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Assessment of injury severity at the accident scene by the emergency physician : Utility of technical crash parameters: results of a pilot study.
MedLine Citation:
PMID:  22460722     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Technical parameters of road traffic crashes are routinely documented by emergency physicians on scene. It is, however, unclear whether this information contributes to the estimation of injury severity of vehicle drivers. MATERIALS AND METHODS: In this study, three experienced emergency physicians were asked to predict the injury severity of vehicle drivers [categorized according to Injury Severity Score (ISS) values of <16 and ≥16 as moderate to severe or life-threatening] based on increasingly complex technical crash information, ranging from routine variables to photo documentation of the crash scene. A sample of 100 cases (mean ISS 23.6±26.9) was obtained from the prospective database of an in-depth technical and medical car crash research project conducted in the northeastern part of Germany. Statistical analysis comprised inter-rater agreement beyond chance (kappa values) and indicators of diagnostic test accuracy (i.e. sensitivity, specificity and so on). RESULTS: The inter-rater agreement of injury severity based on technical crash information was moderate to substantial (kappa 0.42-0.66). Amongst the three observers and various amounts of technical data, sensitivity ranged between 18 and 80%, and specificity ranged between 41 and 89% in predicting the presence of major trauma. Presentation of photographs from the crash scene increased diagnostic accuracy. Still, the presented information led to a shift from a 50% prior probability of life-threatening injuries to a maximum of 40% in the negative and 67% in the positive case. CONCLUSION: Neither basic technical parameters that are easy to obtain after a car crash nor additional technical information markedly contribute to the emergency physician's estimation of a vehicle driver's injury severity. The presented results should be supported by a subsequent study including a larger sample.
Authors:
G Matthes; U Schmucker; M Frank; C Huwer; A Ekkernkamp; D Stengel
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-31
Journal Detail:
Title:  Der Unfallchirurg     Volume:  -     ISSN:  1433-044X     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8502736     Medline TA:  Unfallchirurg     Country:  -    
Other Details:
Languages:  GER     Pagination:  -     Citation Subset:  -    
Affiliation:
Abteilung für Unfall- und Wiederherstellungschirurgie, Klinik und Poliklinik für Chirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland, gerrit.matthes@ukb.de.
Vernacular Title:
Notärztliche Einschätzung der Verletzungsschwere am Unfallort : Diagnostischer Wert technischer Parameter - Ergebnisse einer Pilotstudie.
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