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Trauma mortality

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https://www.readbyqxmd.com/read/29683829/harmful-or-physiologic-diagnosing-fibrinolysis-shutdown-in-a-trauma-cohort-with-rotational-thromboelastometry
#1
J Carolina Gomez-Builes, Sergio A Acuna, Bartolomeu Nascimento, Fabiana Madotto, Sandro B Rizoli
BACKGROUND: Despite its central role in early trauma coagulopathy, abnormal fibrinolysis continues to be poorly understood. Excessive fibrinolysis is a known contributor to mortality. Recent studies with thromboelastography (TEG) suggest decreased fibrinolysis (or shutdown) may be just as harmful. Considering the broad use of 2 different viscoelastic assays, which are not interchangeable, we proposed for the first time to define and characterize fibrinolysis shutdown using rotational thromboelastometry (ROTEM)...
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29683734/six-year-review-of-traumatic-brain-injury-in-a-regional-trauma-unit-demographics-contributing-factors-and-service-provision-in-ireland
#2
Patrick W Owens, Noel P Lynch, Donal P O'Leary, Aoife J Lowery, Michael J Kerin
BACKGROUND: Traumatic brain injury (TBI) represents a significant burden of care for acute surgical services, particularly in the absence of on-site neurosurgical cover or sufficient post-acute rehabilitation facilities. We examine factors contributing to TBI, prolonged lengths of stay (LoS) and implications for hospital resources. Long-term outcomes are assessed. METHODS: This is a retrospective cohort study of patients admitted to a regional trauma unit with TBI from 2008 to 2013...
April 23, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29683405/longitudinal-evaluation-of-plasma-concentrations-of-presepsin-in-patients-after-severe-trauma-a-prospective-observational-study
#3
Christian Koch, Sophie Ruhrmann, Michael Pöhlmann, Emmanuel Schneck, Borros Arneth, Thomas Zajonz, Michael Sander, Markus A Weigand, Florian Uhle
BACKGROUND: The high mortality rate of patients suffering from severe trauma is based not only on the mechanism of injury, but also on the higher risk for development of subsequent infections. Therefore, the early recognition of infection after severe trauma is of particular importance for patient outcome. However, early diagnosis is often masked by the consequences of the sterile, damage-triggered immune response. Our study sought to analyze the course of soluble CD14-subtype (sCD14-ST, presepsin) compared with clinically established inflammatory and infectious biomarkers in a cohort of patients with severe trauma...
April 23, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29683388/hematocrit-and-impact-of-transfusion-in-patients-receiving-extracorporeal-life-support
#4
Justyna Swol, Christopher Marschall, Justus T Strauch, Thomas A Schildhauer
INTRODUCTION: Increasing the hematocrit is considered to increase oxygen delivery to the patient, especially when hypoxic conditions exist and the patient may become more stable. The aim of this study was to evaluate the relationship between hematocrit and hospital mortality via subgroup analyses of trauma and non-trauma patients. METHODS: The hospital length of stay (LOS) and LOS in the intensive care unit (ICU) and hospital after extracorporeal life support (ECLS) treatment of 81 patients were analyzed and compared...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29682837/massive-transfusion-changing-practice-in-a-single-norwegian-centre-2002-2015
#5
H Doughty, T O Apelseth, J Sivertsen, K Annaniasen, T Hervig
OBJECTIVES: To describe the change in massive transfusion (MT) practice in a single Norwegian centre throughout the period 2002-2015. BACKGROUND: MT support for traumatic haemorrhage has changed since the mid-2000s. However, life-threatening haemorrhage may occur in other clinical specialties. In 2007, Haukeland University Hospital (HUS) introduced a universal MT programme including education, Acute Transfusion Packages (ATPs) and thromboelastography. METHODS/MATERIALS: A retrospective review was performed of all MT episodes defined as ≥10 red cell concentrates (RCC) in 24 h...
April 23, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29682389/blunt-pancreatic-injury-in-major-trauma-decision-making-between-nonoperative-and-operative-treatment
#6
Christopher Ull, Sebastian Bensch, Thomas Armin Schildhauer, Justyna Swol
Blunt trauma injuries to the pancreas are rare but are associated with significant overall mortality and a high complication rate. Motor vehicle collisions are the leading cause of blunt pancreatic trauma, followed by falls, and sports injuries. We discuss the decision-making process used during the clinical courses of 3 patients with life-threatening blunt pancreatic injuries caused by traumatic falls. We also discuss the utility of the American Association for the Surgery of Trauma Organ Injury Scale (AAST-OIS), which provides a system for grading pancreatic trauma...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29682010/craniofacial-trauma-in-pediatric-patients-following-winnowing-blade-injury-review-of-literature
#7
REVIEW
Harsha Huliyappa, Balakrishna Ojha, Anil Chandra, Sunil Kumar Singh, Chhitij Srivastava
In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for "fan blade injury" showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682003/differentiation-in-an-inclusive-trauma-system-allocation-of-lower-extremity-fractures
#8
F S Würdemann, D P J Smeeing, S Ferree, F Nawijn, E J M M Verleisdonk, L P H Leenen, R M Houwert, F Hietbrink
Background: Implementation of an inclusive trauma system leads to reduced mortality rates, specifically in polytrauma patients. Field triage is essential in this mortality reduction. Triage systems are developed to identify patients with life-threatening injuries, and trauma mechanisms are important for triaging. Although complex extremity fractures are mostly non-lethal, these injuries are frequently the result of a high-energy trauma mechanism. The aim of this study is to compare injury and patient characteristics, as well as resource demands, of lower extremity fractures between a level (L)1 and level (L)2 trauma centre in a mature inclusive trauma system...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29680410/influence-of-entrapment-on-prehospital-management-and-the-hospital-course-in-polytrauma-patients-a-retrospective-analysis-in-air-rescue
#9
Christian Macke, Marika Sarakintsis, Marcel Winkelmann, Philipp Mommsen, Mohamed Omar, Christian Schröter, Christian Krettek, Christian Zeckey
BACKGROUND: Entrapment is a challenging and crucial factor in the prehospital setting. Few studies have addressed whether entrapment has an influence on on-scene treatment or on the following hospital course. OBJECTIVES: Here we aimed to investigate the influence of entrapment on prehospital management and on the hospital course of polytrauma patients. METHODS: We performed a retrospective analysis of consecutive patients with an Injury Severity Score ≥16 and aged 16-65 years that were admitted between 2005 and 2013 to a Level I trauma center...
April 18, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29679240/a-case-of-tension-faecopneumothorax-after-delayed-diagnosis-of-traumatic-diaphragmatic-hernia
#10
Tien Yew Chern, Allan Kwok, Soni Putnis
BACKGROUND: Traumatic diaphragmatic injuries from blunt or penetrating trauma are difficult to detect in the acute setting and, if missed, can result in significant morbidity and mortality in the future. We present a case demonstrating the natural progression of this resulting in faecopneumothorax, which is a rare but serious presentation. CASE PRESENTATION: A 22-year-old young man presented with left upper quadrant and chest pain, nausea, vomiting, and intermittent obstipation with a background of previous lower chest wall stabbings...
April 20, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29675813/computational-model-for-hyperfibrinolytic-onset-of-acute-traumatic-coagulopathy
#11
Tie Bo Wu, Sheng Wu, Matthew Buoni, Thomas Orfeo, Kathleen Brummel-Ziedins, Mitchell Cohen, Linda Petzold
The onset of acute traumatic coagulopathy in trauma patients exacerbates hemorrhaging and dramatically increases mortality. The disease is characterized by increased localized bleeding, and the mechanism for its onset is not yet known. We propose that the fibrinolytic response, specifically the release of tissue-plasminogen activator (t-PA), within vessels of different sizes leads to a variable susceptibility to local coagulopathy through hyperfibrinolysis which can explain many of the clinical observations in the early stages from severely injured coagulopathic patients...
April 19, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29675749/evaluation-of-severe-and-fatal-injuries-in-extreme-and-contact-sports-an-international-multicenter-analysis
#12
Christian D Weber, Klemens Horst, Anthony R Nguyen, Rolf Lefering, Hans-Christoph Pape, Frank Hildebrand
PURPOSE: The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. METHODS: We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®)...
April 19, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29675632/factors-affecting-mortality-and-reoperations-in-high-energy-pelvic-fractures
#13
Peyman Bakhshayesh, Lars Weidenhielm, Anders Enocson
AIM: Factors affecting mortality during the first year following high-energy pelvic fractures has not been reported previously. Nor has surgical complications leading to reoperations been reported in a cohort with only high-energy pelvic trauma patients. OBJECTIVES: The aim of this study was to report and analyse factors affecting outcome, in terms of mortality and reoperations, up to 1 year after the injury in patients with a traumatic pelvic ring injury due to a high-energy trauma...
April 19, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#14
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29672992/life-in-the-fast-lane-settled-pastoralism-in-the-central-eurasian-steppe-during-the-middle-bronze-age
#15
Margaret A Judd, Jessica L Walker, Alicia Ventresca Miller, Dmitry Razhev, Andrey V Epimakhov, Bryan K Hanks
OBJECTIVES: We tested the hypothesis that the purported unstable climate in the South Urals region during the Middle Bronze Age (MBA) resulted in health instability and social stress as evidenced by skeletal response. METHODS: The skeletal sample (n = 99) derived from Kamennyi Ambar 5 (KA-5), a MBA kurgan cemetery (2040-1730 cal. BCE, 2 sigma) associated with the Sintashta culture. Skeletal stress indicators assessed included cribra orbitalia, porotic hyperostosis, dental enamel hypoplasia, and tibia periosteal new bone growth...
April 19, 2018: American Journal of Human Biology: the Official Journal of the Human Biology Council
https://www.readbyqxmd.com/read/29672869/age-of-transfused-blood-in-critically-ill-adult-trauma-patients-a-prespecified-nested-analysis-of-the-age-of-blood-evaluation-randomized-trial
#16
Robert S Green, Mete Erdogan, Jacques Lacroix, Paul C Hébert, Alan T Tinmouth, Elham Sabri, Tinghua Zhang, Dean A Fergusson, Alexis F Turgeon
BACKGROUND: Blood transfusion is common in the resuscitation of patients with traumatic injury. However, the clinical impact of the length of storage of transfused blood is unclear in this population. STUDY DESIGN AND METHODS: We undertook a prespecified nested analysis of 372 trauma victims of the 2510 critically ill patients from 64 centers treated as part of the Age of Blood Evaluation (ABLE) randomized controlled trial. Patients were randomized according to their trauma status to receive either a transfusion of fresh blood stored not more than 7 days or standard-issue blood...
April 19, 2018: Transfusion
https://www.readbyqxmd.com/read/29670613/innate-immunity-in-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome-and-its-implications-for-therapy
#17
REVIEW
Hiroyuki Horiguchi, Tyler J Loftus, Russell B Hawkins, Steven L Raymond, Julie A Stortz, McKenzie K Hollen, Brett P Weiss, Elizabeth S Miller, Azra Bihorac, Shawn D Larson, Alicia M Mohr, Scott C Brakenridge, Hironori Tsujimoto, Hideki Ueno, Frederick A Moore, Lyle L Moldawer, Philip A Efron
Clinical and technological advances promoting early hemorrhage control and physiologic resuscitation as well as early diagnosis and optimal treatment of sepsis have significantly decreased in-hospital mortality for many critically ill patient populations. However, a substantial proportion of severe trauma and sepsis survivors will develop protracted organ dysfunction termed chronic critical illness (CCI), defined as ≥14 days requiring intensive care unit (ICU) resources with ongoing organ dysfunction...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29669611/needle-thoracostomy-does-changing-needle-length-and-location-change-patient-outcome
#18
Lori A Weichenthal, Scott Owen, Geoffory Stroh, John Ramos
BACKGROUND: Needle thoracostomy (NT) is a common prehospital intervention for patients in extremis or cardiac arrest due to trauma. The purpose of this study is to compare outcomes, efficacy, and complications after a change in policy related to NT in a four-county Emergency Medical Services (EMS) system with a catchment area of greater than 1.6 million people. METHODS: This is a before and after observational study of all patients who had NT performed in the Central California (USA) EMS system...
April 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29669572/one-year-and-three-year-mortality-prediction-in-adult-major-blunt-trauma-survivors-a-national-retrospective-cohort-analysis
#19
Ting Hway Wong, Nivedita Vikas Nadkarni, Hai V Nguyen, Gek Hsiang Lim, David Bruce Matchar, Dennis Chuen Chai Seow, Nicolas K K King, Marcus Eng Hock Ong
BACKGROUND: Survivors of trauma are at increased risk of dying after discharge. Studies have found that age, head injury, injury severity, falls and co-morbidities predict long-term mortality. The objective of our study was to build a nomogram predictor of 1-year and 3-year mortality for major blunt trauma adult survivors of the index hospitalization. METHODS: Using data from the Singapore National Trauma Registry, 2011-2013, we analyzed adults aged 18 and over, admitted after blunt injury, with an injury severity score (ISS) of 12 or more, who survived the index hospitalization, linked to death registry data...
April 18, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29668810/predictors-of-chest-drainage-complications-in-trauma-patients
#20
Cecília Araújo Mendes, Elcio Shiyoiti Hirano
OBJECTIVE: to identify predictors of chest drainage complications in trauma patients attended at a University Hospital. METHODS: we conducted a retrospective study of 68 patients submitted to thoracic drainage after trauma, in a one-year period. We analyzed gender, age, trauma mechanism, trauma indices, thoracic and associated lesions, environment in which the procedure was performed, drainage time, experience of the performer, complications and evolution. RESULTS: the mean age of the patients was 35 years and the male gender was the most prevalent (89%)...
2018: Revista do Colégio Brasileiro de Cirurgiões
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