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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/29342496/-adverse-events-in-the-treatment-of-periprosthetic-fractures-around-the-knee-a-clinical-and-radiological-outcome-analysis
#1
Anna Janine Schreiner, Christoph Gonser, Christoph Ihle, Max Konstantin Zauleck, Tim Klopfer, Fabian Stuby, Ulrich Stöckle, Björn Gunnar Ochs
BACKGROUND: The incidence of periprosthetic fractures associated with total knee arthroplasty (PpFxK) has been reported to be 0.3 - 5.5%. 40% of all cases are related to revision TKA. The most common localisation is the distal femur. Classification is performed according to Rorabeck (RB). RB I - II fractures are usually treated with locked plating and retrograde intramedullary nailing, whereas RB III fractures are an indication for revision arthroplasty using a hinged endoprosthesis...
January 17, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29339844/the-risk-of-deep-vein-thrombosis-in-total-joint-patients-compared-to-orthopaedic-trauma-patients-need-for-new-prevention-guidelines
#2
Michelle Shen, Norele J Cutrera, Ashley C Dodd, Christopher Wallace, Frank R Avilucea, Craig Melbourne, Alex A Jahangir, Hassan H Mir, William T Obremskey, Manish K Sethi
Background: The development of Deep Vein Thrombosis (DVT) is a major concern following orthopaedic surgery. No study has yet to compare the rate and risk factors for DVT between total joint and orthopaedic trauma patients. To evaluate if DVT prophylaxis for trauma should differ from total joints, we explored the rate and risk factors for DVT between both cohorts. Methods: Using a CPT code search from 2005 to 2013 in the ACS-NSQIP database, 150,657 orthopaedic total joint patients and 44,594 orthopaedic trauma patients were identified...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29337650/the-association-of-external-transfer-status-with-adverse-outcomes-in-otolaryngology
#3
Krish Suresh, Christopher J Gouveia, Robert C Kern, John D Cramer
Objective To compare rates of morbidity and mortality in patients treated by otolaryngologists who undergo interhospital transfers vs those who do not and to quantify conditions requiring interhospital transfers in this population. Study Design Cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program. Subjects and Methods We identified patients requiring surgery by otolaryngologists in the National Surgical Quality Improvement Program database from 2006 to 2013. We compared patients who were transferred from an outside institution to those admitted from home...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29334643/longitudinal-determinants-of-depression-among-world-trade-center-health-registry-enrollees-14-15-years-after-the-9-11-attacks
#4
Melanie H Jacobson, Christina Norman, Angela Nguyen, Robert M Brackbill
BACKGROUND: Exposure to the September 11, 2001 (9/11) terrorist attacks has been found to be associated with posttraumatic stress disorder (PTSD) and comorbid PTSD and depression up to 10-11 years post-disaster. However, little is known about the longitudinal predictors of mental health conditions over time. METHODS: We examined longitudinal determinants of depression within strata of PTSD among 21,258 enrollees of the World Trade Center Health Registry who completed four questionnaires over 14 years of follow-up (Wave 1 in 2003-04; Wave 2 in 2005-06; Wave 3 in 2011-12; and Wave 4 in 2015-16)...
January 3, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29331842/predicting-1-year-disability-and-mortality-of-injured-older-adults
#5
Alvin D Jeffery, Mary S Dietrich, Cathy A Maxwell
PURPOSE: The growing incidence of elderly patients injured from falls, combined with a growing understanding of the contribution of cognition and frailty to mortality, prompted this work. Our objective was to develop a clinical risk prediction model for prognosticating disability and mortality among injured older adults 1 year after hospitalization. METHODS: Secondary analysis of prospective longitudinal data from an urban Level 1 trauma center. A proportional odds regression model was used to model mortality and functional status as ordinal outcomes...
January 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29323806/spine-and-spinal-cord-injuries-after-falls-from-tree-stands-during-the-wisconsin-deer-hunting-season
#6
Kimberly Hamilton, Brandon Rocque, Nathaniel Brooks
BACKGROUND: Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. METHODS: We reviewed the University of Wisconsin Hospital and Clinics' trauma database for tree stand-related injuries from 1999 to 2013...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29321366/venous-thromboembolism-associated-with-protein-s-deficiency-due-to-arg451-mutation-in-pros1-gene-a-case-report-and-a-literature-review
#7
Ewa Wypasek, Marek Karpinski, Martine Alhenc-Gelas, Anetta Undas
Protein S (PS) is a vitaminK-dependent glycoproteinwhich plays an important role in the regulation of blood coagulation. PS deficiency has been found in 1.5-7% of thrombophilic patients. Here, we report the first Polish case with PS deficiency caused by the p.Arg451* in the PROS1 gene detected in a 21-year-old man with trauma-induced venous thromboembolism. To our knowledge, we provided the review of all the available data on this mutation (a total of 56 cases). The proband, his mother and his sister were screened for thrombophilia...
December 2017: Journal of Genetics
https://www.readbyqxmd.com/read/29318084/how-does-frailty-factor-into-mortality-risk-assessment-of-a-middle-aged-and-geriatric-trauma-population
#8
Sanjit R Konda, Ariana Lott, Hesham Saleh, Sebastian Schubl, Jeffrey Chan, Kenneth A Egol
Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29315199/a-waist-hip-ratio-surrogate-more-predictive-than-bmi-of-wound-complications-following-pelvic-and-acetabulum-surgery
#9
Todd Jaeblon, Kevin J Perry, Joseph A Kufera
OBJECTIVES: To determine if a novel surrogate of waist hip ratio (WHR) is more predictive of wound complications following pelvis or acetabulum stabilization than BMI, and describe the method of measuring a WHR proxy (WHRp). DESIGN: Retrospective review. SETTING: One Level-1 Trauma Center PATIENTS:: 161 patients following operative repair of pelvis and acetabulum fractures. INTERVENTION: Operative stabilization of a pelvic ring injury or acetabular fracture MAIN OUTCOME MEASUREMENTS:: Infection (pin, superficial, deep), Wound healing complication METHODS:: We retrospectively reviewed 161 subjects following operative repair of pelvic and acetabular fractures...
January 8, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29309952/application-of-tourniquet-in-civilian-trauma-systematic-review-of-the-literature
#10
Charlotte Beaucreux, Benoît Vivien, Ethan Miles, Sylvain Ausset, Pierre Pasquier
INTRODUCTION: The effectiveness of a tourniquet (TQ) in case of extremity haemorrhages is well recognised to prevent death on the battlefield. However, little is known about the usefulness of TQ in civilian trauma settings, including terrorist attack situations. The aim of this systematic review was to analyse the evidence-based medical literature in order to precise the use of TQ in the management of extremity haemorrhages in civilian setting. METHODS: Analysis of all studies published until 12/31/2016 on the Embase, Medline and Opengrey databases...
January 5, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29291174/clinical-study-to-assess-the-outcome-in-surgically-managed-patients-of-spontaneous-intracerebral-hemorrhage
#11
Yashwanth S Sandeep, M Raja Guru, Ranjan Kumar Jena, Veldurti Ananta Kiran Kumar, Amit Agrawal
Introduction: Spontaneous intracerebral hemorrhage (SICH) subtype of stroke is characterized by bleeding into brain parenchyma which is not accompanied by trauma. Emergency surgical evacuation of large size SICH increases the chances of survival but does not help in functional recovery of the patients. The present study was conducted to assess the outcome of surgical management in patients with SICH. Materials and Methods: All patients who were diagnosed with SICH and underwent surgical evacuation of the hematoma included in the study...
October 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29285328/a-new-spiral-dental-implant-a-tool-for-oral-rehabilitation-of-difficult-cases
#12
I Balan, R Calcaterra, D Lauritano, E Grecchi, F Carinci
Spiral dental implant (SDI) is an implant with a conical internal helix that confers the characteristic of self-drilling, self-tapping, and self-bone condensing. These proprieties offer better control during insertion of SDI giving a high primary stabilization, even in poor quality bone. A shorter diameter of SDI results in reduced drilling during insertion and consequently less trauma and minimal bone loss. To address the research purpose, the investigators designed a retrospective cohort study. The study population was composed of 25 patients, 11 males and 14 females that have been treated by Dr...
July 2017: Oral & Implantology
https://www.readbyqxmd.com/read/29273370/is-there-a-weekend-effect-in-emergency-general-surgery
#13
David Metcalfe, Manuel Castillo-Angeles, Arturo J Rios-Diaz, Joaquim M Havens, Adil Haider, Ali Salim
BACKGROUND: Weekend admission is associated with increased mortality across a range of patient populations and health-care systems. The aim of this study was to determine whether weekend admission is independently associated with serious adverse events (SAEs), in-hospital mortality, or failure to rescue (FTR) in emergency general surgery (EGS). METHODS: An observational study was performed using the National Inpatient Sample in 2012-2013; the largest all-payer inpatient database in the United States, which represents a 20% stratified sample of hospital discharges...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29273253/elbow-arthroscopy-30-day-postoperative-complication-profile-and-associated-risk-factors
#14
Manish S Noticewala, David P Trofa, Danica D Vance, Charles M Jobin, William N Levine, Christopher S Ahmad
PURPOSE: To analyze (1) the incidence and type of complications after elbow arthroscopy, (2) the incidence of returning to the operating room (OR) after elbow arthroscopy, and (3) patient and risk factors for complications across a national surgical outcome database. METHODS: Patients who underwent elbow arthroscopy from January 2005 through December 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database by use of Current Procedural Terminology codes...
December 19, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29251704/improved-outcomes-in-elderly-trauma-patients-with-the-implementation-of-two-innovative-geriatric-specific-protocols-final-report
#15
Eric H Bradburn, Brian W Gross, Shreya Jammula, William H Adams, Jo Ann Miller
INTRODUCTION: Elderly trauma care is challenging due to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMG) were implemented: High Risk Geriatric Protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the Anticoagulation and Trauma Alert (ACT), which is designed to streamline the care of geriatric trauma patients on anticoagulants...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29251701/lower-emergency-general-surgery-egs-mortality-among-hospitals-with-higher-quality-trauma-care
#16
John W Scott, Thomas C Tsai, Pooja U Neiman, Gregory J Jurkovich, Garth H Utter, Adil H Haider, Ali Salim, Joaquim M Havens
BACKGROUND: Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to non-modifiable patient factors including comorbidities and physiologic derangements at presentation, leaving few targets for quality improvement. Though the hospital-level traits that contribute to EGS outcomes are not well understood, we hypothesized that facilities with lower trauma mortality would have lower EGS mortality...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249533/is-prescribed-lower-extremity-weight-bearing-status-after-geriatric-lower-extremity-trauma-associated-with-increased-mortality
#17
Ida Leah Gitajn, Daniel Connelly, Daniel Mascarenhas, Stephen Breazeale, Peter Berger, Carrie Schoonover, Brook Martin, Robert V O'Toole, Raymond Pensy, Marcus Sciadini
OBJECTIVES: Evaluate whether mortality after discharge is elevated in geriatric fracture patients whose lower extremity weight-bearing is restricted. DESIGN: Retrospective cohort study SETTING: Urban Level 1 trauma center PATIENTS/PARTICIPANTS: 1746 patients >65 years of age INTERVENTION: Post-operative lower extremity weight-bearing status MAIN OUTCOME MEASURE: Mortality, as determined by the Social Security Death Index RESULTS: Univariate analysis demonstrated that patients who were weight-bearing as tolerated on bilateral lower extremities (BLE) had significantly higher 5-year mortality compared to patients with restricted weight-bearing on one lower extremity and restricted weight-bearing on BLE (30%, 21% and 22% respectively, p < 0...
December 14, 2017: Injury
https://www.readbyqxmd.com/read/29241028/a-latent-class-analysis-of-ptsd-symptoms-among-inner-city-primary-care-patients
#18
Akm Fazlur Rahman, Amita Manatunga, Ying Guo, Limin Peng, Megan Warnock, Kerry J Ressler, Tanja Jovanovic
OBJECTIVES: Examine evidence for different subclasses of posttraumatic stress disorder (PTSD) symptoms in a sample of trauma exposed, low-income, predominantly African American men and women. Assess the relationship between PTSD subclasses with major depressive disorder (MDD) and types of trauma experienced. METHOD: Latent class analysis (LCA) using a multivariate normal mixture model on the 17-item PTSD Symptom Scale (PSS) was used to identify latent subclasses of PTSD symptoms (N = 5063)...
December 7, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/29239949/labor-analgesia-as-a-predictor-for-reduced-postpartum-depression-scores-a-retrospective-observational-study
#19
Grace Lim, Lia M Farrell, Francesca L Facco, Michael S Gold, Ajay D Wasan
BACKGROUND: Using labor, epidural analgesia has been linked to a reduced risk of postpartum depression, but the role of labor pain relief in this association remains unclear. The goal of this study was to test the hypothesis that effective epidural analgesia during labor is associated with reduced postpartum depression symptomatology. METHODS: A single, institutional, retrospective, observational cohort design was chosen. The primary outcome was Edinburgh postnatal depression scale (EPDS) score, measured at the 6-week postpartum visit...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29237195/-interdisciplinary-inpatient-treatment-for-adolescents-and-young-adults-16%C3%A2-%C3%A2-25-years-with-mental-illness-in-adolescent-psychiatry
#20
Anne Karow, Michael Lipp, Eva Schweigert, Mary Sengutta, Gaby Wiltfang, Linus Wittmann, Martin Lambert, Carola Bindt, Jürgen Gallinat, Michael Schulte-Markwort
Objective The investigation of clinical characteristics of patients in adolescence psychiatry relevant for transition medicine. Methodology Sociodemographic and clinical data (SCID I/II, SIPS/SOPS, SPI-A, GAF, CGI) were consecutively taken from the interdisciplinary inpatient treatment centre for adolescents and young adults with mental disorders (N = 229, aged 16 - 25). Results Average age was 19 years (38 % male, 23 % migration background). A high proportion of early mental illnesses and comorbidities (66 %), psychosis risk syndromes (20 %) and suicidality (54 %), treatment discontinuation (33 %) with daily-life, social and family stress factors (52 % positive family history, 34 % trauma) were observed and a persistently high level of support and treatment was needed despite a significant clinical improvement (p < 0...
December 13, 2017: Psychiatrische Praxis
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