confirmed to occur at home using the“Electronic Death Registration System(EDRS)”database,from February 20,2020,to September 23,2021,in the Fars province,south of Iran.A semi-structured,face-to-face survey consisting of 29 items was filled by the family caregivers,and the information was confirmed based on medical records.Results:One hundred and ninety-three deaths were included,with 60.1%male and 39.9%female.More than 75%of cases had at least one comorbid condition.Death was unexpected for 65.8%of the families and 45.1%of the deceased cases had been medically managed at home during the disease.According to the family caregivers’opinion,the most frequent causes of death at home in their COVID-19 patients were early discharge/release from the hospital(28.5%),physician's reassurance to continue home quarantine/supportive care(14.5%),hopeless/oldest-old patient(11.9%),and family/relative recommendation to not to hospitalize their patient due to fears,myths,etc.(8.8%).Conclusions:In family caregivers’belief,deaths at home might be related to healthcare system preparedness,physicians’knowledge,and public education and empowerment.
基金This research was supported with grant number of 1396-01-38-16261 by Shiraz University of Medical Sciences in Shiraz,Iran.
文摘Purpose: Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran.Methods: This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each co- variate on trauma hospitalization (≥3 days as longer stay).Results: This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical inter- vention and infection in a patient had the greatest impact on prolonged LOS.Conclusion: This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors.
基金This research has been supported with grant number of 98-01-38-19738 by Shiraz University of Medical Sciences in Shiraz,Iran.
文摘Purpose:Trauma is well known as one of the main causes of death and disability throughout the world.Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patient outcomes,as well as reducing mortality rates.Methods:In this retrospective cohort study,systematic randomization was used to select 849 patients referred to the main trauma center of south of Iran during a period of six months(February 2017-July 2017);the patients case files were evaluated in terms of demographic information,pre-and post-accident conditions,clinical conditions at the time of admission and finally,accident outcomes.A logistic regression model was used to analyze the role of factors affecting mortality among subjects.Results:Among subjects,60.4%were in the age-group of 15-39 years.There was a 10.4%mortality rate among patients and motor-vehicle accide nts were the most comm on mecha nism of injury(66.7%).Aging led to in creased risk of fatality in this study.For each urHt increase in Glasgow coma scale(GCS),risk of death decreased by about 40%(odds ratio(OR)=0.63,95%confidence interval(CI):0.59—0.67).For each unit increase in injury severe score(ISS),risk of death increased by 10%(OR=1.11%,95%Cl:1.08-1.14)and for each unit in crease in trauma revised injury severity score(TRISS),there was 18%decrease in the risk of fatality(OR=0.82,95%CI:0.71-0.88).Conclusion:The most common cause of trauma and the most common cause of death from trauma was traffic accidents.It was also found that an increase in the ISS index increases the risk of death in trauma patients,but the increase in GCS,revised trauma score(RTS)and TRISS indices reduces the risk of death in trauma patients.The TRISS indicator is better predictor of traumatic death than other indicators.
文摘Purpose： Trauma-related injuries are the leading cause of death worldwide. Some risk factors make trau- matic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hos- pitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran. Methods： This prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran. Centers for Disease Control and Prevention/National Healthcare Safety Network surveil- lance system criteria were applied to define 5 types of nosocomial infections. The variables analyzed as the risk factors of infection and mortality included sex, age, mechanism of injury, site of injury, injury severity score （ISS）, surgical intervention, length of hospitalization, intensive care unit （ICU） admission, and type of pathogen. Then, the incidence of nosocomial infection and also risk factors of mortality in traumatic patients were evaluated. All data analyses were performed using the statistical package for social sciences, version 15 （SPSS Inc., Chicago） and p 〈 0.05 is considered to be statistically significant. Results： The incidence of nosocomial infection was 7.2% （p 〈 0.001）. Pneumonia was the most common type of infection detected in our study. Infection led to a 7.8-fold increase in mortality of the traumatic patients （p 〈 O.001 ）. Admission in intensive care units and old age were the main risk factors of mortality in infected traumatic patients. Old age, gunshot and motor vehicle accidents, trauma to extremities and abdomen, higher injury severity score, and prolonged hospitalization, made the traumatic patients more susceptible to infection.
