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severe trauma brain injury

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https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#1
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786463/hybrid-diffusion-imaging-in-mild-traumatic-brain-injury
#2
Yu-Chien Wu, Sourajit Mitra Mustafi, Jaroslaw Harezlak, Chandana Kodiweera, Laura A Flashman, Thomas McAllister
Mild traumatic brain injury (mTBI) is an important public health problem. Although conventional medical imaging techniques can detect moderate-to-severe injuries, they are relatively insensitive to mTBI. In this study, we used hybrid diffusion imaging (HYDI) to detect white-matter alterations in nineteen patients with mTBI and 23 other trauma-control patients. Within 15 days (SD=10) of brain injury, all subjects underwent magnetic-resonance HYDI and were assessed with battery of neuropsychological tests of sustained attention, memory, and executive function...
May 22, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29778065/reliability-of-the-sub-components-of-the-instrumented-timed-up-and-go-test-in-ambulatory-children-with-traumatic-brain-injury-and-typically-developed-controls
#3
Mark A Newman, Mark A Hirsch, Richard D Peindl, Nahir A Habet, Tobias J Tsai, Michael S Runyon, Toan Huynh, Nigel Zheng
BACKGROUND: Studies have evaluated the test-re-test reliability of subcomponents of the timed up and-go test in adults by using body-worn inertial sensors. However, studies in children have not been reported in the literature. RESEARCH QUESTION: To evaluate the within-session reliability of subcomponents of a newly developed electronically augmented timed 'upand-go' test (EATUG) in ambulatory children with traumatic brain injury (TBI) and children with typical development (TD)...
May 16, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29776836/analysis-of-incidence-of-traumatic-brain-injury-in-blunt-trauma-patients-with-glasgow-coma-scale-of-12-or-less
#4
Alexander Becker, Kobi Peleg, Oded Olsha, Adi Givon, Boris Kessel
PURPOSE: Early diagnosis of traumatic brain injury (TBI) is important for improving survival and neurologic outcome in trauma victims. The purpose of this study was to assess whether Glasgow Coma Scale (GCS) of 12 or less can predict the presence of TBI and the severity of associated injuries in blunt trauma patients. METHODS: A retrospective cohort study including 303,435 blunt trauma patients who were transferred from the scene to hospital from 1998 to 2013. The data was obtained from the records of the National Trauma Registry maintained by Israel's National Center for Trauma and Emergency Medicine Research, in the Gertner Institute for Epidemiology and Health Policy Research...
April 16, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29774196/common-carotid-artery-dissection-in-multiple-extracranial-injury-a-case-report
#5
Jin Sang Kil, Mi Kyung Lee, Ki Seong Eom
Traumatic common carotid artery dissection (CCAD) is rare. To our knowledge, only 14 case reports have described traumatic CCAD previously. Here, we report a case of CCAD in a patient with severe trauma. A 50-year-old man was lying on the road after drinking alcohol when a car drove over him. Computed tomography (CT) revealed multiple rib fractures with hemopneumothorax, lung contusion, flail chest, large amount of hematoma with bladder rupture, and fractures on the C6 spinous process, sacral ala, iliac bone, and pubic ramus...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29774192/efficacy-of-the-all-in-one-therapeutic-strategy-for-severe-traumatic-brain-injury-preliminary-outcome-and-limitation
#6
Young-Soo Park, Yohei Kogeichi, Yoichi Shida, Hiroyuki Nakase
Objective: Despite recent advances in medicine, no significant improvement has been achieved in therapeutic outcomes for severe traumatic brain injury (TBI). In the treatment of severe multiple traumas, accurate judgment and prompt action corresponding to rapid pathophysiological changes are required. Therefore, we developed the "All-in-One" therapeutic strategy for severe TBI. In this report, we present the therapeutic concept and discuss its efficacy and limitations. Methods: From April 2007 to December 2015, 439 patients diagnosed as having traumatic intracranial injuries were treated at our institution...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29766131/does-intracranial-pressure-management-hurt-more-than-it-helps-in-traumatic-brain-injury
#7
Charles A Adams, Deborah M Stein, Jonathan J Morrison, Thomas M Scalea
Traumatic brain injury (TBI) is the leading cause of death after traumatic injury. Raised intracranial pressure (ICP) is particularly associated with poor TBI outcomes, prompting clinicians to monitor this parameter, using it to guide therapies aimed at reducing pressures. Despite this approach being recommended by several bodies such as the Brain Trauma Foundation and the American College of Surgeons, the evidence demonstrating that ICP-guided therapy improves outcome is limited. The topic was debated at the 36th Annual Point/Counterpoint Acute Care Surgery Conference and the following article summarizes the discussants points of view along with a summary of the evidence...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766126/factor-viia-administration-in-traumatic-brain-injury-an-aast-mitc-propensity-score-analysis
#8
Sarah Lombardo, D Millar, Gregory J Jurkovich, Raul Coimbra, Ram Nirula
Background: Recombinant factor VIIa (rFVIIa) has been used off-label as an adjunct in the reversal of warfarin therapy and management of hemorrhage after trauma. Only a handful of these reports are rigorous studies, from which results regarding safety and effectiveness have been mixed. There remains no clear consensus as to the role of rFVIIa in traumatic brain injury (TBI). Methods: Eleven level 1 trauma centers provided clinical data and head CT scans of patients with a Glasgow Coma Scale (GCS) score of ≤13 and radiographic evidence of TBI...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766125/trauma-early-mortality-prediction-tool-tempt-for-assessing-28-day-mortality
#9
Ryan C Kunitake, Lucy Z Kornblith, Mitchell Jay Cohen, Rachael A Callcut
Background: Prior mortality prediction models have incorporated severity of anatomic injury quantified by Abbreviated Injury Severity Score (AIS). Using a prospective cohort, a new score independent of AIS was developed using clinical and laboratory markers present on emergency department presentation to predict 28-day mortality. Methods: All patients (n=1427) enrolled in an ongoing prospective cohort study were included. Demographic, laboratory, and clinical data were recorded on admission...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764673/comparison-between-thromboelastography-and-conventional-coagulation-test-should-we-abandon-conventional-coagulation-tests-in-polytrauma-patients
#10
Jaume Tur Martínez, Patrizio Petrone, Alexander Axelrad, Corrado P Marini
INTRODUCTION: TEG provides an in-vivo assessment of viscoelastic clot strength in whole blood compared with CCT, which may not reflect the influence of platelets. The aim of this study was to compare TEG vs. CCT in trauma patients stratified by mechanism of injury (MOI) and pre-existing coagulation status. METHODS: A retrospective, observational study of 230 polytrauma patients admitted to a University Hospital Level 1 Trauma Center, with TEG and CCT on admission stratified by MOI: multiple trauma (MT), isolated traumatic brain injury (TBI) or MT+TBI...
May 12, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29760839/severely-elevated-blood-pressure-and-early-mortality-in-children-with-traumatic-brain-injuries-the-neglected-end-of-the-spectrum
#11
M Austin Johnson, Matthew A Borgman, Jeremy W Cannon, Nathan Kuppermann, Lucas P Neff
Introduction: In adults with traumatic brain injuries (TBI), hypotension and hypertension at presentation are associated with mortality. The effect of age-adjusted blood pressure in children with TBI has been insufficiently studied. We sought to determine if age-adjusted hypertension in children with severe TBI is associated with mortality. Methods: This was a retrospective analysis of the Department of Defense Trauma Registry (DoDTR) between 2001 and 2013. We included for analysis patients <18 years with severe TBI defined as Abbreviated Injury Severity (AIS) scores of the head ≥3...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29751187/brain-trauma-foundation-guideline-compliance-results-of-a-multidisciplinary-international-survey
#12
Ryan Hirschi, Casey Rommel, Joshua Letsinger, Raminder Nirula, Gregory William John Hawryluk
BACKGROUND: The Brain Trauma Foundation (BTF) guidelines reflect evidence-based best practices in the management of traumatic brain injury (TBI) however compliance varies. OBJECTIVE: To inform self-reported physician compliance and predictors of compliance related to BTF guidelines via an international survey. METHODS: We conducted an international, multidisciplinary survey examining self-reported adherence to the BTF guidelines and multiple factors potentially affecting adherence...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29744222/chest-wall-stabilization-in-trauma-patients-why-when-and-how
#13
REVIEW
Jose Ribas Milanez de Campos, Thomas W White
Blunt trauma to the chest wall and rib fractures are remarkably frequent and are the basis of considerable morbidity and possible mortality. Surgical remedies for highly displaced rib fractures, especially in cases of flail chest, have been undertaken intermittently for more than 50 years. Rib-specific plating systems have started to be used in the last 10 years. These have ushered in the modern era of rib repair with chest wall stabilization (CWS) techniques that are safer, easier to perform, and more efficient...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29742630/perceived-changes-in-quality-of-life-in-trauma-patients-a-focus-group-study
#14
Nena Kruithof, Marjan Johanna Traa, Maria Karabatzakis, Suzanne Polinder, Jolanda de Vries, Mariska Adriana Cornelia de Jongh
Quality of life (QoL) following a physical trauma is still insufficiently known from a patient perspective. The aim of this study was to qualitatively report perceived changes in QoL after trauma. Focus groups were conducted. Patients admitted to the hospital were eligible for inclusion if they had a lower extremity trauma, severe injuries, or severe traumatic brain injury (TBI). Patients 75 years or older were invited. To analyze the perceived changes in QoL, open coding was used. Patients (n = 20, M = 55 years) reported comparable consequences...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742216/pain-assessment-of-traumatic-brain-injury-victims-using-the-brazilian-version-of-the-behavioral-pain-scale
#15
Caíque Jordan Nunes Ribeiro, Andra Carla Santos de Araújo, Saulo Barreto Brito, Daniele Vieira Dantas, Mariangela da Silva Nunes, José Antonio Barreto Alves, Maria do Carmo de Oliveira Ribeiro
OBJECTIVE: To evaluate the validity and reliability of the Brazilian version of the Behavioral Pain Scale (BPS-Br) in victims of traumatic brain injury. METHODS: Observational prospective study with paired and repeated measures conducted at two intensive care units (clinical and surgical) of a large general hospital. The convenience sample consisted of adult victims of moderate or severe penetrating or blunt craniocerebral trauma who were sedated and mechanically ventilated...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29741969/frequency-and-prognostic-factors-of-olfactory-dysfunction-after-traumatic-brain-injury
#16
Mette Bratt, Toril Skandsen, Thomas Hummel, Kent G Moen, Anne Vik, Ståle Nordgård, Anne-S Helvik
OBJECTIVE: To assess the frequency and factors associated with posttraumatic olfactory dysfunction, including anosmia, in a follow-up of patients with moderate and severe traumatic brain injury (TBI). METHODS: The setting was a cross-sectional study of patients that were consecutively included in the Trondheim TBI database, comprising injury-related variables. Eligible participants 18-65 years were contacted 9-104 months post trauma and asked olfactory-related questions...
May 9, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29741076/monitoring-of-hospital-acquired-pneumonia-in-patients-with-severe-brain-injury-on-first-access-to-intensive-neurological-rehabilitation-first-year-of-observation
#17
Gianfranco Beghi, Antonio De Tanti, Paolo Serafini, Chiara Bertolino, Antonietta Celentano, Graziella Taormina
Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3...
May 9, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29738402/is-first-rib-fracture-a-culprit-or-a-sign-of-injury-severity-it-is-both
#18
Alexander Fokin, Joanna Wycech, Eric Picard, Russell Weisz, Ivan Puente
OBJECTIVES: First rib fractures (1 RFX) have been correlated with increased morbidity and mortality. Whether this is due to the fracture of the rib itself or due to an increased number of associated injuries remains debatable. DESIGN: Retrospective cohort study SETTING:: Level 1 trauma center PATIENTS:: 1089 patients with rib fractures divided into 3 groups: Group A (n=44) with isolated 1 RFX, Group B (n=116) with 1 RFX combined with other rib fractures, and Group C (n=929) with rib fractures without 1 RFX...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29729813/a-two-center-validation-of-patient-does-not-follow-commands-and-three-other-simplified-measures-to-replace-the-glasgow-coma-scale-for-field-trauma-triage
#19
Emily Hopkins, Steven M Green, Michael Kiemeney, Jason S Haukoos
STUDY OBJECTIVE: Out-of-hospital personnel worldwide calculate the 13-point Glasgow Coma Scale (GCS) score as a routine part of field trauma triage. We wish to independently validate a simpler binary assessment to replace the GCS for this task. METHODS: We analyzed trauma center registries from Loma Linda University Health (2003 to 2015) and Denver Health Medical Center (2009 to 2015) to compare the binary assessment "patient does not follow commands" (ie, GCS motor score <6) with GCS score less than or equal to 13 for the prediction of 5 trauma outcomes: emergency intubation, clinically significant brain injury, need for neurosurgical intervention, Injury Severity Score greater than 15, and mortality...
May 2, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29716619/the-impact-of-blood-type-o-on-mortality-of-severe-trauma-patients-a-retrospective-observational-study
#20
Wataru Takayama, Akira Endo, Hazuki Koguchi, Momoko Sugimoto, Kiyoshi Murata, Yasuhiro Otomo
BACKGROUND: Recent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage. In this study, we evaluated the impact of the difference in the ABO blood type on mortality in patients with severe trauma. METHODS: A retrospective observational study was conducted in two tertiary emergency critical care medical centers in Japan. Patients with trauma with an Injury Severity Score (ISS) > 15 were included...
May 2, 2018: Critical Care: the Official Journal of the Critical Care Forum
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