Thomas Kristiansen

• Sivanesan, Shivanthe; Ramberg, Håkon; Kristiansen, Thomas; Thapa, Suraj; Bjøre, Marthe & Berge, Viktor [Vis alle 15 forfattere av denne artikkelen] (2026). Perioperative propranolol during robotic-assisted radical prostatectomy: A randomised, double-blind, placebo-controlled, pilot trial (PeP-RALP). BJUI Compass. 7(9). doi: 10.1002/bco2.70267.
• Jørgenrud, Benedicte Marie; Bråthen, Camilla Christin; Stenehjem, Jo; Kristiansen, Thomas; Rosseland, Leiv Arne & Bogstrand, Stig Tore (2024). Identifying excessive chronic alcohol use with phosphatidylethanol in patients with suspected severe injury-results from the IDART study. Alcohol and Alcoholism. ISSN 0735-0414. 59(3), s. 1–8. doi: 10.1093/alcalc/agae014. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Acute and chronic alcohol use are well-known risk factors for accidents and injuries, and concurrent psychoactive drug use can increase injury risk further. Phosphatidylethanol (PEth) 16:0/18:1 is a biomarker used to determine alcohol consumption the previous 3-4 weeks. The aim was to investigate the prevalence of chronic alcohol use in trauma patients, as determined by PEth 16:0/18:1 concentrations, and how excessive chronic alcohol use relate to demographic variables, injury mechanisms and drug use. Setting: Patients received at Norwegian trauma hospitals from March 2019 to February 2020. The study is part of the Impairing Drugs and Alcohol as Risk factors for Traumatic Injuries study. Methods: All patients aged ≥ 16 years received with trauma team were included in the study. Data on injury date and mechanism, gender and age was registered. Blood samples were analyzed for 22 psychoactive medicinal and illicit drugs, ethanol and phosphatidylethanol 16:0/18:1. Regression analyses were conducted to assess associations between alcohol use and gender, age, injury mechanism and drug use. Results and conclusion: Of the 4845 patients included in the study, 10% had PEth 16:0/18:1 concentration ≥ 600 nM (~430 ng/mL), indicative of excessive chronic alcohol use. Being male, between 44-61 years old, involved in violence, and testing positive for medicinal drugs was associated with excessive chronic alcohol use.Excessive chronic alcohol use was common among males, middle-aged, patients with violence as injury mechanism and those with medicinal drug use. These findings emphasize the need to detect and treat excessive chronic alcohol use among trauma patients.

• Kelpanides, Inga Katherina; Katzenschlager, Stephan; Skogvoll, Eirik; Tjelmeland, Ingvild Beathe Myrhaugen; Berner, Guro Grindheim & Alm-Kruse, Kristin [Vis alle 11 forfattere av denne artikkelen] (2024). Out-of-hospital cardiac arrest in children in Norway: A national cohort study, 2016–2021. Resuscitation Plus. 18. doi: 10.1016/j.resplu.2024.100662. Fulltekst i vitenarkiv Vis sammendrag

  Aim Children constitute an important and distinct subgroup of out-of-hospital cardiac arrest (OHCA) patients. This population-based cohort study aims to establish current age-specific population incidence, precipitating causes, circumstances, and outcome of paediatric OHCA, to guide a focused approach to prevention and intervention to improve outcomes. Methods Data from the national Norwegian Cardiac Arrest Registry was extracted for the six-year period 2016–21 for persons aged <18 years. We present descriptive statistics for the population, resuscitation events, presumed causes, treatment, and outcomes, alongside age-specific incidence and total paediatric mortality rates. Results Three hundred and eight children were included. The incidence of OHCA was 4.6 per 100 000 child-years and markedly higher in children <1 year at 20.9 child-years. Leading causes were choking, cardiac and respiratory disease, and sudden infant death syndrome. Overall, 21% survived to 30 days and 18% to one year. Conclusion A registry-based approach enabled this study to delineate the characteristics and trajectories of OHCA events in a national cohort of children. Precipitating causes of paediatric OHCA are diverse compared to adults. Infants aged <1 year are at particularly high risk. Mortality is high, albeit lower than for adults in Norway. A rational community approach to prevention and treatment may focus on general infant care, immediate first aid by caretakers, and identification of vulnerable children by primary health providers. Cardiac arrest registries are a key source of knowledge essential for quality improvement and research into cardiac arrest in childhood.

• Bråthen, Camilla Christin; Jørgenrud, Benedicte Marie; Bogstrand, Stig Tore; Gjerde, Hallvard; Rosseland, Leiv Arne & Kristiansen, Thomas (2023). Prevalence of use and impairment from drugs and alcohol among trauma patients: A national prospective observational study. Injury. ISSN 0020-1383. 54(12). doi: 10.1016/j.injury.2023.111160. Fulltekst i vitenarkiv Vis sammendrag

  Background: Being under the influence of psychoactive substances increases the risk of involvement in and dying from a traumatic event. The study is a prospective population-based observational study that aims to determine the prevalence of use and likely impairment from psychoactive substances among patients with suspected severe traumatic injury. Method: This study was conducted at 35 of 38 Norwegian trauma hospitals from 1 March 2019 to 29 February 2020. All trauma admissions for patients aged ≥ 16 years admitted via trauma team activation during the study period were eligible for inclusion. Blood samples collected on admission were analysed for alcohol, benzodiazepines, benzodiazepine-like hypnotics (Z-drugs), opioids, stimulants, and cannabis (tetrahydrocannabinol). Results: Of the 4878 trauma admissions included, psychoactive substances were detected in 1714 (35 %) and in 771 (45 %) of these, a combination of two or more psychoactive substances was detected. Regarding the level of impairment, 1373 (28 %) admissions revealed a concentration of one or more psychoactive substances indicating likely impairment, and 1052 (22 %) highly impairment. Alcohol was found in 1009 (21 %) admissions, benzodiazepines and Z-drugs in 613 (13 %), opioids in 467 (10 %), cannabis in 352 (7 %), and stimulants in 371 (8 %). Men aged 27-43 years and patients with violence-related trauma had the highest prevalence of psychoactive substance use with respectively 424 (50 %) and 275 (80 %) testing positive for one or more compounds. Conclusion: The results revealed psychoactive substances in 35 % of trauma admissions, 80 % of which were likely impaired at the time of traumatic injury. A combination of several psychoactive substances was common, and younger males and patients with violence-related injuries were most often impaired. Injury prevention strategies should focus on high-risk groups and involve the prescription of controlled substances. We should consider toxicological screening in trauma admissions and incorporation of toxicological data into trauma registries.

• Andresen, Åke Erling Lappen; Lauritzen, Magnus Varlid; Kramer-Johansen, Jo & Kristiansen, Thomas (2023). Implementation and use of a supraglottic airway device in the management of out-of-hospital cardiac arrest by firefighter first responders – A prospective feasibility study. Resuscitation Plus. 16. doi: 10.1016/j.resplu.2023.100480. Fulltekst i vitenarkiv Vis sammendrag

  Aim We wanted to assess the implementation and use of a supraglottic airway (SGA) for on-call firefighter first responders in out-of-hospital cardiac arrest. Methods We trained 502 firefighter first responders, located at 35 fire stations in the South-East of Norway, in the use of SGA during cardiopulmonary resuscitation in adult out-of-hospital cardiac arrest. Training consisted of 45 minutes of theoretical and practical training in small groups. Primary outcome was successful ventilation with SGA assessed by both firefighter first responders and first paramedic arriving on-scene. Secondary outcomes included time expenditure and complications related to the procedure, evaluation of the training, and descriptive characteristics of the out-of-hospital cardiac arrest cases. Results An SGA was used by firefighter first responders in 23 out-of-hospital cardiac arrests, and successful ventilation was achieved in 20 (87%) cases. Air-leak was described in the three unsuccessful cases. The median procedural time was 30 seconds (IQR = 15–40), with no observed procedural complications. Firefighter first responders arrived in median time 9 minutes (IQR = 6–10 min) before the ambulance. They performed chest compressions on all patients and 6 (26%) of the patients received shock with semi-automatic external defibrillator. After training, all participants were able to successfully ventilate a manikin with the SGA. The cost of the SGA equipment for all fire stations was 3955 GBP. Conclusion Implementation of an SGA for firefighter first responders in out-of-hospital cardiac arrest management seems feasible, safe and can be introduced with limited amount of training and limited use of resources.

• Andresen, Åke Erling Lappen; Kramer-Johansen, Jo & Kristiansen, Thomas (2022). Emergency cricothyroidotomy in difficult airway simulation – a national observational study of Air Ambulance crew performance. BMC Emergency Medicine. 22(1), s. 1–8. doi: 10.1186/s12873-022-00624-6. Fulltekst i vitenarkiv Vis sammendrag

  Background: Advanced prehospital airway management includes complex procedures carried out in challeng‑ ing environments, necessitating a high level of technical and non-technical skills. We aimed to describe Norwegian Air Ambulance-crews’ performance in a difcult airway scenario simulation, ending with a “cannot intubate, cannot oxygenate”-situation. Methods: The study describes Air Ambulance crews’ management of a simulated difcult airway scenario. We used video-observation to assess time expenditure according to pre-defned time intervals and technical and non-techni‑ cal performance was evaluated according to a structured evaluation-form. Results: Thirty-six crews successfully completed the emergency cricothyroidotomy with mean procedural time 118 (SD: ±70) seconds. There was variation among the crews in terms of completed procedural steps, including prepara‑ tion of equipment, patient- monitoring and management. The participants demonstrated uniform and appropriate situational awareness, and efective communication and resource utilization within the crews was evident. Conclusions: We found that Norwegian Air Ambulance crews managed a prehospital “cannot intubate, cannot oxygenate”-situation with an emergency cricothyroidotomy under stressful conditions with efective communica‑ tion and resource utilization, and within a reasonable timeframe. Some discrepancies between standard operating procedures and performance are observed. Further studies to assess the impact of check lists on procedural aspects of airway management in the prehospital environment are warranted.

• Stenehjem, Jo Steinson; Røise, Olav; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 10 forfattere av denne artikkelen] (2021). Injury Prevention and long-term Outcomes following Trauma - The IPOT project: a protocol for prospective nationwide registry-based studies in Norway. BMJ Open. 11(5). doi: 10.1136/bmjopen-2020-046954. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Traumatic injuries constitute a major cause of mortality and morbidity. Still, the public health burden of trauma in Norway has not been characterised using nationwide registry data. More knowledge is warranted on trauma risk factors and the long-term outcomes following trauma. The Injury Prevention and long-term Outcomes following Trauma project will establish a comprehensive research database. The Norwegian National Trauma Registry (NTR) will be merged with several data sources to pursue the following three main research topics: (1) the public health burden of trauma to society (eg, excess mortality and disability-adjusted life-years (DALYs)), (2) trauma aetiology (eg, socioeconomic factors, comorbidity and drug use) and (3) trauma survivorship (eg, survival, drug use, use of welfare benefits, work ability, education and income). Methods and analysis The NTR (n≈27 000 trauma patients, 2015–2018) will be coupled with the data from Statistics Norway, the Norwegian Patient Registry, the Cause of Death Registry, the Registry of Primary Health Care and the Norwegian Prescription Database. To quantify the public health burden, DALYs will be calculated from the NTR. To address trauma aetiology, we will conduct nested case–control studies with 10 trauma-free controls (drawn from the National Population Register) matched to each trauma case on birth year, sex and index date. Conditional logistic regression models will be used to estimate trauma risk according to relevant exposures. To address trauma survivorship, we will use cohort and matched cohort designs and time-to-event analyses to examine various post-trauma outcomes.

• Andresen, Åke Erling Lappen; Kramer-Johansen, Jo & Kristiansen, Thomas (2019). Percutaneous vs surgical emergency cricothyroidotomy: An experimental randomized crossover study on an animal-larynx model. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. 63(10), s. 1306–1312. doi: 10.1111/aas.13447. Fulltekst i vitenarkiv Vis sammendrag

  Background Airway management is a paramount clinical skill for the anaesthesiologist. The Emergency Cricothyroidotomy (EC) constitutes the final step in difficult airway algorithms securing a patent airway via a front‐of‐neck access. The main distinction among available techniques is whether the procedure is surgical and scalpel‐based or percutaneous and needle‐based. Methods In an experimental randomized crossover trial, using an animal larynx model, we compared two EC techniques; the Rapid Four Step Technique and the Melker Emergency Cricothyrotomy Kit®. We assessed time expenditure and success rates among 20 anaesthesiologists and related this to previous training, seniority and clinical experience with EC. Results All participants achieved successful airway access with both methods. Average time to successful airway access for scalpel‐based EC was 54 (±31) seconds and for percutaneous EC 89 (±38) seconds, with 35 (95% CI: 14‐57) seconds time difference, P = .003. Doctors with recent (<12 months) EC training performed better compared to the non‐training group (37 vs 61 seconds, P = .03 for scalpel‐based EC, and 65 vs 99 seconds, P = .02 for percutaneous EC). We found no differences according to clinical seniority or previous real‐life EC experience. Conclusions Our study demonstrated that anaesthesiologists achieved successful airway access on an animal experimental model with both EC methods within a reasonable time frame, but the scalpel‐based EC is performed more promptly. Recent EC training affected the time expenditure positively, while seniority and clinical EC experience did not. EC procedures should be regularly trained for.

• Uleberg, Oddvar; Pape, Kristine; Kristiansen, Thomas; Romundstad, Pål Richard & Klepstad, Pål (2018). Population-based analysis of the impact of trauma on longer-term functional outcomes. British Journal of Surgery. ISSN 0007-1323. 106(1), s. 65–73. doi: 10.1002/bjs.10965. Fulltekst i vitenarkiv
• Uleberg, Oddvar; Kristiansen, Thomas; Pape, Kristine; Romundstad, Pål Richard & Klepstad, Pål (2017). Trauma care in a combined rural and urban region: an observational study. Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. 61(3), s. 346–356. doi: 10.1111/aas.12856. Fulltekst i vitenarkiv
• Røislien, Jo; Lossius, Hans Morten & Kristiansen, Thomas (2015). Does transport time help explain the high trauma mortality rates in rural areas? New and traditional predictors assessed by new and traditional statistical methods. Injury Prevention. ISSN 1353-8047. 21(6), s. 367–373. doi: 10.1136/injuryprev-2014-041473. Fulltekst i vitenarkiv
• Kristiansen, Thomas; Lossius, Hans Morten; Rehn, Marius; Kristensen, Petter; Gravseth, Hans Magne Ulrik & Røislien, Jo [Vis alle 7 forfattere av denne artikkelen] (2014). Epidemiology of trauma: A population-based study of geographical risk factors for injury deaths in the working-age population of Norway. Injury. ISSN 0020-1383. 45(1), s. 23–30. doi: 10.1016/j.injury.2013.07.007. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Trauma is a major global cause of morbidity and mortality. Population-based studies identifying high-risk populations and regions may facilitate primary prevention and the development of optimal trauma systems. This study describes the epidemiology of adult trauma deaths in Norway and identifies high-risk areas by assessing different geographical measures of rurality. Methods All trauma-related deaths in Norway from 1998 to 2007 among individuals aged 16–66 years were identified by accessing national registries. Mortality data were analysed by linkage to population and geographical data at municipal, county and national levels. Three measures of rurality (centrality, population density and settlement density) were compared based on their association with trauma mortality rates. Results The study included 8466 deaths, of which 78% were males. The national annual trauma mortality rate was 28.7 per 100,000. Population density was the best predictor of high-risk areas, and there was a consistent inverse relationship between mortality rates and population density. The most rural areas had 52% higher trauma mortality rates compared to the most urban areas. This difference was largely due to deaths following transport-related injury. Seventy-eight per cent of all deaths occurred in the prehospital phase. Rural areas and death following self-harm had higher proportion of prehospital deaths. Conclusion Rural areas, as defined by population density, are at a higher risk of deaths following traumatic injuries and have higher proportions of prehospital deaths and deaths following transport-related injuries. The heterogeneous characteristics of trauma populations with respect to geography and mode of injury should be recognised in the planning of preventive strategies and in the organisation of trauma care.

• Uleberg, Oddvar; Vinjevoll, Ole-Petter; Kristiansen, Thomas & Klepstad, Pål (2014). Norwegian trauma care: a national cross-sectional survey of all hospitals involved in the management of major trauma patients. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 22:64(64). doi: 10.1186/s13049-014-0064-0. Fulltekst i vitenarkiv Vis sammendrag

  Background: Approximately 10% of the Norwegian population is injured every year, with injuries ranging from minor injuries treated by general practitioners to major and complex injuries requiring specialist in-hospital care. There is a lack of knowledge concerning the caseload of potentially severely injured patients in Norwegian hospitals. Aim of the study was to describe the current status of the Norwegian trauma system by identifying the number and the distribution of contributing hospitals and the caseload of potentially severely injured trauma patients within these hospitals. Methods: A cross-sectional survey with a structured questionnaire was sent in the summer of 2012 to all Norwegian hospitals that receive trauma patients. These were defined by number of trauma team activations in the included hospitals. A literature review was performed to assess over time the development of hospitals receiving trauma patients. Results: Forty-one hospitals responded and were included in the study. In 2011, four trauma centres and 37 acute care hospitals received a total of 6,570 trauma patients. Trauma centres received 2,175 (33%) patients and other hospitals received 4,395 (67%) patients. There were significant regional differences between health care regions in the distribution of trauma patients between trauma centres and acute care hospitals. More than half (52.5%) of the hospitals received fewer than 100 patients annually. The national rate of hospital admission via trauma teams was 13 per 10,000 inhabitants. There was a 37% (from 65 to 41) reduction in the number of hospitals receiving trauma patients between 1988 and 2011. Conclusions: In 2011, hospital acute trauma care in Norway was delivered by four trauma centres and 37 acute care hospitals. Many hospitals still receive a small number of potentially severely injured patients and only a few hospitals have an electronic trauma registry. Future development of the Norwegian trauma system needs to address the challenge posed by a scattered population and long geographical distances. The implementation of a trauma system, carefully balanced between centres with adequate caseloads against time from injury to hospital care, is needed and has been shown to have a beneficial effect in countries with comparable challenges. Keywords: Epidemiology, Injury, Norway, Trauma, Trauma system

• Kristiansen, Thomas; Ringdal, Kjetil G.; Skotheimsvik, Tarjei; Salthammer, Halvor Kjørholt; Gaarder, Christine & Næss, Pål Aksel [Vis alle 7 forfattere av denne artikkelen] (2012). Implementation of recommended trauma system criteria in south-eastern Norway: a cross-sectional hospital survey. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 20. doi: 10.1186/1757-7241-20-5. Fulltekst i vitenarkiv Vis sammendrag

  Background: Formalized trauma systems have shown beneficial effects on patient survival and have harvested great recognition among health care professionals. In spite of this, the implementation of trauma systems is challenging and often met with resistance. Recommendations for a national trauma system in Norway were published in 2007. We wanted to assess the level of implementation of these recommendations. Methods: A survey of all acute care hospitals that receive severely injured patients in the south-eastern health region of Norway was conducted. A structured questionnaire based on the 2007 national recommendations was used in a telephone interview of hospital trauma personnel between January 17 and 21, 2011. Seventeen trauma system criteria were identified from the recommendations. Results: Nineteen hospitals were included in the study and these received more than 2000 trauma patients annually via their trauma teams. Out of the 17 criteria that had been identified, the hospitals fulfilled a median of 12 criteria. Neither the size of the hospitals nor the distance between the hospitals and the regional trauma centre affected the level of trauma resources available. The hospitals scored lowest on the criteria for transfer of patients to higher level of care and on the training requirements for members of the trauma teams. Conclusion: Our study identifies a major shortcoming in the efforts of regionalizing trauma in our region. The findings indicate that training of personnel and protocols for inter-hospital transfer are the major deficiencies from the national trauma system recommendations. Resources for training of personnel partaking in trauma teams and development of inter-hospital transfer agreements should receive immediate attention.

• Kristiansen, Thomas; Rehn, Marius; Gravseth, Hans Magne; Lossius, Hans Morten & Kristensen, Petter (2012). Paediatric trauma mortality in Norway: population-based study of injury characteristics and urban-rural differences. Injury. ISSN 0020-1383. 43, s. 1865–1872. doi: 10.1016/j.injury.2011.08.011. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Paediatric injury is a major global public health challenge. Epidemiological research is required for effective primary injury prevention and to develop trauma systems for optimal management of childhood injuries. This study aimed to describe the characteristics and geographical distribution of paediatric trauma deaths and to assess the relationship between rural locations and mortality rates. Materials and methods: By accessing national registries, all trauma related deaths of persons aged 0–15 years in Norway from 1998 to 2007 were included. Paediatric trauma mortality rates and injury characteristic were analysed in relation to three different measures of municipal rurality: centrality, population density and settlement density. Results: There were 462 trauma related deaths during the study period and the national annual paediatric mortality rate was 4.81/100 000. Rural areas had higher mortality rates, and this difference was best predicted by municipal centrality. Rural trauma was characterised by traffic accidents and deaths that occurred prior to reaching hospital. The rural and northernmost county, Finnmark, had a mortality rate three times the national average. Conclusion: Mortality rates after childhood injury are high in rural areas. Substantiated measures of rurality are required for optimal allocation of primary and secondary preventive measures.

• Kristensen, Petter; Kristiansen, Thomas; Rehn, Marius; Gravseth, Hans Magne Ulrik & Bjerkedal, Tor (2012). Social inequalities in road traffic deaths at age 16-20 years among all 611 654 Norwegians born between 1967 and 1976: a multilevel analysis. Injury Prevention. ISSN 1353-8047. 18(1), s. 3–9. doi: 10.1136/ip.2011.031682. Fulltekst i vitenarkiv Vis sammendrag

  Background: Road traffic injury is a major cause of death among youths. Aims: To estimate mortality differences in family socioeconomic position (SEP) and municipal disadvantage level. Methods: Data on all Norwegians born in 1967–76, gathered from national registries, were linked by a unique national identification number. The 611 654 participants were followed-up for 5 years from age 16 years. Parental education level, father's income level, and proportion of high-income earners in the municipality served as SEP indicators. Associations between SEP and road traffic deaths were analysed by multilevel Poisson regression. Results: Road traffic deaths (n=676, rate 22.2 per 100 000 person-years) constituted a major cause of death, of which 91.9% were motor vehicle occupants. SEP distributions differed according to gender and type of motor vehicle crash (collision, non-collision). There was an inverse relationship between municipal proportions of high-income earners and mortality (population attributable fraction (PAF) 0.43, 95% CI 0.30 to 0.53) in all categories of gender-specific crash types. Family SEP gradients were not found except for male non-collision deaths, where increasing mortality was found in association with decreasing parental education level (PAF 0.94, 95% CI 0.59 to 0.99) and increasing paternal income (PAF 0.25, 95% CI 0.06 to 0.40). Conclusion: The different SEP patterns for road traffic deaths across gender and motor vehicle crash type illustrate that heterogeneity of social inequalities in health can be found even within narrow age bands and for similar causes of death.

• Kristiansen, Thomas; Søreide, Kjetil; Ringdal, Kjetil G.; Rehn, Marius; Krüger, Andreas J. & Reite, Andreas [Vis alle 9 forfattere av denne artikkelen] (2012). Trauma systems and early management of severe injuries in Scandinavia: review and current status. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 04(17). doi: 10.1186/1757-7241-17-S3-O29. Fulltekst i vitenarkiv
• Kristiansen, Thomas; Lossius, Hans Morten; Søreide, Kjetil; Steen, Petter Andreas; Gaarder, Christine & Næss, Pål Aksel (2011). Patients referred to a Norwegian trauma centre: effect of transfer distance on injury patterns, use of resources and outcomes. Journal of Trauma Management & Outcomes. 5(1), s. 9–9. doi: 10.1186/1752-2897-5-9. Fulltekst i vitenarkiv Vis sammendrag

  Background: Triage and interhospital transfer are central to trauma systems. Few studies have addressed transferred trauma patients. This study investigated transfers of variable distances to OUH (Oslo University Hospital, Ullevål), one of the largest trauma centres in Europe. Methods: Patients included in the OUH trauma registry from 2001 to 2008 were included in the study. Demographic, injury, management and outcome data were abstracted. Patients were grouped according to transfer distance: ≤20 km, 21-100 km and > 100 km. Results: Of the 7.353 included patients, 5.803 were admitted directly, and 1.550 were transferred. The number of transfers per year increased, and there was no reduction in injury severity during the study period. Seventy-six per cent of the transferred patients were severely injured. With greater transfer distances, injury severity increased, and there were larger proportions of traffic injuries, polytrauma and hypotensive patients. With shorter distances, patients were older, and head injuries and injuries after falls were more common. The shorter transfers less often activated the trauma team: ≤20 km -34%; 21-100 km -51%; > 100 km -61%, compared to 92% of all directly admitted patients. The mortality for all transferred patients was 11%, but was unequally distributed according to transfer distance. Conclusion: This study shows heterogeneous characteristics and high injury severity among interhospital transfers. The rate of trauma team assessment was low and should be further examined. The mortality differences should be interpreted with caution as patients were in different phases of management. The descriptive characteristics outlined may be employed in the development of triage protocols and transfer guidelines.

• Kristiansen, Thomas & Kristensen, Petter (2011). Er trafikkdød forbundet med sosiale forskjeller? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 131, s. 1407–1407. doi: 10.4045/tidsskr.11.0644. Fulltekst i vitenarkiv Vis sammendrag

  Forekomsten av dødelige trafikkskader er mangedoblet etter fylte 16 år (fig 1). Økningen er mest markant blant menn, hvor ulykker er den største dødsårsaken frem til fylte 40 år. Vi har studert forekomsten av dødelige trafikkskader blant alle som var født i Norge i tiårsperioden 1967 – 76 (1). Studien omfattet 611 654 personer, som ble fulgt fra 16 – 21 års alder. Under oppfølgingen døde 676 etter veitrafikkhendelser (insidensrate 22,2 per 100 000 personår). Den totale dødeligheten etter trafikkskader var halvert i høyinntektskommuner sammenliknet med lavinntektskommuner. På individnivå var det imidlertid ikke signifikant sammenheng mellom foreldrenes inntekt og risikoen for trafikkdød. For ikke-kollisjonsdød, der kjøretøyet kjører av veien uten å støte sammen med annet kjøretøy, var det uttalte sosiale ulikheter på individnivå for guttene i studien: Lavt utdanningsnivå hos foreldrene var sterkt assosiert med økt risiko for dødelige trafikkskader. Studien viser nyanser i risiko for trafikkskader som tidligere har vært ukjent og som bør vektlegges i det videre arbeidet mot trafikkdød i denne aldersgruppen.

• Kristiansen, Thomas; Søreide, Kjetil; Ringdal, Kjetil G.; Rehn, Marius; Krüger, Andreas J. & Reite, Andreas [Vis alle 9 forfattere av denne artikkelen] (2010). Trauma systems and early management of severe injuries in Scandinavia: Review of the current state. Injury. ISSN 0020-1383. 41(5), s. 444–452. doi: 10.1016/j.injury.2009.05.027. Fulltekst i vitenarkiv
• Rehn, Marius & Kristiansen, Thomas (2010). Triage and interhospital transfer: influencing trauma mortality? Acta Anaesthesiologica Scandinavica. ISSN 0001-5172. Fulltekst i vitenarkiv
• Kristiansen, Tarjei & Wangensteen, Ivar (2006). Effect of losses on area prices in the Norwegian electricity market. International Journal of Electrical Power & Energy Systems. ISSN 0142-0615. 28(1), s. 43–47. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Ulf, Kongsgaard & Kristiansen, Thomas (2023). Selvkirurgi. doi: 10.4045/TIDSSKR.23.0158. Fulltekst i vitenarkiv
• Rasmussen, Anders; Stenehjem, Jo Steinson; Røise, Olav; Gran, Jon Michael; Kristiansen, Thomas & Uleberg, Oddvar [Vis alle 8 forfattere av denne artikkelen] (2022). Standardised mortality rates for non-traumatic deaths among survivors of trauma in Norway (2015-2018). Fulltekst i vitenarkiv
• Uleberg, Oddvar; Kristiansen, Thomas; Nordseth, Trond; Stenehjem, Jo S.; Gran, Jon Michael & Clausen, Thomas [Vis alle 8 forfattere av denne artikkelen] (2022). Skader etter vold og ulykker - den glemte pandemi? 142(8), s. 678–679. doi: 10.4045/tidsskr.22.0261. Fulltekst i vitenarkiv
• Uleberg, Oddvar; Stenehjem, Jo S.; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2022). The injury prevention and outcomes following trauma (IPOT) project: is a nationwide registry-based study in Norway feasible? Fulltekst i vitenarkiv
• Kristiansen, Thomas; Kvandal, Per; Kleven, Josef; Fremmerlid, Margit Louise & Kongsgaard, Ulf E. (2022). Cerebral circulatory ultrasound assessment of patients undergoing robotic surgery in Trendelenburg position (CURT) - results from a pilot study on intraoperative transcranial Doppler monitoring. Fulltekst i vitenarkiv
• Stenehjem, Jo S.; Røise, Olav; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2021). Injury Prevention and long-term Outcomes following Trauma - the IPOT project: a protocol for prospective nationwide registry-based studies in Norway. Fulltekst i vitenarkiv
• Rosseland, Leiv Arne; Stenehjem, Jo S.; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Vis alle 12 forfattere av denne artikkelen] (2021). The Injury Prevention and Outcomes following Trauma project: a prospective nationwide registry-based study in Norway. Fulltekst i vitenarkiv
• Kvandal, Per; Kleven, Josef; Kongsgaard, Ulf; Fremmerlid, Margit Louise & Kristiansen, Thomas (2021). Cerebral Circulatory Ultrasound Assessment Of Patients Undergoing Robotic Surgery In A Trendelenburg Position - CURT. Fulltekst i vitenarkiv
• Bråthen, Camilla Christin; Jørgenrud, Benedicte Marie; Skadberg, Eline; Bogstrand, Stig Tore; Gjerde, Hallvard & Rosseland, Leiv Arne [Vis alle 7 forfattere av denne artikkelen] (2019). IDART: Impairing drug and alcohol as risk factors for traumatic injuries. Fulltekst i vitenarkiv
• Kristiansen, Thomas; Olin, Per Bertil Mårten & Haugaa, Håkon (2019). Low-flow extracorporeal carbon dioxide removal - three years´experience at OUS Rikshospitalet. Fulltekst i vitenarkiv
• Uleberg, Oddvar; Pape, Kristine; Kristiansen, Thomas; Romundstad, Pål Richard & Klepstad, Pål (2018). Long term impacts of trauma on return to work and need for medical benefits - a population-based follow-up study. Fulltekst i vitenarkiv
• Kristiansen, Thomas; Kristensen, Petter; Gravseth, Hans Magne Ulrik; Rehn, Marius; Røislien, Jo & Søreide, Kjetil [Vis alle 7 forfattere av denne artikkelen] (2013). Epidemiology of trauma: a population-based study of fatal injury and geographical challenges in Norwegian trauma care. Fulltekst i vitenarkiv
• Kristiansen, Thomas; Rehn, Marius; Gravseth, Hans Magne Ulrik; Lossius, HM & Kristensen, Petter (2011). Paediatric trauma mortality in Norway. Fulltekst i vitenarkiv
• Kristiansen, Thomas; Rehn, Marius; Braarud, Anne-Cathrine; Holtan, Anders; Skaga, Nls Oddvar & Strand, Terje [Vis alle 9 forfattere av denne artikkelen] (2010). NYE TRIAGEKRITERIER: OSLO–AKERSHUS TRIAGE STUDIE (OATS). Fulltekst i vitenarkiv
• Lossius, Hans Morten; Kristiansen, Thomas; Ringdal, Kjetil G. & Rehn, Marius (2010). Inter-hospital transfer: the crux of the trauma system, a curse for trauma registries. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 18. doi: 10.1186/1757-7241-18-15. Fulltekst i vitenarkiv Vis sammendrag

  The inter-hospital transfer of patients is crucial to a well functioning trauma system, and the transfer process may serve as a quality indicator for regional trauma care. However, the assessment of the transfer process requires high-quality data from various sources. Prospective studies and studies based on single-centre trauma registries may fail to capture an appropriate width and depth of data. Thus the creation of inclusive regional and national trauma registries that receive information from all of the services within a trauma system is a prerequisite for high quality inter-hospital transfer studies in the future.

• Kristensen, Petter; Kristiansen, Thomas; Rehn, Marius; Gravseth, Hans Magne Ulrik & Bjerkedal, Tor (2010). Fatal road traffic injuries at age 16-20 years among 611654 persons born in Norway 1967-1976: multilevel cohort study. Injury Prevention. ISSN 1353-8047. 16, s. A156–A156. doi: 10.1136/ip.2010.029215.559. Fulltekst i vitenarkiv
• Kristiansen, Thomas; Rehn, Marius; Gravseth, Hans Magne Ulrik; Lossius, HM & Kristensen, Petter (2010). Patterns of paediatric trauma deaths: 10-year population–based register study. Fulltekst i vitenarkiv
• Kristensen, Petter; Kristiansen, Thomas; Rehn, Marius; Gravseth, Hans Magne Ulrik & Bjerkedal, Tor (2010). Fatal road traffic injuries at age 16-20 years among 611654 persons born in Norway 1967-1976: multilevel cohort study. Fulltekst i vitenarkiv
• Rehn, Marius; Kristiansen, Thomas; Braarud, Anne-Cathrine; Holtan, Anders; Skaga, Nls Oddvar & Strand, Terje [Vis alle 9 forfattere av denne artikkelen] (2010). Nye triagekriterier: Oslo–Akershus Triage Studie (OATS). Fulltekst i vitenarkiv
• Jørgenrud, Benedicte Marie; Gjerde, Hallvard; Bråthen, Camilla Christin; Bogstrand, Stig Tore; Rosseland, Leiv Arne & Kristiansen, Thomas (2022). Rusmiddel- og legemiddelbruk som risikofaktorer for alvorlige ulykker. Oslo universitetssykehus HF. Fulltekst i vitenarkiv
• Uleberg, Oddvar; Klepstad, Pål; Pape, Kristine & Kristiansen, Thomas (2019). The trauma system and the patient - a national, regional and individual perspective. Norges teknisk-naturvitenskapelige universitet. ISSN 9788232637010. Fulltekst i vitenarkiv Vis sammendrag

  Sammendrag Traumesystemet og pasienten - et nasjonalt, regionalt og individuelt perspektiv Morbiditet og mortalitet som følge av traumatiske skader utgjør på verdensbasis en betydelig helseutfordring både for samfunnet og det enkelte individ. Kunnskap om den historiske utviklingen, epidemiologiske utviklingstrekk og implementering av traumesystemer er et viktig element for å bidra til en kontinuerlig kvalitetsheving av den behandlingen disse pasientene mottar. Selv om skader utgjør en av våre største folkehelseutfordringer har man hatt begrenset kunnskap om epidemiologi og behandling av potensielt alvorlig skadde pasienter, både i Norge og i Midt-Norge. Delarbeid 1 er en nasjonal tverrsnitts studie som inkluderer alle førti-en norske sykehus som mottok potensielt alvorlig skadde pasienter i 2011. Vi observerte en betydelig reduksjon av antall sykehus over tid og at mange sykehus fremdeles mottok et lite antall pasienter. På et nasjonalt nivå bidro akuttsykehus med traumefunksjon betydelig i den primære vurderingen av traumepasienter. Vi konkluderte med at den fremtidige utviklingen av traumesystemet må ta hensyn til utfordringene med en spredt befolkningsstruktur og geografiske utfordringer veid opp mot behovet for sykehus med tilstrekkelig pasientvolum og behovet for intervensjoner til riktig tid. Delarbeid 2 er en retrospektiv multisenter observasjons studie som inkluderer 2323 pasienter ved åtte sykehus innenfor et definert geografisk område (Midt-Norge). Vi observerte at kun et lite antall av pasientene ble definert som alvorlige skadde pasienter, og at de fleste av disse pasientene mottok endelig behandling ved det regionale traumesenteret. Akuttsykehus med traumefunksjon bidro i betydelig grad, ettersom mer enn halvparten av alle pasienter initialt ankom disse sykehusene og at majoriteten av disse pasientene mottok sin endelige behandling der. Vi konkluderte med at i en region med et spredt nettverk av sykehus, geografiske utfordringer, lav andel av alvorlige skadde pasienter, er det avgjørende for et bra behandlingsutfall at det foreligger optimal triage, desentralisert kapasitet for tidlig stabilisering og effektiv overføring av pasienter til institusjon med endelig behandlingsmulighet. Delarbeid 3 er en studie med 1191 potensielt alvorlig skadde pasienter i arbeidsfør alder, hvor man benyttet retrospektive traumeregisterdata fra syv sykehus som ble koblet med nasjonale administrative databaser. Målet var å beskrive sammenhengen mellom hvordan skadealvorlighet på lang sikt påvirker evnen til å komme tilbake i jobb og behovet for medisinske støtteordninger. Vi observerte at pasienter med mindre og moderate skader hadde to- til tre ganger større risiko for å benytte medisinske støtteordninger i oppfølgningsperioden, sammenlignet med tiden før skaden. Median tid for å komme tilbake i jobb, var henholdsvis 1, 4 og 11 måneder hos pasienter med mindre, moderate og alvorlige skader. Studien bekreftet at alvorlige skader gir betydelige langtidseffekter, men viste også at pasienter med mindre og moderate skader har høyere risiko for negative langsiktige helseeffekter enn tidligere vist. Samlet bidrar artiklene til økt basiskunnskap om organiseringen, behandlingen og utkomme hos potensielt alvorlig skadde pasienter. Dette er viktig når man skal innføre traumesystemer, foreta analyser av nøkkelindikatorer og evaluere kvalitet innen traumeomsorgen. I tillegg understreker funnene også viktigheten av langtidsoppfølgning hos dem med mindre og moderate skader, som et ledd for å redusere samfunnets totale skadebyrde.

Se alle arbeider i NVA