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https://www.readbyqxmd.com/read/27912932/trauma-surgery-by-general-surgeons-still-an-option-for-proximal-femoral-fractures
#1
Kaij Treskes, Stijn C Voeten, Maria C J M Tol, Wietse P Zuidema, Jefrey Vermeulen, J Carel Goslings, Niels W L Schep
INTRODUCTION: Surgery for proximal femoral fractures in the Netherlands is performed by trauma surgeons, general surgeons and orthopaedic surgeons. The aim of this study was to assess whether there is a difference in outcome for patients with proximal femoral fractures operated by trauma surgeons versus general surgeons. Secondly, the relation between hospital and surgeon volume and postoperative complications was explored. METHODS: Patients of 18 years and older were included if operated for a proximal femoral fracture by a trauma surgeon or a general surgeon in two academic, eight teaching and two non-teaching hospitals in the Netherlands from January 2010 until December 2013...
November 18, 2016: Injury
https://www.readbyqxmd.com/read/27912035/failure-to-rescue-after-infectious-complications-in-a-statewide-trauma-system
#2
Elinore J Kaufman, Emily Earl-Royal, Philip S Barie, Daniel N Holena
BACKGROUND: The failure to rescue (FTR) rate, the rate of death after a complication, measures a center's ability to identify and manage complications by "rescuing" vulnerable patients. Infectious complications are common after trauma, but risk factors for death after infection are not established. We hypothesized that risk factors would differ for FTR after infectious complications, development of infections, and for development of and death after non-infectious complications. PATIENTS AND METHODS: We analyzed trauma registry data for adult patients admitted to all 30 level I and II Pennsylvania trauma centers, 2011-2014...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27910090/spinal-fractures-in-older-adult-patients-admitted-after-low-level-falls-10-year-incidence-and-outcomes
#3
Randeep S Jawa, Adam J Singer, Daniel N Rutigliano, Jane E McCormack, Emily C Huang, Marc J Shapiro, Suzanne D Fields, Brian N Morelli, James A Vosswinkel
OBJECTIVES: To evaluate the incidence of spinal fractures and their outcomes in the elderly who fall from low-levels in a suburban county. DESIGN: Retrospective county-wide trauma registry review from 2004 to 2013. SETTING: Suburban county with regionalized trauma care consisting of 11 hospitals. PARTICIPANTS: Adult trauma patients aged ≥65 years who were admitted after falling from <3 feet. MEASUREMENTS: Demographic characteristics, comorbidities, and outcomes...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#4
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27900296/outcomes-after-quadriceps-tendon-repair-in-patients-over-80-years-of-age
#5
Prasad Ellanti, Andrew Moriarty, Matthew Nagle, Tom McCarthy
BACKGROUND: Quadriceps tendon (QT) ruptures are uncommon and mostly occur in those who are 50-60 years of age. Timely surgical repair can result in a good functional outcome, however, little is known about the outcome in the older patient. METHODS: A retrospective review of all QT ruptures between 2009 and 2014 was conducted. Patients over the age of 80 were included. Those with penetrating trauma or partial ruptures were excluded. A chart review was undertaken to gather demographic and operative details...
April 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#6
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27893619/substituting-systolic-blood-pressure-with-shock-index-in-the-national-trauma-triage-protocol
#7
Ansab A Haider, Asad Azim, Peter Rhee, Narong Kulvatunyou, Kareem Ibraheem, Andrew Tang, Terence O'Keeffe, Hajira Iftikhar, Gary Vercruysse, Bellal Joseph
INTRODUCTION: The National Trauma Triage Protocol (NTTP) is an algorithm that guides emergency medical services providers through four decision steps to identify the patients that would benefit from trauma center care. The NTTP defines a systolic blood pressure (SBP) of less than 90 mm Hg as one of the criteria for trauma center need. The aim of our study was to determine the impact of substituting SBP of less than 90 mm Hg with shock index (SI) on triage performance. METHODS: A 2-year (2011-2012) retrospective analysis of all trauma patients 18 years or older in the National Trauma Databank was performed...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893002/incidence-and-etiologies-of-acquired-third-nerve-palsy-using-a-population-based-method
#8
Chengbo Fang, Jacqueline A Leavitt, David O Hodge, Jonathan M Holmes, Brian G Mohney, John J Chen
Importance: Among cranial nerve palsies, a third nerve palsy is important because a subset is caused by life-threatening aneurysms. However, there is significant disagreement regarding its incidence and the reported etiologies. Objective: To determine the incidence and etiologies of acquired third nerve palsy using a population-based method. Design, Setting, and Participants: All newly diagnosed cases of acquired third nerve palsy from January 1, 1978, through December 31, 2014, in Olmsted County, Minnesota, were identified using the Rochester Epidemiology Project, a record-linkage system of medical records for all patient-physician encounters among Olmsted County residents...
November 17, 2016: JAMA Ophthalmology
https://www.readbyqxmd.com/read/27884333/c-spine-injury-and-mandibular-fractures-lifesaver-broken-in-two-spots
#9
Michael W Chu, Tahereh Soleimani, Tyler A Evans, Sarah I Fernandez, Leigh Spera, Carrie Klene, Ben L Zarzaur, Sunil S Tholpady
BACKGROUND: Trauma is a leading cause of injury and mortality and may involve mandibular fractures and cervical spine injuries. Manipulation of the spine during trauma protocols and operative treatment has the potential to cause serious spinal cord injuries. The purpose of this study was to identify risk factors associated with cervical spine injury (CSI) in patients with mandibular fractures. METHODS: The National Trauma Databank (2007-2010) was used to identify patients with mandibular fractures...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27881629/risk-of-fractures-after-stroke-results-from-the-ontario-stroke-registry
#10
Moira K Kapral, Jiming Fang, Shabbir M H Alibhai, Peter Cram, Angela M Cheung, Leanne K Casaubon, Marla Prager, Melissa Stamplecoski, Brennan Rashkovan, Peter C Austin
OBJECTIVE: To determine the risk of fractures after stroke. METHODS: Using the Ontario Stroke Registry, we identified a population-based sample of consecutive patients seen in the emergency department or hospitalized with stroke (n = 23,751) or TIA (n = 11,240) at any of 11 stroke centers in Ontario, Canada, and discharged alive between July 1, 2003, and March 31, 2012. We compared the risk of low-trauma fractures in patients with stroke vs those with TIA using propensity score methods to adjust for differences in baseline factors...
November 23, 2016: Neurology
https://www.readbyqxmd.com/read/27876077/post-traumatic-acute-kidney-injury-a-cross-sectional-study-of-trauma-patients
#11
Wei-Hung Lai, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Ching-Hua Hsieh, Hsiao-Yun Hsieh
BACKGROUND: The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. METHODS: Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System...
November 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27870814/the-contemporary-microbiology-and-rates-of-concomitant-osteomyelitis-in-acute-septic-arthritis
#12
Jessica Branson, Jesus G Vallejo, Anthony R Flores, Kristina G Hulten, Edward O Mason, Sheldon L Kaplan, J Chase McNeil
BACKGROUND: Septic arthritis (SA) and acute osteomyelitis (AO) are among the most common serious bacterial infections of childhood. Knowledge of the microbiology of SA is critical to treatment. Awareness of the presence of attendant AO is also important to guide clinical management. We sought to describe the current microbiology of SA in children as well as describe clinical features associated with coexisting AO. MATERIALS AND METHODS: Patients with SA were identified from the infectious diseases consult service records from 2010-2014...
November 18, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27863722/is-nasotracheal-intubation-safe-in-facial-trauma-patients
#13
Omeed Payam Jazayeri-Moghaddas, Wayne Tse, Karen A Herzing, Ronald J Markert, Alyssa J Gans, Mary C McCarthy
BACKGROUND: In the prehospital setting, oral intubation is preferred in facial trauma patients due to the potential for further injury during nasotracheal intubation. This study compared the complications of nasal vs. oral vs. nasal + oral intubations performed by first responder crews in facial trauma patients. Our objective was to assess patient outcomes and complications to determine the risk of nasal intubation in facial trauma patients in the prehospital setting. METHODS: Patients with facial trauma between 2008 and 13 were abstracted from the Miami Valley Hospital trauma registry: 50 were nasal only (n), 27 nasal + oral (no), and 135 oral only (o) intubation...
November 8, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27857999/do-age-and-anticoagulants-affect-the-natural-history-of-acute-subdural-hematomas
#14
Brandon P Lucke-Wold, Ryan C Turner, Darnell Josiah, Chelsea Knotts, Sanjay Bhatia
Acute subdural hematoma is a serious complication following traumatic brain injury. Large volume hematomas or those with underlying brain injury can cause mass effect, midline shift, and eventually herniation of the brain. Acute subdural hematomas in the young are associated with high-energy trauma and often have underlying contusions, while acute subdural hematomas in the elderly are associated with minor trauma and an absence of underlying contusions, even though the elderly are more likely to be on anticoagulants or anti-platelet therapy...
2016: Arch Emerg Med Crit Care
https://www.readbyqxmd.com/read/27857918/effectiveness-of-cortical-atrophy-scale-and-indirect-indices-of-brain-atrophy-to-predict-chronic-subdural-hematoma-in-older-patients
#15
Eun-Oh Jeong, Seung-Won Choi, Jeong-Wook Lim, Hyon-Jo Kwon, Seon-Hwan Kim, Hyeon-Song Koh, Jin-Young Youm, Shi-Hun Song
OBJECTIVE: To determine whether baseline cerebral atrophy can predict the rate of future chronic subdural hematoma (CSDH) after head trauma and compare indirect markers of brain atrophy with volumetric analysis of computed tomography (CT). METHODS: Single institution case-control study involving 1,476 patients who visited our hospital after head trauma from January 2009 to December 2014. Forty-one patients with delayed CSDH were identified and age, gender matched 41 patients were selected as control group...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27857907/clinical-outcome-of-acute-epidural-hematoma-in-korea-preliminary-report-of-285-cases-registered-in-the-korean-trauma-data-bank-system
#16
Young Ha Jeong, Ji Woong Oh, Sungmin Cho
OBJECTIVE: The aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS). METHODS: Of 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. We subcategorized the patients into two groups with good and poor outcomes...
October 2016: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/27851859/hospital-factors-associated-with-care-discontinuity-following-emergency-general-surgery
#17
Joaquim M Havens, Olubode A Olufajo, Thomas C Tsai, Wei Jiang, Alexandra B Columbus, Stephanie L Nitzschke, Zara Cooper, Ali Salim
Importance: Although there is evidence that changes in clinicians during the continuum of care (care discontinuity) are associated with higher mortality and complications among surgical patients, little is known regarding the drivers of care discontinuity among emergency general surgery (EGS) patients. Objective: To identify hospital factors associated with care discontinuity among EGS patients. Design, Setting, and Participants: We performed a retrospective analysis of the 100% Medicare inpatient claims file, from January 1, 2008, to November 30, 2011, and matched patient details to hospital information in the 2011 American Hospital Association Annual Survey database...
November 16, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27851666/factors-associated-with-nonaccidental-trauma-evaluation-among-patients-below-36-months-old-presenting-with-femur-fractures-at-a-level-1-pediatric-trauma-center
#18
Allison M Blatz, Catherine W Gillespie, Arielle Katcher, Allison Matthews, Matthew E Oetgen
BACKGROUND: In 2009, the American Academy of Orthopedic Surgeons published clinical practice guidelines (CPGs) on the treatment of pediatric diaphyseal femur fractures, which recommended a nonaccidental trauma (NAT) evaluation for all patients below 36 months of age. A recent study of these guidelines found <50% clinical compliance with this treatment recommendation. We aimed to identify areas for improvement in compliance with this guideline. METHODS: A retrospective review was performed of all patients presenting to a single pediatric tertiary care hospital with a diaphyseal femur fracture from January 2007 to June 2013 who were below 36 months old...
November 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27849322/the-effect-of-body-mass-index-on-trauma-severity-and-prognosis-in-trauma-patients
#19
Hasan Mansur Durgun, Recep Dursun, Yılmaz Zengin, Ayhan Özhasenekler, Murat Orak, Mehmet Üstündağ, Cahfer Güloğlu
BACKGROUND: As in the rest of the world, the prevalence of obesity in Turkey has been increasing in recent years and has become a major public health issue. Although many trials have been conducted to study the effects of obesity on internal diseases, there are few studies investigating the effects of obesity on prognosis of trauma patients. The present study analyzed the effects of body mass index (BMI) on trauma severity and prognosis in trauma patients. METHODS: This study was prospectively conducted with trauma patients older than 15 years of age who presented at the Dicle University Faculty of Medicine emergency medicine department trauma unit between June 1, 2013 and May 31, 2014...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27846358/-subtrochanteric-fracture-in-children-treated-with-minimally-invasive-surgery-case-report
#20
R Guzmán-Vargas, D F Rincón-Cardozo, J A Camacho-Casas
Subtrochanteric fractures in children are rare events that occur in only 4% of all femur fractures; most injuries occur as a result of high-energy trauma, being young male patients the most affected. The management of this type of injury is controversial; there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement, and the use of external fixators. Most suggest that for children under 10 a nonoperative approach should be preferred and that older ones should be managed surgically, but it is between six and 12-year-olds that most of the controversy exists...
March 2016: Acta Ortopédica Mexicana
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