Feasibility of conducting a military-relevant multicenter cohort study to assess outcomes of early trauma resuscitative interventions in a prolonged care civilian setting.

Autor:	Mould-Millman NK; From the Department of Emergency Medicine (N.-K.M.-M., J.M.D., C.F.), School of Medicine, University of Colorado Denver, Aurora, Colorado; Division of Surgery (H.J.L.), Stellenbosch University, Cape Town, South Africa; Adult and Child Consortium for Health Outcomes Research and Delivery Science (B.B.), and Department of Biostatistics and Informatics (B.F.), Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Emergency Medical Services (S.d.V.), Western Cape Government, Cape Town, South Africa; US Army Institute for Surgical Research (S.G.S.), Joint Base San Antonio, Fort Sam Houston, Texas; Division of Surgery (E.S.), and Division of Forensic Medicine (J.V.), Stellenbosch University; Worcester Hospital (L.H.), Khayelitsha Hospital (S.M.), and Ceres Hospital (K.D.), Western Cape Government Department of Health; Division of Emergency Medicine (W.S.), University of Cape Town, Cape Town, South Africa; Department of Emergency Medicine (S.K.), School of Medicine, University of Colorado Denver, Aurora, Colorado; US Department of Defense Joint Trauma System En Route Combat Casualty Care (C.C.), San Antonio, Texas; Department of Surgery (E.E.M.), Ernest E. Moore Shock Trauma Center at Denver Health, Denver; Department of Emergency Medicine (A.A.G.), and Department of Emergency Medicine (V.S.B.), School of Medicine, University of Colorado Denver, Aurora, Colorado., Dixon JM, Lategan HJ, Beaty B, Fosdick B, Fleischer C, de Vries S, Schauer SG, Steyn E, Verster J, Hodsdon L, Mukonkole S, Doubell K, Stassen W, Keenan S, Cunningham C, Moore EE, Ginde AA, Bebarta VS
Jazyk:	angličtina
Zdroj:	The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2023 Aug 01; Vol. 95 (2S Suppl 1), pp. S88-S98. Date of Electronic Publication: 2023 May 22.
DOI:	10.1097/TA.0000000000004066
Abstrakt:	Background: The Epidemiology and Outcomes of Prolonged Trauma Care (EpiC) study is a 4-year, prospective, observational, large-scale epidemiologic study in South Africa. It will provide novel evidence on how early resuscitation impacts postinjury mortality and morbidity in patients experiencing prolonged care. A pilot study was performed to inform the main EpiC study. We assess outcomes and experiences from the pilot to evaluate overall feasibility of conducting the main EpiC study. Methods: The pilot was a prospective, multicenter, cohort study at four ambulance bases, four hospitals, and two mortuaries from March 25 to August 27, 2021. Trauma patients 18 years or older were included. Data were manually collected via chart review and abstraction from clinical records at all research sites and inputted into Research Electronic Data Capture. Feasibility metrics calculated were as follows: screening efficiency, adequate enrollment, availability of key exposure and outcome data, and availability of injury event date/time. Results: A total of 2,303 patients were screened. Of the 981 included, 70% were male, and the median age was 31.4 years. Six percent had one or more trauma relevant comorbidity. Fifty-five percent arrived by ambulance. Forty percent had penetrating injuries. Fifty-three percent were critically injured. Thirty-three percent had one or more critical interventions performed. Mortality was 5%. Four of the eight feasibility metrics exceed the predetermined threshold: screening ratio, monthly enrollment, percentage with significant organ failure, and missing injury date/time for emergency medical services patients. Two feasibility metrics were borderline: key exposure and primary outcome. Two feasibility metrics fell below the feasibility threshold, which necessitate changes to the main EpiC study: percentage with infections and missing injury date/time for walk-in patients. Conclusion: The EpiC pilot study suggests that the main EpiC study is overall feasible. Improved data collection for infections and methods for missing data will be developed for the main study. Level of Evidence: Prognostic and Epidemiological; Level V. (Copyright © 2023 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.)
Databáze:	MEDLINE
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