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K J Ponsen

Publications and source records attributed to K J Ponsen.

6 recordsLinked to original sources
PubMed2007

Effect of surgical delay on outcome in hip fracture patients: a retrospective multivariate analysis of 192 patients.

Previous studies have not demonstrated consistent results on the effect of surgical delay on outcome. This study investigated the association between the delay to surgery and the development of postoperative complications, length of hospital stay (LOS) and one-year mortality. Patients that underwent surgery for a hip fracture in a two-year period were included in a retrospective study. Uni- and multivariate regression analysis was performed in 192 hip fracture patients. There was a trend towards fewer postoperative complications (P = 0.064; multivariate regression, MR) and shorter LOS (P = 0.088; MR) in patients with a delay of less than one day to surgery. No association between surgical delay and one-year mortality was found in the population as a whole (P = 0.632; univariate regression, UR). Delay to surgery beyond one day was associated with an increased risk of infectious complications (P = 0.004; MR). In ASA I and II class patients, operation beyond one day from admission was associated with an increased risk of one-year mortality (P = 0.03; MR) and more postoperative infectious complications (P = 0.02; MR). The trends towards fewer complications and shorter LOS suggest that early surgery (within one day from admission) is beneficial for hip fracture patients who are able to undergo an operation.

Aged↗
PubMed2005

In-hospital downgrading of the trauma team: Validation of the Academic Medical Center downgrading criteria.

BACKGROUND: To reduce overtriage of trauma patients while at the same time minimising undertriage, an in-hospital triage tool was developed with the purpose of reducing the initial full trauma team (downgrading) in a structured and evidence-based manner. This study evaluated the effect on overtriage rates by the AMC downgrading protocol (AMCDP) consisting of 24 criteria scored during the primary survey. PATIENTS AND METHODS: We prospectively investigated if any of the patients treated by the downgraded trauma team (DTT) were undertriaged by the protocol. All patients fulfilling the definition of severely injured (SI) patients but treated by the DTT were deemed undertriaged patients. Overtriage was measured by the percentage of patients treated by a full trauma team (FTT) while not classified as an SI patient. RESULTS: A total of 220 patients were eligible and triaged by the AMCDP. After triage, 95 patients (43%) were treated by the DTT while 125 patients (57%) were treated by the FTT. A total of 66 patients (30%) met one or more of the criteria for an SI patient. None of these patients were treated by the DTT. Of the 125 patients treated by the FTT, 59 patients were not defined as SI. CONCLUSION: For the entire study population no undertriage was found, while implementation of the AMCDP reduced overtriage in the entire study population from 70% to 26.8%. Similar trauma centres can benefit from implementing the AMC downgrading protocol.

Adolescent↗
PubMed2005

M-study; arguments for regional trauma databases.

BACKGROUND: The TRISS methodology, in combination with coefficients derived from the Major Trauma Outcome Study (MTOS), is the most widely used outcome prediction model for the care of trauma patients. Utilizing the M-statistic, different populations of trauma patients can be compared with the population originally enrolled in the MTOS. PURPOSE: We hypothesized that databases outside of North-America would not be well matched to the MTOS study and thus the TRISS methodology would not accurately predict outcome in these different populations. METHODS: All trauma studies utilizing TRISS methodology that were published between 1990-2003 were reviewed and M-statistics calculated based on the population described in the study. The populations were grouped by the following geographic locations: Europe, Asia/Africa and North-America. RESULTS: The median M-statistic for Europe was 0.65, compared with 0.88 for Asian/African databases, and 0.90 for North-American studies. There was a significant difference between European and North-American studies (p < 0.05). CONCLUSION: The trauma populations described in European studies differ significantly from the MTOS with respect to injury severity match, indicating the need for the development of regional trauma databases and modified TRISS coefficients based on the geographic location of the injured population included.

Calibration↗
PubMed2001

Trauma outcome analysis of a Jakarta University Hospital using the TRISS method: validation and limitation in comparison with the major trauma outcome study. Trauma and Injury Severity Score.

BACKGROUND: In this prospective study, the TRISS methodology is used to compare trauma care at a University Hospital in Jakarta, Indonesia, with the standards reported in the Major Trauma Outcome Study (MTOS). METHODS: Between February 24, 1999, and July 1, 1999, all consecutive patients with multiple and severe trauma were included in the study (n = 105). Survival analysis was completed for 97 (92%) patients. RESULTS: The majority of patients were men (81%), and the average age was 28 years. Ninety-five patients (98%) sustained blunt trauma, with motor vehicle crashes being the most common (68%). The predicted mortality was 14% and the observed mortality was 29%. The Z and M statistics were 7.87 and 0.843, respectively. CONCLUSION: We conclude that in developing countries both institution-bound factors and specific limitations in the TRISS methodology are responsible for the difference between predicted and observed mortality, indicating the need for a regional database.

Adolescent↗