Background: Despite advances in the treatment of abdominal INJURIES in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal INJURIES compare with HEAD INJURIES in trauma patients and non-trauma surgical ICU patients. Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality. Results: The 90-day mortality was 21. 9% in abdominal INJURIES patients. According to multivariate Cox regression, the expected hazard mortality was 2. 758 times higher in patients with abdominal INJURIES compared to non-trauma patients (HR: 2. 758, 95% CI: 1. 077– 7. 063, P = 0. 034). About more than 50% of all deaths in the abdominal and HEAD trauma groups occurred within 20 days after admission. Mean time to death was 27. 85 ± 20. 1, 30. 27 ± 18. 22 and 31. 43 ± 26. 24 days for abdominal-trauma, surgical-ICU, and HEAD-trauma groups, respectively. Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal INJURIES, multi-organ dysfunction in abdominal INJURIES, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.

BACKGROUND: HEAD injury is still a major cause of death and disability. Despite advances in intensive monitoring and clinical practice, little data is available to show the predictive value of intracranial pressure monitoring in assessment of the outcome of HEAD INJURIES. This study was undertaken to evaluate this predictive value and is the first Iranian study in which ICP monitoring has been included. METHODS: In a prospective study from September 1999 to September 2003, all HEAD- injured patients (53 patients) with GCS of 4-8 who were admitted to Nemazee Hospital of Shiraz University of Medical Sciences were included in this study. Subarachnoid screw method or ventricular catheter via ventriculostomy was used to determine intracranial pressure. Patients were monitored for 3 days and were followed for two years at 6-month intervals. RESULTS: Car accidents were the most common cause of HEAD injury (43.3%) and 43.3% of patients had GCS of 8. Sixty percent of patients had abnormal intracranial pressure. The patients were most commonly in their first decade of life (18.8%) and 81% of patients were male. Controlling increased intracranial pressure was successful in 60% of patients and resulted in a decrease of mortality rate from 60% to 15%. CONCLUSIONS: Early treatment of increased intracranial pressure in HEAD injury patients would be beneficial in reducing mortality and morbidity rates.      

Background: Occupational accidents made INJURIES in different parts of the body,two important parts of them are HEAD and neck. We aimed to identify the risk factors of work-related HEAD and neck INJURIES with using of a nationwide occupational accident data. Methods: This analytical cross-sectional study was conducted on the nationwide data that was gathered in 2013-2018. The target population was industrialized and non-industrialized adults, aged 18 yr or older. De-pendent variable was the HEAD and neck INJURIES. The independent variables were included, age, sex, education level, work experience, job, shift work, injury cause, referred center, season, accident day, accident time, and action after accident. Univariate logistic regression analyses and subsequently, a multivariate logistic regression model was used for analysis. Results: Out of the 17066 injured workers, 4072 (23. 86%) subjects had HEAD and neck INJURIES. The results of multivariate logistic regressions model showed, age ranges 30-39 (OR = 1. 218,95% CI: 1. 036, 1. 433,P= 0. 017), 40-49 (OR = 1. 313,95% CI: 1. 044, 1. 652,P= 0. 020), and >= 60 (OR=1. 620,95%CI: 1. 028, 2. 553,P=0. 038) and having male sex (OR = 1. 657,95% CI: 1. 075, 2. 555,P= 0. 022) were final work-related risk factors of HEAD and neck INJURIES in Iran. Also winter season (OR = 1. 212,95% CI: 1. 00, 1. 469,P= 0. 050) could increase the HEAD and neck INJURIES odds. Conclusion: Older workers in Iran are more vulnerable against the occupational HEAD and neck INJURIES. More-over, having male sex was other risk factor of the HEAD and neck INJURIES.