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Trauma mortality

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https://www.readbyqxmd.com/read/29036623/predictors-of-mortality-in-high-risk-patients-with-qt-prolongation-in-a-community-hospital
#1
Charlotte Gibbs, Jacob Thalamus, Kristian Heldal, Øystein Lunde Holla, Kristina H Haugaa, Jan Hysing
Aims: To determine predictors of mortality in patients with corrected QT interval (QTc) ≥ 500 ms in a community hospital. Methods and results: In this retrospective observational study, we searched the electrocardiogram (ECG) database at Telemark Hospital Trust, Norway, from January 2004 to December 2014. Medication, electrolyte abnormalities, and medical conditions known to prolong the QT interval were recorded. From the medical records, we assessed whether the prolonged QTc was noted by the health care providers...
October 3, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29035925/acute-kidney-injury-in-trauma-patients
#2
Anatole Harrois, Nicolas Libert, Jacques Duranteau
PURPOSE OF REVIEW: To review epidemiology and pathophysiology of acute kidney injury (AKI) in trauma patients and propose strategies that aim at preventing AKI after trauma. RECENT FINDINGS: AKI in trauma patients has been reported to be as frequent as 50% with an association to a prolonged length of stay and a raise in mortality. Among the specific risk factors encountered in trauma patients, hemorrhagic shock, rhabdomyolysis severity, age, and comorbidities are independently associated with AKI occurrence...
October 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29035924/rotational-therapy-in-thoracic-injuries-what-is-the-evidence
#3
Philipp Störmann, Ingo Marzi, Sebastian Wutzler
PURPOSE OF REVIEW: To review the current use of continuous lateral rotational therapy (CLRT) in patients with thoracic injuries and its impact on clinical course, complications and outcome. RECENT FINDINGS: Patient positioning is a key factor in the treatment of severe thoracic injuries and CLRT, and intermittent supine and prone position are basic options. There is a lack of randomized controlled studies for trauma patients with chest injury undergoing kinetic therapy as standard of care...
October 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29033682/usefulness-of-tc99m-mebrofenin-hepatobiliary-scintigraphy-and-single-photon-emission-computed-tomography-computed-tomography-in-the-diagnosis-of-bronchobiliary-fistula
#4
Rahul Vithalrao Parghane, Rohit Kumar Phulsunga, Rajesh Gupta, Rajender Kumar Basher, Anish Bhattacharya, Bhagwant Rai Mittal
Bronchobiliary fistula (BBF), a rare complication of liver disease, is an abnormal communication between the biliary tract and bronchial tree. BBF may occur as a consequence of local liver infections such as hydatid or amebic disease, pyogenic liver abscess or trauma to the liver, obstruction of biliary tract, and tumor. As such management of liver disease with BBF is very difficult and often associated with a high rate of morbidity and mortality. Therefore, timely diagnosis of BBF is imperative. Hepatobiliary scintigraphy along with hybrid single photon emission computed tomography/computed tomography using Tc99m-mebrofenin is a very useful noninvasive imaging modality, in the diagnosis of BBF...
October 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/29033079/polytrauma-patients-in-the-netherlands-and-the-usa-a-bi-institutional-comparison-of-processes-and-outcomes-of-care
#5
Suzan Dijkink, Gwendolyn M van der Wilden, Pieta Krijnen, Lisa Dol, Steven Rhemrev, David R King, Marc A DeMoya, George C Velmahos, Inger B Schipper
BACKGROUND: Modern trauma systems differ worldwide, possibly leading to disparities in outcomes. We aim to compare characteristics and outcomes of blunt polytrauma patients admitted to two Level 1 Trauma Centers in the US (USTC) and the Netherlands (NTC). METHODS: For this retrospective study the records of 1367 adult blunt trauma patients with an Injury Severity Score (ISS) ≥ 16 admitted between July 1, 2011 and December 31, 2013 (640 from NTC, 727 from USTC) were analysed...
October 10, 2017: Injury
https://www.readbyqxmd.com/read/29032876/clinical-value-of-triage-lactate-in-risk-stratifying-trauma-patients-using-interval-likelihood-ratios
#6
Bonny J Baron, Andrew Nguyen, Dimitre Stefanov, Amit Shetty, Shahriar Zehtabchi
Emergency physicians face the challenge of rapidly identifying high-risk trauma patients. Lactate (LAC) is widely used as a surrogate of tissue hypoperfusion. However, clinically important values for LAC as a predictor of mortality are not well defined. OBJECTIVES: 1. To assess the value of triage LAC in predicting mortality after trauma. 2. To compute interval likelihood ratios (LR) for LAC. METHODS: Retrospective chart review of trauma patients with a significant injury mechanism that warranted labs at an urban trauma center...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29030143/impact-of-atrial-fibrillation-on-outcomes-with-motor-vehicle-accidents
#7
Kanishk Agnihotri, N V Pothineni, Paris Charilaou, Vaibhav R Vaidya, Badal Thakkar, Vishal Goyal, Sabeeda Kadavath, Nileshkumar Patel, Apurva Badheka, Peter Noseworthy, Suraj Kapa, Paul Friedman, Bernard Gersh, Hakan Paydak, Abhishek Deshmukh
BACKGROUND: We examined the effect of AF a commonly encountered arrhythmia with significant morbidity on mortality following a motor vehicle accident (MVA) related hospitalization. METHODS: The Nationwide Inpatient Sample (NIS) was queried to identify patients with AF (ICD-9 CM 427.31) and MVA (ICD-9 CM E810.0-E819.9), considered separately and together, from 2003 through 2012. Baseline characteristics were identified and multilevel mixed model multivariate analysis was employed to verify the impact of AF on in-patient mortality in survivors...
October 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29029781/returning-from-the-acidotic-abyss-mortality-in-trauma-patients-with-a-ph%C3%A2-%C3%A2-7-0
#8
Samuel W Ross, Bradley W Thomas, A Britton Christmas, Kyle W Cunningham, Ronald F Sing
No abstract text is available yet for this article.
October 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29029642/post-trauma-morbidity-measured-as-sick-leave-is-substantial-and-influenced-by-factors-unrelated-to-injury-a-retrospective-matched-observational-cohort-study
#9
Erik von Oelreich, Mikael Eriksson, Olof Brattström, Andrea Discacciati, Lovisa Strömmer, Anders Oldner, Emma Larsson
BACKGROUND: Mortality as an endpoint has been the focus of trauma research whereas few studies investigate long-term outcomes in terms of morbidity. An adequate analysis of post-injury morbidity includes several dimensions, for this reason sick leave has been used as a proxy for morbidity in the current study. The aim of this retrospective matched observational cohort study was to investigate sick leave before and after trauma and factors associated with prolonged sick leave. METHODS: Patients from a level one trauma centre 2005-2010 were matched in a 1:5 ratio with uninjured controls...
October 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29029604/trauma-burden-in-tanzania-a-one-day-survey-of-all-district-and-regional-public-hospitals
#10
Hendry R Sawe, Juma A Mfinanga, Khalid R Mbaya, Phillip M Koka, Said S Kilindimo, Michael S Runyon, Victor G Mwafongo, Lee A Wallis, Teri A Reynolds
BACKGROUND: Trauma contributes significantly to the burden of disease and mortality throughout the world, but particularly in developing countries. In Tanzania, there is an enormous research gap on trauma; the limited data available reflects realities in cities and areas with moderately- to highly-resourced treatment centers. Our aim was to provide a description of the injury epidemiology across all of Tanzania. Our data will serve as a basis for future larger studies. METHODS: This is a subgroup analysis of a cross-sectional, prospective study of the clinical epidemiology of patients presenting at all public district and regional hospitals in Tanzania...
October 13, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29025609/blood-loss-in-trochanteric-fractures-multivariate-analysis-comparing-dynamic-hip-screw-and-gamma-nail
#11
Mario Ronga, Daniele Bonzini, Marco Valoroso, Giuseppe La Barbera, Jacopo Tamini, Mario Cherubino, Paolo Cherubino
INTRODUCTION: Anaemia in patients with trochanteric fracture is associated with increased morbidity and mortality and it is an independent risk factor for functional mobility of patients. Several authors have reported the blood loss following operative treatment comparing different fixation systems but few authors have evaluated many associated variables that could influence the perioperative blood loss. PURPOSE: To evaluate the blood loss in patients that had their trochanteric fracture stabilized with dynamic hip screw (DHS) or Gamma nail...
October 2017: Injury
https://www.readbyqxmd.com/read/29024879/single-intervention-for-a-reduction-in-portable-chest-radiography-pcxr-in-cardiovascular-and-surgical-trauma-icus-and-associated-outcomes
#12
Joseph E Tonna, Kensaku Kawamoto, Angela P Presson, Chong Zhang, Mary C Mone, Robert E Glasgow, Richard G Barton, John R Hoidal, Yoshimi Anzai
PURPOSE: Studies suggest that "on-demand" radiography is equivalent to daily routine with regard to adverse events. In these studies, provider behavior is controlled. Pragmatic implementation has not been studied. MATERIALS AND METHODS: This was a quasi-experimental, pre-post intervention study. Medical directors of two intervention ICUs requested pCXRs be ordered on an on-demand basis at one time point, without controlling or monitoring behavior or providing follow-up...
October 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29023379/effect-of-early-pelvic-binder-use-in-the-emergency-management-of-suspected-pelvic-trauma-a-retrospective-cohort-study
#13
Sheng-Der Hsu, Cheng-Jueng Chen, Yu-Ching Chou, Sheng-Hao Wang, De-Chuan Chan
BACKGROUND: We aimed to evaluate the effect of early pelvic binder use in the emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. METHODS: We enrolled trauma patients with initial stabilization using a pelvic binder when suspecting pelvic injury. The inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: a loss of consciousness or a Glasgow coma score (GCS) of <13; systolic blood pressure of <90 mmHg; falling from ≥6 m; injury to multiple vital organs; and suspected pelvic injury...
October 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29022789/the-impact-of-mechanism-on-the-management-and-outcome-of-penetrating-colonic-trauma
#14
G V Oosthuizen, V Y Kong, T Estherhuizen, J L Bruce, G L Laing, J J Odendaal, D L Clarke
Introduction In light of continuing controversy surrounding the management of penetrating colonic injuries, we set out to compare the outcome of penetrating colonic trauma according to whether the mechanism of injury was a stab wound or a gunshot wound. Methods Our trauma registry was interrogated for the 5-year period from January 2012 to December 2016. All patients over the age of 18 years with penetrating trauma (stab or gunshot) and with intraoperatively proven colonic injury were reviewed. Details of the colonic and concurrent abdominal injuries were recorded, together with the operative management strategy...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29022788/developing-a-simplified-clinical-prediction-score-for-mortality-in-patients-with-cerebral-gunshot-wounds-the-maritzburg-score
#15
V Y Kong, J Odendaal, B Sartorius, D L Clarke, J L Bruce, G L Laing, T Esterhuizen
Introduction Cerebral gunshot wounds are highly lethal and literature on the clinical scores for mortality prediction is limited. Materials and methods A retrospective study was undertaken over a 5-year period at the Pietermaritzburg Metropolitan Trauma Service in South Africa. A simplified clinical prediction score was developed based on clinical and/or physiological variables readily available in the resuscitation room. Results A total of 102 patients were included; 92% (94/102) were male and the mean age was 29 years; 22% (22/102) died during the admission...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29022129/the-utility-of-local-anesthesia-for-neurosurgical-interventions-in-a-low-resource-setting-a-case-series
#16
Jessica Eaton, Asma Bilal Hanif, Suzgisam Mzumara, Anthony Charles
INTRODUCTION: Trauma is a major contributor to global morbidity and mortality, and injury to the central nervous system is the most common cause of death in these patients. While the provision of surgical services is being recognized as essential to global public health efforts, specialty areas such as neurosurgery remain overlooked. METHOD: This is a retrospective case review of patients with operable lesions, such as extra-axial hematomas and unstable depressed skull fractures that underwent neurosurgical interventions under local anesthesia...
October 11, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29021720/burn-injury-review-of-pathophysiology-and-therapeutic-modalities-in-major-burns
#17
I Kaddoura, G Abu-Sittah, A Ibrahim, R Karamanoukian, N Papazian
Despite a considerable decrease in their incidence worldwide, burn injuries remain one of the commonest forms of trauma and account for a weighty proportion of trauma cases in health-care emergencies around the globe. Although the latest data reveal a substantial decline in burn-related mortality and hospital admissions in the US over the past three decades, severe thermal injuries continue to trigger devastating morbidity and significant mortality while their management remains a dynamic challenge for the entire medical and paramedical community...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29020093/a-shift-from-motorised-travel-to-active-transport-what-are-the-potential-health-gains-for-an-australian-city
#18
Belen Zapata-Diomedi, Luke D Knibbs, Robert S Ware, Kristiann C Heesch, Marko Tainio, James Woodcock, J Lennert Veerman
INTRODUCTION: An alarmingly high proportion of the Australian adult population does not meet national physical activity guidelines (57%). This is concerning because physical inactivity is a risk factor for several chronic diseases. In recent years, an increasing emphasis has been placed on the potential for transport and urban planning to contribute to increased physical activity via greater uptake of active transport (walking, cycling and public transport). In this study, we aimed to estimate the potential health gains and savings in health care costs of an Australian city achieving its stated travel targets for the use of active transport...
2017: PloS One
https://www.readbyqxmd.com/read/29019874/injury-patterns-among-various-age-and-gender-groups-of-trauma-patients-in-southern-iran-a-cross-sectional-study
#19
Shahram Bolandparvaz, Mahnaz Yadollahi, Hamid Reza Abbasi, Mehrdad Anvar
Administrative data from trauma referral centers are useful sources while studying epidemiologic aspects of injuries. We aimed to provide a hospital-based view of injuries in Shiraz considering victims' age and gender, using administrative data from trauma research center.A cross-sectional registry-based study of adult trauma patients (age ≥15 years) sustaining injury through traffic accidents, violence, and unintentional incidents was conducted. Information was retrieved from 3 hospital administrative databases...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29019796/monitoring-modalities-and-assessment-of-fluid-status-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-east
#20
David S Plurad, William Chiu, Ali S Raja, Samuel M Galvagno, Uzer Khan, Dennis Y Kim, Samuel A Tisherman, Jeremy Ward, Mark E Hamill, Vicki Bennett, Brian Williams, Bryce Robinson
BACKGROUND: Fluid administration in critically ill surgical patients must be closely monitored to avoid complications. Resuscitation guided by invasive methods are not consistently associated with improved outcomes. As such, there has been increased use of Focused Ultrasound and Arterial Pulse Waveform Analysis (APWA) to monitor and aid resuscitation. An assessment of these methods using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework is presented...
October 11, 2017: Journal of Trauma and Acute Care Surgery
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