Abstract：
BACKGROUND:Major trauma activation is a process that mobilizes personnel and resources required to care for severely injured patients. Exsanguinating truncal trauma patients require an additional response beyond major trauma activation aimed at expediting haemorrhage control. To address this requirement, 'Code Crimson' (CC) activation was developed. Our aim was to examine the performance of CC activation as a process measure in the identification and management of patients with exsanguinating truncal trauma. METHODS:Retrospective cohort study (2010-2015) of all adult patients who underwent operative intervention within 6 h of arrival for truncal trauma was performed. Patients were classified into: (i) major haemorrhage (assessment of blood consumption score ≥2, base deficit ≥5 and/or transfusion ≥5 U of red blood cells pre-/intra-operatively), or (ii) no major haemorrhage. We evaluated the proportion of patients with/without major haemorrhage in which a CC was activated as well as time to operating theatre across groups. RESULTS:A total of 210 patients were included with a median Injury Severity Score of 20 (interquartile range (IQR) 9-29) and overall mortality of 13%. Eighty-nine patients were classified as major haemorrhage and 61 patients underwent CC activation. The majority of CC activations (92%) fulfilled major haemorrhage criteria (sensitivity 63%, specificity 96%). Time to theatre was lower in those with CC activation with median time of 23 min (IQR 15-39.5) versus non-CC with median of 95 min (IQR 43-180, P < 0.001). CONCLUSION:CC was primarily activated in patients with major haemorrhage and led to a decrease in time to theatre for patients with operative truncal trauma.
journal_name
ANZ J Surgjournal_title
ANZ journal of surgeryauthors
Tovmassian D,Hameed AM,Ly J,Pathmanathan N,Devadas M,Gomez D,Hsu JMdoi
10.1111/ans.15650subject
Has Abstractpub_date
2020-04-01 00:00:00pages
481-485issue
4eissn
1445-1433issn
1445-2197journal_volume
90pub_type
杂志文章abstract：BACKGROUND:The role of splenectomy remains unclear in patients with gastric cancer who undergo total gastrectomy. The aim of this study was to prospectively evaluate the impact of splenectomy on circulating T-lymphocyte subsets and survival in advanced gastric cancer. METHODS:Analysis of lymphocyte subsets was perform...
journal_title：ANZ journal of surgery
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更新日期：2004-06-01 00:00:00
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journal_title：ANZ journal of surgery
pub_type： 传,历史文章,杂志文章
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更新日期：2008-09-01 00:00:00
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更新日期：2020-11-01 00:00:00
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