Displaying publications 1 - 20 of 31 in total

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  1. Yunus SS, Ngeow WC, Ramli R
    Am J Emerg Med, 2015 Sep;33(9):1253-7.
    PMID: 26026365 DOI: 10.1016/j.ajem.2015.05.009
    A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated.
    Matched MeSH terms: Injury Severity Score
  2. Yeap EJ, Rao J, Pan CH, Soelar SA, Younger ASE
    Foot Ankle Surg, 2016 Sep;22(3):164-169.
    PMID: 27502224 DOI: 10.1016/j.fas.2015.06.008
    BACKGROUND: This study compares the outcomes of calcaneal fracture surgery after open reduction internal fixation and plating (ORIF) versus arthroscopic assisted percutaneous screw fixation (APSF).

    METHODS: Group I (N=12) underwent ORIF. Group II (N=15) underwent APSF. Anthropometric data, pre and post-operative stay, complications and duration off work were recorded in this retrospective case cohort study. Radiographs were analyzed for Bohler's, Gissane's angle and Sanders' classification. AOFAS Hindfoot and SF 36 scores were collected at final follow-up.

    RESULTS: Anthropometric data, Bohler's and Gissane's angles, AOFAS and SF 36 scores were not significantly different. Pre-operative duration was 12.3 days in ORIF and 6.9 days in APSF. Post-operative duration was 7.3 days vs 3.8 days. Duration off work was 6.2 months vs 2.9 months.

    CONCLUSION: The APSF group was able to have surgery earlier, go home faster, and return to work earlier. This study was not powered to demonstrate a difference in wound complication rates.

    Matched MeSH terms: Injury Severity Score
  3. Wang PY, Tseng WC, Lee MC, Hsu LM, Shin SD, Jamaluddin SF, et al.
    Sci Rep, 2023 Apr 23;13(1):6602.
    PMID: 37088796 DOI: 10.1038/s41598-023-33471-x
    Children and adolescents are vulnerable to non-accidental injury. Early identification and prevention rely on detailed epidemiological studies, which are limited in Asia. This retrospective study used the registry data of Pan-Asian Trauma Outcome Study (PATOS) from October 1, 2015 to December, 31, 2020. Pediatric patients (aged score (EMR-ISS) were collected. Major trauma was defined as an EMR-ISS score > 24. The study enrolled 451 patients with non-accidental injuries, accounting for 2.81% of pediatric trauma events presented to an emergency department in the PATOS registry. The overall mortality rate was 0.9%, similar to those in Western countries. Mortality rate was high in preschool children (8.7%, p = 0.017) than in other age groups. The sex-specific incidence was higher in boys (3.10% vs. 2.13%, p = 0.001). In adolescents, more events occurred on the street (25.9%), whereas home remained the most common locale in girls of all ages. In the multivariable regression analysis, abdominal and multiple injuries were risk factors for major trauma.
    Matched MeSH terms: Injury Severity Score
  4. Usman J, McIntosh AS, Quarrie K, Targett S
    J Sci Med Sport, 2015 Sep;18(5):529-33.
    PMID: 25156881 DOI: 10.1016/j.jsams.2014.07.020
    Shoulder injuries in rugby union football have been the focus of few in-depth studies, despite their frequency and severity. The study's objective was to describe the incidence, patterns and mechanisms of shoulder injuries in rugby.
    Matched MeSH terms: Injury Severity Score
  5. Truelle JL, von Wild K, Höfer S, Neugebauer E, Lischetzke T, von Steinbüchel N, et al.
    Acta Neurochir. Suppl., 2008;101:125-9.
    PMID: 18642646
    There is no disease-specific health-related quality of life (HRQoL) tool devoted to traumatic brain injury (TBI).
    Matched MeSH terms: Injury Severity Score
  6. Tan JH, Mohamad Y, Imran Alwi R, Henry Tan CL, Chairil Ariffin A, Jarmin R
    Injury, 2019 May;50(5):1125-1132.
    PMID: 30686543 DOI: 10.1016/j.injury.2019.01.027
    BACKGROUND: Most trauma mortality prediction scores are complex in nature. GAP (Glasgow Coma Scale, Age, Systolic blood pressure) and mGAP (mechanism, Glasgow Coma Scale, Age, Systolic blood pressure) scores are relatively simple scoring tools. However, these scores were not validated in low and middle income countries including Malaysia and its accuracies are influenced by the fluctuating physiologic parameters. This study aims to develop a relevant simplified anatomic trauma scoring system for the local trauma patients in Malaysia.

    METHOD: A total of 3825 trauma patients from 2011 to 2016 were extracted from the Hospital Sultanah Aminah Trauma Surgery Registry. Patients were split into a development sample (n = 2683) and a validation sample (n = 1142). Univariate analysis is applied to identify significant anatomic predictors. These predictors were further analyzed using multivariable logistic regression to develop the new score and compared to existing score systems. The quality of prediction was determined regarding discrimination using sensitivity, specificity and receiver operating characteristic [ROC] curve.

    RESULTS: Existing simplified score systems (GAP & mGAP) revealed areas under the ROC curve of 0.825 and 0.806. The newly developed HeCLLiP (Head, cervical spine, lung, liver, pelvic fracture) score combines only five anatomic components: injury involving head, cervical spine, lung, liver and pelvic bone. The probabilities of mortality can be estimated by charting the total score points onto a graph chart or using the cut-off value of (>2) with a sensitivity of 79.2 and specificity of 70.6% on the validation dataset. The HeCLLiP score achieved comparable values of 0.802 for the area under the ROC curve in validation samples.

    CONCLUSION: HeCLLiP Score is a simplified anatomic score suited to the local Malaysian population with a good predictive ability for trauma mortality.

    Matched MeSH terms: Injury Severity Score
  7. Tan BB, Chan CY, Saw LB, Kwan MK
    Indian J Orthop, 2012 Nov;46(6):710-3.
    PMID: 23325978 DOI: 10.4103/0019-5413.104235
    Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS). We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery.
    Matched MeSH terms: Injury Severity Score
  8. Shahrudin MD, Noori SM
    Hepatogastroenterology, 1997 Mar-Apr;44(14):519-21.
    PMID: 9164529
    To review our experience in managing post-hepatorrhaphy complications in liver trauma.
    Matched MeSH terms: Injury Severity Score
  9. Sethi D, Aljunid S, Saperi SB, Clemens F, Hardy P, Elbourne D, et al.
    Ann Emerg Med, 2007 Jan;49(1):52-61, 61.e1.
    PMID: 17084938
    STUDY OBJECTIVE: The trauma services provided by 6 hospitals operating at 2 levels of care (4 secondary or district general hospitals and 2 tertiary care hospitals) in Malaysia are compared in terms of mortality and disability for direct admissions to emergency departments to test the hypothesis that care at a tertiary care hospital is better than at a district general hospital.
    METHODS: All cases were recruited prospectively for 1 year. The hospitals were purposefully selected as typical for Malaysia. There are 3 primary outcome measures: death, musculoskeletal impairment, and disability at discharge. Adjustment was made for potential covariates and within-hospital clustering by using multivariable random-effects logistic regression analysis.
    RESULTS: For direct admissions, logistic-regression-identified odds of dying were associated with older age (>55 years), odds ratio (OR) 1.9 (95% confidence interval [CI] 1.3 to 2.8); head injury, OR 2.7 (95% CI 1.9 to 3.9); arrival by means other than ambulance, OR 0.6 (95% CI 0.4 to 0.8); severe injuries (Injury Severity Score >15) at a district general hospital, OR 45.2 (95% CI 27.0 to 75.7); severe injuries at a tertiary care hospital, OR 11.2 (95% CI 7.3 to 17.3); and admission to a tertiary care hospital compared to a district general hospital if severely injured (Injury Severity Score >15), OR 0.2 (95% CI 0.1 to 0.4). Admission to a tertiary care hospital was associated with increased odds of disability (OR 1.9; 95% CI 1.5 to 2.3) and musculoskeletal impairment (OR 3.5; 95% CI 2.7 to 4.4) at discharge.
    CONCLUSION: Care at a tertiary care hospital was associated with reduced mortality (by 83% in severe injuries), but with a higher likelihood of disability and impairment, which has implications for improving access to trauma services for the severely injured in Malaysia and other low- and middle-income settings.
    Matched MeSH terms: Injury Severity Score
  10. Sethi D, Aljunid S, Saperi SB, Zwi AB, Hamid H, Mustafa AN, et al.
    J Trauma, 2002 Sep;53(3):508-16.
    PMID: 12352489
    The effectiveness of trauma services provided by three hospitals operating at different levels of care, district general (DGH), tertiary care, and central tertiary, were compared in Malaysia.
    Matched MeSH terms: Injury Severity Score
  11. Sartelli M, Abu-Zidan FM, Labricciosa FM, Kluger Y, Coccolini F, Ansaloni L, et al.
    World J Emerg Surg, 2019;14:34.
    PMID: 31341511 DOI: 10.1186/s13017-019-0253-2
    Background: Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.

    Methods: This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018.

    Results: A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8.

    Conclusions: The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.

    Matched MeSH terms: Injury Severity Score
  12. Ramli R, Oxley J, Noor FM, Abdullah NK, Mahmood MS, Tajuddin AK, et al.
    J Forensic Leg Med, 2014 Aug;26:39-45.
    PMID: 25066171 DOI: 10.1016/j.jflm.2014.06.007
    Motorcycle fatalities constitute the majority of road traffic deaths in Malaysia. The aims of this study were to describe the pattern of fatal injuries among Klang Valley fatal motorcyclists and to describe the factors associated with fatal (vs non-fatal) injuries.
    Matched MeSH terms: Injury Severity Score
  13. Ramli R, Mohd Yunus SS
    PMID: 32187977 DOI: 10.3390/ijerph17061922
    The child restraint legislation in Malaysia becomes mandatory from 1 January 2020. Prior to commencement of the rule, a survey showed that only 36% of Malaysian parents were aware of the importance of a child restraint system (CRS) and only 27% usage was reported during travel. The Malaysian Institute of Road Safety report showed that children transported in private vehicles were the leading groups of casualties among children aged 1 to 4 years old (43.8%) and 5 to 9 years old (30.2%), respectively. We performed a narrative review using the PubMed, ScienceDirect and Google Scholar databases using keywords such as child restraint system, unrestrained injuries, Malaysia and epidemiology. The objectives of this review were: (1) to determine the prevalence on the use of CRS in Malaysia, (2) to evaluate the injuries related to unrestrained children and (3) to show the nation's preparation towards implementation of the child restraint law. Six papers on prevalence, one paper on injury and six mainstream newspaper were included in this study. The prevalence of a CRS use was shown between 5% to 41.8%. In relation to injury, the only publication from this country showed that among 19 children involved in a car crash, five (26.3%) children had non-craniomaxillofacial (CMF) injuries, ten (52.6%) with CMF injuries only, two (10.5%) with both CMF and non-CMF injuries and two (10.5%) without any injury. Overall, the Injury Severity Score (ISS) range was between 0 to 13 (median, 1.00; interquartile range, 1). Preparation to comply with the best practice of the child restraint law is still ongoing, especially those addressing the issues related to the low-income parents in the country. Due to scarcity of publication and data on the CRS use and injuries related to its non-usage, it is advocated that parallel with the implementation legislation, vigorous forms of public education as well as good data management must be performed and monitored regularly by the road safety authority in this country.
    Matched MeSH terms: Injury Severity Score
  14. Nik Azlan NM, Ong SF
    Med J Malaysia, 2019 04;74(2):116-120.
    PMID: 31079121
    INTRODUCTION: This study evaluates factors that influence door to operation theatre (OT) time in a tertiary referral centre following activation of trauma team. Specific factors observed in this study were association of the injury severity score (ISS), activation of trauma team and the number of referred specialty to door to operation theatre time.

    METHODS: Retrospective chart review that evaluates all trauma patients which required immediate operative intervention from January 2011 to December 2015. Trauma patients were selected from the resuscitation log book and data were collected by chart review of selected patients.

    RESULTS: Only 5 out of 279 patients (1.8%) achieved optimal door to OT time. (<60 minutes) Mean door to OT time was 299.27 minutes (95% CI: 280.52, 318.52). Trauma team activation has shown significant improvement in door to OT time (p=0.047). Time of multiple team referrals (p=0.023) and time of operative decision (p<0.001) both had significant impact on door to OT time. Other factors included were demographics, ISS score, Glasgow Coma Scale (GCS), mechanism of injury and systolic blood pressure on arrival all which showed no significance.

    CONCLUSION: Trauma team activation in a tertiary centre improved trauma care by reducing door to OT time to less than 60 minutes. Implementation of an effective trauma team activation system in all hospitals throughout Malaysia is recommended.

    Matched MeSH terms: Injury Severity Score
  15. Nik Ab Rahman NH, Mohd Hussain H
    Med J Malaysia, 2013 Apr;68(2):148-52.
    PMID: 23629562 MyJurnal
    Trauma is an ever increasing problem and it is the leading cause of morbidity and mortality in the under 40s age group. The main purpose of this study is to determine the pattern of death related to trauma cases presenting to the emergency department (ED) of a university hospital. This was a retrospective analysis of 75 consecutive trauma case records at a university hospital for a one year period. The most common cause of deaths is motor vehicle crashes. The mean score for the injury severity score (ISS) and revised trauma score (RTS) on arrival to the ED among the succumbed patients were 27.8 (s.d 8.6) and 5.7 (s.d 1.1) respectively. 58.7% of deaths occurred within 48 hours after the admission. Less than 50% of studied patients were still alive beyond 45 hours post admission and less than 10% still alive beyond 11 days. Our analysis also showed that 28% (n=21) and 56% (n=41) of the studied sample had a probability of survival between 50% to 75% and more than 75% respectively upon arrival based on the initial vital signs in the ED and the trauma and injury severity score (TRISS) methodology. Overall, we observed similar injury mechanisms, demographics and causes of death compare to other studies. The figures from this study, mandate further exploration of preventive issues and management improvements that should be applied not only to the current trauma system, but also to the health care system in general.
    Matched MeSH terms: Injury Severity Score
  16. Mohd Mokhtar MA, Azhar ZI, Jamaluddin SF, Cone DC, Shin SD, Shaun GE, et al.
    Prehosp Emerg Care, 2023;27(7):875-885.
    PMID: 37459651 DOI: 10.1080/10903127.2023.2237107
    OBJECTIVE: Asia is experiencing a demographic shift toward an aging population at an unrivaled rate. This can influence the characteristics and outcomes of trauma. We aim to examine different characteristics of older adult trauma patients compared to younger adult trauma patients and describe factors that affect the outcomes in Asian countries.

    METHODS: This is a retrospective, international, multicenter study of trauma across participating centers in the Pan Asian Trauma Outcome Study (PATOS) registry, which included trauma cases aged ≥18 years, brought to the emergency department (ED) by emergency medical services (EMS) from October 2015 to November 2018. Data of older adults (≥65 years) and younger adults (<65 years) were analyzed and compared. The primary outcome measure was in-hospital mortality, and secondary outcomes were disability at discharge and hospital and intensive care unit (ICU) length of stays.

    RESULTS: Of 39,804 trauma patients, 10,770 (27.1%) were older adults. Trauma occurred more among older adult women (54.7% vs 33.2%, p Score (ISS) compared to the younger adult trauma patient (5.4 ± 6.78 vs 4.76 ± 8.60, p 

    Matched MeSH terms: Injury Severity Score
  17. Mohamed Haflah NH, Ng MH, Mohd Yunus MH, Naicker AS, Htwe O, Fahmi M, et al.
    Int J Low Extrem Wounds, 2017 Sep;16(3):212-216.
    PMID: 28862056 DOI: 10.1177/1534734617724974
    Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect. A tissue engineered skin construct, MyDermTM was employed to cover this large defect. Complete wound closure was achieved 35 days postimplantation. The patient then underwent plating of the tibia for nonunion with no adverse effect to the grafted site. The tibia eventually healed 5 months postplating, and the cosmetic appearance of the newly formed skin was satisfactory.
    Matched MeSH terms: Injury Severity Score
  18. Ludin SM, Rashid NA
    Enferm Clin, 2019 09;29 Suppl 2:674-680.
    PMID: 31311746 DOI: 10.1016/j.enfcli.2019.04.103
    OBJECTIVE: Severe traumatic brain injury (TBI) survivors show physical and functional improvement but remain with the cognitive and psycho-social problem through our recovery. This study aims to measure the health-related quality of life of TBI survivors within 6 months post-injury.

    METHOD: A cohort study was conducted where 33 severe TBI survivors recruited at two tertiary hospitals. The health-related quality of life was measured using the Quality of Life after Brain Injury (QOLIBRI) tool.

    RESULTS: Participants mean age was 31.79 years old. The impaired range of health-related quality of life on 6 months post-injury seen, but an improvement occurs within 3-6 months post-injury.

    CONCLUSIONS: Age and ventilation duration showed a moderate negative correlation in all domains and length of hospital stay showed a moderate negative correlation to social, daily life and self-domains. Nevertheless, small sample size and time constraint were the limitations of this study.

    Matched MeSH terms: Injury Severity Score
  19. Leow JJ, Lim VW, Lingam P, Go KT, Teo LT
    World J Surg, 2014 Jul;38(7):1694-8.
    PMID: 24510246 DOI: 10.1007/s00268-014-2459-5
    Ethnic disparities in trauma mortality outcomes have been demonstrated in the United States according to the US National Trauma Data Bank. The aim of this study was to determine the effect of race/ethnicity on trauma mortality in Singapore.
    Matched MeSH terms: Injury Severity Score*
  20. Lee MC, Tseng WC, Hsu LM, Shin SD, Jamaluddin SF, Tanaka H, et al.
    Prehosp Emerg Care, 2023;27(2):227-237.
    PMID: 35380921 DOI: 10.1080/10903127.2022.2062804
    OBJECTIVE: Injury is a major cause of morbidity and mortality in children. However, the epidemiology and prehospital care for pediatric unintentional injuries in Asia are still unclear.

    METHODS: A total of 9,737 pediatric patients aged <18 years with unintentional injuries cared for at participating centers of the Pan-Asian Trauma Outcome Study (PATOS) from October 2015 to December 2020 were reviewed retrospectively. Patients were divided into two groups: those <8 and those ≥8 years of age. Variables such as patient demographics, injury epidemiology, Injury Severity Score (ISS), and prehospital care were collected. Injury severity and administered prehospital care stratified by gross national income were also analyzed.

    RESULTS: Pediatric unintentional injuries accounted for 9.4% of EMS-transported trauma cases in the participating Asian centers, and the mortality rate was 0.88%. The leading cause of injury was traffic injuries in older children aged ≥8 years (56.5%), while falls at home were common among young children aged <8 years (43.9%). Compared with younger children, older children with similar ISS tended to receive more prehospital interventions. Uneven disease severity was found in that older children in lower-middle and upper-middle-income countries had higher ISS compared with those in high-income countries. The performance of prehospital interventions also differed among countries with different gross national incomes. Immobilizations were the most performed prehospital intervention followed by oxygen administration, airway management, and pain control; only one patient received prehospital thoracentesis. Procedures were performed more frequently in high-income countries than in upper-middle-income and lower-middle-income countries.

    CONCLUSIONS: The major cause of injury was road traffic injuries in older children, while falls at home were common among young children. Prehospital care in pediatric unintentional injuries in Asian countries was not standardized and might be insufficient, and the economic status of countries may affect the implementation of prehospital care.

    Matched MeSH terms: Injury Severity Score
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