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Trauma older patient

Hatim A AlSulaim, R Sterling Haring, Anthony O Asemota, Blair J Smart, Joseph K Canner, Aslam Ejaz, David T Efron, Catherine G Velopulos, Elliott R Haut, Eric B Schneider
OBJECTIVE: To assess the relationship between The International Classification of Diseases, Ninth Revision, Clinical Modification-derived conscious status and mortality rates in trauma centres (TC) vs. non-trauma centres (NTC). METHODS: Patients in the 2006-2011 Nationwide Emergency Department Sample meeting, The Centers for Disease Control and Prevention criteria for traumatic brain injury (TBI), with head/neck Abbreviated Injury Scale (AIS) scores ≥3 were included...
March 21, 2018: Brain Injury: [BI]
Alexander Fisher, Leon Fisher, Wichat Srikusalanukul, Paul N Smith
INTRODUCTION: The data on predictive value of the routinely obtained preoperative biochemical parameters in hip fracture (HF) patients are limited. The aims of this study were to examine in older HF patients (1) the relationships between a broad set of routine laboratory parameters at admission and in-hospital mortality, and (2) evaluate the prognostic value the biomarkers and clinical characteristics (alone or in combination) provide to predict a fatal outcome. PATIENTS AND METHODS: In 1820 consecutive patients with low-trauma osteoporotic HF aged >60 years (mean age 82...
March 8, 2018: Injury
Eric J Charles, Nicholas J Napoli, Lily E Johnston, Carrie A Foster, Deirdre A Goode, Trevor B Parker, Eleanor A Sharp, Laura Barnes, Jeffrey S Young
The most common mechanism of traumatic injury is ground-level fall. The objective of this study was to understand how patients sustaining falls and their outcomes have evolved. An institutional trauma database was used to identify adult patients who suffered a fall and were admitted to a Level I trauma center during two distinct time periods: 1998 to 2003 (past) and 2008 to 2013 (current). Data on anticoagulant use and comorbidities was gathered by retrospective chart review of patients treated during 2003 and 2013...
March 1, 2018: American Surgeon
Chih-Yuan Wang, Yi-Chan Chen, Ti-Hsuan Chien, Hao-Yu Chang, Yu-Hsien Chen, Chih-Ying Chien, Ting-Shuo Huang
Here we conducted a retrospective analysis of hospital-based trauma registry database for evaluating the impacts of comorbidities on the prognosis for traumatized patients using Index of Coexistent Comorbidity Disease (ICED) scores. We analyzed the data of patients with blunt trauma who visited emergency department between January 1, 2011, and December 31, 2015 in Chang-Gung Memorial Hospital, Keelung branch, a single level I trauma center in the Northern Taiwan. All consecutive patients with blunt trauma who admitted to the intensive care unit or ordinary ward after initial managements in the emergency department were included...
2018: PloS One
Andres X Samayoa, Thai Vu, Tanya Olszewski, Michael Bova, Qi Yan, Orlando Kirton
INTRODUCTION: Managing trauma in the elderly is challenging and requires a multidisciplinary team approach. The aim of this study is to characterize and compare outcomes in patients 90 years and older in the last two decades. METHODS: Retrospective review of trauma patients 90 years and older admitted from 1996 to 2015. The patients were divided into two groups: Early Decade (ED) and Late Decade (LD). RESULTS: A total of 1697 patients were recorded, 551 (ED) and 1146 (LD)...
March 9, 2018: American Journal of Surgery
Georgios Alexandridis, Amy C Gunning, Ger D J van Olden, Egbert-Jan M M Verleisdonk, Michiel J M Segers, Luke P H Leenen
PURPOSES: Calcaneal fractures are known to influence patients' quality of life negatively. The type of calcaneal fracture might have a relation with the patient outcome. To inform patients in an early stage on how their calcaneal fracture may affect their lives, knowledge of the fracture characteristics is necessary. This study evaluates the association of type of calcaneal fracture, measurement of conventional radiograph angles, and the Sanders classification with patient-reported outcomes...
March 17, 2018: International Orthopaedics
Tom J Crijns, Stein J Janssen, Jacob T Davis, David Ring, Hugo B Sanchez
BACKGROUND: Radiographic fracture classification helps with research on prognosis and treatment. AO/OTA classification into fracture type has shown to be reliable, but further classification of fractures into subgroups reduces the interobserver agreement and takes a considerable amount of practice and experience in order to master. QUESTIONS/PURPOSES: We assessed: (1) differences between more and less experienced trauma surgeons based on hip fractures treated per year, years of experience, and the percentage of their time dedicated to trauma, (2) differences in the interobserver agreement between classification into fracture type, group, and subgroup, and (3) differences in the interobserver agreement when assessing fracture stability compared to classifying fractures into type, group and subgroup...
March 14, 2018: Injury
Andrés Retamal C, Giancarlo Schiappacasse F, Lizbet Pérez M, Pablo Alvayay Q, Isabel Schild W
Pediatric cancer is the second cause of death in children older than 5 years in our country, after trauma. Positron emission tomography/computed tomography (PET/CT) is a hybrid technique that involves radiation, which has been used for some time in adults and is being progressively imple mented in children. This technique allows morphological and functional assessments of the body with applications in neoplastic and non-neoplastic pathology. Its main role in oncology is in the evaluation and control of lymphomas, sarcomas and neuroblastomas, among others...
December 2017: Revista Chilena de Pediatría
Olga Gutkowska, Jacek Martynkiewicz, Marek Stępniewski, Jerzy Gosk
Brachial plexus injuries (BPIs) caused by shoulder dislocation usually have a transient character and tend to resolve spontaneously. However, in some patients the symptoms can persist and require operative intervention. This work aims to determine the risk factors for persistent BPIs resulting from shoulder dislocation. The study comprised 73 patients (58 men, 15 women; mean age: 50 years) treated operatively between the years 2000 and 2016 for persistent BPIs resulting from shoulder dislocation. Patient age, gender, type of initial trauma, number of affected nerves, presence of accompanying injuries, and time interval from dislocation to its reduction were analysed...
2018: BioMed Research International
Geoffrey C Wall, Matthew J Taylor, Hayden L Smith
Background Fluoroquinolone (quinolones) antibiotics are commonly prescribed worldwide. Hypersensitivity reactions to these agents have been reported, but little systematic data exists concerning prevalence, types of reactions, or associated factors. Objective To identify the prevalence of patients reporting an allergy to quinolones, types of reactions claimed, and patient information associated with allergy. Setting A tertiary 370 bed level 1 trauma center, located in a Midwestern City in the United States...
March 14, 2018: International Journal of Clinical Pharmacy
Andre M Samuel, Pablo J Diaz-Collado, Raj J Gala, Matthew L Webb, Adam M Lukasiewicz, Bryce A Basques, Daniel D Bohl, Han Jo Kim, Jonathan N Grauer
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To determine the rate of venous thromboembolism event (VTE) and risk factors for their occurrence in patients with vertebral fractures. SUMMARY OF BACKGROUND DATA: Deep vein thrombosis or pulmonary embolism (VTE) events are a significant source of potentially preventable morbidity and mortality in trauma patients. In patients with traumatic vertebral fractures, a common high-energy injury sometimes resulting in spinal cord injury, there is debate about what factors may be associated with such VTEs...
March 13, 2018: Spine
Todd D Rozen
OBJECTIVE: To present results from the United States Cluster Headache Survey comparing the clinical presentation of tobacco nonexposed and tobacco-exposed cluster headache patients. BACKGROUND: Cluster headache is uniquely tied to a personal history of tobacco usage/cigarette smoking and, if the individual cluster headache sufferer did not smoke, it has been shown that their parent(s) typically did and that individual had significant secondary smoke exposure as a child...
March 14, 2018: Headache
Alysia K Robertson, Erica Snow, Theodora S Browne, Sha'Tia Brownell, Ifeoma Inneh, Jaclyn F Hill
PURPOSE: Although acute compartment syndrome (ACS) is associated with pediatric supracondylar humerus (SCH) fractures, there are limited data describing its incidence and risk factors. The purpose of our study was to report the local and national incidence of ACS with SCH and floating elbow (concomitant SCH and forearm) fracture patterns and the associated risk factors. METHODS: We retrospectively queried data for SCH fracture patients over a 4-year period from our institution (a level I pediatric trauma center) and the National Trauma Data Bank (NTDB)...
March 9, 2018: Journal of Pediatric Orthopedics
Marie Hexeberg Tollefsen, Anne Vik, Toril Skandsen, Oddrun Sandrød, Susan Frances Deane, Vidar Rao, Kent Gøran Moen
OBJECT: We aimed to examine the effect of preinjury antithrombotic medication on clinical and radiological neuroworsening in TBI and study the effect on outcome. METHODS: 184 consecutive patients ≥50 years old with moderate and severe TBI admitted to a level 1 trauma center were included. Neuroworsening was assessed clinically by using Glasgow Coma Scale (GCS) score and radiologically by using Rotterdam CT score on repeated time points. Functional outcome was assessed with the Glasgow Outcome Scale Extended (GOSE) at 6 months postinjury...
March 7, 2018: World Neurosurgery
Nancy Kusmaul, Keith Anderson
Traumatic events are widely acknowledged to have long-term impacts on individuals, yet only recently have health-care professionals begun to assess for and gain an understanding of trauma in the lives of older adults. For many older adults, trauma is often disenfranchised and overlooked as being either a distant past event (e.g., child abuse) or a normal part of aging (e.g., widowhood). Trauma-informed care, on the other hand, calls for health-care professionals to acknowledge that past and recent events may have been traumatic for older adults and to assess and care plan to reduce or prevent re-traumatization...
March 9, 2018: Social Work in Health Care
Joseph Marcotte, Joshua Hazelton, Chirag Arya, Michael Dalton, Amber Batool, John Gaughan, Linh Nguyen, John Porter, Nicole Fox
BACKGROUND: The indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long term SFTs. Following this study, we modified our institutional guidelines for SFT placement...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Brett D Crist, Troy D Pashuck
OBJECTIVES: To determine the reliability of a condensed computer-based condensed patient-centered outcome score system versus multiple standard uncondensed validated outcome scores used in orthopaedic trauma. DESIGN: Prospective SETTING:: Level I trauma centerPatients/Participants: One hundred patients older than 18 years with various orthopaedic injuries were evaluated at a Level I trauma clinic. INTERVENTION: Study participants were randomly assigned to complete the paper-based and computer-based versions of the EQ-5D and Musculoskeletal Functional Assessment (MFA) at different times during the same visit...
February 20, 2018: Journal of Orthopaedic Trauma
Sandra Braaf, Shanthi Ameratunga, Andrew Nunn, Nicola Christie, Warwick Teague, Rodney Judson, Belinda J Gabbe
BACKGROUND: Navigating complex health care systems during the multiple phases of recovery following major trauma entails many challenges for injured patients. Patients' experiences communicating with health professionals are of particular importance in this context. The aim of this study was to explore seriously injured patients' perceptions of communication with and information provided by health professionals in their first 3-years following injury. METHODS: A qualitative study designed was used, nested within a population-based longitudinal cohort study...
March 7, 2018: BMC Health Services Research
Stephen C Gale, JoAnn Peters, Jason S Murry, Jessica S Crystal, Viktor Y Dombrovskiy
Background: Late middle age (LMA), is a watershed between youth and old age, with unique physical and social changes and declines in vitality, but a desire to remain active despite increasing comorbidity. While post-injury outcomes in the elderly are well studied, little is known regarding LMA patients. We analyzed the injured LMA population admitted to a rural, regional Level 1 Trauma Center relative to outcomes for both younger and older patients. Materials and methods: Our registry was queried retrospectively for patients admitted 7/2008- 12/2015; they were divided into three cohorts: 18-54, 55-65, and >65 years...
March 2018: Annals of Medicine and Surgery
Hyung-Joo Lee, Youn-Jung Kim, Dong-Woo Seo, Chang Hwan Sohn, Seung Mok Ryoo, Shin Ahn, Yoon-Seon Lee, Won Young Kim, Kyoung Soo Lim
OBJECTIVE: The detection of intracranial injury in patients with facial injury rather than traumatic brain injury (TBI) remains a challenge for emergency physicians. This study aimed to evaluate the incidence and risk factors of intracranial injury in patients with orbital wall fracture (OWF), who were classified with a chief complaint of facial injury rather than TBI. METHODS: This retrospective case-control study enrolled adult OWF patients (age ≥18 years) who presented at the hospital between January 2004 and March 2016...
February 24, 2018: Injury
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