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polytrauma mortality

Martin Rozanovic, Csaba Csontos, Lajos Bogár, Lívia Szélig, Tímea Bocskai, Patrícia Kovács, Marianna Matancic, Attila Miseta, Csaba Loibl
BACKGROUND: In polytrauma and burn injury Systemic Inflammatory Response Syndrome (SIRS) develops. SIRS is presented in many hospitalized patients, including those who never develop infection or sepsis. Both in SIRS and sepsis the leukocyte activation occurs. In acute phase reaction leukocytes' upward flotation i.e. leukocyte antisedimentation rate (LAR) can indicate infectious origin. OBJECTIVE: To evaluate the predictive power of LAR, serum C-reactive protein (CRP) and procalcitonin (PCT) levels regarding mortality risk and development of septic complications...
October 20, 2016: Clinical Hemorheology and Microcirculation
S E Dekker, H-M de Vries, W D Lubbers, P M van de Ven, E J Toor, F W Bloemers, L M G Geeraedts, P Schober, C Boer
PURPOSE: Despite the availability of different lactate clearance (LC) metrics for clinical use, it remains unknown which metric is superior as a clinical predictor for outcome, particularly in trauma patients. This retrospective study compared four previously described metrics of LC and examined the association between LC and outcome in trauma patients. METHODS: Lactate values of trauma patients admitted to a level I trauma center between 2010 and 2013 were retrieved from patient records...
October 13, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Lauren Elizabeth Thomson, Nicola Fry, Richard Jackson
Trauma is one of the leading causes of death worldwide, with road traffic accidents being the leading cause of death in the age group of 15-29 years However, with modern advances in management and the introduction of specialised trauma centres, more and more are surviving severe and life-threatening trauma. The ideal timing of fracture fixation has been the subject of debate for a number of decades. There is evidence to suggest that fracture fixation in the patient with polytrauma is best achieved early on to reduce the incidence of morbidity and mortality, with damage control surgery in the more appropriate option in those patients who are haemodynamically unstable...
October 11, 2016: Postgraduate Medical Journal
Ahmad S Alobaidi, Ammar Al-Hassani, Ayman El-Menyar, Husham Abdelrahman, Mazin Tuma, Hassan Al-Thani, Mohammed A Aldosari
BACKGROUND: Femur fracture (FF) is a common injury, and intramedullary nailing (IMN) is the standard surgical fixation. However, the time of intervention remains controversial. We aimed to describe the reamed IMN (rIMN) timing and hospital outcomes in trauma patients presenting with FF. MATERIALS AND METHODS: A retrospective analysis was conducted for all patients admitted with FF and they underwent fixation at level 1 trauma unit between January 2010 and January 2012...
July 2016: International Journal of Critical Illness and Injury Science
Anne-Britt E Dekker, Pieta Krijnen, Inger B Schipper
AIM: To investigate posttraumatic cytokine alterations and their value for predicting complications and mortality in polytraumatized patients. METHODS: Studies on the use of specific cytokines to predict the development of complications and mortality were identified in MEDLINE, EMBASE, Web of Science and the Cochrane Library. Of included studies, relevant data were extracted and study quality was scored. RESULTS: Forty-two studies published between 1988 and 2015 were identified, including 28 cohort studies and 14 "nested" case-control studies...
August 4, 2016: World Journal of Critical Care Medicine
Sanjay Kumar Yadav, Subodh Kumar, Mahesh Chander Misra, Sushma Sagar, V K Bansal
Liver injury is the major cause of morbidity and mortality in polytrauma patients. This study was conducted to know the burden of hepatobiliary injury and its outcome in our setup. It is a retrospective study of all patients with traumatic hepatobiliary injuries from January 2008 through April 2012 at JPNATC, New Delhi. All patients were resuscitated as per ATLS guidelines. Management of patients was based on hemodynamic status and associated injuries. Liver injury occurred in 7.52 % of all trauma admissions and 20...
August 2016: Indian Journal of Surgery
Carlo Biz, Lisa Buffon, Roberto Marin, Natalia Petrova
INTRODUCTION AND BACKGROUND: Trauma is the most frequent cause of death in people under 40 years old. It is an important problem not only because of the high mortality but also because of the consequential disability that can lead to serious economic consequences. STUDY AIMS: This descriptive, comparative study investigates the definitive management of poly-traumatised patients in an Italian Orthopaedic Ward in order to highlight its strengths and weaknesses in comparison with the most recent literature...
April 21, 2016: International Journal of Orthopaedic and Trauma Nursing
Salman Abbasi Fard, Mauricio J Avila, Cameron M Johnstone, Apar S Patel, Christina M Walter, Jesse Skoch, Kamran V Sattarov, Ali A Baaj
Traumatic atlanto-occipital dislocation (AOD) is an ominous injury with high mortality and morbidity in trauma patients. Improved survival has been observed with advancements in pre-hospital and hospital care. Furthermore, high quality imaging studies are accessible at most trauma centers; these are crucial for prompt diagnosis of AOD. The objective of this study is to perform a comprehensive literature review of traumatic AOD, with specific emphasis on identifying prognostic factors for survival. A review of the literature was performed using the Medline database for all traumatic atlanto-occipital articles published between March 1959 and June 2015; 141 patients from 60 total studies met eligibility criteria for study inclusion...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
B A Zahoor, J E Piercey, D R Wall, K D Tetsworth
Mucormycosis as a consequence of trauma is a devastating complication; these infections are challenging to control, with a fatality rate approaching 96% in immunocompromised patients. We present a case where a proactive approach was successfully employed to treat mucormycosis following complex polytrauma. Aggressive repeated surgical debridement, in combination with appropriate antifungal therapy, proved successful in this instance. In our opinion, mucormycosis in trauma mandates an aggressive surgical approach...
August 23, 2016: Annals of the Royal College of Surgeons of England
Matthias Weuster, Alexander Brück, Sebastian Lippross, Leif Menzdorf, Stefanie Fitschen-Oestern, Peter Behrendt, Timo Iden, Jan Höcker, Rolf Lefering, Andreas Seekamp, Tim Klüter
BACKGROUND: Accidental hypothermia (AH) endangers the patient after polytrauma. Past studies have emphasized this entity as a major risk factor. The aim of this study was to describe the epidemiology of AH in major trauma considering the preclinical and clinical course. Predictors should be elucidated. METHODS: This is a retrospective investigation from the TraumaRegister DGU. Patients were documented in the period between 2002 and 2012. The study compared multiple-injured patients with or without hypothermic temperatures...
November 2016: Journal of Trauma and Acute Care Surgery
G Naqvi, G Johansson, G Yip, A Rehm, A Carrothers, K Stöhr
Introduction Paediatric trauma is a significant burden to healthcare worldwide and accounts for a large proportion of deaths in the UK. Methods This retrospective study examined the epidemiological data from a major trauma centre in the UK between January 2012 and December 2014, reviewing all cases of moderate to severe trauma in children. Patients were included if aged ≤16 years and if they had an abbreviated injury scale score of ≥2 in one or more body region. Results A total of 213 patients were included in the study, with a mean age of 7...
August 4, 2016: Annals of the Royal College of Surgeons of England
Marius Papurica, Alexandru F Rogobete, Dorel Sandesc, Raluca Dumache, Carmen A Cradigati, Mirela Sarandan, Radu Nartita, Sonia E Popovici, Ovidiu H Bedreag
BACKGROUND: The complexity of the cases of critically ill polytrauma patients is given by both the primary, as well as the secondary, post-traumatic injuries. The severe injuries of organ systems, the major biochemical and physiological disequilibrium, and the molecular chaos lead to a high rate of morbidity and mortality in this type of patient. The 'gold goal' in the intensive therapy of such patients resides in the continuous evaluation and monitoring of their clinical status. Moreover, optimizing the therapy based on the expression of certain biomarkers with high specificity and sensitivity is extremely important because of the clinical course of the critically ill polytrauma patient...
2016: Clinical Laboratory
Lin Xu, Kun Zhao, Xiao Shen, Xin-Xin Fan, Kai Ding, Ren-Min Liu, Feng Wang
BACKGROUND As an extracellularly released mediator, high-mobility group box 1 (HMGB1) initiates sterile inflammation following severe trauma. Serum HMGB1 levels correlate well with acute traumatic coagulopathy (ATC) in trauma patients, which is independently associated with higher mortality. We investigated the involvement of HMGB1 in ATC through blocking extracellular HMGB1. MATERIAL AND METHODS The ATC model was induced by polytrauma and hemorrhage in male Sprague-Dawley rats, which were randomly assigned to sham, ATC, and ATCH (ATC with HMGB1 blockade) groups...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
B Banskota, S Shrestha, R K Chaudhary, T Rajbhandari, S Rijal, B K Shrestha, A K Banskota
BACKGROUND: The anecdotal burden of morbidity secondary to motorbike accidents is thought to enormous by personnel involved in trauma care. The objective of the present study is to ascertain patterns and association of injuries and causes of mortality in a cohort of motorbike accident victims. METHODS: A retrospective chart review of 1337 motorbike accident admissions B and B Hospital in Kathmandu between January 2009 and December 2010 was undertaken. RESULTS: Majority of victims were between 20 to 50 years [1230 (92%) males]...
January 2016: Journal of Nepal Health Research Council
K M Rai, R Kale, S K Mohanty, A Chakrabarty, M R Waghray, Rajesh Kumar, Dinesh Prasad, A K Lahiri
BACKGROUND: To analyze the outcome of the management of casualties in a level II trauma centre of a forward hospital of Armed Forces over a nine year period. Retrospective analysis of all casualties received in a single forward hospital of Indian Army was carried out. METHOD: During 9 years (1990-1998), a total of 5737 casualties were received in a single level II zonal hospital of the Army in a forward area. Majority of the injuries were caused by bullets, or by fragments of improvised explosive devices...
January 2004: Medical Journal, Armed Forces India
Husain Shabbir Ali, Fahmi Yousef Khan, Saibu George, Nissar Shaikh, Jameela Al-Ajmi
Objective. The purpose of this study is to collect data on epidemiology, microbiology, and outcome of VAP in our ICUs for reevaluation of the therapeutic strategies. Methods. This retrospective study involved all adult patients, 15 years of age or older, diagnosed with VAP in multidisciplinary ICUs at Hamad General Hospital between January 2010 and December 2012. Results. A total of 106 patients were enrolled. The mean incidence of VAP was 5.0 per 1000 ventilator-days. It was predominant among younger age group (<60 years), male patients (80...
2016: BioMed Research International
Joanne C Sierink, Kaij Treskes, Michael J R Edwards, Benn J A Beuker, Dennis den Hartog, Joachim Hohmann, Marcel G W Dijkgraaf, Jan S K Luitse, Ludo F M Beenen, Markus W Hollmann, J Carel Goslings
BACKGROUND: Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. We aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in patients with trauma. METHODS: We undertook an international, multicentre, randomised controlled trial at four hospitals in the Netherlands and one in Switzerland...
August 13, 2016: Lancet
Loredana Luca, Alexandru Florin Rogobete, Ovidiu Horea Bedreag, Mirela Sarandan, Carmen Alina Cradigati, Marius Papurica, Anelore Gruneantu, Raluca Patrut, Corina Vernic, Corina Maria Dumbuleu, Dorel Sandesc
OBJECTIVE: Trauma patient requires a complex therapeutic management because of multiple severe injuries or secondary complications. The most significant injury found in patients with trauma is head injury, which has the greatest impact on mortality. Intracranial pressure (ICP) monitoring is required in severe traumatic head injury because it optimises treatment based on ICP values and cerebral perfusion pressure (CPP). METHODS: From a total of 64 patients admitted in the intensive care unit (ICU) 'Casa Austria', from the Polytraumatology Clinic of the Emergency County Hospital "Pius Brinzeu" Timisoara, Romania, between January 2014 and December 2014; only patients who underwent ICP monitoring (n=10) were analysed...
December 2015: Turkish Journal of Anaesthesiology and Reanimation
U S Dadhwal, N Pathak
Severe traumatic injury is a public health care problem; with injuries accounting for 12% of the global mortality. Continued improvement in the survival of severely injured trauma patients is a paramount goal. Bailout/damage control surgery following trauma has developed as a major advance in surgical practice in the last twenty years. The principles of damage control surgery defied the traditional surgical teaching of definitive operative intervention and were slow to be adopted. Currently, damage control surgery has been successfully utilized to manage traumatic thoracic, abdominal, extremity, and peripheral vascular injuries...
October 2010: Medical Journal, Armed Forces India
W Mutschler, M Mutschler, M Graw, R Lefering
Long-term survival after severe trauma is rarely addressed in German trauma journals although knowledge of life expectancy and identification of factors contributing to increased mortality are important for lifetime care management, development of service models, and targeting health promotion and prevention interventions. As reliable data in Germany are lacking, we compiled data mainly from the USA and Australia to describe life expectancy, risk factors, and predictors of outcome in patients experiencing traumatic spinal cord injury, traumatic brain injury, and polytrauma...
July 2016: Der Unfallchirurg
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