Table 4.
Description of missed injuries
| Author, year, origin, N | (N)with MI | Area involved | % | (N)with clinically significant MI | Description of change in management | Mortality and morbidity |
|---|---|---|---|---|---|---|
| Enderson, 1990, Tennessee, USA N=399 |
36 |
MSK |
51 |
7 |
OT, N= 7 |
Nil deaths |
| Spinal |
12 |
(MSK N=3, Facial N=1, Abdomen N=3) |
Stroke, N=1 |
|||
| Facial |
5 |
|||||
| Thoracic |
12 |
|||||
| Abdominal |
15 |
|||||
| Vascular |
5 |
|||||
| Biffl, 2003, |
81 vs. 52 |
MSK |
32 vs. 46 |
Not reported |
Not reported |
Not reported |
| Rhode Island, USA |
Spinal |
29 vs. 24 |
||||
| Pre TTS: N= 3412 vs. Post TTS: 3442 |
Abdominal |
17 vs. 18 |
||||
| Brain |
10 vs. 6 |
|||||
| Pelvic |
5 vs. 0 |
|||||
| Vascular |
3 vs. 2 |
|||||
| Diaphragm |
3 vs. 0 |
|||||
| Vles, 2003, |
49 |
Chest |
33 |
22 |
OT, N=12 |
Morbidity unspecified, N=3 |
| The Netherlands N=3879 |
MSK |
27 |
(Chest N=1, MSK N=4, Facial N=5, Other N=2) |
|||
| Skull |
7 |
ICC, N=2 |
||||
| Facial |
13 |
Cast, N=6 |
||||
| C-Spine |
7 |
|||||
| Other |
10 |
Halo/brace, N=2 |
||||
| Hoff, 2004 |
42 |
Extremities |
45 |
19 |
OT, N=4 (not specified) |
Not reported |
| Pennsylvania, USA |
Spine |
21 |
Cast, N=7 |
|||
| N=432 |
Chest |
15 |
Transfer, N=1 |
|||
| Pelvis/proximal skeleton |
19 |
Change in advice, N=6, Home equipment, N=1 |
||||
| Soundappan, 2004 |
12 |
Head/face |
33 |
1 |
OT, N=1 (not specified) |
Nil deaths |
| Sydney, Australia |
Spine |
17 |
Prolonged LOS, N=4 |
|||
| N=76 |
Extremities |
50 |
Delay in mobilisation, N=4 |
|||
| Howard, 2006, |
13 |
Extremities |
70 |
Not reported |
Not reported |
Not reported |
| Indianapolis, USA |
Face |
12 |
||||
| N=90 |
Spine |
12 |
||||
| Chest |
6 |
|||||
| Okello, 2007, |
76 |
Head and neck |
24 |
Not reported |
Not reported |
Not reported |
| Uganda |
Face |
8 |
Mulivariate regression shows higher morbidity and longer LOS in patients with MI compared to patients without MI. This may not reflect causality. |
|||
| N=403 |
Thorax |
11 |
||||
| Abdomen/pelvis |
20 |
|||||
| Extremities |
26 |
|||||
| Janjua, 2008 |
134 |
MSK |
40 |
30 |
OT, N=11 (Orthopedic n=3, Laparatomy N=7, |
Death 1.5% (N=2: C1 fracture; epidural hematoma) |
| Sydney, Australia |
STI |
36 |
Thoracotomy N=1) |
Complications 8% (peritonitis N=4 after missed hollow viscus injury) |
||
| Abdomen |
6 |
Laceration repair, N=2 |
||||
| N=206 |
Nerve injury |
9 |
Embolisation, N=1 |
|||
| (Hemo-) Pneumothorax |
5 |
Not specified, N=17 |
||||
| Ursic, 2009 |
35 vs 62 |
Not reported |
|
Not reported |
Not reported |
Mortality |
| Sydney, Australia |
Pre 3.5% vs. post 2.5% |
|||||
| Pre TTS: N=981 vs. Post TTS= 1006 | ||||||
| Huynh, 2010 |
80 |
Orthopedic |
60 |
31 | OT, N=7 (Orthopedic N=4, Facial N=2, Spinal N=1) |
Not reported |
| North Carolina, USA |
Facial/plastics/dental |
21 |
Cast, N=24 | |||
| N=5143 |
Neurosurgical |
16 |
||||
| Ophthalmology | 3 |
Description of missed injuries. Anatomical area, clinically significant missed injuries, change in management and mortality and morbidity.
MI Missed Injury, OT operating Theatre, ISS Injury Severity Score, TS Tertiary Survey, USA United States of America, MSK musculoskeletal. Not all columns add up to 100% due to low proportions not being reported.
TTS Tertiary Trauma Survey.