Penetrating thoracoabdominal injuries in Quebec: implications for surgical training and maintenance of competence

Bergeron, Eric; Lavoie, Andre; Razek, Tarek; Belcaid, Amina; Lessard, Julie; Clas, David
August 2005
Canadian Journal of Surgery;Aug2005, Vol. 48 Issue 4, p284
Academic Journal
Background The frequency of penetrating trauma is low in Canada. Current recommendations for the care of patients with penetrating injuries originate from inner city trauma centres with a high volume of such injuries and may not apply to Canada. The purpose of this study was to review the incidence and treatment of penetrating thoracoabdominal injuries in the 4 tertiary trauma centres in Quebec. Methods We identified all patients with penetrating thoracic or abdominal injuries who were taken to any of the 4 tertiary trauma centres in the province of Quebec between Apr. 1, 1998, and Mar. 31, 2001. Patients who were dead on arrival were excluded. Only patients with an Abbreviated Injury Scale of 2 or greater for the thoracic or abdominal regions were included. Results In total, 245 patients meeting our inclusion criteria were identified. Of these 223 (91%) were male. The mean (and standard deviation) age was 33.8 (13.2) years; range 15-90 years. The median Injury Severity Score was 10 (range 4-75). Overall in-hospital mortality was 6.9%. There were 203 patients (82.8%) with thoracic injuries and 192 patients (78.4%) with abdominal injuries. Fifty (20.4%) of these patients had injuries to both regions. A thoracotomy was carried out in 48 (31.4%) of 153 patients who had injuries to the thorax, and the abdomen was explored in 133 (93.7%) of the 142 patients with abdominal injuries. The incidence of these injuries in the study period varied from 3 to 49 cases per centre. Conclusions The annual incidence of penetrating thoracoabdominal injuries is extremely low in all 4 of Quebec's tertiary trauma centres, and the number of thoracoabdominal procedures is even lower. Such a low exposure may jeopardize education and clinical competence. We need to rethink our educational strategies both for residents and for continuing medical education. New approaches to training and maintenance of competence must be developed.


Related Articles

  • Relationship Between Trauma Center Volumes and Outcomes. Nathens, Avery B.; Jurkovich, Gregory J.; Maier, Ronald V.; Grossman, David C.; MacKenzie, Ellen J.; Moore, Maria; Rivara, Frederick P. // JAMA: Journal of the American Medical Association;3/7/2001, Vol. 285 Issue 9, p1164 

    Presents a study to evaluate the association between trauma center volume and outcomes of trauma patients. Design; Setting; Patients; Main outcome measures; Results; Conclusions.

  • SCREENING AND BRIEF INTERVENTION IN THE EMERGENCY DEPARTMENT.  // Alcohol Research & Health;2004/2005, Vol. 28 Issue 2, p55 

    The article presents an abstract of the paper "Screening and Brief Intervention in the Emergency Department," by Gail D'Onofrio and Linda C. Degutis, published in the June 2004 issue of the journal "Alcohol Research & Health." According to both the authors, almost one-third of patients treated...

  • History and development of trauma registry: lessons from developed to developing countries. Nwomeh, Benedict C.; Lowell, Wendi; Kable, Renae; Haley, Kathy; Ameh, Emmanuel A. // World Journal of Emergency Surgery;2006, Vol. 1, p32 

    Background: A trauma registry is an integral component of modern comprehensive trauma care systems. Trauma registries have not been established in most developing countries, and where they exist are often rudimentary and incomplete. This review describes the role of trauma registries in the care...

  • Survey Reveals Need To Strengthen Financial Viability Of State Trauma System: Texas Trauma System Viability. Rubin, Amir Dan; Clifton, Guy L. // Internet Journal of Healthcare Administration;2002, Vol. 1 Issue 2, p24 

    A survey of Texas's leading Level 1 and 2 Trauma Centers revealed the need to ensure financial stability of the state's trauma system. Many people do not realize the prevalence of traumatic injuries. Trauma is actually the leading cause of death in persons under 34 years of age, and is one of...

  • Helicopter Evacuation of Trauma Victims in Los Angeles: Does it Improve Survival? Talving, Peep; Teixeira, Pedro G. R.; Barmparas, Galinos; DuBose, Joseph; Inaba, Kenji; Lam, Lydia; Demetriades, Demetrios // World Journal of Surgery;Nov2009, Vol. 33 Issue 11, p2469 

    The purpose of this study was to investigate the relationship between the method of transport after injury and survival among trauma patients admitted to a Level 1 trauma facility in Los Angeles, California. The trauma registry of LAC+USC Medical Center was reviewed to identify all injured...

  • Helicopter EMS: Research Endpoints and Potential Benefits. Thomas, Stephen H.; Arthur, Annette O. // Emergency Medicine International;2012, p1 

    Patients, EMS systems, and healthcare regions benefit from Helicopter EMS (HEMS) utilization. This article discusses these benefits in terms of specific endpoints utilized in research projects. The endpoint of interest, be it primary, secondary, or surrogate, is important to understand in the...

  • Prehospital Information for Optimal Patient Care. Davis, James S.; Graygo, Jill; Augenstein, Jeffrey; Schulman, Carl I. // American Surgeon;Apr2013, Vol. 79 Issue 4, p441 

    The article presents a study which examines helpful hospital information during emergency medical services (EMS) handoffs. Prehospital providers and attending physicians at a Level I trauma center were surveyed to rate the usefulness of handoff questions for various injury mechanisms. The survey...


    The article presents an abstract of the paper "Legal Barriers to Alcohol Screening in Emergency Departments and Trauma Centers," by Judge Linda Chezem, published in the June 2004 issue of the journal "Alcohol Research & Health." Research has shown that many patients being treated in emergency...

  • Schockraummanagement von Schwerverletzten. Shafizadeh, S.; Tjardes, T.; Steinhausen, E.; Balke, M.; Paffrath, T.; Bouillon, B.; Bäthis, H. // Der Orthopäde;Aug2010, Vol. 39 Issue 8, p771 

    There is clinical evidence that a standardized management of trauma patients in the emergency room improves outcome. ATLS® is a training course that teaches a systematic approach to the trauma patient in the emergency room. The aims are a rapid and accurate assessment of the patient’s...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics