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https://www.readbyqxmd.com/read/28087409/thioredoxin-a-novel-biomarker-of-post-injury-sepsis
#1
Jesper Eriksson, Andreas Gidlöf, Mikael Eriksson, Emma Larsson, Olof Brattström, Anders Oldner
BACKGROUND: Thioredoxin (TRX), an endogenous anti-oxidant protein induced in inflammatory conditions, has been shown to increase in plasma and to be associated with outcome in septic patients. This biomarker has never been studied in a trauma setting. We hypothesized that TRX would be increased after trauma and associated with post-injury sepsis. METHODS: Single-centre prospective observational study conducted at the intensive care unit (ICU) at the Karolinska University Hospital, Stockholm, Sweden, a level-1 trauma centre...
January 10, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/28074459/comparison-of-revised-trauma-score-injury-severity-score-and-trauma-and-injury-severity-score-for-mortality-prediction-in-elderly-trauma-patients
#2
Shahrokh Yousefzadeh-Chabok, Marieh Hosseinpour, Leila Kouchakinejad-Eramsadati, Fatemeh Ranjbar, Reza Malekpouri, Alireza Razzaghi, Zahra Mohtasham-Amiri
BACKGROUND: Trauma is the fifth leading cause of death in patients 65 years and older. This study is a comparison of results of Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma. METHODS: This is a cross-sectional study of records of 352 elderly trauma patients who were admitted to Pour-Sina Hospital in Rasht between 2010 and 2011. Injury scoring systems were compared in terms of specificity, sensitivity, and cut-off points using receiver operating characteristic curve of patient prognosis...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28063676/early-predictors-for-massive-transfusion-in-older-adult-severe-trauma-patients
#3
Takao Ohmori, Taisuke Kitamura, Junko Ishihara, Hirokazu Onishi, Tsuyoshi Nojima, Kotaro Yamamoto, Ryu Tamura, Kentaro Muranishi, Toshiyuki Matsumoto, Takamitsu Tokioka
BACKGROUND: Many scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/28052919/traumatic-brain-injuries-in-older-adults-6-years-of-data-for-one-uk-trauma-centre-retrospective-analysis-of-prospectively-collected-data
#4
Carol Hawley, Magdy Sakr, Sarah Scapinello, Jesse Salvo, Paul Wrenn
OBJECTIVES: Our aim was to determine the incidence of traumatic brain injury (TBI) in older adults and investigate the relationship between injury characteristics and outcomes. METHODS: Retrospective analysis of prospectively collected data submitted to Trauma Audit and Research Network (TARN) database for a major trauma centre in the West Midlands, UK, from 2008 to 2014. The Mayo Scale was used to categorise TBI. All patients were aged ≥65 years and were admitted with head or brain injuries meeting TARN inclusion criteria: injury resulting in immediate admission to hospital for 3 days, admitted to a high dependency area or death following trauma...
January 4, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28052158/factors-associated-with-nontransfer-in-trauma-patients-meeting-american-college-of-surgeons-criteria-for-transfer-at-nontertiary-centers
#5
Quanhong Zhou, Matthew R Rosengart, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry, Joshua B Brown
Importance: Secondary triage from nontertiary centers is vital to trauma system success. It remains unclear what factors are associated with nontransfer among patients who should be considered for transfer to facilities providing higher-level care. Objective: To identify factors associated with nontransfer among patients meeting American College of Surgeons (ACS) guideline criteria for transfer from nontertiary centers. Design, Setting, and Participants: A retrospective cohort study was performed using multilevel logistic regression to ascertain factors associated with nontransfer from nontertiary centers, including demographics, injury characteristics, and center resources...
January 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28050533/total-ruptures-of-the-extensor-apparatus-of-the-knee
#6
Diogo Moura, Fernando Fonseca
OBJECTIVE: This was a retrospective case-control study on total ruptures of the extensor apparatus of the knee, aimed to compare patella fractures with tendinous ruptures. METHODS: The sample included 190 patients and 198 total ruptures of the knee extensor apparatus. All patients were evaluated by the same examiner after a minimum one-year follow-up. RESULTS: Tendinous ruptures occurred most frequently in men, in younger patients, and had better clinical and functional outcomes when compared with patella fractures; however, the former presented higher levels of thigh atrophy...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28048948/mechanism-of-injury-may-influence-infection-risk-from-early-blood-transfusion
#7
Charles A Karcutskie, Jonathan P Meizoso, Juliet J Ray, Davis B Horkan, Xiomara D Ruiz, Carl I Schulman, Nicholas Namias, Kenneth G Proctor
BACKGROUND: Blood transfusion is a known risk factor for infection in trauma patients. Differences based on mechanism of injury have not been well described. We hypothesize that infection risk in trauma patients with early blood transfusion is different based on blunt or penetrating mechanism of injury. PATIENTS AND METHODS: Adults admitted to the trauma intensive care unit from January 2010 through January 2015 were reviewed retrospectively. Those receiving transfusion after 24 h were excluded...
January 3, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28039943/the-pecarn-tbi-rules-do-not-apply-to-abusive-head-trauma
#8
Julia Nicole Magana, Nathan Kuppermann
The Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) prediction rules were developed to identify children at very low risk for clinically-important TBIs (ciTBIs), for whom computed tomography (CT) scans can typically be obviated.(1) The PECARN prediction rules have been validated in several settings and countries.(2-5) The PECARN TBI rules, one developed for children younger than 2 years, and the other for those 2 years and older, rely on accurate patient history and physical examination findings gathered at the time of emergency department (ED) presentation...
December 31, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28030934/the-physiotherapeutic-context-of-loss-of-dominant-arm-function-due-to-occupational-accidents
#9
Anna Kostiukow, Elżbieta Kaluga, Włodzimierz Samborski, Elżbieta Rostkowska
INTRODUCTION: The study examines the problem of dominant arm function loss in rural adult patients due to work-related accidents. The types of risks involved in farmyard work include falling from a height, manually moving loads, overturning/accident whilst driving an agricultural tractor, noise and vibration, use of pesticides, and the risk of being cut or injured. The study focuses on adaptation of the non-dominant arm. OBJECTIVE: The main aim of the study was evaluation of visual-motor coordination on the basis of performance of the non-dominant hand in patients after the loss of function of the dominant arm...
23, 2016: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28030710/association-of-radiologic-indicators-of-frailty-with-1-year-mortality-in-older-trauma-patients-opportunistic-screening-for-sarcopenia-and-osteopenia
#10
Stephen J Kaplan, Tam N Pham, Saman Arbabi, Joel A Gross, Mamatha Damodarasamy, Itay Bentov, Lisa A Taitsman, Steven H Mitchell, May J Reed
Importance: Assessment of physical frailty in older trauma patients admitted to the intensive care unit is often not feasible using traditional frailty assessment instruments. The use of opportunistic computed tomography (CT) scans to assess sarcopenia and osteopenia as indicators of underlying frailty may provide complementary prognostic information on long-term outcomes. Objective: To determine whether sarcopenia and/or osteopenia are associated with 1-year mortality in an older trauma patient population...
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28030506/rib-fracture-fixation-in-the-65-year-and-older-population-a-paradigm-shift-in-management-strategy-at-a-level-i-trauma-center
#11
Michael T Fitzgerald, DennisW Ashley, Hesham Abukhdeir, D Benjamin Christie
BACKGROUND: Rib fractures after chest wall trauma are a common injury, however carry a significant morbidity and mortality risk. The impact of rib fractures in the ≥ 65yo patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients ≥ 65yo receiving rib plating have decreased mortality, complication rates, and an accelerated return to normal functional states when compared to controls. METHODS: With IRB approval, a retrospective review analyzed patients ≥ 65yo with rib fractures admitted from 2009-2015 receiving rib plating(RP group)(n=23) compared to non-operative, injury-matched controls admitted from 2003-2008(NO group)(n=50)...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28000125/prevalence-and-risk-factors-for-early-seizure-in-patients-with-traumatic-brain-injury-analysis-from-national-trauma-data-bank
#12
Shahram Majidi, Yamane Makke, Amr Ewida, Bahareh Sianati, Adnan I Qureshi, Mohamad Z Koubeissi
BACKGROUND: Traumatic brain injury (TBI) is a well-known risk factor for seizures. We aimed to identify the frequency and risk factors for seizure occurrence during hospitalization for TBI. METHODS: We used ICD-9-CM codes to identify patients 18 years of age or older from the National Trauma Data Bank who were admitted with TBI. We also used ICD-9-CM codes to identify the subset who had seizures during hospitalization. Patient demographics, comorbidities, Glasgow Coma Scale (GCS) score, Injury Severity Score Abbreviated Injury Scale (ISSAIS), in-hospital complications, and discharge disposition were compared in the seizure group (SG) and no-seizure group (NSG)...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27999959/validation-of-trauma-scales-iss-niss-rts-and-triss-for-predicting-mortality-in-a-colombian-population
#13
Carlos Oliver Valderrama-Molina, Nelson Giraldo, Alfredo Constain, Andres Puerta, Camilo Restrepo, Alba León, Fabián Jaimes
BACKGROUND: Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting. MATERIALS AND METHODS: Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay...
December 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27997467/functional-outcomes-of-operative-management-of-scapula-fractures-in-a-geriatric-cohort
#14
Peter A Cole, Jeffrey A Gilbertson, Peter A Cole
OBJECTIVES: To analyze functional outcomes, motion, and strength in patients 65 years of age and older who underwent operative management of a scapula fracture. DESIGN: Retrospective review of prospective database. SETTING: A single level-1 teaching trauma center. PATIENTS/PARTICIPANTS: Two hundred fifty patients with scapula fractures were operated between January 2002 and March 2014. A review identified 16 geriatric patients 65 years of age and older...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27994985/mortality-in-tongue-cancer-patients-treated-by-curative-surgery-a-retrospective-cohort-study-from-cgrd
#15
Ming-Shao Tsai, Chia-Hsuan Lai, Chuan-Pin Lee, Yao-Hsu Yang, Pau-Chung Chen, Chung-Jan Kang, Geng-He Chang, Yao-Te Tsai, Chang-Hsien Lu, Chih-Yen Chien, Chi-Kuang Young, Ku-Hao Fang, Chin-Jui Liu, Re-Ming A Yeh, Wen-Cheng Chen
BACKGROUND: Our study aimed to compare the outcomes of surgical treatment of tongue cancer patients in three different age groups. METHODS: From 2004 to 2013, we retrospectively analyzed the clinical data of 1,712 patients who were treated in the four institutions constituting the Chang Gung Memorial Hospitals (CGMH). We divided and studied the patients in three age groups: Group 1, younger (<65 years); Group 2, young old (65 to <75); and Group 3, older old patients (≥75 years)...
2016: PeerJ
https://www.readbyqxmd.com/read/27993211/trauma-patients-who-present-in-a-delayed-fashion-a-unique-and-challenging-population
#16
Mary J Kao, Hector Nunez, Sean F Monaghan, Daithi S Heffernan, Charles A Adams, Stephanie N Lueckel, Andrew H Stephen
BACKGROUND: A proportion of trauma patients present for evaluation in a delayed fashion after injury, likely due to a variety of medical and nonmedical reasons. There has been little investigation into the characteristics and outcomes of trauma patients who present delayed. We hypothesize that trauma patients who present in a delayed fashion are a unique population at risk of increased trauma-related complications. MATERIALS AND METHODS: This was a retrospective review from 2010-2015 at a Level I trauma center...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27993204/massive-transfusion-in-pediatric-trauma-analysis-of-the-national-trauma-databank
#17
Michelle C Shroyer, Russell L Griffin, Vincent E Mortellaro, Robert T Russell
BACKGROUND: Massive transfusion (MT) in pediatric trauma has been described in combat populations and other single institutions studies. We aim to define the incidence of MT in a large US civilian pediatric trauma population, identify predictive parameters of MT, and the mortality associated with MT. METHODS: Data from the National Trauma Databank (2010-2012), a trauma registry maintained by the American College of Surgeons, were analyzed. We included pediatric trauma patients ≤14 y that underwent MT, as defined by 40 mL/kg of blood products within the first 24 h after admission...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27992236/creating-new-opportunities-to-educate-families-on-the-impact-of-frailty-and-cognitive-impairment-in-a-trauma-intensive-care-unit-results-of-a-quality-improvement-project
#18
Mohana B Karlekar, Cathy A Maxwell, Mary S Dietrich, Richard S Miller
BACKGROUND: Older adults comprise a rapidly growing proportion of admissions to acute care hospitals and trauma centers. Older adults admitted to a trauma intensive care unit (TICU) often have a more complicated inpatient and posthospital course. This is the most pronounced in frail elders with cognitive dysfunction. We aimed at integrating validated screening instruments for physical frailty and cognitive impairment into the standard nursing assessment of all older trauma patients admitted to our TICU and stepdown unit...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27979485/discharge-destination-and-readmission-rates-in-older-trauma-patients
#19
David S Strosberg, Blain Chaise Housley, Daniel Vazquez, Amy Rushing, Steven Steinberg, Christian Jones
BACKGROUND: In older trauma patients, the impact of discharge destination on readmission rates is not known. The objective of this study was to evaluate the association between the discharge destination and the 30-day readmission rate in older trauma patients. MATERIALS AND METHODS: A previously validated database of all patients aged 45 years or older undergoing trauma evaluation at our level 1 trauma center between January 1, 2008 and December 31, 2008 was analyzed to retrospectively compare the incidences of 30-day readmission between patients discharged to home, to inpatient rehabilitation facilities, and to other extended care facilities (ECFs)...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27964962/improving-community-ambulation-after-hip-fracture-protocol-for-a-randomised-controlled-trial
#20
D Orwig, K K Mangione, M Baumgarten, M Terrin, R Fortinsky, A M Kenny, A L Gruber-Baldini, B Beamer, Ana Tosteson, M Shardell, L Magder, E Binder, K Koval, B Resnick, R L Craik, J Magaziner
INTRODUCTION: After a hip fracture in older persons, significant disability often remains; dependency in functional activities commonly persists beyond 3 months after surgery. Endurance, dynamic balance, quadriceps strength, and function are compromised, and contribute to an inability to walk independently in the community. In the United States, people aged 65 years and older are eligible to receive Medicare funding for physiotherapy for a limited time after a hip fracture. A goal of outpatient physiotherapy is independent and safe household ambulation 2 to 3 months after surgery...
January 2017: Journal of Physiotherapy
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