Articles: mortality.
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J. Korean Med. Sci. · Oct 2024
Nationwide Evaluation of the Validity of the Trauma and Injury Severity Score Method in Korean Regional Trauma Centers Using Multi-Institutional Large-Scale Data.
The Trauma and Injury Severity Score (TRISS) method is a widely used tool for assessing patient severity and predicting survival probability in trauma care. However, its accuracy and applicability in the Korean context, particularly for neurotrauma patients, have not been thoroughly validated yet. Previous studies at a single institution have identified significant discrepancies between TRISS predictions and actual outcomes, particularly in severe neurotrauma cases. This study aimed to evaluate the accuracy of the TRISS method on a national scale using data from multiple regional trauma centers (RTCs) in Korea. ⋯ Our study confirms that the TRISS method's misclassification issues observed at a single institution are prevalent across multiple RTCs in Korea. The accuracy of the TRISS method decreases with increasing injury severity, particularly in neurotrauma patients. These findings highlight the need to revise evaluation criteria and develop more accurate prediction models tailored to the Korean trauma care system. Implementing these changes will enhance the reliability of trauma care assessments and ensure more equitable support for RTCs, ultimately improving the quality and equity of trauma care in Korea.
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J. Korean Med. Sci. · Oct 2024
Association of Preoperative Opioid and Glucocorticoid Use With Mortality and Complication After Total Knee or Hip Arthroplasty.
The association between preoperative opioid or glucocorticoid (GC) use and clinical outcomes, such as postoperative mortality after total joint arthroplasty (TJA), is unclear. ⋯ Preoperative GC use and concomitant use of opioid analgesics with GC were associated with increased postoperative mortality and morbidity after TJA. However, preoperative chronic opioid analgesic use alone did not affect postoperative mortality or morbidity.
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Acute kidney injury (AKI) is a common complication during hospitalization and is associated with adverse outcomes. ⋯ Among patients hospitalized with AKI, recommendations from a kidney action team did not significantly reduce the composite outcome of worsening AKI stage, dialysis, or mortality, despite a higher rate of recommendation implementation in the intervention group than in the usual care group.
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High-dose haemodiafiltration has been shown, in a randomised clinical trial, to result in a 23% lower risk of mortality for patients with kidney failure when compared with conventional high-flux haemodialysis. Nevertheless, whether treatment effects differ across subgroups, whether a dose-response relationship with convection volume exists, and the effects on cause-specific mortality remain unclear. The aim of this individual patient data meta-analysis was to compare the effects of haemodiafiltration and standard haemodialysis on all-cause and cause-specific mortality. ⋯ European Commission Research and Innovation, Horizon 2020.
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Pre-pandemic data suggests that methamphetamine-related mortality and opioid co-involvement have been increasing in the United States (US). However, there was a staggering number of US drug overdose deaths in 2020 and 2021, particularly among males. An updated examination of sex-specific trends in methamphetamine-related mortality, the extent to which these deaths may be driven by the heroin and fentanyl co-involvement, and whether this co-involvement might explain the disproportionate number of male methamphetamine deaths is warranted. ⋯ Increasing methamphetamine-related mortality among males and females has been accompanied by a dramatic increase in the proportion of heroin and/or synthetic opioid co-involvement among both sexes. Robust harm reduction efforts are needed to mitigate these increases, particularly for people who co-use stimulants and opioids.