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Quality improvement of trauma care: an innovative approach by health services research

Research Project

Project/Area Number 16K15388
Research Category

Grant-in-Aid for Challenging Exploratory Research

Allocation TypeMulti-year Fund
Research Field Medical and hospital managemen
Research InstitutionUniversity of Tsukuba

Principal Investigator

Abe Toshikazu  筑波大学, 医学医療系, 客員教授 (70633973)

Co-Investigator(Kenkyū-buntansha) 田宮 菜奈子  筑波大学, 医学医療系, 教授 (20236748)
Project Period (FY) 2016-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2016: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Keywords外傷 / ヘルスサービスリサーチ
Outline of Final Research Achievements

We conducted health services researches of trauma care using data of Japan Trauma Data Bank. We described a trend of trauma care and outcomes during 10 years. We also reported the descriptive epidemiology of pediatric trauma, which has been little information. In regard to prehospital care, we evaluated not only helicopters with physicians but also ambulances with physicians, which was limited information and effectiveness. We also investigated the use of whole-body CT, which is a trend in trauma care. In regard to resuscitation and treatments, we demonstrated the effectiveness of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has been recently introduced. We also reported limitations of tracheostomy, which is one of the classic resuscitation methods, and problems of using catecholamine. All of them were published mainly on major journals in the field of emergency and critical care medicine.

Academic Significance and Societal Importance of the Research Achievements

外傷は若年の主な死因であり予後も悪い。しかし、未だ予後を劇的に改善させる医療手段は見つかっていない。我々は既存の医療サービスが外傷患者の予後の改善にある程度寄与すると考えた。つまり、外傷の予後が大きく改善していない理由として医療が本当に必要な時に必要な方法で必要としている人に確かにサービスとして常に届けられていない可能性がある。
研究代表者が調査・解析し、報告した項目は全て現在、外傷診療で当たり前に行われていることである。当たり前の診療にも良し悪し、改善点があり、今回の研究を用いて、もう一度見直しことができた。今後の外傷診療の診療の質の改善の礎になる研究となった。

Report

(4 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (12 results)

All 2019 2018 2017 2016

All Journal Article (9 results) (of which Peer Reviewed: 2 results,  Open Access: 2 results,  Acknowledgement Compliant: 1 results) Presentation (3 results) (of which Int'l Joint Research: 2 results)

  • [Journal Article] Is Whole-Body CT Associated With Reduced In-Hospital Mortality in Children With Trauma? A Nationwide Study2019

    • Author(s)
      Abe Toshikazu、Aoki Makoto、Deshpande Gautam、Sugiyama Takehiro、Iwagami Masao、Uchida Masatoshi、Nagata Isao、Saitoh Daizoh、Tamiya Nanako
    • Journal Title

      Pediatric Critical Care Medicine

      Volume: Online first Issue: 6 Pages: 1-1

    • DOI

      10.1097/pcc.0000000000001898

    • Related Report
      2018 Annual Research Report
  • [Journal Article] The authors reply2019

    • Author(s)
      Aoki Makoto、Abe Toshikazu、Hagiwara Shuichi、Oshima Kiyohiro
    • Journal Title

      Critical Care Medicine

      Volume: 47 Issue: 3 Pages: e274-e275

    • DOI

      10.1097/ccm.0000000000003607

    • Related Report
      2018 Annual Research Report
  • [Journal Article] Epidemiology, Patterns of treatment, and Mortality of Pediatric Trauma Patients in Japan2019

    • Author(s)
      Aoki Makoto、Abe Toshikazu、Saitoh Daizoh、Oshima Kiyohiro
    • Journal Title

      Scientific Reports

      Volume: 9 Issue: 1 Pages: 917-917

    • DOI

      10.1038/s41598-018-37579-3

    • Related Report
      2018 Annual Research Report
  • [Journal Article] Efficacy of the presence of an emergency physician in prehospital major trauma care: A nationwide cohort study in Japan2018

    • Author(s)
      Hirano Yohei、Abe Toshikazu、Tanaka Hiroshi
    • Journal Title

      The American Journal of Emergency Medicine

      Volume: Epub ahead of print Issue: 9 Pages: 1605-1610

    • DOI

      10.1016/j.ajem.2018.11.014

    • Related Report
      2018 Annual Research Report
  • [Journal Article] Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock2018

    • Author(s)
      Aoki Makoto、Abe Toshikazu、Saitoh Daizoh、Hagiwara Shuichi、Oshima Kiyohiro
    • Journal Title

      Critical Care Medicine

      Volume: 46 Issue: 12 Pages: e1145-e1151

    • DOI

      10.1097/ccm.0000000000003428

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries2018

    • Author(s)
      Abe Toshikazu、for the LUNG-SAFE Investigators and the ESICM Trials Group、Madotto Fabiana、Pham T?i、Nagata Isao、Uchida Masatoshi、Tamiya Nanako、Kurahashi Kiyoyasu、Bellani Giacomo、Laffey John G.
    • Journal Title

      Critical Care

      Volume: 22 Issue: 1 Pages: 195-195

    • DOI

      10.1186/s13054-018-2126-6

    • NAID

      120007133817

    • Related Report
      2018 Annual Research Report
  • [Journal Article] Descriptive epidemiology of traumatic spinal injury in Japan2018

    • Author(s)
      Tafida Mahammad Abbas、Wagatsuma Yukiko、Ma Enbo、Mizutani Taro、Abe Toshikazu
    • Journal Title

      Journal of Orthopaedic Science

      Volume: 23 Issue: 2 Pages: 273-276

    • DOI

      10.1016/j.jos.2017.10.013

    • Related Report
      2018 Annual Research Report
  • [Journal Article] Ten-year inhospital mortality trends for patients with trauma in Japan: a multicentre observational study2018

    • Author(s)
      Nagata Isao、Abe Toshikazu、Uchida Masatoshi、Saitoh Daizoh、Tamiya Nanako
    • Journal Title

      BMJ Open

      Volume: 8 Issue: 2 Pages: e018635-e018635

    • DOI

      10.1136/bmjopen-2017-018635

    • NAID

      120007133993

    • Related Report
      2018 Annual Research Report 2017 Research-status Report
  • [Journal Article] Resuscitative endovascular balloon occlusion of the aorta versus aortic cross clamping among patients with critical trauma: a nationwide cohort study in Japan2016

    • Author(s)
      Toshikazu Abe, Masatoshi Uchida, Isao Nagata, Daizoh Saitoh, Nanako Tamiya
    • Journal Title

      Critical Care

      Volume: 20 Issue: 1 Pages: 400-400

    • DOI

      10.1186/s13054-016-1577-x

    • NAID

      120007135253

    • Related Report
      2016 Research-status Report
    • Peer Reviewed / Open Access / Acknowledgement Compliant
  • [Presentation] 救命センターに搬送された小児外傷患者の疫学,治療,死亡率~日本外傷データバンクデータを用いて2018

    • Author(s)
      青木誠, 阿部智一, 齋藤大蔵, 大嶋清宏
    • Organizer
      日本救急医学会
    • Related Report
      2018 Annual Research Report
  • [Presentation] Increased risk of mortality with vasopressor use in traumatic hemorrhage shock: a nationwide cohort study in Japan2017

    • Author(s)
      Makoto Aoki, Toshikazu Abe, Shuichi Hagiwara, Kiyohiro Oshima
    • Organizer
      American Heart Association Scientific Session
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research
  • [Presentation] Resuscitative Endovascular Balloon Occlusion of the Aorta versus Aortic Cross Clamping among patients with critical trauma: a nationwide cohort study in Japan2016

    • Author(s)
      Toshikazu Abe, Masatoshi Uchida, Isao Nagata, Daizoh Saitoh, Nanako Tamiya
    • Organizer
      AHA Scientific Sessions
    • Place of Presentation
      New Orleans, USA
    • Year and Date
      2016-11-12
    • Related Report
      2016 Research-status Report
    • Int'l Joint Research

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Published: 2016-04-21   Modified: 2020-03-30  

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