Forensic Pathologists and Clinical Trauma Reviews: Performance Improvement, Public Health, and a Concise Autopsy Documentation Guide.

Deland Weyrauch,Jacqueline Nunez,Christopher C Borck,Jonathan Gates,Monika Nelson,Tyler J Jones,Lisa Henneberry,James R Gill
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Abstract

As a powerful tool for discovering and documenting injury, the forensic autopsy has been incorporated into trauma care quality improvement. Autopsy findings are used to determine the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) to assess a patient's trauma severity. Clinical trauma services use autopsy reports to educate, improve patient care, and strengthen the information used in epidemiological and injury prevention studies. However, there is sometimes a disconnect between the forensic pathologist's injury descriptions and the information needed by the trauma service and for AIS/ISS coding.We formed a collaboration between forensic pathologists and trauma teams to improve this communication. Accordingly, we describe injuries that are commonly overlooked or poorly described in autopsy reports, useful injury terminology, opportunities for trauma care improvement revealed by autopsies, and which medical examiner/coroner cases will most benefit from attention to specific injury details. We demonstrate how differences in injury description impact AIS/ISS results, and distill the detailed AIS manual into a pragmatic, concise, "quick reference" autopsy-directed guide for the forensic pathologist. Collaborations between trauma teams and forensic pathologists benefit each other and help communicate autopsy findings in a more clinically useful way to stakeholders to further benefit the living.
法医病理学家和临床创伤审查:绩效改进、公共卫生和简明尸检文件指南》。
作为发现和记录损伤的有力工具,法医尸检已被纳入创伤护理质量改进的范畴。尸检结果用于确定简略损伤量表(AIS)和损伤严重程度评分(ISS),以评估患者的创伤严重程度。临床创伤服务部门利用尸检报告开展教育、改善患者护理并加强流行病学和伤害预防研究中使用的信息。然而,有时法医病理学家的伤情描述与创伤服务和 AIS/ISS 编码所需的信息之间会出现脱节。因此,我们描述了尸检报告中常见的被忽视或描述不清的损伤、有用的损伤术语、尸检揭示的改善创伤护理的机会,以及哪些法医/验尸官病例最受益于对特定损伤细节的关注。我们展示了损伤描述的差异对 AIS/ISS 结果的影响,并将详细的 AIS 手册提炼为实用、简明、"快速参考 "的尸检指南,供法医病理学家参考。创伤团队和法医病理学家之间的合作对彼此都有好处,有助于以更有益于临床的方式向利益相关者传达尸检结果,从而进一步造福于生者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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