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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/27910090/spinal-fractures-in-older-adult-patients-admitted-after-low-level-falls-10-year-incidence-and-outcomes
#1
Randeep S Jawa, Adam J Singer, Daniel N Rutigliano, Jane E McCormack, Emily C Huang, Marc J Shapiro, Suzanne D Fields, Brian N Morelli, James A Vosswinkel
OBJECTIVES: To evaluate the incidence of spinal fractures and their outcomes in the elderly who fall from low-levels in a suburban county. DESIGN: Retrospective county-wide trauma registry review from 2004 to 2013. SETTING: Suburban county with regionalized trauma care consisting of 11 hospitals. PARTICIPANTS: Adult trauma patients aged ≥65 years who were admitted after falling from <3 feet. MEASUREMENTS: Demographic characteristics, comorbidities, and outcomes...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27908375/treatment-of-radiation-induced-urethral-strictures
#2
REVIEW
Matthias D Hofer, Joceline S Liu, Allen F Morey
Radiation therapy may result in urethral strictures from vascular damage. Most radiation-induced urethral strictures occur in the bulbomembranous junction, and urinary incontinence may result as a consequence of treatment. Radiation therapy may compromise reconstruction due to poor tissue healing and radionecrosis. Excision and primary anastomosis is the preferred urethroplasty technique for radiation-induced urethral stricture. Principles of posterior urethroplasty for trauma may be applied to the treatment of radiation-induced urethral strictures...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27905046/in-hospital-mortality-with-use-of-percutaneous-endoscopic-gastrostomy-in-traumatic-brain-injury-patients-results-of-a-nationwide-population-based-study
#3
Rabail Chaudhry, Sachin Batra, Omar L Mancillas, Robert Wegner, Navneet Grewal, George W Williams
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a frequently performed invasive procedure that has been associated with high short-term mortality. Its use of special interest in traumatic brain injury (TBI) patients as nutrition support constitutes important issues in intensive care of this group. We used a national database to determine the incidence of, and factors associated with, in-hospital mortality among TBI patients undergoing PEG. METHODS: We conducted a retrospective study using the US nationwide inpatient sample to analyze data from all hospitalizations in 2008 with International Classification of Diseases, Ninth Revision, diagnostic and procedure codes identifying patients with TBI and hemorrhagic stroke who received PEG...
November 30, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27902169/risk-factors-for-contralateral-hip-fractures-following-femoral-neck-fractures-in-elderly-analysis-of-the-hungarian-nationwide-health-insurance-database
#4
Krisztina Juhász, Imre Boncz, Balázs Patczai, Tibor Mintál, Andor Sebestyén
OBJECTIVES: This study aims to investigate the significance of demographic and clinical factors on incidence of second (contralateral) hip fracture in elderly Hungarian population using the nationwide health insurance database in Hungary. PATIENTS AND METHODS: The study included a total of 3,783 patients (917 males, 2,866 females) treated for primary monotraumatic femoral neck fractures caused by low-energy trauma in the year 2000. Cox regression and Kaplan-Meier survival analyses, and log-rank test were performed to evaluate the following prognostic factors: age, gender, place of living, type of primary fracture and surgical intervention, hospital providing treatment for primary fracture, and comorbidities...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27900778/predicting-post-traumatic-stress-disorder-treatment-response-in-refugees-multilevel-analysis
#5
Joris F G Haagen, F Jackie June Ter Heide, Trudy M Mooren, Jeroen W Knipscheer, Rolf J Kleber
OBJECTIVES: Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. DESIGN: A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time...
November 30, 2016: British Journal of Clinical Psychology
https://www.readbyqxmd.com/read/27896468/evaluation-of-major-trauma-in-elderly-patients-a%C3%A2-single-trauma-center-analysis
#6
Samo Kocuvan, Drago Brilej, Domen Stropnik, Rolf Lefering, Radko Komadina
BACKGROUND: The objective of the study was to gather information about elderly major trauma patients admitted to one particular Slovenian trauma centre in Celje and examine this group of polytrauma patients, specifically with respect to mechanisms of injury, injury severity and distribution of injuries. Further on, to identify morbidity and mortality rates and compare these to the younger population and, finally, to determine the factors that have the most impact on treatment results...
November 28, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27895200/demographics-mechanisms-of-injury-and-concurrent-injuries-associated-with-calcaneus-fractures-a-study-of-14-516-patients-in-the-american-college-of-surgeons-national-trauma-data-bank
#7
Daniel D Bohl, Nathaniel T Ondeck, Andre M Samuel, Pablo J Diaz-Collado, Stephen J Nelson, Bryce A Basques, Michael P Leslie, Jonathan N Grauer
: Background This study uses the American College of Surgeons National Trauma Data Bank (NTDB) to update the field on the demographics, injury mechanisms, and concurrent injuries among a national sample of patients admitted to the hospital department with calcaneus fractures. Methods Patients with calcaneus fractures in the NTDB during 2011-2012 were identified and assessed. Results A total of 14 516 patients with calcaneus fractures were included. The most common comorbidity was hypertension (18%), and more than 90% of fractures occurred via traffic accident (49%) or fall (43%)...
November 28, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27890837/association-between-pre-hospital-time-and-mortality-following-blunt-thoracic-aortic-injuries
#8
Biniam Kidane, Vaibhav Gupta, Mostafa El-Beheiry, Kelly Vogt, Neil G Parry, Richard Malthaner, Thomas L Forbes
OBJECTIVE: Blunt traumatic thoracic aortic injuries (BTAI) can be lethal, but advances in trauma systems and in surgical care have helped reduce mortality. The purpose of this study was to investigate whether time from injury to presentation is associated with mortality following BTAI. METHODS: Using the Ontario Trauma Registry, all patients were identified who were hospitalized with BTAI between 1999 & 2009. Variables including age, sex, Injury Severity Score, Charlson comorbidity index, systolic blood pressure on admission, operative intervention, and time from injury to presentation were analysed using multivariate logistic regression to determine independent predictors of mortality...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27886876/complications-in-the-management-of-patients-with-spine-trauma
#9
REVIEW
Geoffrey Stricsek, George Ghobrial, Jefferson Wilson, Thana Theofanis, James S Harrop
More than 50% of patients diagnosed with acute, traumatic spinal cord injury will experience at least 1 complication during their hospitalization. Age, severity of neurological injury, concurrent traumatic brain injury, comorbid illness, and mechanism of injury are all associated with increasing risk of complication. More than 75% of complications will occur within 2 weeks of injury. The complications associated with SCI carry a significant risk of morbidity and mortality; their early identification and management is critical in the care of the SCI patient...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27877043/polycystic-ovary-syndrome-and-mental-disorders-a-systematic-review-and-exploratory-meta-analysis
#10
REVIEW
Sergio Luís Blay, João Vicente Augusto Aguiar, Ives Cavalcante Passos
BACKGROUND: The association between depression, anxiety, and polycystic ovary syndrome (PCOS) is still unclear. Therefore, a systematic review and meta-analysis was conducted to assess the rates of comorbid psychiatric disorders among women with PCOS compared to women without it. METHODS: PubMed/MEDLINE, Embase, PsycINFO, and Web of Science databases were searched from inception to November 27, 2015. Studies were eligible for inclusion if they were original reports in which the rates of mood (bipolar disorder, dysthymia, or major depressive disorder), obsessive-compulsive spectrum disorders, trauma- and stressor-related disorders, anxiety disorders or psychotic disorders, somatic symptom and related disorders, or eating disorders had been investigated among women with an established diagnosis of PCOS and compared with women without PCOS...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27876077/post-traumatic-acute-kidney-injury-a-cross-sectional-study-of-trauma-patients
#11
Wei-Hung Lai, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Ching-Hua Hsieh, Hsiao-Yun Hsieh
BACKGROUND: The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. METHODS: Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System...
November 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27863269/mortality-length-of-stay-bloodstream-and-respiratory-viral-infections-in-a-pediatric-intensive-care-unit
#12
Kam Lun Hon, Man Ping Luk, Wing Ming Fung, Cho Ying Li, Hiu Lee Yeung, Pui Kwun Liu, Shun Li, Kathy Yin Ching Tsang, Chi Kong Li, Paul Kay Sheung Chan, Kam Lau Cheung, Ting Fan Leung, Pei Lin Koh
OBJECTIVES: We investigated whether diagnostic categories and presence of infections were associated with increased mortality or length of stay (LOS) in patients admitted to a pediatric intensive care unit (PICU). METHODS: A retrospective study of all PICU admissions between October 2002 and April 2016 was performed. Oncologic vs nononcologic, trauma/injuries vs nontraumatic, infectious (gram-positive, gram-negative, fungal bloodstream infections, common respiratory viruses) vs noninfectious diagnoses were evaluated for survival and LOS...
September 30, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27857495/the-impact-of-resident-involvement-on-outcomes-in-orthopedic-trauma-an-analysis-of-20-090-cases
#13
Phillip M Mitchell, Svetlana A Gavrilova, Ashley C Dodd, Basem Attum, William T Obremskey, Manish K Sethi
BACKGROUND: Involvement in patient care is critical in training orthopedic surgery residents for independent practice. As the focus on outcomes and quality measures intensifies, the impact of resident intraoperative involvement on patient outcomes will be increasingly scrutinized. We sought to determine the impact of residents' intraoperative participation on 30-day post-operative outcomes in the orthopedic trauma population. METHODS: A total of 20,090 patients from the American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2013 were identified...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27854110/association-between-carotid-artery-tortuosity-and-carotid-dissection-a-case-control-study
#14
Sarasa T Kim, Waleed Brinjikji, Vance T Lehman, Carrie M Carr, Patrick H Luetmer, Charlotte H Rydberg
BACKGROUND: Carotid artery dissections have long been associated with compromise of the structural integrity of the arterial wall from heritable connective-tissue disorders, hypertension, and trauma. However, an association between spontaneous internal carotid artery dissection and tortuous or redundant carotid anatomy has not been fully explored. METHODS: Patients with CTA confirmed spontaneous cervical internal carotid artery dissections were compared to a group of age and sex matched controls who also received CTA of the neck...
November 17, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27849494/inpatient-trauma-focused-treatment-for-veterans-implementation-and-evaluation-of-patient-perceptions-and-outcomes-of-an-integrated-evidence-based-treatment-approach
#15
Deleene S Menefee, Wendy S Leopoulos, Jana K Tran, Ellen Teng, Jill Wanner, Elisabeth Wilde, Stephen McCauley, Susan X Day
BACKGROUND: Practice guidelines for post-traumatic stress disorder (PTSD) treatment suggest that inpatient care may be warranted when the severity of the clinical presentation is marred with significant concerns about suicidality and psychiatric comorbidity. Yet, limited guidance exists on conducting trauma-focused treatment in acute hospital settings beyond the traditional medical or stabilization model. OBJECTIVE: The purpose of this current article is to describe and evaluate the integration of evidence-based treatments (EBTs) for PTSD implemented in two gender-specific, Veterans Affairs inpatient programs...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27848054/incidence-and-predictive-risk-factors-of-postoperative-sepsis-in-orthopedic-trauma-patients
#16
Nikita Lakomkin, Vasanth Sathiyakumar, Brandon Wick, Michelle S Shen, A Alex Jahangir, Hassan Mir, William T Obremskey, Ashley C Dodd, Manish K Sethi
BACKGROUND: Postoperative sepsis is associated with high mortality and the national costs of septicemia exceed those of any other diagnosis. While numerous studies in the basic orthopedic science literature suggest that traumatic injuries facilitate the development of sepsis, it is currently unclear whether orthopedic trauma patients are at increased risk. The purpose of this study was thus to assess the incidence of sepsis and determine the risk factors that significantly predicted septicemia following orthopedic trauma surgery...
November 15, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27846352/-risk-factors-and-frequency-in-re-ruptures-of-the-anterior-cruciate-ligament-in-adults
#17
M L Velázquez-Rueda, J P Martínez-Ávila, A G Pérez-Serna, F Gómez-García
BACKGROUND: The anterior cruciate ligament (ACL) takes part in the knees articular cinematic regulation, which is why its rupture should be repaired as soon as possible. The surgical treatment is targeted to substitute the ruptured ACL with a graft that recreates the anatomical and biomechanical functions. Nevertheless, there are different factors that may produce a second rupture. OBJECTIVE: To determine the risk factors and frequency of failure in the ACL reconstruction...
March 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27837460/fixation-free-incisional-hernia-repair-in-the-elderly-our-experience-with-a-tentacle-shaped-implant
#18
Giorgio Romano, Pier Giorgio Calò, Enrico Erdas, Fabio Medas, Luca Gordini, Francesco Podda, Giuseppe Amato
BACKGROUND: Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair. AIMS: In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias...
November 11, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27809859/variation-in-type-and-frequency-of-diagnostic-imaging-during-trauma-care-across-multiple-time-points-by-patient-insurance-type
#19
Nathaniel Bell, Laura Repáraz, William R Fry, R Stephen Smith, Alejandro Luis
BACKGROUND: Research has shown that uninsured patients receive fewer radiographic studies during trauma care, but less is known as to whether differences in care are present among other insurance groups or across different time points during hospitalization. Our objective was to examine the number of radiographic studies administered to a cohort of trauma patients over the entire hospital stay as well as during the first 24-hours of care. METHODS: Patient data were obtained from an American College of Surgeons (ACS) verified Level I Trauma Center between January 1, 2011 and December 31, 2012...
November 3, 2016: BMC Medical Imaging
https://www.readbyqxmd.com/read/27804994/associations-between-adverse-childhood-experiences-and-clinical-characteristics-of-eating-disorders
#20
S Guillaume, I Jaussent, L Maimoun, A Ryst, M Seneque, L Villain, D Hamroun, P Lefebvre, E Renard, Ph Courtet
Patients with eating disorders (EDs) frequently report a history of childhood trauma (CT). We investigated whether certain subtypes of CT are associated with more severe features of EDs, independently of psychiatric comorbidity, and whether they act additively. One hundred and ninety-two patients with DSM-V-defined EDs were consecutively recruited. Five clinical characteristics were assessed: restraint, eating, shape and weight concerns on the EDE-Q, and daily functioning. CT was assessed by the childhood traumatism questionnaire...
November 2, 2016: Scientific Reports
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