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https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#1
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#2
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27896407/mixed-methods-assessment-of-trauma-and-acute-care-surgical-quality-improvement-programs-in-peru
#3
Lacey N LaGrone, Amy K Fuhs, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Roberto Valderrama, Leah N Isquith-Dicker, Jaime Herrera-Matta, Charles N Mock
BACKGROUND: Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. METHODS: This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27893559/personalized-reconstruction-of-traumatic-orbital-defects-based-on-precise-three-dimensional-orientation-and-measurements-of-the-globe
#4
Li Huang, Lisong Lin, Zhihong Wang, Bin Shi, Xiaofeng Zhu, Yu Qiu, Yue Huang, Xueyuan Yu, Yunyang Liao
OBJECTIVE: The aim of the study was to precisely assess the severity of traumatic orbital defects and techniques for personalized orbital reconstruction. METHODS: A retrospective study was conducted in 97 patients with traumatic orbital defects who were treated in our hospital between July 2003 and June 2012. Pre- and postoperative spiral computed tomography scans were performed in all patients. A spatial orientation technique was used to measure the three-dimensional position of the globe and calculate the changes in the orbital volume...
November 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27892596/extracorporeal-membrane-oxygenation-support-in-trauma-versus-nontrauma-patients-with-noninfectious-acute-respiratory-failure
#5
Hyoung Soo Kim, Sang Ook Ha, Sang Jin Han, Hyun-Sook Kim, Sun Hee Lee, Ki-Suck Jung, Sunghoon Park
The utility of extracorporeal membrane oxygenation (ECMO) in patients with acute respiratory distress syndrome (ARDS) of noninfectious origin remains unclear. Data on patients with ARDS of noninfectious origin who underwent ECMO were reviewed retrospectively. We compared the pre-ECMO characteristics and hospital outcomes of patients with traumatic and nontraumatic ARDS. In total, 23 patients (trauma, n = 9; nontrauma, n = 14) were included in the study. The mean patient age was 42 years, there were three females, and the mean pre-ECMO Simplified Acute Physiologic Score (SAPS) II was 60...
November 28, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27890837/association-between-pre-hospital-time-and-mortality-following-blunt-thoracic-aortic-injuries
#6
Biniam Kidane, Vaibhav Gupta, Mostafa El-Beheiry, Kelly Vogt, Neil G Parry, Richard Malthaner, Thomas L Forbes
OBJECTIVE: Blunt traumatic thoracic aortic injuries (BTAI) can be lethal, but advances in trauma systems and in surgical care have helped reduce mortality. The purpose of this study was to investigate whether time from injury to presentation is associated with mortality following BTAI. METHODS: Using the Ontario Trauma Registry, all patients were identified who were hospitalized with BTAI between 1999 & 2009. Variables including age, sex, Injury Severity Score, Charlson comorbidity index, systolic blood pressure on admission, operative intervention, and time from injury to presentation were analysed using multivariate logistic regression to determine independent predictors of mortality...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27890745/mini-open-thoracolumbar-corpectomy-perioperative-outcomes-and-hospital-cost-analysis-compared-to-open-corpectomy
#7
Olawale A R Sulaiman, Juanita Garces, Mansour Mathkour, Tyler Scullen, R Benson Jones, Teresa Arrington, Cuong J Bui
BACKGROUND: Standard open surgical management of thoracolumbar infection, trauma and tumor is associated with significant morbidity. Mini-open and less morbid surgical techniques are being introduced. Our objective is to compare perioperative and immediate post-operative morbidity of open and mini-open thoracolumbar corpectomy techniques including direct hospital costs. METHODS: We retrospectively reviewed the medical records of all patients who underwent open or mini-open corpectomy along with their demographics (age, sex, body mass index (BMI), primary diagnosis), operative data (length of surgery, EBL, blood transfusion-BT), surgical level, pre- and post-operative neurologic status (using ASIA scale), immediate peri-operative complications (within 30 days post-op), overall length of stay (LOS-A), length of stay from surgery (LOS-S), and total direct hospital costs were tabulated and analyzed...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27876077/post-traumatic-acute-kidney-injury-a-cross-sectional-study-of-trauma-patients
#8
Wei-Hung Lai, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Ching-Hua Hsieh, Hsiao-Yun Hsieh
BACKGROUND: The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. METHODS: Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System...
November 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27871770/ptsd-in-those-who-care-for-the-injured
#9
Kevin Luftman, Jayson Aydelotte, Kevin Rix, Sadia Ali, Katherine Houck, Thomas B Coopwood, Pedro Teixeira, Alex Eastman, Brian Eastridge, Carlos V R Brown, Matthew Davis
BACKGROUND: Post Traumatic Stress Disorder (PTSD) has become a focus for the care of trauma victims, but the incidence of PTSD in those who care for injured patients has not been well studied. Our hypothesis was that a significant proportion of health care providers involved with trauma care are at risk of developing PTSD. METHODS: A system-wide survey was applied using a modified version of the Primary Care PTSD Screen [PC-PTSD], a validated PTSD screening tool currently being used by the VA to screen veterans for PTSD...
November 10, 2016: Injury
https://www.readbyqxmd.com/read/27863295/the-effect-of-early-psychological-symptom-severity-on-long-term-functional-recovery-a-secondary-analysis-of-data-from-a-cohort-study-of-minor-injury-patients
#10
Sara F Jacoby, Justine Shults, Therese S Richmond
BACKGROUND: The mental health consequences of injuries can interfere with recovery to pre-injury levels of function and long term wellbeing. OBJECTIVES: The purpose of this study was to explore the relationship between psychological symptoms after minor injury and long-term functional recovery and disability. DESIGN: This exploratory study uses secondary data derived from a longitudinal cohort study of psychological outcomes after minor injury...
November 9, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27858844/forced-duction-training-a-potential-key-point-for-recovery-in-pediatric-patients-with-trapdoor-fracture
#11
Yinwei Li, Xuefei Song, Lunhao Li, Xianqun Fan, Ming Lin
Trapdoor fracture is a type of orbital fracture frequently observed in pediatric patients after facial trauma. The treatment options and surgical outcomes associated with this fracture are controversial.This study investigated the surgery principles and strategies as well as the functional training for the recovery and prognosis of pediatric patients with trapdoor fracture.A retrospective study was conducted on 21 pediatric patients with orbital trapdoor fracture who received the transconjunctival approach for orbital defect reconstruction surgery between 2009 and 2014 at the Department of Ophthalmology, Shanghai Ninth People's Hospital...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27857912/biomarkers-of-physiological-disturbances-for-predicting-mortality-in-decompressive-craniectomy
#12
Young Ha Jeong, So Hyun Kim, Eun Hee Choi, Kum Whang
OBJECTIVE: Of many critical care regimens, the management of physiological disturbances in serum is particularly drawing an attention in conjunction with patient outcome. The aim of this study was to assess the association of serum biochemical markers with mortality in head trauma patients with decompressive craniotomy. METHODS: Ninety six patients with acute subdural hematoma underwent decompressive craniectomy between January 2014 and December 2015. The clinical data and laboratory variables of these patients were recorded and analyzed retrospectively...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857907/clinical-outcome-of-acute-epidural-hematoma-in-korea-preliminary-report-of-285-cases-registered-in-the-korean-trauma-data-bank-system
#13
Young Ha Jeong, Ji Woong Oh, Sungmin Cho
OBJECTIVE: The aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS). METHODS: Of 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. We subcategorized the patients into two groups with good and poor outcomes...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27855275/epidemiology-and-aetiology-of-traumatic-cardiac-arrest-in-england-and-wales-a-retrospective-database-analysis
#14
Ed Barnard, David Yates, Antoinette Edwards, Marisol Fragoso-Iñiguez, Tom Jenks, Jason E Smith
BACKGROUND: Historically, reported survival from traumatic cardiac arrest (TCA) was extremely low. More recent publications have recorded survival to discharge of up to 8%. This improvement is likely to be multi-factorial; however, there are currently no published data describing the epidemiology or aetiology of TCA in England and Wales to guide future practice improvement. METHODS: Population-based analysis of 2009-2015 Trauma Audit and Research Network (TARN) data...
November 14, 2016: Resuscitation
https://www.readbyqxmd.com/read/27849481/brief-report-systemic-vascular-access-and-resuscitation-via-corpus-cavernosum
#15
Melville Bradley
BACKGROUND: Pre-hospital systemic vascular access with early resuscitation in the hypovolemic trauma patient can be problematic and is attempted through venous cut-downs, peripheral IV lines, and/or interosseous routes. This brief report examines an alternative for males via the corpus cavernosum (CC). METHODS: A systematic literature review using certain inclusion criteria including, but not limited to, corpus cavernosum access and resuscitation was conducted and a summary table created...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27836253/bi-manual-proximal-external-aortic-compression-after-major-abdominal-pelvic-trauma-and-during-ambulance-transfer-a-simulation-study
#16
M J Douma, D O'Dochartaigh, P G Brindley
BACKGROUND: Applying manual pressure after hemorrhage is intuitive, cost-free, and logistically-simple. When direct abdominal-pelvic compression fails, clinicians can attempt indirect proximal-external-aortic-compression (PEAC), while expediting transfer and definitive rescue. This study quantifies the sustainability of simulated bi-manual PEAC both immediately on scene and during subsequent ambulance transfer. The goal is to understand when bi-manual PEAC might be clinically-useful, and when to prioritize compression-devices or endovascular-occlusion...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/27832843/time-is-the-enemy-mortality-in-trauma-patients-with-hemorrhage-from-torso-injury-occurs-long-before-the-golden-hour
#17
A Q Alarhayem, J G Myers, D Dent, L Liao, M Muir, D Mueller, S Nicholson, R Cestero, M C Johnson, R Stewart, Grant O'Keefe, B J Eastridge
INTRODUCTION: The concept of the "Golden Hour" has been a time-honored tenet of prehospital trauma care, despite a paucity of data to substantiate its validity. Non-compressible torso hemorrhage has been demonstrated to be a significant cause of mortality in both military and civilian settings. We sought to characterize the impact of prehospital time and torso injury severity on survival. Furthermore, we hypothesized that time would be a significant determinant of mortality in patients with higher Abbreviated Injury Scale (AIS) grades of torso injury (AIS ≥ 4) and field hypotension (prehospital SBP ≤ 110 mmHg) as these injuries are commonly associated with hemorrhage...
October 20, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27827332/a-preventative-respiratory-protocol-to-identify-trauma-subjects-at-risk-for-respiratory-compromise-on-a-general-in-patient-ward
#18
Bethany A Nyland, Sarah K Spilman, Meghan E Halub, Keith D Lamb, Julie A Jackson, Trevor W Oetting, Sheryl M Sahr
BACKGROUND: Patients are at risk for respiratory complications after sustaining blunt chest trauma, yet contradictory evidence exists about the utility of prophylactic respiratory therapy to reduce respiratory complications in this population. This study assessed the effectiveness of a proactive respiratory protocol on an in-patient ward to identify trauma patients at risk for pulmonary complications, administer appropriate therapies, and prevent deterioration requiring transfer to the ICU...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27817882/does-early-beta-blockade-in-isolated-severe-traumatic-brain-injury-reduce-the-risk-of-post-traumatic-depression
#19
Rebecka Ahl, Gabriel Sjolin, Shahin Mohseni
INTRODUCTION: Depressive symptoms occur in approximately half of trauma patients, negatively impacting on functional outcome and quality of life following severe head injury. Pontine noradrenaline has been shown to increase upon trauma and associated β-adrenergic receptor activation appears to consolidate memory formation of traumatic events. Blocking adrenergic activity reduces physiological stress responses during recall of traumatic memories and impairs memory, implying a potential therapeutic role of β-blockers...
October 31, 2016: Injury
https://www.readbyqxmd.com/read/27815528/effects-of-unit-design-on-acute-care-nurses-walking-distances-energy-expenditure-and-job-satisfaction-a-pre-post-relocation-study
#20
Darcy Copeland, Misty Chambers
OBJECTIVES: The purpose of this study was to determine what differences occurred in steps taken and energy expenditure among acute care nurses when their work environment moved from a hospital with centralized nurses' stations to a hospital with decentralized nurses' stations. Additional goals were to determine design features nurses perceived as contributing to or deterring from their work activities and what changes occurred in reported job satisfaction. Since design features can also affect patient outcomes, patient falls were monitored...
November 3, 2016: HERD
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