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Reliability of a patient survey assessing ＂Short Form Injury Questionnaire 7＂ in Iran

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Chinese Journal of Traumatology 2012年第3期15卷 145-147页

作者： Mahdi Sharif-Alhoseini Soheil Saadat afarin rahimi-movaghar Abbas Motevalian Masoumeh Amin-Esmaeili Mitra Hefazi Vafa rahimi-movaghar Sina Trauma and Surgery Research Center Tehran University of Medical Sciences Tehran 11365-3876 Iran Iranian Research Center for HIV/AIDS(IRCHA) Tehran University of Medical Sciences Tehran 11365-3876 Iran School of Public Health Tehran University of Medical Sciences Tehran 11365-3876 Iran

Objective： Injury is a major cause of morbidity and mortality in the world. The assessment of patterns and severity of injury in high-risk groups is crucial for planning and service development. On a large scale na- tional household survey, we estimated the annual incidence and the patterns of injury, the demographics of the injured people, as well as the service use for all injuries in Iran. The current study aims at assessing the reliability of the ques- tionnaire before carrying out a national survey. Methods： In a pilot study using cluster random sam- pling approach, 73 people were interviewed. The interview- ers asked the participants to report all injuries occurred in them and the care provided during the previous 12 months, based on ＂Short Form Injury Questionnaire 7＂. About two weeks later, the interview was repeated by another interviewer. Results： In our test-retest reliability, Kappa score was good for three and moderate for four questions. The ques- tion on the injured organ had the highest test-retest reliabil- ity with a Kappa score of 0.84. Conclusions： The reliability of the questionnaire and the procedure of questioning are confirmed. The ques- tionnire is proper for utilization in large national surveies.

关键词： Injury severity score Reproducibility of results Iran

Evaluating clinical abdominal scoring system in predicting the necessity of laparotomy in blunt abdominal trauma

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Chinese Journal of Traumatology 2011年第3期14卷 156-160页

作者： Peyman Erfantalab-Avini Nima Hafezi-Nejad Mojtaba Chardoli Vafa rahimi-movaghar Department of Emergency Medicine Tehran University of Medical Sciences Tehran 11365-3876 Iran Sina Trauma and Surgery Research Center Department of Neurosurgery Tehran University of Medical Sciences Tehran 11365-3876 Iran Students' Scientific Research Center Tehran University of Medical Sciences Tehran 11365-3876 Iran Research Center for Neural Repair University of Tehran Tehran 11365-3876 Iran

Objectives： Trauma is among the leading causes of death. Medical management of blunt abdominal trauma （BAT） relies on judging patients for whom laparotomy is mandatory. This study aimed to determine BAT patients＇ signs, as well as paraclinical data, and to clarify the accuracy, sensitivity, specificity, positive and negative predictive value of clinical abdominal scoring system （CASS）, a new scoring system based on clinical signs, in predicting whether a BAT patient needs laparotomy or not. Methods： Totally 400 patients suspected of BAT that arrived at the emergency department of two university hospitals in Tehran from March 20, 2007 to March 19, 2009 were included in this study. They were evaluated for age, sex, type of trauma, systolic blood pressure, Glasgow coma scale （GCS）, pulse rate, time of presentation after trauma, abdomial clinical findings, respiratory rate, temperature, hemoglobin （Hb） concentration, focused abdominal sonography in trauma （FAST） and CASS. Results： Our measurements showed that CASS had an accuracy of 94%, sensitivity of 100%, specificity of 88%, positive predictive value of 90% and negative predictive value of 100% in determining the necessity of laparotomy in BAT patients. Moreover, in our analysis, systolic blood pressure, GCS, pulse rate, Hb concentration, time of presentation after trauma, abdominal clinical findings and FAST were also shown to be helpful in confirming the need for laparotomy （P〈0.05）. Conclusion： CASS is a promising scoring system in rapid detection of the need for laparotomy as well as in minimizing auxiliary expense for further evaluation in BAT patients, thus to promote the cost-benefit ratio and accuracy of diagnosis.

关键词： Abdominal injuries Laparotomy Patients Wounds nonpenetrating

Comparison of road traffic fatalities and injuries in Iran with other countries

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Chinese Journal of Traumatology 2008年第3期11卷 131-134页

作者： Mohammad R Rasouli Mohsen Nouri Mohammad-Reza Zarei Soheil Saadat Vafa rahimi-movaghar Trauma and Surgery Research Center Sina HospitalMedical Sciences/University of Tehran Tehran Iran

Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006. Results： RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2：1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries. Conclusions： This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.

关键词： Accidents, road traffic Fatality Wounds and injuries Iran World

Comparison of epidemiologic features between upper and lower limb injuries and risk factors for intensive care unit admission in a university hospital affiliated with the National Trauma Registry of Iran

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Chinese Journal of Traumatology 2024年第6期27卷 389-394页

作者： Pouya Mahdavi Sharif Mohsen Merati Vali Baigi Mohammadreza Zafarghandi Vafa rahimi-movaghar Moein Khormali Marjan Laal Payman Salamati Sina Trauma and Surgery Research Center Tehran University of Medical SciencesTehranIran Department of Epidemiology and Biostatistics School of Public HealthTehran University of Medical SciencesTehranIran

Purpose:Upper extremity injuries(UEIs)and lower extremity injuries(LEIs)constitute a considerable component of ***,their epidemiologic differences and short-term in-hospital outcomes are not fully *** study aims to compare such discrepancies in a large-scale ***:In this retrospective study,all patients with UEIs and/or LEIs hospitalized from 24th July 2016 to 16th May 2020 in Sina Hospital,Tehran,Iran,and registered at the National Trauma Registry of Iran were enrolled in the *** demographic and clinical characteristics were extracted from the National Trauma Registry of Iran *** were grouped into either UEI or *** those with concomitant UEIs and LEIs,the more severe one based on the abbreviated injury scale was defined as the principal *** addition,cases with the abbreviated injury scale>3 for both UEI and LEI or concomitant injuries to body areas other than the limbs were *** samplest-test,Mann-WhitneyU test,Chi-square test,quintile regression models,and logistic regression models with"margins"command were used for statistical analyses,as ***:In this research,3170 eligible cases were *** the LEI group,there was a much higher proportion of male patients(86.7%vs.82.0%)and higher mean age(years,42.9vs.35.3)compared to the UEI group(bothp<0.001).Patients with an injury severity score(ISS)of 9-15 were outnumbered in the LEI group(22.9%vs.1.6%,p<0.001),while the proportion of those with an ISS<9 was higher in the UEI group(98.1%vs.76.8%,p<0.001).The multiple logistic regression model showed a statistically significant association between intensive care unit(ICU)admission and ISS(odds ratio(OR)=4.01 for ISS ***<9,95%confidence interval(CI)):3.01-5.35;OR=17.65 for ISS≥***<9,95%CI:4.03-77.27),age(OR=1.02,95%CI:1.01-1.03),cause of injury(OR=0.27 for blunt *** traffic crash,95%CI:0.08-0.90;OR=0.49 for cut/stab *** traffic crash,9

关键词： Wounds and injuries Lower extremity Upper extremity Intensive care unit Length of hospital stay

Establishment of a regional multicenter traumatic spine fracture/dislocation registry

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Chinese Journal of Traumatology 2014年第4期17卷 235-238页

作者： Vafa rahimi-movaghar Soheil Saadat Saba Jafarpour Department of Neurosurgery Shariati Hospital Tehran University of Medical Sciences Tehran Iran Sina Trauma and Surgery Research Center Tehran University of Medical Sciences Tehran Iran Sina Trauma and Surgery Research Center Tehran University of Medical Sciences Tehran Iran

Objective：Trauma is one of the leading causes of mortality and morbidity in adults and a major contributor to health care *** spine-related injuries constitute a small proportion of trauma cases,they need special consideration due to poor functional outcomes and substantial *** relatively extensive previous studies on traumatic spinal injuries,there is still obscurity in some aspects of the *** purpose of this study is to establish a regional multicenter traumatic spine fracture/dislocation ***：This is a prospective case series study,including all patients with acute traumatic spine lesions admitted to a regional multicenter since *** is extracted based upon a form developed by Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences,Tehran,*** electronic data entry software is initiated and data will be entered to the *** remains confidential and security considerations will be taken based on standards of data entry ***：The results of this study will include age and gender distribution of the patients,causes of injury,location of pain and neurological deficit,the American Spinal Injury Association score and Frankel grade on admission,at discharge,after 6 and 12 months and at the latest annual follow-up,radiologic findings,details of operative procedures and methods of external ***：This study will identify prognostic factors that influence the ultimate fate of spine fracture patients and determine short and long-term outcome of different treatment *** can lead to a considerable improvement in patient care and will have a great national and transnational impact.

关键词： Spinal fractures Registries Spinal injuries Prospective studies

Epidemiology and short-term mortality in traumatic patients admitted to Shariati Hospital in Iran between 2012 and 2013

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Chinese Journal of Traumatology 2015年第5期18卷 275-278页

作者： Sima Sheikhghomi Vafa rahimi-movaghar Saba Jafarpour Soheil Saadat Iron University of Medical Sdences Tehran 11365-3876 Iran Sina Trauma and Surgery Research Center Tehran University of Medical Sciences Tehran 11365-3876 lran Department of Neurology Boston Children's Hospital Harvard Medical School 1 Autumn St Boston MA 02115 United States

Purpose： Trauma is an inevitable part of the health burden in every country. Both the preventive and rehabilitative aspects of traumatic injuries are expensive. Since most of the injuries happen in low- and middle-income developing countries, a judicious allocation of the limited resources to the most cost- efficient strategies is necessary. The present study was designed to report the causes of trauma, injured body regions, trauma severity scores and the one year survival rate of a randomly selected sample of trauma patients in a major referral hospital in Tehran, Iran. Methods： We chose and analyzed a random subgroup of traumatic patients admitted during the one- year period of May 2012 to May 2013 to Shariati Hospital, a major University Teaching Hospital in Tehran, Iran. Patients who stayed at the hospital for less than 24 h were excluded. In total, 73 traumatic patients were registered. The mean age was （40.19 ＋ 20.34） years and 6Z1% of them were male. Results： In general, the most common cause of injury was falls （47.9%）, followed by road traffic crashes （RTCs, 40.8%）. Assault and exposure to inanimate mechanical forces each were only associated with 5.6% of all injuries. The only cause of injury in ages of more than 65 years was fall. The most common cause of injury in ages between 15 and 45 years was RTCs. During the study, two deaths occurred： one was at ICU and the other was at home. The most commonly injured body region was the head （23.8%）, followed by the elbow and forearm （19%）, hip and thigh （15.9%）, and multiple body regions （14.3%）. The mean abbreviated injury score was 2.23 ± 1.02; injury severity index was 7.26 ± 7.06; and revised trauma score was 7.84, calculated for 38 patients. Conclusion： Prevention strategy of traumatic injury should focus on falls and RTCs, which are respec- tively the most common cause of trauma in older aged people and young males.

关键词： Accidents Traffic Epidemiology Iran Body regions Complications

Spinal cord injuries from road traffic crashes in southeastern Iran

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Chinese Journal of Traumatology 2007年第6期10卷 323-326页

作者： Mohammad R Rasouli Mohsen Nouri Vafa rahimi-movaghar Trauma and Surgery Research Center Sina Hospital Medical Sciences/Tehran University

Objective ： To analyze the data of patients with spinal cord injury （SCI） induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning. Methods ： In this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated. Results： Among 64 patients with SCI, 38 patients （59.4 %, 36 males and 2 females, aged 27.42 years ± 9.44 years on average） were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases （68.4%） and 12 cases （31.6%）, respectively. And 31patients （81. 6%） had complete SCI. Conus medularis （T12-L2 ） was the most affected level. Conclusions： Results are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.

关键词： Accidents, road traffic Spinal cord injury Iran

Spinal cord injury in Parkour sport （free runn,ng）： a rare case report

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Chinese Journal of Traumatology 2014年第3期17卷 178-179页

作者： Nima Derakhshan Mohammad Reza Zarei Zahed Malekmohammady Vafa rahimi-movaghar Trauma Research Center Shiraz University of MedicalSciences Shiraz Iran Sina Trauma and Surgery Research Center EmergencyMedicine Tehran Iran Trauma Research Center Department of Neurosurgery Sina Trauma and Surgery Research Center TehranUniversity of Medical Sciences Tehran Iran

A 24-year-old male was transferred to the emergency department while being in the state of quadriplegia with a history of performing Parkour sport, which is also called double front flip. Neurological examination revealed that the patient＇s muscle power was 0/5 at all extremities. The patient did not show any sense of light touch or pain in his extremities. In radiological studies, cervical spine X-ray and CT scan images showed C4-C5 subluxation with bilateral locked facets and spinal cord injury. The results of this very rare case study revealed that exercising Parkour sport without taking into account safety standards could result in irreversible injuries to the cervical spinal cord with fatal outcome.

关键词： Spinal cord injuries Cervical vertebrae Athletic injuries

The effect of tranexamic acid in traumatic brain injury： A randomized controlled trial

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Chinese Journal of Traumatology 2017年第1期20卷 49-51页

作者： Abolfazl Jokar Koorosh Ahmadi Tayyebeh Salehi Mahdi Sharif-Alhoseini Vafa rahimi-movaghar Department of Emergency Medicine Arak University of Medical Science Arak Iran Department of Emergency Medicine Alborz University of Medical Sciences Karaj Iran Sina Trauma and Surgery Research Center Tehran University of Medical Sciences Tehran Irand Department ofNeurosurgery Shariati Hospital Tehran University of Medical Sciences Tehran lran

Purpose： Traumatic brain injury （TBI） is a leading cause of death and disability, lntracranial hemorrhage （ICH） secondary to TBI is associated with a high risk of coagulopathy which leads to increasing risk of hemorrhage growth and higher mortality rate. Therefore, antifibrinolytic agents such as tranexamic acid （TA） might reduce traumatic ICH. The aim of the present study was to investigate the extent of ICH growth after TA administration in TBI patients. Methods： This single-blind randomized controlled trial was conducted on patients with traumatic ICH （with less than 30 ml） referring to the emergency department of Vali-Asr Hospital, Arak, Iran in 2014. Patients, based on the inclusion and exclusion criteria, were divided into intervention and control groups （40 patients each）. All patients received a conservative treatment for ICH, as well as either intravenous TA or placebo. The extent of ICH growth as the primary outcome was measured by brain cr scan after 48 h. Results： Although brain CT scan showed a significant increase in hemorrhage volume in both groups after 48 h, it was significantly less in the TA group than in the control group （p = 0.04）. The mean total hemorrhage expansion was （1.7 ± 9.7） ml and （4.3 ± 12.9） ml in TA and placebo groups, respectively （p 〈 0.001）. Conclusion： It has been established that TA, as an effective hospital-based treatment for acute TBI, could reduce ICH growth. Larger studies are needed to compare the effectiveness of different doses.

关键词： Traumatic brain injuries Intracranial hemorrhage Traumatic Tranexamic acid