+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Predictors of missed injuries in hospitalized trauma patients in the emergency department

Predictors of missed injuries in hospitalized trauma patients in the emergency department

European Journal of Trauma and Emergency Surgery 36(6): 559-566

To determine the extent of missed injuries in patients hospitalized with major trauma in a Turkish Level 1 emergency department. We also tried to identify the primary factors contributing to each missed injury and to determine their subsequent adverse short-term clinical outcomes. This is a retrospective analysis of prospectively collected data on a cohort of trauma patients. Trauma patients were divided into two groups: patients with missed injury and others. Logistic regression was used to define factors affecting "missed injury". A total of 670 hospitalized trauma patients were included. The incidence of missed injuries in the patients and the rate of missed injury per patient were 13.3% (95% CI 6-20) and 1.64, respectively. The most frequently missed diagnosis was injuries of the musculoskeletal system (38%; 95% CI 30-46). It was "clavicle fracture and/or dislocation" (35%; 95% CI 16-53) when the rate of missed diagnosis according to the frequency of the specific injury was calculated. A multiple logistic regression analysis showed that the predictors of missed injuries were patient's age (OR 0.74, 95% CI 0.63-0.87), total number of injuries (OR 1.74, 95% CI 1.38-2.20), and ISS (OR 1.10, 95% CI 1.03-1.18). Radiological errors were prominent in almost 90% (95% CI 85-95). Missed injury caused additional hospital stay (30%; 95% CI 21-40) and additional surgery was required (15%; 95% CI 8-23). The study highlights the need for a trauma team approach and the need for support of radiological report in the ED.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 058599726

Download citation: RISBibTeXText

PMID: 26816311

DOI: 10.1007/s00068-010-0018-9

Related references

Missed injuries upon admission of severely injured trauma patients to the emergency department. Nederlands Tijdschrift Voor Geneeskunde 143(40): 2028-2029, 1999

Predictors of survival after emergency department thoracotomy in trauma patients with predominant thoracic injuries in Southern Israel: a retrospective survey. Open Access Emergency Medicine 11: 95, 2019

Incidence and predictors of missed injuries in trauma patients in the initial hot report of whole-body CT scan. Injury 43(1): 73-77, 2012

Missed trauma in the emergency department. Journal of Emergency Nursing: Jen 10(4): 228-229, 1984

Predictors of Delayed Emergency Department Throughput Among Blunt Trauma Patients. Journal of Surgical Research 245: 81-88, 2020

Evaluation of urogenital injuries in patients with trauma in the emergency department. Ulusal Travma Ve Acil Cerrahi Dergisi 18(2): 133-140, 2012

The diagnostic accuracy emergency department laboratory utility and morbidity of missed diagnoses in emergency department patients admitted with abdominal pain. Annals of Emergency Medicine 17(10): 1120-1121, 1988

Predictors of Long-Term Mortality in Oldest Old Patients (90+) Hospitalized to Medical Wards via the Emergency Department: The SAFES Cohort. Journal of Nutrition Health and Aging 19(6): 702-707, 2015

Commonly missed injuries in the accident and emergency department. Trauma 6(1): 41-51, 2004

Early immunologic responses to trauma in the emergency department patients with major injuries. Resuscitation 80(1): 83-88, 2009

Extremity injuries as predictors of emergency care resource needs among blunt trauma patients in Japan. American Surgeon 80(2): 197-203, 2014

What are the predictors of scapula fractures in high-impact blunt trauma patients and why do we miss them in the emergency department?. European Journal of Trauma and Emergency Surgery 38(2): 157-162, 2012

Epidemiological Study of Patients of Road Traffic Injuries Attending Emergency Department of a Trauma Center in New Delhi. Indian Journal of Critical Care Medicine 21(10): 678-683, 2017

Predictors of Intrathoracic Injury after Blunt Torso Trauma in Children Presenting to an Emergency Department as Trauma Activations. Journal of Emergency Medicine 52(6): 793-800, 2017

Predictors for survival of penetrating trauma using emergency department thoracotomy in an urban trauma center: the Cardiac Instability Score. Journal of the National Medical Association 102(2): 126-130, 2010