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https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#1
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930046/canadian-benchmarks-for-acute-injury-care
#2
Lynne Moore, David Evans, Natalie L Yanchar, Jaimini Thakore, Henry Thomas Stelfox, Sayed Morad Hameed, Richard Simons, John Kortbeek, Julien Clément, François Lauzier, Alexis F Turgeon
BACKGROUND: Acute care injury outcomes vary substantially across Canadian provinces and trauma centres. Our aim was to develop Canadian benchmarks to monitor mortality and hospital length of stay (LOS) for injury admissions. METHODS: Benchmarks were derived using data from the Canadian National Trauma Registry on patients with major trauma admitted to any level I or II trauma centre in Canada and from the following patient subgroups: isolated traumatic brain injury (TBI), isolated thoracoabdominal injury, multisystem blunt injury, age 65 years or older...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28928193/the-course-and-prognostic-factors-of-cognitive-status-after-central-nervous-system-trauma-a-systematic-review-protocol
#3
Tatyana Mollayeva, Nicole Pacheco, Andrea D'Souza, Angela Colantonio
INTRODUCTION: Traumatic brain injury (TBI) is among the most disabling injuries, resulting in a range of cognitive impairments. Traumatic spinal cord injury (SCI) often occurs in conjunction with TBI; the two are best considered together in the context of trauma to the central nervous system (CNS). Despite strong indications of cognitive dysfunction in CNS trauma, little is known about its natural history or relationship with other factors. The current protocol outlines a strategy for a systematic review of the current evidence examining CNS trauma as a prognostic factor of cognitive decline in the adult population...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28915305/trauma-epidemiology-of-women-in-puerto-rico-2002-2011
#4
Sofía Muns-Aponte, Omar García-Rodríguez, Ediel O Ramos-Meléndez, Pablo Rodríguez-Ortiz
OBJECTIVE: Recent literature has suggested that trauma is heterogenic and that physiological response to it differs between sexes. The study represented in this manuscript aimed to describe gender differences in the mortality rates of trauma patients at the Puerto Rico Trauma Hospital (PRTH). MATERIALS AND METHODS: This was a cross-sectional study performed at PRTH. A total of 14,874 injured patients admitted to the hospital from 2002 to 2011 were included in the sample and divided into 2 groups, based on sex...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28915155/social-support-and-pain-outcomes-after-trauma-exposure-among-older-adults-a-multicenter-longitudinal-study
#5
Natalie L Richmond, Michelle L Meyer, Allison G Hollowell, Erin E Isenberg, Robert M Domeier, Robert A Swor, Phyllis L Hendry, David A Peak, Niels K Rathlev, Jeffrey S Jones, David C Lee, Christopher W Jones, Timothy F Platts-Mills
OBJECTIVES: Certain forms of social support have been shown to improve pain coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure. METHODS: We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department (ED) after a motor vehicle collision (MVC) to characterize the relationship between perceived social support and MVC-related pain after trauma overall and by subgroups based on gender, depressive symptoms, and marital status...
September 14, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28913001/methamphetamine-use-and-emergency-department-utilization-20-years-later
#6
John R Richards, Sheiva Hamidi, Connor D Grant, Colin G Wang, Nabil Tabish, Samuel D Turnipseed, Robert W Derlet
BACKGROUND: Methamphetamine (MAP) users present to the emergency department (ED) for myriad reasons, including trauma, chest pain, and psychosis. The purpose of this study is to determine how their prevalence, demographics, and resource utilization have changed. METHODS: Retrospective review of MAP patients over 3 months in 2016. Demographics, mode of arrival, presenting complaints, disposition, and concomitant cocaine/ethanol use were compared to a 1996 study at the same ED...
2017: Journal of Addiction
https://www.readbyqxmd.com/read/28888692/canadian-study-of-health-and-aging-clinical-frailty-scale-does-it-predict-adverse-outcomes-among-geriatric-trauma-patients
#7
Annie Cheung, Barbara Haas, Thom J Ringer, Amanda McFarlan, Camilla L Wong
BACKGROUND: The Canadian Study of Health and Aging Clinical Frailty Scale (CFS) and the laboratory Frailty Index (FI-lab) are validated tools based on clinical and laboratory data, respectively. Their utility as predictors of geriatric trauma outcomes is unknown. Our primary objective was to determine whether pre-admission CFS is associated with adverse discharge destination. Secondary objectives were to evaluate the relationships between CFS and in-hospital complications and between admission FI-lab and discharge destination...
September 6, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28887864/oral-maxillofacial-trauma-of-a-geriatric-population-in-a-super-ageing-country
#8
Ryohei Ito, Kosei Kubota, Akinari Inui, Hiroshi Nakagawa, Takao Kon, Norihiko Narita, Yoshihiro Tamura, Toshiaki Oyama, Anna Satake, Ken Furudate, Wataru Kobayashi
BACKGROUND/AIM: World population has been aging and oral-maxillofacial trauma of geriatric population is expected to increase. The aim of this study was to analyze the characteristic features of oral-maxillofacial trauma in the geriatric population. MATERIALS AND METHODS: Data from 127 patients aged 65 years old or older, who were treated for oral-maxillofacial trauma at the Department of Oral and Maxillofacial Surgery, Hirosaki University, from 2000 to 2014, were retrospectively analyzed...
September 8, 2017: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/28886979/development-of-a-prediction-model-for-diagnosis-of-acute-poisoning-in-patients-with-altered-mental-status-and-absent-history-of-alcohol-drug-ingestion
#9
Robert Camilleri
BACKGROUND: Diagnosis of acute poisoning in patients with altered mental status and absent history is a challenging diagnostic problem in clinical practice. OBJECTIVE: The aims of the study were to develop a simple clinical tool to stratify risk of acute poisoning in patients with altered mental states and no history of alcohol/drug ingestion, and develop a prediction model using initial observations from which a simple risk score could be derived. METHODS: The study was carried out on non-trauma patients aged 15 years and older admitted with altered mental states and no history of alcohol or drug ingestion...
September 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28883869/ataxia-in-childhood-epidemiological-clinical-and-neuroradiologic-features-and-the-risk-of-recurrence
#10
REVIEW
Mohsen Javadzadeh, Masoud Hassanvand Amouzadeh, Shaghayegh Sadat Esmail Nejad, Ezatollah Abasi, Abbas Alipour, Mohsen Mollamohammadi
OBJECTIVE: This study was conducted on the demographic data, clinical characteristics, electroencephalography, neuroradiological findings, and their impact on the recurrence of ataxia. MATERIALS & METHODS: A 3-yr retrospective review of 49 children with ataxia in Mofid Children Hospital, Tehran, Iran was conducted from Apr 2013 to Apr 2016. The demographic, clinical and paraclinical data were recorded in pre-prepared questionnaires. The patients were also classified in two groups of with or without recurrence and the results were compared...
2017: Iranian Journal of Child Neurology
https://www.readbyqxmd.com/read/28881905/perforated-esophageal-intervention-focus-perf-study-a-multi-center-examination-of-contemporary-treatment
#11
J T Ali, R D Rice, E A David, J D Spicer, J J Dubose, L Bonavina, S Siboni, T A O'Callaghan, X Luo-Owen, S Harrison, C G Ball, J Bini, G A Vercruysse, D Skarupa, C C Miller Iii, A L Estrera, K G Khalil
The treatment of esophageal perforation (EP) remains a significant clinical challenge. While a number of investigators have previously documented efficient approaches, these were mostly single-center experiences reported prior to the introduction of newer technologies: specifically endoluminal stents. This study was designed to document contemporary practice in the diagnosis and management of EP at multiple institutions around the world and includes early clinical outcomes. A five-year (2009-2013) multicenter retrospective review of management and outcomes for patients with thoracic or abdominal esophageal perforation was conducted...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28881894/outcomes-following-the-main-treatment-options-in-patients-with-a-leaking-esophagus-a-systematic-literature-review
#12
S Persson, I Rouvelas, T Irino, L Lundell
Leakage from the esophagus and gastroesophageal junction can be lethal due to uncontrolled contamination of the mediastinum. The most predominant risk factors for the subsequent clinical outcome are the patients' delay as well as the delay of diagnosis. Two major therapeutic concepts have been advocated: either prompt closure of the leakage by insertion of a self-expandable metal stent (SEMS) or more traditionally, surgical exploration. The objective of this review is to carefully scrutinize the recent literature and assess the outcomes of these two therapeutic alternatives in the management of iatrogenic perforation-spontaneous esophageal rupture as separated from those with anastomotic leak...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28877805/increased-age-predicts-failure-to-rescue
#13
Galinos Barmparas, Matthew J Martin, Douglas A Wiegmann, Ken R Catchpole, Bruce L Gewertz, Eric J Ley
Failure to rescue (FTR), defined as any death after the development of in-hospital complications, is an important quality measure, but the relationship with age after a traumatic injury, has not been well defined. We sought to examine whether older trauma patients are at higher risk for FTR. The National Trauma Databank (NTDB) research datasets 2007 to 2011 were queried for patients ≥16 years who had any reported complication. Those who survived (non-FTR) were compared with those who did not (FTR) using a forward logistic regression model...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28877802/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#14
COMPARATIVE STUDY
Carlos V R Brown, Kevin Rix, Amanda L Klein, Brent Ford, Pedro G R Teixeira, Jayson Aydelotte, Ben Coopwood, Sadia Ali
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28876692/paediatric-splenectomy-the-johannesburg-experience
#15
N Patel, A Nicola, P Bennett, E Mapunda, J Loveland, A Grieve
BACKGROUND: Splenectomy is uncommon in children and data on splenectomies in the South African paediatric population is sparse. A deeper understanding of the demographics, indications, techniques, and postoperative management of patients requiring splenectomy may improve care. METHOD: Patient records for all splenectomies performed in children aged 0 to 16 years at Charlotte Maxeke Johannesburg Academic (CMJAH) and Chris Hani Baragwanath Academic Hospitals (CHBAH) between 2000 and 2015 were reviewed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876621/the-absolute-number-of-repeat-operations-for-complex-intra-abdominal-sepsis-is-not-a-useful-predictor-of-non-survival
#16
M F Scriba, G L Laing, J L Bruce, D L Clarke
BACKGROUND: When multiple repeat laparotomies are required to manage intra-abdominal sepsis, questions about futility of treatment frequently arise. This study focuses specifically on patients who required two or more repeat laparotomies and describes the spectrum of disease necessitating multiple repeat laparotomies and the associated outcomes in the hope of clarifying the issue. METHOD: This study was conducted over a 20-month period (December 2012 - July 2014) at Greys Hospital in Pietermaritzburg, South Africa...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876563/defining-predictors-of-mortality-in-pediatric-trauma-patients
#17
P Brysiewicz, D L Clarke, B Sartorius, J L Bruce, G L Laing
BACKGROUND: The aim of this study was to describe our cohort of pediatric trauma patients and to analyze their physiological data. The intention was to highlight the difficulty in using systolic blood pressure (SBP) readings in this population and to investigate the role of base excess (BE) in predicting clinical outcomes in pediatric trauma patien. METHOD: The Pietermaritzburg Metropolitan Trauma Service (PMTS) maintains a prospective digital trauma registry, and all pediatric trauma patients admitted to the service for the period January 2012 - July 2016 were included...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28874952/duration-of-mechanical-ventilation-in-the-emergency-department
#18
Lauren B Angotti, Jeremy B Richards, Daniel F Fisher, Jeffrey D Sankoff, Todd A Seigel, Haitham S Al Ashry, Susan R Wilcox
INTRODUCTION: Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS). METHODS: This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28870273/factors-associated-with-delay-in-trauma-team-activation-and-impact-on-patient-outcomes
#19
Rory Connolly, Michael Y Woo, Jacinthe Lampron, Jeffrey J Perry
OBJECTIVE: Trauma code activation is initiated by emergency physicians using physiological and anatomical criteria, mechanism of injury, and patient demographic factors. Our objective was to identify factors associated with delayed trauma team activation. METHODS: We assessed consecutive cases from a regional trauma database from January 2008 to March 2014. We defined a delay in trauma code activation as a time greater than 30 minutes from the time of arrival. We conducted univariate analysis for factors potentially influencing trauma team activation, and we subsequently used multiple logistic regression analysis models for delayed activation in relation to mortality, length of stay, and time to operative management...
September 5, 2017: CJEM
https://www.readbyqxmd.com/read/28866754/opioid-associated-iatrogenic-withdrawal-in-critically-ill-adult-patients-a-multicenter-prospective-observational-study
#20
Pan Pan Wang, Elaine Huang, Xue Feng, Charles-André Bray, Marc M Perreault, Philippe Rico, Patrick Bellemare, Paul Murgoi, Céline Gélinas, Annie Lecavalier, Dev Jayaraman, Anne Julie Frenette, David Williamson
BACKGROUND: Opioids and benzodiazepines are frequently used in the intensive care unit (ICU). Regular use and prolonged exposure to opioids in ICU patients followed by abrupt tapering or cessation may lead to iatrogenic withdrawal syndrome (IWS). IWS is well described in pediatrics, but no prospective study has evaluated this syndrome in adult ICU patients. The objective of this study was to determine the incidence of IWS caused by opioids in a critically ill adult population. This multicenter prospective cohort study was conducted at two level-1 trauma ICUs between February 2015 and September 2015 and included 54 critically ill patients...
September 2, 2017: Annals of Intensive Care
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