Univariate and Multivariable Analyses on Independent Predictors for Cervical Spinal Injury in Patients with Head Injury.

Objective: This study aims to identify independent factors associated with cervical spinal injuries in head-injured patients. The extent of injuries to other body parts was assessed by the Abbreviated Injury Scale (AIS) and was included in the analysis.

Methods: Consecutive head-injured patients admitted via the emergency department from January 1, 2014 to December 31, 2016 were retrospectively reviewed.

Impact of AIS 2015 versus 1998 on injury severity scoring and mortality prediction - single centre retrospective comparison study.

Background: A key component of trauma system evaluation is the Injury Severity Score (ISS). The ISS is dependent on the AIS, and as AIS versions are updated this effects the number of patients within a health system which are considered severely injured (ISS >15). This study aims to analyse the changes comparing AIS1998 and AIS2015, and its impact on injury severity scoring and survival prediction model in a major trauma centre.

Return to work after injury in Hong Kong: prospective multi-center cohort study.

Purpose: Trauma remains a major cause of morbidity and disability worldwide; however, reliable data on the health status of an urban Asian population after injury are scarce. The aim was to evaluate 1-year post-trauma return to work (RTW) status in Hong Kong.

Methods: This was a prospective, multi-center cohort study involving four regional trauma centers from 2017 to 2019 in Hong Kong.

Seven-year excess mortality, functional outcome and health status after trauma in Hong Kong.

Purpose: The purpose was to investigate long-term health impacts of trauma and the aim was to describe the functional outcome and health status up to 7 years after trauma.

Methods: We conducted a prospective, multi-centre cohort study of adult trauma patients admitted to three regional trauma centres with moderate or major trauma (ISS ≥ 9) in Hong Kong (HK). Patients were followed up at regular time points (1, 6 months and 1, 2, 3, 4, 5, 6, and 7 years) by telephone using extended Glasgow Outcome Scale (GOSE) and the Short-Form 36 (SF36).

RISC II is superior to TRISS in predicting 30-day mortality in blunt major trauma patients in Hong Kong.

Purpose: Hong Kong (HK) trauma registries have been using the Trauma and Injury Severity Score (TRISS) for audit and benchmarking since their introduction in 2000. We compare the mortality prediction model using TRISS and Revised Injury Severity Classification, version II (RISC II) for trauma centre patients in HK.

Methods: This was a retrospective cohort study with all five trauma centres in HK.

The impact of SARS and COVID-19 on major trauma in Hong Kong.

Background: The coronavirus disease 2019 (COVID-19) pandemic has been enormously disruptive and harmful to people around the world, but its impact on other illnesses and injuries has been more variable. To evaluate the ramification of infectious disease outbreaks on major traumatic injuries, we compared changes in the incidence of major trauma cases during the 2003 Severe Acute Respiratory Syndrome (SARS) period with COVID-19 in 2020.

Methods: Data were analyzed from the trauma registry of a major, tertiary-care teaching hospital in Hong Kong.

Major trauma care in Hong Kong and Germany: a trauma registry data benchmark study.

Background: Trauma remains a leading cause of death and effective trauma management within a well-developed trauma system has been shown to reduce morbidity and mortality. A trauma registry, as an integral part of a mature trauma system, can be used to monitor the quality of trauma care and to provide a means to compare local versus international standards. Hong Kong and Germany both have highly developed health care services.

Trauma team activation criteria and outcomes of geriatric trauma: 10 year single centre cohort study.

Background: With the aging population, the number of older patients with multiple injuries is increasing. The aim of this study was to understand the patterns and outcomes of older patients admitted to a major trauma centre in Hong Kong from 2006 to 2015, and investigate the performance of the trauma team activation (TTA) criteria for these elderly patients.

Methods: This was a retrospective cohort study from a university hospital major trauma centre in Hong Kong from 2006 to 2015.

Three-in-one protocol reduces mortality of patients with haemodynamically unstable pelvic fractures-a five year multi-centred review in Hong Kong.

Purpose: The mortality rate in patients with haemodynamically unstable pelvic fractures is as high as 40-60%. Despite the new advances in trauma care which are in phase in trauma centres in Hong Kong, the management of haemodynamically unstable pelvic fracture is still heterogeneous. The aim of this study is to review the results of management of haemodynamically unstable pelvic fracture patients in Hong Kong over a five year period.

Occult pneumothoraces in Chinese patients with significant blunt chest trauma: radiological classification and proposed clinical significance.

Background: An occult pneumothorax (OP) is a pneumothorax not seen on a supine chest X-ray (CXR) but detected on abdominal or thoracic computed tomography (CT) scanning. With the increasing use of CT in the management of significantly injured trauma patients, more OPs are being detected. The aim of this study was to classify OPs diagnosed on thoracic CT (TCT) and correlate them with their clinical significance.

Prevalence of survivor bias in observational studies on fresh frozen plasma:erythrocyte ratios in trauma requiring massive transfusion.

Observational studies on transfusion in trauma comparing high versus low plasma:erythrocyte ratio were prone to survivor bias because plasma administration typically started later than erythrocytes. Therefore, early deaths were categorized in the low plasma:erythrocyte group, whereas early survivors had a higher chance of receiving a higher ratio. When early deaths were excluded, however, a bias against higher ratio can be created.

Neurological outcomes of neurosurgical operations for multiple trauma elderly patients in Hong Kong.

Background: We aimed to investigate neurological outcomes in elderly patients with multiple trauma, and to review their clinical outcomes following neurosurgical operations.

Patients And Methods: The study was conducted in a regional trauma center in Hong Kong. We collected prospective data on consecutive trauma patients from January 2001 to December 2008.

Protection from traumatic brain injury in hormonally active women vs men of a similar age: a retrospective international study.

Background: It has been suggested that women with traumatic brain injury have more favorable outcomes than do men because of higher levels of circulating estrogen and progesterone that may reduce brain edema.

Objectives: To determine whether there is any association between sex and mortality in TBI patients and whether there is any association between sex and brain edema.

Design: Retrospective cohort study using data from 2001 to 2007 collected from a trauma registry in Hong Kong and the Victorian State Trauma Registry.

Early risk stratification of patients with major trauma requiring massive blood transfusion.

Background: There is limited evidence to guide the recognition of patients with massive, uncontrolled hemorrhage who require initiation of a massive transfusion (MT) protocol.

Objective: To risk stratify patients with major trauma and to predict need for MT.

Designs: Retrospective analysis of an administrative trauma database of major trauma patients.

Neurological outcome in patients with traumatic brain injury and its relationship with computed tomography patterns of traumatic subarachnoid hemorrhage.

Object: Traumatic subarachnoid hemorrhage (SAH) is a poor prognostic factor for traumatic brain injury. The authors aimed to further investigate neurological outcome among head injury patients by examining the prognostic values of CT patterns of traumatic SAH, in particular, the thickness and distribution.

Methods: The study was conducted using a database in a regional trauma center in Hong Kong.

Fresh-frozen plasma transfusion strategy in trauma with massive and ongoing bleeding. Common (sense) and sensibility.

During trauma resuscitation involving massive transfusion, the best fresh-frozen plasma to packed red blood cells ratio is unknown. No randomised controlled trial (RCT) is available on this subject, although there are plenty of observational studies suggesting that the ratio should be about 1:1. This ratio also makes more physiological sense, and we suggest that in patients with massive and ongoing bleeding, it is a sensible strategy with which to start resuscitation.

Occult pneumothorax in Chinese patients with significant blunt chest trauma: incidence and management.

Background: Occult pneumothorax (OP) is a pneumothorax not visualised on a supine chest X-ray (CXR) but detected on computed tomography (CT) scanning. With increasing CT use for trauma, more OP may be detected. Management of OP remains controversial, especially for patients undergoing mechanical ventilation.

Impact on trauma patient management of installing a computed tomography scanner in the emergency department.

Background: Computed tomography (CT) plays a central diagnostic role for trauma patients. A 16-slice multi-detector CT scanner was installed in the emergency department (ED) of Prince of Wales Hospital in December 2004. The aims of this study were to evaluate the impact of the CT scanner within the ED on trauma management and to compare the utilisation patterns of trauma CT before and after the introduction of EDCT.

Timing of tracheal intubation in traumatic cardiac tamponade: a word of caution.

Airway, breathing, and circulation are top priorities in any resuscitation. However, in cardiac tamponade, the decision to intubate the trachea and initiate positive pressure ventilation (PPV) should only be taken after consideration of the deleterious haemodynamic effects of positive intrathoracic pressure. We suggest that the threshold for intubation and PPV should be raised in tamponade and that intubation and PPV should, if possible, be timed so that relief of tamponade can immediately follow.

High risk trauma in older adults in Hong Kong: a multicentre study.

Background: Trauma is the eighth leading cause of death in Hong Kong. In 2002, 18.5% of the population of Hong Kong was aged 55 years or above, which increased to 22.

Trauma care systems: a comparison of trauma care in Victoria, Australia, and Hong Kong, China.

Background: Despite the high incidence of major trauma, few studies have directly compared the performance of trauma systems. This study compared the trauma system performance in Victoria, Australia, (VIC) and Hong Kong, China (HK).

Methods: Prospectively collected data over 5 years from January 2001 from the 2 trauma systems were compared using univariate analysis.

Do trauma teams make a difference? A single centre registry study.

Objective: To evaluate the association between trauma team activation according to well-established protocols and patient survival.

Methods: Single centre, registry study of data collected prospectively from trauma patients (who were treated in a trauma resuscitation room, who died or who were admitted to ICU) of a tertiary referral trauma centre Emergency Department (ED) in Hong Kong. A 10-point protocol was used to activate rapid trauma team response to the ED.

Outcome of traumatic extradural haematoma in Hong Kong.

Aim: Traumatic extradural haematoma (EDH) is a neurosurgical emergency and timely surgical intervention for significant EDH is the gold standard. This study aims to determine the incidence and mortality of consecutive patients with traumatic EDH admitted to the Emergency Department (ED) of Prince of Wales Hospital (PWH), a University Hospital Trauma Centre in Hong Kong.

Patients And Methods: Retrospective analysis of prospectively collected data for all consecutive trauma cases admitted through the ED during 2001-2004.

Five year analysis of Jockey Club horse-related injuries presenting to a trauma centre in Hong Kong.

Background: Professional horse riding-related injuries have not been studied before in Hong Kong, although horse racing takes place very regularly in the territory. In addition, the equestrian events of the 2008 Beijing Olympic Games will come to Hong Kong. This study analysed the pattern of horse-related injury among patients who presented to a trauma centre in a teaching hospital in Hong Kong.