Wounds and Injuries Clinical Trial
Official title:
Long-term Outcome Related Prognostic Factor and Biomarkers of Major Trauma Database Analysis
The investigators were looking for resuscitation management, trauma mechanism, risk factors, and de novo biomarkers related to prognosis and long-term outcome for evaluating trauma patients besides injury severity score (ISS) guiding the traumatologist. The medicare resource could be utilized efficiently along with increasing in the survival and quality of lifer (QoL) in major trauma.
Severe traumatic injury occupied the sixth leading cause of death in Taiwan, especially in
young adults. In 2013, there were accidental deaths in every 76 minutes. Not compared with
the malignancy, heart disease, cerebrovascular disease, diabetes mellitus, or pneumonia
Since 1995, Taiwan replaced a previous patchwork of separate social health insurance funds
with one single-payer, National Health Insurance (NHI) scheme that is administered by an
agency of the central government's Department of Health. NHI supported the cost of Critical
Illness and Injury that numerous patients with major trauma were eligible for preference.
However, the national medical cost of trauma care, especially in poly-trauma or major trauma
were impressive: the adjusted national inpatient trauma yearly costs were estimated at
$37,511,328,659 US dollars; the national insurance cost provided by Bureau of National
Health Insurance, Department of Health for trauma was over $20,000,000,000 new Taiwan
dollars till 1999 with increasing yearly.
Recently it flashed bulletins nationwide and overseas for catastrophes, such as aircraft
accident, wrecks, or underground gas explosions. There was a stirring of interest in life
support system for major trauma related rescue from dying. Death to trauma is caused by
costly damages on scene, hemorrhage shock or trauma and massive transfusion related acute
respiratory distress syndrome (ARDS). Extra-Corporeal Membrane Oxygenation (ECMO) can rescue
life from severe cardiopulmonary failure, but coexisting complication as bleeding and
coagulopathy restricting the utilization the use in trauma patients. Besides, there were
more portable ECMO sets making a debut, especially for air transportation. It act now the
medical transferral for trauma patients under ECMO support. The portable ECMO sets launched
with possibility, accessibility, and convenience. The issue of life support system
utilization, long-term outcome, and medical cost-effectiveness for major trauma patients was
worth discussing no matter in National Taiwan University Hospital (NTUH) trauma database or
National Health Insurance Research Database (NHIRD).
Immune system alteration was previously considered the mechanism of post-traumatic stress
disorder (PTSD). Moreover, an externally experienced traumatic event induces downstream
alterations in immune function by reducing methylation.
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Observational Model: Cohort, Time Perspective: Prospective
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