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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/28930950/increased-mortality-in-trauma-patients-who-develop-postintubation-hypotension
#1
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Postintubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada, between 2000 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#2
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28927908/the-impact-of-the-standard-american-diet-in-rats-effects-on-behavior-physiology-and-recovery-from-inflammatory-injury
#3
Stacie K Totsch, Tammie L Quinn, Larissa J Strath, Laura J McMeekin, Rita M Cowell, Barbara A Gower, Robert E Sorge
BACKGROUND AND AIMS: Obesity is a significant health concern in the Western world and the presence of comorbid conditions suggests an interaction. The overlapping distributions of chronic pain populations and obesity suggests that an interaction may exist. Poor quality diet (high carbohydrates, saturated fats, omega-6 polyunsaturated fatty acids) can lead to increased adiposity which can activate immune cells independent of the activating effect of the diet components themselves. This dual action can contribute to chronic inflammation that may alter susceptibility to chronic pain and prolong recovery from injury...
September 16, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28921003/mortality-and-cardiorespiratory-complications-in-trochanteric-femoral-fractures-a-ten-year-retrospective-analysis
#4
Juliane Carow, John Bennet Carow, Mark Coburn, Bong-Sung Kim, Benjamin Bücking, Christopher Bliemel, Leo Cornelius Bollheimer, Cornelius Johannes Werner, Jan Philipp Bach, Matthias Knobe
PURPOSE: Despite intense research and innovations in peri-operative management, a high mortality rate and frequent systemic complications in trochanteric femoral fractures persist. The aim of the present study was to identify predictive factors for mortality and cardio-respiratory complications after different treatment methods in a ten year period at a level I trauma centre. METHODS: Retrospectively, all patients above 60 years of age with trochanteric femoral fracture between January 2000 and May 2011 were analyzed at a level I trauma centre...
September 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28885520/caring-for-trauma-patients-with-coexisting-heart-failure
#5
Karen Bergman Schieman, Kelley Pattison, Conor Early
The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28878814/thoracic-trauma-severity-contributes-to-differences-in-intensive-care-therapy-and-mortality-of-severely-injured-patients-analysis-based-on-the-traumaregister-dgu%C3%A2
#6
Jörg Bayer, Rolf Lefering, Sylvia Reinhardt, Jan Kühle, Jörn Zwingmann, Norbert P Südkamp, Thorsten Hammer
BACKGROUND: Thoracic trauma is a relevant source of comorbidity throughout multiply-injured patient care. We aim to determine a measurable influence of chest trauma's severity on early resuscitation, intensive care therapy, and mortality in severely injured patients. METHODS: Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, injury severity score (ISS) ≥ 16 are analyzed. Isolated brain injury and severe head injury led to exclusion...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28877802/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#7
COMPARATIVE STUDY
Carlos V R Brown, Kevin Rix, Amanda L Klein, Brent Ford, Pedro G R Teixeira, Jayson Aydelotte, Ben Coopwood, Sadia Ali
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28868158/near-miss-for-big-red-a-unique-case-of-penetrating-glass-injury-of-the-thoracic-spine-and-posterior-mediastinum
#8
Paul J Deramo, Vaidehi Agrawal, Henry C Jefferson
INTRODUCTION: A 42-year-old female with no significant comorbidities presented to our care with a penetrating glass injury to her mid-thoracic spine after falling backwards onto a table. CASE PRESENTATION: A large fragment of glass was protruding from her spine, and multi-planar computed tomography imaging revealed protrusion through the thoracic spinal vertebrae with the glass shards located 2 mm from the aortic lumen. The management of this patient posed several challenges, including initial care of the patient, evaluation of potentially affected structures and the appropriate sequence of therapeutic interventions...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#9
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28861676/machete-injuries-to-the-upper-extremity
#10
Chester J Donnally, William Hannay, Derek A Rapp, Nikola Lekic, Seth D Dodds
PURPOSE: We intend to describe and analyze the spectrum of upper extremity injuries that arises from both accidental and intentional machete injuries with a focus on associated complications and comorbidities. This review is the first from a United States institution, and the only from a designated level 1 trauma center. METHODS: A retrospective review of machete related upper extremity injuries admitted to a level 1 trauma center from 2008 to 2016. The following data was collected on admitted patients: demographics, mechanism of injury, surgical management, and complications...
August 31, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28855960/resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-a-systematic-review-of-the-literature
#11
REVIEW
Emiliano Gamberini, Federico Coccolini, Beatrice Tamagnini, Costanza Martino, Vittorio Albarello, Marco Benni, Marcello Bisulli, Nicola Fabbri, Tal Martin Hörer, Luca Ansaloni, Carlo Coniglio, Marco Barozzi, Vanni Agnoletti
AIMS: Resuscitative endovascular balloon occlusion of the aorta has been a hot topic in trauma resuscitation during these last years. The aims of this systematic review are to analyze when, how, and where this technique is performed and to evaluate preliminary results. METHODS: The literature search was performed on online databases in December 2016, without time limits. Studies citing endovascular balloon occlusion of the aorta in trauma were retrieved for evaluation...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28855778/older-age-comorbid-illnesses-and-injury-severity-affect-immediate-outcome-in-elderly-trauma-patients
#12
Dvora Kirshenbom, Zila Ben-Zaken, Nehama Albilya, Eva Niyibizi, Miklosh Bala
INTRODUCTION: Trauma in elderly population is frequent and is associated with significant mortality, not only due to age but also due to complicated factors such as the severity of injury, preexisting comorbidity, and incomplete general assessment. Our primary aim was to determine whether age, Injury Severity Score (ISS), and preexisting comorbidities had an adverse effect on the outcome in patients aged 65 years and above following blunt trauma. METHODS: We included 1027 patients aged ≥65 years who were admitted to our Level I Trauma Center following blunt trauma...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28852333/perioperative-considerations-when-treating-isolated-periprosthetic-distal-femur-fractures
#13
Michael S Reich, Mindy Duong, Mary A Breslin, Mai P Nguyen, Heather A Vallier
BACKGROUND: Periprosthetic distal femur (PPDF) fractures occur most frequently via low energy mechanisms in elderly patients. This population is often frail and ill-suited to the physiologic burden of trauma and surgery. Here, we describe the perioperative and early hospital course for patients with PPDF fractures, and identify risk factors for poor outcomes. METHODS: Consecutive patients with isolated PPDF fractures from 2005 - 2015 were treated operatively at a Level I trauma center...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28851339/comorbid-post-traumatic-stress-disorder-in-alcohol-use-disorder-relationships-to-demography-drinking-and-neuroimmune-profile
#14
Sudan Prasad Neupane, Jørgen G Bramness, Lars Lien
BACKGROUND: This study examined how alcohol use disorder (AUD) patients with post-traumatic stress disorder (PTSD) differed from those without PTSD in terms of demography, drinking patterns and C-reactive protein, inflammatory cytokines, tryptophan metabolism parameters, and brain-derived neurotrophic factor (BDNF). METHODS: A consecutive sample (N = 187) of treatment-receiving AUD individuals were recruited from Nepalese facilities. They underwent fully structured psychiatric interviews...
August 29, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28843860/swallowing-dysfunction-in-elderly-trauma-patients
#15
Danuel V Laan, T K Pandian, Donald H Jenkins, Brian D Kim, David S Morris
PURPOSE: Newly diagnosed swallowing dysfunction is rare, with an incidence <1% in hospitalized patients. The purpose of this study was to evaluate the incidence and clinical characteristics of dysphagia in elderly trauma patients specifically. METHODS: Patients ≥75years who had newly diagnosed swallowing dysfunction were identified by retrospective review of our institutional trauma database from 2009-2012. A comparison group without dysphagia was also identified that was matched by age, gender, injury mechanism, and injury severity score (ISS)...
July 15, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28842086/comparison-of-time-to-operation-and-efficacies-of-ultrasound-guided-nerve-block-and-general-anesthesia-in-emergency-external-fixation-of%C3%A2-lower-leg-fractures-ao-42-43-44
#16
Chan Kang, Sang-Bum Kim, Youn-Moo Heo, You-Gun Won, Byung-Hak Oh, June-Bum Jun, Gi-Soo Lee
The present randomized controlled trial evaluated the usefulness of ultrasound (US)-guided nerve block (NB) for emergency external fixation of lower leg fractures, by investigating the time required before surgery and the clinical results stratified by the anesthesia method (US-guided NB or general anesthesia [GA]). From June 2014 to April 2016, 40 patients who had undergone emergency surgery for external fixator application were enrolled in the present study. We measured the lead time before the start of surgery after the decision to perform emergency surgery in both groups...
September 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28841615/normative-values-of-the-michigan-hand-outcomes-questionnaire-for-patients-with-and-without-hand-conditions
#17
Michael T Nolte, Melissa J Shauver, Kevin C Chung
BACKGROUND: The Michigan Hand Outcomes Questionnaire has been widely used for nearly 20 years to assess patients with a variety of hand and upper extremity conditions. However, normative data have not previously been collected, limiting interpretation. METHODS: The Michigan Hand Outcomes Questionnaire was administered to 579 participants recruited from the general population. In addition, participants were asked to identify any problem affecting their hand(s), including trauma, hand disease/condition, systemic illness, or nonspecific symptoms...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28822575/dementia-as-a-predictor-of-mortality-in-adult-trauma-patients
#18
Benjamin C Jordan, Joseph Brungardt, Jared Reyes, Stephen D Helmer, James M Haan
BACKGROUND: The specific contribution of dementia towards mortality in trauma patients is not well defined. The purpose of the study was to evaluate dementia as a predictor of mortality in trauma patients when compared to case-matched controls. METHODS: A 5-year retrospective review was conducted of adult trauma patients with a diagnosis of dementia at an American College of Surgeons-verified level I trauma center. Patients with dementia were matched with non-dementia patients and compared on mortality, ICU length of stay, and hospital length of stay...
July 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28816877/fractures-in-spinal-ankylosing-disorders-a-narrative-review-of-disease-and-injury-types-treatment-techniques-and-outcomes
#19
Tarush Rustagi, Doniel Drazin, Cumhur Oner, Jonathan York, Gregory D Schroeder, Alexander R Vaccaro, Rod J Oskouian, Jens R Chapman
INTRODUCTION: Spinal ankylosing disorders encompass ankylosing spondylitis (AS), disseminated hyperostosis of the spine, and end-stage spondylosis. All these result in a stiffened and frequently deformed spinal column. This makes the spinal column highly susceptible to severe injuries that are commonly associated with unfavorable outcomes. Improved understanding of the underlying disease processes and clinical comorbidities may alter the poor injury related morbidity and mortality outcomes...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28815072/hybrid-and-total-minimally-invasive-esophagectomy-how-i-do-it
#20
REVIEW
Luigi Bonavina, Emanuele Asti, Andrea Sironi, Daniele Bernardi, Alberto Aiolfi
Esophagectomy is a major surgical procedure associated with a significant risk of morbidity and mortality. Minimally invasive esophagectomy is becoming the preferred approach because of the potential to limit surgical trauma, reduce respiratory complications, and promote earlier functional recovery. Various hybrid and total minimally invasive surgical techniques have been introduced in clinical practice over the past 20 years, and minimally invasive esophagectomy has been shown equivalent to open surgery concerning the short-term outcomes...
July 2017: Journal of Thoracic Disease
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