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polytrauma mortality

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https://www.readbyqxmd.com/read/29313512/mortality-during-road-traffic-accidents-in-bangui-central-african-republic
#1
B J D Tékpa, H C Diemer, P A Issa Mapouka, V Ndoma Ngatchokpo, B Gassima, M N Nali
The authors examined mortality during road traffic accidents (RTAs) to propose solutions for their prevention. This descriptive prospective study took place over a 12-month period (June 1, 2011, to May 30, 2012) and included all fatalities from RTAs brought to selected hospitals. These RTA fatalities were studied in the morgues and selected sites. An autopsy was conducted for each victim to clarify the cause of death. An injury severity score (ISS) was also calculated for each victim. The data were analyzed with Epi-Info 2008...
November 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/29310566/analysis-of-oxidative-stress-related-markers-in-critically-ill-polytrauma-patients-an-observational-prospective-single-center-study
#2
Mihai Sandesc, Alexandru Florin Rogobete, Ovidiu Horea Bedreag, Anca Dinu, Marius Papurica, Carmen Alina Cradigati, Mirela Sarandan, Sonia Elena Popovici, Lavinia Melania Bratu, Tiberiu Bratu, Adrian Tudor Stan, Dorel Sandesc
Critically ill polytrauma patients have increased production of free radicals (FRs) and consequent alterations in biochemical pathways, as well as disruption of cellular integrity, due to increased lipid peroxidation. The aim of this study was to investigate several biomarkers associated with increased oxidative stress in critically ill polytrauma patients, and to evaluate the effect of antioxidant treatment on the clinical outcome in these patients. A total of 67 polytrauma patients from an intensive care unit met the selection criteria...
January 9, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29304054/injury-mechanisms-patterns-and-outcomes-of-older-polytrauma-patients-an-analysis-of-the-dutch-trauma-registry
#3
Rob de Vries, Inge H F Reininga, Oliver Pieske, Rolf Lefering, Mostafa El Moumni, Klaus Wendt
BACKGROUND: Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. METHODS: Data from polytrauma (ISS≥16) patients between 2009 and 2014 were extracted from the Dutch trauma registry (DTR). Younger (Group A: ages 18-59) and older (Group B: ages ≥60) polytrauma patients were compared...
2018: PloS One
https://www.readbyqxmd.com/read/29258783/air-versus-ground-transportation-in-isolated-severe-head-trauma-a-national-trauma-data-bank-study
#4
Alberto Aiolfi, Elizabeth Benjamin, Gustavo Recinos, Alejandro De Leon Castro, Kenji Inaba, Demetrios Demetriades
BACKGROUND: The effect of prehospital helicopter emergency medical services (HEMS) on mortality has been analyzed previously in polytrauma patients with discordant results. OBJECTIVE: Our aim was to compare outcomes in patients with isolated severe blunt traumatic brain injuries (TBIs) transported by HEMS or ground emergency medical services (GEMS). METHODS: We conducted a National Trauma Data Bank study (2007-2014). All adult patients (≥16 years old) who sustained an isolated severe blunt TBI and were transported by HEMS or GEMS were included in the study...
December 16, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29258687/analysis-of-mortality-and-fixation-failure-in-geriatric-fractures-using-quantitative-computed-tomography
#5
Tyler S Pidgeon, Joey P Johnson, Matthew E Deren, Andrew R Evans, Roman A Hayda
OBJECTIVES: While osteoporosis has been shown to be a contributing factor in low energy fractures in the elderly, limited data exists regarding the correlation of bone mineral density (BMD) and T-Scores to mortality and failure of fracture fixation. This study seeks to determine the relationship between femoral neck BMD in elderly patients with typical geriatric fractures and mortality and fracture fixation failure using Quantitative Computed Tomography (QCT). MATERIALS AND METHODS: Patients over the age of 65 who sustained fractures of the proximal humerus, distal radius, pelvic ring, acetabulum, hip, proximal tibia, and ankle who also underwent a CT scan that included an uninjured femoral neck were retrospectively reviewed...
December 15, 2017: Injury
https://www.readbyqxmd.com/read/29221655/interleukin-6-and-interleukin-10-plasma-levels-and-mrna-expression-in-polytrauma-patients
#6
Heber B Sapan, Idrus Paturusi, Andi Asadul Islam, Irawan Yusuf, Ilhamjaya Patellongi, Muhammmad Nasrum Massi, Aryono D Pusponegoro, Syafrie K Arief, Ibrahim Labeda, Leo Rendy, Mochammad Hatta
PURPOSE: Host response to polytrauma occasionally has unpredictable outcomes. Immune response is a major factor influencing patient's outcome. This study evaluated the interaction of two main cytokines in immune response after major trauma, specifically interleukin-6 (IL-6) and interleukin-10 (IL-10). Plasma level of these cytokines is determined by mRNA expression of these cytokines genes which may decide the outcome of polytrauma patients. METHODS: This prospective multicenter trial held at four trauma centers enrolled 54 polytrauma patients [Injury Severity Score (ISS) ≥ 16]...
December 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29211186/epidemiology-of-acute-kidney-injury-and-chronic-kidney-disease-in-the-intensive-care-unit
#7
Darwin Tejera, Fernanda Varela, Daniela Acosta, Stephanie Figueroa, Sebastián Benencio, Cristina Verdaguer, Mauricio Bertullo, Federico Verga, Mario Cancela
OBJECTIVE: To describe the epidemiology of acute kidney injury, its relationship to chronic kidney disease, and the factors associated with its incidence. METHODS: A cohort study and follow-up were conducted in an intensive care unit in Montevideo, Uruguay. We included patients admitted between November 2014 and October 2015 who were older than 15 years of age and who had at least two measurements of serum creatinine. We excluded patients who were hospitalized for less than 48 hours, patients who died at the time of hospitalization, and patients with chronic renal disease who were on hemodialysis or peritoneal dialysis...
November 30, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29206763/association-of-clinical-hypoperfusion-variables-with-lactate-clearance-and-hospital-mortality
#8
Jessica Londoño, César Niño, James Díaz, Carlos Morales, Jimmy León, Elisa Bernal, Cesar Vargas, Leonardo Mejía, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes
BACKGROUND: lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination might replace it as screening tool. We asked to determine the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 hours of resuscitation and; the association between clinical parameters, lactate and mortality...
December 4, 2017: Shock
https://www.readbyqxmd.com/read/29199182/delayed-diagnosis-and-treatment-of-high-grade-blunt-pancreatic-trauma-case-report-and-review-of-literature
#9
Myftar Torba, Arben Gjata, Francesco Rulli, Ilir Kajo, Sotir Ceka, Tajar Asqeri
INTRODUCTION: Despite technological advancement, high grade pancreatic injuries following blunt abdominal trauma continues to remain a disease that is associated with high morbidity and mortality rates, particularly in cases of delayed diagnosis. The aim of this paper was the presentation of delayed diagnosis and treatment peculiarities of high grade pancreatic trauma and a review of literature. CASE REPORT: A 55-years old man, involved in motor vehicle crashes, was referred to our level I trauma center...
November 29, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29187245/d-%C3%AE-hydroxybutyrate-and-melatonin-for-treatment-of-porcine-hemorrhagic-shock-and-injury-a-melatonin-dose-ranging-study
#10
Andrea Wolf, Kristine E Mulier, Sydne L Muratore, Gregory J Beilman
OBJECTIVE: Treatment with a combination of D-β-hydroxybutyrate (BHB) and melatonin (M) improves survival in hemorrhagic shock models. Our objective was to find the most effective melatonin concentration in combination with 4 molar BHB (4 M BHB). Survival and markers of organ injury were analyzed in pigs exposed to pulmonary contusion, liver crush injury, and hemorrhagic shock and treated with lactated Ringer's solution; 4 M BHB/43 mM M; 4 M BHB/20 mM M; 4 M BHB/10 mM M; 4 M BHB/4...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29178941/s100a8-a9-and-srage-kinetic-after-polytrauma-an-explorative-observational-study
#11
Philippe Joly, John C Marshall, Philippe A Tessier, Chantal Massé, Nathalie Page, Anne Julie Frenette, François Khazoom, Soazig Le Guillan, Yves Berthiaume, Emmanuel Charbonney
BACKGROUND: Following tissue injury after trauma, the activation of innate immune pathways results in systemic inflammation, organ failure and an increased risk of infections. The objective of this study was to characterize the kinetics of the S100A8/S100A9 complex, a new-recognized alarmin, as well as its soluble receptor sRAGE, over time after trauma as potential early biomarkers of the risk of organ damage. METHODS: We collected comprehensive data from consenting patients admitted to an ICU following severe trauma...
November 25, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29175047/hemorrhagic-shock-drives-glycocalyx-barrier-and-organ-dysfunction-early-after-polytrauma
#12
Rebecca Halbgebauer, Christian K Braun, Stephanie Denk, Benjamin Mayer, Paolo Cinelli, Peter Radermacher, Guido A Wanner, Hans-Peter Simmen, Florian Gebhard, Daniel Rittirsch, Markus Huber-Lang
Polytrauma (PT) is frequently associated with hemorrhagic shock (HS), which increases morbidity and mortality. Although various aspects of HS have been addressed in PT patients, the impact of an additional HS is largely unknown regarding the development of multiple organ dysfunction associated with disturbed glycocalyx and barrier function early after trauma. A prospective, longitudinal, mono-centered, observational study enrolling severely injured patients (Injury Severity Score, ISS=38.1±2.6) served for an in-depth analysis of blood (drawn on days 0, 1, 2, 3 and 5) and clinical data (up to 21days) of 30 patients who were then stratified into PT with and without HS...
November 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29138874/using-il-6-concentrations-in-the-first-24%C3%A2-h-following-trauma-to-predict-immunological-complications-and-mortality-in-trauma-patients-a-meta-analysis
#13
REVIEW
Zhi Qiao, Weikang Wang, Luxu Yin, Peng Luo, Johannes Greven, Klemens Horst, Frank Hildebrand
PURPOSE: In previous studies, interleukin-6 (IL-6) has been shown to have a high predictive value for the development of complications and mortality after trauma; however, there is some uncertainty around these results. The aim of this meta-analysis was to assess the value of early IL-6 levels (within the first 24 h after trauma) for predicting post-traumatic complications [acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRS), sepsis, multiple organ failure (MOF), and multiple organ dysfunction syndrome (MODS)] and mortality...
November 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29125848/early-decreased-tlr2-expression-on-monocytes-is-associated-with-their-reduced-phagocytic-activity-and-impaired-maturation-in-a-porcine-polytrauma-model
#14
Lukas Schimunek, Rafael Serve, Michel P J Teuben, Philipp Störmann, Birgit Auner, Mathias Woschek, Roman Pfeifer, Klemens Horst, Tim-P Simon, Miriam Kalbitz, Ramona Sturm, Hans-C Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
In their post-traumatic course, trauma patients suffering from multiple injuries have a high risk for immune dysregulation, which may contribute to post-injury complications and late mortality. Monocytes as specific effector cells of the innate immunity play a crucial role in inflammation. Using their Pattern Recognition Receptors (PRRs), notably Toll-Like Receptors (TLR), the monocytes recognize pathogens and/or pathogen-associated molecular patterns (PAMPs) and organize their clearance. TLR2 is the major receptor for particles of gram-positive bacteria, and initiates their phagocytosis...
2017: PloS One
https://www.readbyqxmd.com/read/29114277/contributing-factors-for-coagulopathy-in-traumatic-brain-injury
#15
Ajit Shrestha, Ramesh Man Joshi, Upendra Prasad Devkota
Context: In traumatic brain injury patients, coagulation disorder causes secondary brain injury, thereby increasing mortality and morbidity. Aims: The aim of this study is to identify the factors responsible for coagulopathy in traumatic brain injury. Settings and Design: This prospective longitudinal study from June 2012 included 100 patients with moderate and severe head injury presenting to National Institute of Neurological and Allied Sciences, Kathmandu, over 1-year period...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29110832/thromboelastometric-profile-and-acute-coagulopathy-of-the-polytraumatized-patient-clinical-and-prognostic-implications
#16
Antònia Bonet, Zoilo Madrazo, Maylin Koo, Israel Otero, Montserrat Mallol, Irene Macia, Luciano Ramirez, Antoni Sabaté
INTRODUCTION: About 25-35% of polytraumatized patients have a profound alteration of hemostasis on arrival at the hospital (acute traumatic coagulopathy [CAT]). Viscoelastic tests (ROTEM(®)) measure the hemostatic capacity and provide an early detection of CAT. The objectives of this study are to describe the initial thromboelastogram of these patients and to determine the prevalence of CAT according to predefined thromboelastographic profiles. METHODS: Single-center, observational, prospective study in polytraumatic patients...
October 27, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29063224/predictors-and-time-based-hospital-mortality-in-patients-with-isolated-and-polytrauma-brain-injuries
#17
Ayman El-Menyar, Rafael Consunji, Husham Abdelrahman, Rifat Latifi, Bianca M Wahlen, Hassan Al-Thani
BACKGROUND: Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. We studied the predictors and time-based mortality in patients with isolated and polytrauma brain injuries in a rapidly developing country. We hypothesized that TBI-related 30-day mortality is decreasing over time. METHODS: A retrospective analysis was conducted for all patients with moderate-to-severe TBI who were admitted directly to a level 1 trauma center between 2010 and 2014...
October 23, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29033079/polytrauma-patients-in-the-netherlands-and-the-usa-a-bi-institutional-comparison-of-processes-and-outcomes-of-care
#18
Suzan Dijkink, Gwendolyn M van der Wilden, Pieta Krijnen, Lisa Dol, Steven Rhemrev, David R King, Marc A DeMoya, George C Velmahos, Inger B Schipper
BACKGROUND: Modern trauma systems differ worldwide, possibly leading to disparities in outcomes. We aim to compare characteristics and outcomes of blunt polytrauma patients admitted to two Level 1 Trauma Centers in the US (USTC) and the Netherlands (NTC). METHODS: For this retrospective study the records of 1367 adult blunt trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted between July 1, 2011 and December 31, 2013 (640 from NTC, 727 from USTC) were analysed...
October 10, 2017: Injury
https://www.readbyqxmd.com/read/29018144/ogilvie-s-syndrome-treated-with-an-emergency-laparotomy-right-hemicolectomy-and-end-ileostomy
#19
Andrew James Robinson, John-Patrick Quigley, Athene Banks, Martin Farmer
Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is a rare clinical entity in which there is massive non-toxic colonic dilatation in the absence of a mechanically obstructing lesion. It is an important yet poorly recognised cause of surgical morbidity and mortality occurring typically in elderly patients with multiple comorbidities. ACPO can often be reversed conservatively with colonoscopic or nasogastric decompression. Surgical intervention is seldom necessary. We present a case of Ogilvie's syndrome in which a healthy 76-year-old man developed life-threatening pseudo-obstruction following rib polytrauma after a mechanical fall...
October 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28984515/surgical-timing-for-cervical-and-upper-thoracic-injuries-in-patients-with-polytrauma
#20
Daniel Lubelski, Suzanne Tharin, John J Como, Michael P Steinmetz, Heather Vallier, Timothy Moore
OBJECTIVE Few studies have investigated the advantages of early spinal stabilization in the patient with polytrauma in terms of reduction of morbidity and mortality. Previous analyses have shown that early stabilization may reduce ICU stay, with no effect on complication rates. METHODS The authors prospectively observed 340 polytrauma patients with an Injury Severity Score (ISS) of greater than 16 at a single Level 1 trauma center who were treated in accordance with a protocol termed "early appropriate care," which emphasizes operative treatment of various fractures within 36 hours of injury...
October 6, 2017: Journal of Neurosurgery. Spine
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