Reviewing blunt abdominal injuries in the National Trauma Registry of Iran

To the Editor-in-ChiefWe read with interest Chardouli et al.’s paper entitled “A review on using ultrasound for evaluation of pediatric blunt abdominal trauma” and enjoyed it a lot. Now, we intend to add some of the results of our registry to their invaluable article.The National Trauma Registry of Iran was launched in 2016 at Sina Trauma and Surgery Research Center, and 24 different hospitals from various provinces collaborated in this project. Happily, more than 32,000 patients have been included so far, 4603 of which belong to Sina Hospital. Furthermore, ample evidence shows that blunt abdominal injury is one of the most common presentations in the emergency rooms. Hence, we analyzed our data to find the severity of blunt abdominal injuries compared to other injuries. Among 4603 patients, 208 people had blunt trauma, and 17 were in the abdominal region. The mean injury severity score (ISS) of patients with blunt abdominal injuries was 1.5 (standard deviation (SD)=1.1). Also, the mean ISS of patients with abdominal injuries with other mechanisms (other than blunt traumas) was 3.3 (SD=2.5). The difference was statistically significant (P=0.005). Moreover, the median of ISS among patients with blunt abdominal injuries was 1.0 (interquartile range (IQR)=0.0). Also, the median of ISS among patients with abdominal injuries with other mechanisms was 4.0 (IQR=3.0).All in all, our results show that if injuries are classified into two body regions of abdominal and others, and two mechanisms of blunt and others, blunt abdominal injuries can be less severe than injuries caused by other mechanisms and in other body regions

Social impact of the Iraq-Iran war as experienced by Iranian surgeons

Surgeons played a vital role in the Iraq-Iran War by healing injured soldiers and reducing the rate of death. The purpose of this study was to describe their lived experiences and social impact during the war. This qualitative study was conducted from May 2018-June 2019 and surgeons who participated in the Iraq-Iran War were invited. Semi-structured in-depth interviews were used to collect the data from 28 participants. Four main themes emerged from the data:  1- Military role was important in providing essential facilities and safe zones for personnel and soldiers at the warfront. 2- It was critical to reinforce the infrastructure for immediate medical assistance. 3- Disaster training for medical personnel was vital for triage, treatment, education and research planning. 4- Spiritual and religious beliefs. Disaster planning and training for physicians by drills is essential to meet the challenges of unexpected events and operative readiness requires drill training on a quarterly or semi-annual basis

Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic:Challenges and lessons learned

Purpose: The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients. Methods: An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into 3 groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage. Results: Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% – 100%, 22% – 100% and 29% – 100% for groups 1 – 3. Conclusions: To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.</p

Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic:Challenges and lessons learned

PURPOSE: The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.METHODS: An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into three groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage.RESULTS: Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% to 100%, 22%-100% and 29%-100% for groups 1 - 3.CONCLUSIONS: To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.</p

The association between the outcomes of trauma, education and some socio-economic indicators

Background: There are many debates on socioeconomic indicators influencing trauma outcomes.Objectives: This study aimed to determine the association between education as a socioeconomic indicator and trauma outcomes.Methods: This descriptive-analytical study was conducted on 30,448 trauma patients during 2016-2021. The data were based on the minimum dataset of the National Trauma Registry of Iran (NTRI) from six different trauma centers in various cities of the country. The variables used in this study included age, education level, marital status, cause of injury, Glasgow Coma Scale (GCS), intensive care unit (ICU) admission, Injury Severity Score (ISS), and in-hospital mortality. Logistic regression was used to investigate the association between independent variables and trauma outcomes.Results: The study included 30,448 trauma patients with male predominance (75.8%). The mean age was 36.9 years. The most frequent education level was secondary education, with 14,228 (46.6%). Education levels had significant relationships with ISS, death, and ICU admission (P<0.001). Moreover, after applying the multiple logistic regression, the odds of deaths for trauma patients with no formal, primary, and secondary education levels were 3.36, 5.03, and 3.65 times, respectively, more than the odds of deaths at the higher education level after controlling for other factors (all Ps<0.05). However, there were no such relationships between education levels and the odds of ICU admission.Conclusion: Findings of the present study showed a significant association between the education levels and trauma outcomes. Adjusted for other covariates, the chance of death for trauma patients with no formal, primary, or secondary education levels was higher than that at the higher education level

Correction: The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis.

[This corrects the article DOI: 10.1371/journal.pone.0158031.]

The prevalence of asymptomatic bacteriuria in iranian pregnant women: A systematic review and meta- Analysis

Background Asymptomatic bacteriuria (ASB) is defined as the presence of bacteria in urine without having signs and symptoms. The aim of this meta- Analysis was to estimate the overall prevalence of asymptomatic bacteriuria among Iranian pregnant women. Methods Major national and international databases were searched up to November 2015, including Scientific Information Database, MagIran, Web of Science, Medline, Scopus, Science Direct and Ovid. The checklist of the STROBE statement was used for evaluating the quality of reporting. The extracted data were analyzed and the results were reported using a random- effects model with 95% confidence interval (CI). Results From 3709 obtained studies, 20 included in the meta- Analysis, which involved 15108 pregnant women. The overall prevalence of ASB was 0.13 (95% CI: 0.09, 0.17). The prevalence of ASB in the northern and southern regions of Iran was 0.13 (95% CI: 0.09, 0.18) and 0.11 (95% CI: 0.05, 0.16), respectively. Conclusion Prevalence of ASB among Iranian pregnant women is considerable. Due to the complications of ASB for pregnant women and their children, preventative planning and control of ASB among pregnant women in Iran is necessary. © 2016 Ghafari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Characteristic of included studies in meta-analysis.

<p>Characteristic of included studies in meta-analysis.</p