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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/28212955/health-state-preference-weights-for-the-glasgow-outcome-scale-following-traumatic-brain-injury-a-systematic-review-and-mapping-study
#1
Gordon Ward Fuller, Monica Hernandez, David Pallot, Fiona Lecky, Mathew Stevenson, Belinda Gabbe
BACKGROUND: Valid and relevant estimates of health state preference weights (HSPWs) for Glasgow Outcome Scale (GOS) categories are a key input of economic models evaluating treatments for traumatic brain injury (TBI). OBJECTIVES: To characterize existing HSPW estimates, and model the EuroQol five-dimensional questionnaire (EQ-5D) from the GOS, to inform parameterization of future economic models. METHODS: A systematic review of HSPWs for GOS categories following TBI was conducted using a highly sensitive search strategy implemented in an extensive range of information sources between 1975 and 2016...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28206931/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#2
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/28194710/exchangeable-femoral-neck-dual-modular-tha-prostheses-have-poorer-survivorship-than-other-designs-a-nationwide-cohort-of-324-108-patients
#3
Sandrine Colas, Assia Allalou, Antoine Poichotte, Philippe Piriou, Rosemary Dray-Spira, Mahmoud Zureik
BACKGROUND: Exchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb length) and reduce the risk of dislocation. However exchangeable necks have been reported to result in adverse effects such as stem fractures and acute local tissue reaction...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28188356/brain-trauma-foundation-guidelines-for-intracranial-pressure-monitoring-compliance-and-effect-on-outcome
#4
Alberto Aiolfi, Elizabeth Benjamin, Desmond Khor, Kenji Inaba, Lam Lydia, Demetrios Demetriades
BACKGROUND: Brain Trauma Foundation (BTF) guidelines recommend intracranial pressure (ICP) monitoring in patients who sustained severe traumatic brain injury (TBI). Compliance to BTF guidelines is variable, and the effect of ICP monitoring on outcomes remains a controversial issue. The purpose of this study was to assess guidelines compliance in patients who sustain a severe TBI and to analyze the effect of ICP monitoring on outcomes. METHODS: Trauma Quality Improvement Program database study, which included patients with isolated severe blunt head trauma (head Abbreviated Injury Scale ≥3 with Glasgow Coma Scale <9)...
February 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28181264/promising-directions-for-treating-comorbid-ptsd-and-substance-use-disorder
#5
Sonya B Norman, Jessica L Hamblen
Although trauma focused (TF) psychotherapies are well established as the most effective treatments for posttraumatic stress disorder (PTSD; e.g., Institute of Medicine, 2007), questions remain about when a patient is "ready" for TF treatment. Providers can be hesitant to initiate TF treatment with patients with comorbidity (Cook et al., in press) and may offer patients non-TF options in place of, or in preparation for, TF psychotherapy (Hamblen et al., 2015). Unfortunately, there is no definitive way to determine readiness and providers may be unnecessarily delaying effective treatment...
February 9, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28181262/descriptive-characteristics-and-in-hospital-mortality-of-critically-bleeding-patients-requiring-massive-transfusion-results-from-the-australian-and-new-zealand-massive-transfusion-registry
#6
R Ruseckaite, Z K McQuilten, J C Oldroyd, T H Richter, P A Cameron, J P Isbister, E M Wood
BACKGROUND AND OBJECTIVES: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). MATERIALS AND METHODS: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015...
February 8, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28178306/indicators-of-patients-with-major-depressive-disorder-in-need-of-highly-specialized-care-a-systematic-review
#7
Frédérique C W van Krugten, Meriam Kaddouri, Maartje Goorden, Anton J L M van Balkom, Claudi L H Bockting, Frenk P M L Peeters, Leona Hakkaart-van Roijen
OBJECTIVES: Early identification of patients with major depressive disorder (MDD) that cannot be managed by secondary mental health services and who require highly specialized mental healthcare could enhance need-based patient stratification. This, in turn, may reduce the number of treatment steps needed to achieve and sustain an adequate treatment response. The development of a valid tool to identify patients with MDD in need of highly specialized care is hampered by the lack of a comprehensive understanding of indicators that distinguish patients with and without a need for highly specialized MDD care...
2017: PloS One
https://www.readbyqxmd.com/read/28170001/the-mcp-4-mcp-1-ratio-in-plasma-is-a-candidate-circadian-biomarker-for-chronic-post-traumatic-stress-disorder
#8
C Dalgard, O Eidelman, C Jozwik, C H Olsen, M Srivastava, R Biswas, Y Eudy, S W Rothwell, G P Mueller, P Yuan, W C Drevets, H K Manji, M Vythlingam, D S Charney, A Neumeister, R J Ursano, D M Jacobowitz, H B Pollard, O Bonne
Post-traumatic stress disorder (PTSD) is psychiatric disease, which can occur following exposure to traumatic events. PTSD may be acute or chronic, and can have a waxing and waning course of symptoms. It has been hypothesized that proinflammatory cytokines and chemokines in the cerebrospinal fluid (CSF) or plasma might be mediators of the psychophysiological mechanisms relating a history of trauma exposure to changes in behavior and mental health disorders, and medical morbidity. Here we test the cytokine/chemokine hypothesis for PTSD by examining levels of 17 classical cytokines and chemokines in CSF, sampled at 0900 hours, and in plasma sampled hourly for 24 h...
February 7, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28167395/psychiatric-heterogeneity-of-recent-suicide-attempters-a-latent-class-analysis
#9
Meredith K Ginley, Courtney L Bagge
Presence of, and comorbidity between, psychiatric disorders is a risk factor for suicide attempts. No study to date has used a person-centered approach to determine whether there are subgroups of attempters showing differing patterns of psychiatric disorders. This study aimed to identify psychiatric subgroups amongst recent suicide attempters (i.e., hospitalized within 24h of their attempt) and to determine whether identified classes could be differentiated in terms of important clinical correlates. Participants included 97 adult patients who were hospitalized due to a recent suicide attempt at a large Trauma 1 hospital...
February 3, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28166173/is-this-autograft-worth-it-the-blood-loss-and-transfusion-rates-associated-with-ria-bone-graft-harvest
#10
Lucas S Marchand, David L Rothberg, Erik N Kubiak, Thomas F Higgins
OBJECTIVES: To investigate the blood loss and transfusion rate associated with the use of reamer irrigator aspirator (RIA). DESIGN: Retrospective review. SETTING: Academic Level-I trauma hospital. PATIENTS: One hundred eight patients requiring bone graft harvest for surgical reconstruction of non-union or failed arthrodesis. INTERVENTION: Bone graft harvest preformed via RIA or iliac crest bone graft (ICBG)...
January 30, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28164043/pneumothorax-after-shoulder-arthroscopy-a-rare-but-life-threatening-complication
#11
Sven Bamps, Daan Renson, Stefaan Nijs, Sermon
INTRODUCTION: Arthroscopy has become a major diagnostic tool and treatment option for shoulder pathology. However rare, respiratory complications such as a pneumothorax have been reported in patients undergoing shoulder arthroscopy. Surgery - as well as anesthesiology-related factors and respiratory comorbidity have been hypothesized to intervene in the onset of respiratory complications. CASE REPORT: We report the case of a 42-year-old male patient who underwent an arthroscopy of the left shoulder...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28149195/non-unions-after-fixation-of-humeral-fractures-using-hackethal-s-bundle-nailing-technique
#12
Petr Obruba, Stefan Rammelt, Lubomir Kopp, Karel Edelmann, Jakub Avenarius
OBJECTIVE: The aim of the study was to identify factors contributing to the development of non-union after fixation of diaphyseal humeral fractures using Hackethal's intramedullary nailing technique. METHODS: In the time period from 2001 to 2010 156 patients with diaphyseal humeral fractures were treated surgically using Hackethal's technique. Six of them (3.8%) developed non-union. This group included three women and two men aged 63-69 years and one woman aged 37 years...
September 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28148274/severity-dependent-differences-in-early-management-of-thoracic-trauma-in-severely-injured-patients%C3%A2-analysis-based-on-the-traumaregister-dgu%C3%A2
#13
J Bayer, R Lefering, S Reinhardt, J Kühle, N P Südkamp, T Hammer
BACKGROUND: Major trauma is associated with chest injuries in nearly 50% of multiple injuries. Thoracic trauma is a relevant source of comorbidity throughout the period of multiply-injured patient care and may require swift and well-thought-out interventions in order to avert a deleterious outcome. In this epidemiological study we seek to characterize groups of different thoracic trauma severity in severely injured patients and identify related differences in prehospital and early clinical management...
February 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28147254/pre-treatment-predictors-of-dropout-from-prolonged-exposure-therapy-in-patients-with-chronic-posttraumatic-stress-disorder-and-comorbid-substance-use-disorders
#14
Emily L Belleau, Eu Gene Chin, Sonya G Wanklyn, Laura Zambrano-Vazquez, Julie A Schumacher, Scott F Coffey
Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are commonly co-occurring disorders associated with more adverse consequences than PTSD alone. Prolonged exposure therapy (PE) is one of the most efficacious treatments for PTSD. However, among individuals with PTSD-SUD, 35-62% of individuals drop out of trauma-focused exposure treatments. Thus, it is important to identify predictors of PTSD treatment dropout among substance abusers with PTSD in order to gain information about adapting treatment strategies to enhance retention and outcomes...
January 25, 2017: Behaviour Research and Therapy
https://www.readbyqxmd.com/read/28145950/increased-mortality-in-elderly-patients-with-sarcopenia-and-acetabular-fractures
#15
Matthew E Deren, Jacob Babu, Eric M Cohen, Jason Machan, Christopher T Born, Roman Hayda
BACKGROUND: Sarcopenia is a condition of clinically relevant loss of muscle mass and function. Acetabular fractures in elderly patients are common and difficult to treat. This study aimed to determine if sarcopenia is common in elderly patients with acetabular fractures and correlates with lower-energy mechanisms of injury, higher rates of complications, and higher mortality than patients with normal muscle mass. METHODS: The Rhode Island Hospital Trauma Database was queried for patients who were ≥60 years of age from 2005 to 2014 using the International Classification of Diseases, Ninth Revision, code for closed acetabular fracture, 808...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28141655/an-analysis-of-independent-variables-affecting-surgical-outcomes-in-patients-undergoing-repair-of-maxillofacial-trauma-an-american-college-of-surgeons-national-surgical-quality-improvement-program-study
#16
Stephanie M Cohen, Brian E Rosett, David A Shifrin
INTRODUCTION: Facial fractures, from straightforward closed nasal reductions to complex pan facial fractures, are commonly encountered in the Plastic Surgical community. However, very little has been discussed in the literature regarding the outcomes of facial fractures relating to contributing factors. Our aim was to evaluate a battery of independent variables in order to identify, which, if any, factors correlate with suboptimal outcomes in patients who have undergone facial fracture surgery...
January 30, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28130346/the-use-of-whole-body-computed-tomography-in-major-trauma-variations-in-practice-in-uk-trauma-hospitals
#17
Ian Ayenga Sammy, Hridesh Chatha, Omar Bouamra, Marisol Fragoso-Iñiguez, Fiona Lecky, Antoinette Edwards
INTRODUCTION: Whole-body CT (WBCT) use in patients with trauma in England and Wales is not well documented. WBCT in trauma can reduce time to definitive care, thereby increasing survival. However, its use varies significantly worldwide. METHODS: We performed a retrospective observational study of Trauma Audit and Research Network (TARN) data from 2012 to 2014. The proportion of adult patients receiving WBCT during initial resuscitation at major trauma centres (MTCs) and trauma units/non-designated hospitals (TUs/NDHs) was compared...
January 27, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28129730/functional-outcome-prediction-after-traumatic-spinal-cord-injury-based-on-acute-clinical-factors
#18
Ludovic Kaminski, Virginie Cordemans, Edouard Cernat, Kouamé Innocent M'Bra, Jean-Marc Mac-Thiong
Spinal cord injury (SCI) is a devastating condition that affects patient on a personal as well as on a societal level. The objective of the study is to improve the prediction of long-term functional outcome following SCI based on the acute clinical findings. 76 patients with acute traumatic SCI were prospectively enrolled in a cohort study in a single level I trauma center. Spinal Cord Independence Measure (SCIM) at 1 year after the trauma was the primary outcome. Potential predictors of functional outcome were recorded during the acute hospitalization: age, sex, level and type of injury, comorbidities, American Spinal Injury Association (ASIA) Impairment Scale (AIS), ASIA Motor Score (AMS), ASIA Light Touch score (LT), ASIA Pin Prick score (PP), Injury Severity Score (ISS), Traumatic Brain Injury (TBI) and delay from trauma to surgery...
January 27, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28129262/trauma-and-psychiatric-disorders-a-systematic-review
#19
E A Clous, K C Beerthuizen, K J Ponsen, J S Luitse, M Olff, J C Goslings
BACKGROUND: Suicide is currently a topic of high priority for policy-makers, researchers and clinicians. The World Health Organization estimated 804.000 suicide deaths worldwide in 2012. Some studies that focused on patients with self-inflicted injury revealed that mortality in this group is higher than for patients who sustain unintentional injury. However little is known about the impact of psychiatric disorders on health care resources including length of hospital stay. OBJECTIVES: To determine whether trauma patients with a psychiatric disorder or after attempting suicide are at higher risk of a complicated course than patients without a psychiatric disorder or accidental cause...
January 26, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28121947/rehabilitation-needs-and-participation-restriction-in-patients-with-cognitive-disorder-in-the-chronic-phase-of-traumatic-brain-injury
#20
Hironobu Sashika, Kaoruko Takada, Naohisa Kikuchi
The purpose of this study was to clarify psychosocial factors/problems, social participation, quality of life (QOL), and rehabilitation needs in chronic-phase traumatic brain injury (TBI) patients with cognitive disorder discharged from the level-1 trauma center (L1-TC), and to inspect the effects of rehabilitation intervention to these subjects.A mixed-method research (cross-sectional and qualitative study) was conducted at an outpatient rehabilitation department.Inclusion criteria of subjects were transfer to the L1-TC due to TBI; acute-stage rehabilitation treatment received in the L1-TC from November 2006 to October 2011; age of ≥18 and <70 years at the time of injury; a score of 0-3 on the Modified Rankin Scale at discharge and that of 4-5 due to physical or severe aggressive behavioral comorbid disorders...
January 2017: Medicine (Baltimore)
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