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Trauma mortality

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https://www.readbyqxmd.com/read/28449321/a-review-of-associated-controversies-surrounding-glucocorticoid-use-in-veterinary-emergency-and-critical-care
#1
Maya A Aharon, Jennifer E Prittie, Kate Buriko
OBJECTIVE: To review the literature in human and veterinary medicine regarding the indications for, efficacy of, and controversies surrounding glucocorticoid (GC) administration in the emergency and critical care (ECC) setting, and to provide an overview of the most commonly used synthetic GC formulations. MEDICATIONS: Synthetic GCs vary in GC and mineralocorticoid potency, hypothalamic pituitary axis suppression, duration of action, route of administration, and clinical indication for use...
April 27, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28448166/changes-in-motorcycle-related-injuries-and-deaths-after-mandatory-motorcycle-helmet-law-in-a-district-of-vietnam
#2
Ninh Thi Ha, David Ederer, Van Anh Vo Ha, An Van Pham, Anthony Mounts, Leisha Nolen, David Sugerman
OBJECTIVE: Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City. METHODS: Hospital records for road traffic injuries (RTI) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorised using the Abbreviated Injury Score (AIS). Rate ratios (RR) were used to compare rates pre- and post-law (2005/06-2009/10)...
April 27, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28446987/blunt-chest-trauma-is-there-a-place-for-rib-stabilization
#3
REVIEW
John D Mitchell
Rib fractures are a common and highly morbid finding in patients with blunt chest trauma. Over the past decade, a renewed interest in (and instrumentation for) rib fixation in this cohort has occurred. Stabilization of the chest wall in this setting, particularly when a flail segment is present, is associated with significant reductions in the rates of respiratory failure, pneumonia, ICU stay, and mortality. Thoracic surgeons should remain actively involved in this evolving area of our specialty to further optimize patient outcomes...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28446982/management-of-chest-trauma
#4
REVIEW
Corinna Ludwig, Aris Koryllos
Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28445796/decreasing-the-use-of-damage-control-laparotomy-in-trauma-a-quality-improvement-project
#5
John A Harvin, Lillian S Kao, Mike K Liang, Sasha D Adams, Michelle K McNutt, Joseph D Love, Laura J Moore, Charles E Wade, Bryan A Cotton, John B Holcomb
BACKGROUND: Our institution has published damage control laparotomy (DCL) rates of 30% and documented the substantial morbidity associated with the open abdomen. The purpose of this quality improvement (QI) project was to decrease the rate of DCL at a busy, Level 1 trauma center in the United States. STUDY DESIGN: A prospective cohort of all emergent trauma laparotomies from 11/2013-10/2015 (QI group) were followed. The QI intervention was multi-faceted and included audit and feedback for every DCL case...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445418/hyponatremia-is-associated-with-worse-outcomes-from-fall-injuries-in-the-elderly
#6
Spencer C H Kuo, Pao-Jen Kuo, Cheng-Shyuan Rau, Shao-Chun Wu, Shiun-Yuan Hsu, Ching-Hua Hsieh
Background: Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted due to fall injuries in a Level I trauma center. Methods: We retrospectively reviewed data obtained from the Trauma Registry System for trauma admissions from January 2009 through December 2014. Hyponatremia was defined as a serum sodium level <135 mEq/L, and only patients who had sustained a fall at ground level (<1 m) were included...
April 26, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28443269/epidemiology-and-risk-assessment-of-pediatric-venous-thromboembolism
#7
REVIEW
Arash Mahajerin, Stacy E Croteau
The incidence of diagnosed venous thromboembolism (VTE) has been increasing concurrent with advances in technology and medical care that enhance our ability to treat pediatric patients with critical illness or complex multiorgan system dysfunction. Although the overall incidence of VTE is estimated at 0.07-0.49 per 10,000 children, higher rates are observed in specific populations including hospitalized children, those with central venous catheters (CVCs) or patients convalescing from a major surgery. While the absolute number of pediatric VTE events may seem trivial compared to adults, the increasing incidence, associated with increased mortality and morbidity, the availability of novel therapies, and the impact on the cost of care have made investigation of VTE risk factors and prevention strategies a high priority...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28442203/patterns-of-health-care-use-of-injured-adults-a-population-based-matched-cohort-study
#8
Rebecca J Mitchell, Cate M Cameron, Rod McClure
BACKGROUND: Healthcare use by traumatically injured individuals prior to and subsequent to their injury are not often explored for different types of injuries. This study aims to describe health care use 12 months preceding and 12 months following a traumatic injury by injury type and injury severity. METHOD: Hospital and mortality data from three Australian states were linked in a population-based matched cohort study. Individuals ≥18 years who had an injury-related hospital admission in 2009 were identified as the injured cohort...
April 14, 2017: Injury
https://www.readbyqxmd.com/read/28441681/complications-and-mortality-following-one-to-two-level-anterior-cervical-fusion-for-cervical-spondylosis-in-patients-above-80-years-of-age
#9
Varun Puvanesarajah, Amit Jain, Adam L Shimer, Anuj Singla, Francis Shen, Hamid Hassanzadeh
STUDY DESIGN: A retrospective database review. OBJECTIVE: The aim of this study was to determine the complication and mortality rates in patients 80 years of age and older who were treated with anterior cervical fusion surgery and to compare these rates against those of other elderly patients. SUMMARY OF BACKGROUND DATA: Cervical spondylosis is frequently observed in the elderly and is the most common cause of myelopathy in older adults. With increasing life expectancies, a greater proportion of patients are being treated with spine surgery at a later age...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28439596/comparative-clinical-study-of-laparoscopic-and-open-surgery-in-children-with-choledochal-cysts
#10
Guoxin Song, Xiangyu Jiang, Jian Wang, Aiwu Li
To investigate the safety and effectiveness of laparoscopic management of choledochal cysts compared with the open approach, even in early childhood.  Methods: We conducted a retrospective study of 206 patients with choledochal cysts between June 2003 and May 2015. Of these, 104 patients underwent open cyst excision and hepaticojejunostomy (open operation [OP]) and 102 patients received laparoscopic management and hepaticojejunostomy (laparoscopic operation [LP]). The patients who underwent a laparoscopic approach were further divided by the age of 3 years...
May 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28439309/paediatric-pelvic-fractures-how-do-they-differ-from-adults
#11
E Hermans, S T Cornelisse, J Biert, E C T H Tan, M J R Edwards
BACKGROUND: The aim of this article was to review the incidence, presentation, treatment and complications of paediatric pelvic fractures of children who were admitted to our level 1 trauma centre and to compare them with our data from adult pelvic fracture patients. METHODS: We conducted a retrospective chart review of all children with pelvic fractures who were managed at our institution between January 1993 and December 2013 and compared the data with our database on pelvic fractures in adults during the period 2007 to 2012...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28438987/major-trauma-from-suspected-child-abuse-a-profile-of-the-patient-pathway
#12
Ffion C Davies, Fiona E Lecky, Ross Fisher, Marisol Fragoso-Iiguez, Tim J Coats
BACKGROUND: Networked organised systems of care for patients with major trauma now exist in many countries, designed around the needs of the majority of patients (90% adults). Non-accidental injury is a significant cause of paediatric major trauma and has a different injury and age profile from accidental injury (AI). This paper compares the prehospital and inhospital phases of the patient pathway for children with suspected abuse, with those accidentally injured. METHODS: The paediatric database of the national trauma registry of England and Wales, Trauma Audit and Research Network, was interrogated from April 2012 (the launch of the major trauma networks) to June 2015, comparing the patient pathway for cases of suspected child abuse (SCA) with AI...
April 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28438352/burns-to-the-genitalia-perineum-and-buttocks-increase-the-risk-of-death-among-u-s-service-members-sustaining-combat-related-burns-in-iraq-and-afghanistan
#13
Michael S Clemens, Judson C Janak, Julie A Rizzo, John C Graybill, Michelle F Buehner, Steven J Hudak, Charles K Thompson, Kevin K Chung
PURPOSE: Among service members injured in Iraq and Afghanistan, to determine the risk of mortality associated with combat-related burns to the genitalia, perineum, and buttocks. MATERIALS AND METHODS: The prospectively maintained burn registry from the United States Army Institute of Surgical Research was retrospectively reviewed to identify all service members with combat-related burns sustained in Iraq and Afghanistan from March 2003 to October 2013. The two primary risk factors of interest were (1) any burn to the genitals, perineum, and/or buttocks (PB) and (2) burns involving the entire perineal, genital, and buttock region (complete PB)...
April 21, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28438334/understanding-patterns-of-injury-in-kenya-analysis-of-a-trauma-registry-data-from-a-national-referral-hospital
#14
Isaac M Botchey, Yuen Wai Hung, Abdulgafoor M Bachani, Hassan Saidi, Fatima Paruk, Adnan A Hyder
BACKGROUND: Injuries contribute to a substantial proportion of the burden of disease in Kenya. Trauma registries can be a very useful source of data to understand patterns of injuries and serve to provide information about potential improvements in the care of injured patients. In Kenya, health facility-based injury data has been largely administrative. Our aim was to develop and implement a prospective trauma registry at the largest trauma hospital in Kenya, the Kenyatta National Hospital, and to understand the nature of injuries presenting to the hospital, their treatment and care, and their outcomes...
April 21, 2017: Surgery
https://www.readbyqxmd.com/read/28438222/hypothermia-in-trauma-victims-at-first-arrival-of-ambulance-personnel-an-observational-study-with-assessment-of-risk-factors
#15
Frédéric Lapostolle, James Couvreur, François Xavier Koch, Dominique Savary, Armelle Alhéritière, Michel Galinski, Jean-Luc Sebbah, Karim Tazarourte, Frédéric Adnet
BACKGROUND: Hypothermia is common in trauma victims and is associated with increased mortality, however its causes are little known. The objective of this study was to identify the risk factors associated with hypothermia in prehospital management of trauma victims. METHODS: This was an ancillary analysis of data recorded in the HypoTraum study, a prospective multicenter study conducted by the emergency medical services (EMS) of 8 hospitals in France. Inclusion criteria were: trauma victim, age over 18 years, and victim receiving prehospital care from an EMS team and transported to hospital by the EMS team in a medically equipped mobile intensive care unit...
April 24, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#16
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
April 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28433976/isolated-duodenal-rupture-primary-repair-without-diversion-is-it-safe-review-of-literature
#17
Muwaffaq Mezeil Telfah
Isolated duodenal rupture is a rare injury encountered among children following blunt abdominal trauma. Early diagnosis and treatment are essential to decrease the associated morbidity and mortality. The debate is about the optimum operative management. We report a 6-year-old child who presented with acute abdominal pain due to isolated duodenal injury following blunt abdominal trauma. Emergency laparotomy revealed duodenal rupture at the junction of the first and second part of duodenum and absence of any other visceral injuries...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28433042/-alarmins-and-surgical-injury
#18
J Máca, M Peteja
Surgical intervention is an inseparable part of the management of serious surgical disease. However, surgery also presents a potential risk related to the so-called surgical injury causing immune response. When dysregulated the immune activation is able to cause local complications (i.e. wound dehiscence, impaired healing). Systemic decompartmentization of the immunologic disturbance can negatively influence long-term outcomes (i.e. hospital length of stay, mortality). Due to aseptic conditions in the operating room, such an immune activation is almost always of sterile nature...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28431991/molecular-mechanisms-of-trauma-induced-acute-kidney-injury-inflammatory-and-metabolic-insights-from-animal-models
#19
David M Burmeister, Belinda I Gómez, Michael A Dubick
Trauma-induced acute kidney injury (AKI), such as after hemorrhagic shock (HS) or burn, remains a significant problem in the intensive care unit and is associated with increased mortality. The pathophysiology that drives AKI post-trauma is multi factorial, and includes both inflammatory and metabolic alterations. Identifying the systemic profile that contributes to AKI is crucial not only for early diagnosis, but also for identifying treatments that improve kidney function and maintaining long-term patient health...
April 18, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#20
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
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