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Long-term outcomes in trauma patients

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https://www.readbyqxmd.com/read/29149741/the-isolated-posterior-malleolar-fracture-and-syndesmotic-instability-a-case-report-and-review-of-the-literature
#1
Diederik P J Smeeing, Roderick M Houwert, Moyo C Kruyt, Falco Hietbrink
INTRODUCTION: Ankle fractures are among the most common type of fractures in the lower extremity. A posterior malleolar fracture is frequently part of a more complex ankle fracture and only in rare cases it occurs as isolated injury. Posterior malleolar fractures often occur with associated injuries, such as a Maisonneuve fracture or with bi- or trimalleolar ligamentous injuries. Knowledge about these associated injuries is essential to prevent missed diagnoses. The aim of this article is to describe the isolated posterior malleolar fracture, the possible associated injuries, the diagnostic work-up and therapeutic consequences...
November 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29140952/-don-t-lose-hope-early-hemorrhagic-diffuse-axonal-injury-on-head-ct-is-not-associated-with-poor-outcome-in-moderate-severe-tbi-patients
#2
Nils Henninger, Rebecca A Compton, Muhammad W Khan, Raphael Carandang, Wiley Hall, Susanne Muehlschlegel
BACKGROUND: Diffuse axonal injury (DAI) on MRI has been associated with poor functional outcome after moderate-severe traumatic brain injury (msTBI). Yet, DAI assessment with highly-sensitive MRI-techniques is unfeasible in the acute trauma setting, and CT remains the key diagnostic modality despite its lower sensitivity. We sought to determine whether CT-defined-hemorrhagic-DAI (hDAI) is associated with discharge and favorable 3-and 12-month functional outcome (Glasgow Outcome Score ≥4) after msTBI...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#3
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29138208/validation-of-the-american-orthopaedic-foot-and-ankle-society-ankle-hindfoot-scale-dutch-language-version-in-patients-with-hindfoot-fractures
#4
A Siebe De Boer, Duncan E Meuffels, Cornelis H Van der Vlies, P Ted Den Hoed, Wim E Tuinebreijer, Michael H J Verhofstad, Esther M M Van Lieshout
OBJECTIVES: The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale is among the most used questionnaires for measuring functional recovery after a hindfoot injury. Recently, this instrument was translated and culturally adapted into a Dutch version. In this study, the measurement properties of the Dutch language version (DLV) were investigated in patients with a unilateral hindfoot fracture. DESIGN: Multicentre, prospective observational study...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#5
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29120927/improve-postoperative-sleep-what-can-we-do
#6
Xian Su, Dong-Xin Wang
PURPOSE OF REVIEW: We reviewed evidences regarding occurrence, risk factors, harmful effects, prevention, and management of sleep disturbances in patients after surgery. RECENT FINDINGS: Normal sleep is important to maintain physical and mental health. Sleep disturbances frequently occur in patients after surgery. Factors associated with the development of postoperative sleep disturbances include old age, preoperative comorbidity, type of anesthesia, severity of surgical trauma, postoperative pain, environment stress, as well as other factors leading to discomfort of patients...
November 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29120154/predisposing-factors-responsible-for-the-occurrence-of-bacterial-purulent-meningoencephalitis
#7
Brankica Dupanović, Olgica Gajović, Dragica Terzić, Bogdanka Andrić, Zoran Todorović, Branko Jakovljević, Danko Živković
Bacterial purulent meningoencephalitis (BPME) is a life-threatening infectious disease caused by various pyogenic bacteria. The disease is defined as the inflammatory process of leptomeninges (visceral layer, pia mater and arachnoid membrane) and brain parenchyma with exudates in the subarachnoid space and surrounding brain structures. The aim of the study was to define the predisposing factors responsible for the occurrence of BPME, as well as the possible correlation between the presence of predisposing factors and patient demographic characteristics, etiology and outcome of the disease...
March 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29102747/endoscopic-versus-open-great-saphenous-vein-harvesting-for-femoral-to-popliteal-artery-bypass
#8
Aleem K Mirza, Kendall Stauffer, Mark D Fleming, Randall De Martino, Gustavo Oderich, Manju Kalra, Peter Gloviczki, Thomas Bower
OBJECTIVE: Conflicting data exist on outcomes of open vein harvest (OVH) and endoscopic vein harvest (EVH) for infrainguinal bypass. The purpose of this study was to compare outcomes between OVH and EVH in femoral to popliteal artery bypasses. METHODS: A retrospective review was performed of all patients undergoing common femoral to popliteal artery bypass with great saphenous vein between January 1997 and June 2014. Bypasses using arm or composite vein were excluded, as were those performed for popliteal artery aneurysms or trauma...
November 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29095850/lesions-in-deep-gray-nuclei-after-severe-traumatic-brain-injury-predict-neurologic-outcome
#9
Frédéric Clarençon, Éric Bardinet, Jacques Martinerie, Vincent Pelbarg, Nicolas Menjot de Champfleur, Rajiv Gupta, Eléonore Tollard, Gustavo Soto-Ares, Danielle Ibarrola, Emmanuelle Schmitt, Thomas Tourdias, Vincent Degos, Jérome Yelnik, Didier Dormont, Louis Puybasset, Damien Galanaud
PURPOSE: This study evaluates the correlation between injuries to deep gray matter nuclei, as quantitated by lesions in these nuclei on MR T2 Fast Spin Echo (T2 FSE) images, with 6-month neurological outcome after severe traumatic brain injury (TBI). MATERIALS AND METHODS: Ninety-five patients (80 males, mean age = 36.7y) with severe TBI were prospectively enrolled. All patients underwent a MR scan within the 45 days after the trauma that included a T2 FSE acquisition...
2017: PloS One
https://www.readbyqxmd.com/read/29090361/long-term-disabilities-after-traumatic-head-injury-thi-a-retrospective-analysis-from-a-large-level-i-trauma-center-in-saudi-arabia
#10
Suliman Alghnam, Alaa AlSayyari, Ibrahim Albabtain, Bader Aldebasi, Mohamed Alkelya
BACKGROUND: Traumatic head injuries (THI) are a critical public health problem worldwide, with more than 10 million individuals affected every year. In Saudi Arabia (SA), the burden of THI is unknown even though injury is the leading cause of death and a major cause of disability. Therefore, we aim to estimate the prevalence of long-term of disabilities among survivors of THI treated at a large level-I trauma center in Riyadh. METHODS: The study included 258 patients, who were hospitalized due to a non-fatal THI between years 2005-2014...
November 1, 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#11
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29074734/the-impact-of-out-of-hospital-models-of-care-on-paediatric-emergency-department-presentations
#12
Russell M Viner, Frances Blackburn, Francesca White, Randy Mannie, Tracy Parr, Sara Nelson, Claire Lemer, Anna Riddell, Mando Watson, Francesca Cleugh, Michelle Heys, Dougal S Hargreaves
OBJECTIVE: To estimate the potential impact of enhanced primary care and new out-of-hospital models (OOHMs) on emergency department (ED) presentations by children and young people (CYP). DESIGN: Observational study. PATIENTS & SETTING: Data collected prospectively on 3020 CYP 0â€"17.9 years from 6 London EDs during 14 days by 25 supernumerary clinicians. CYP with transient acute illness, exacerbation of long-term condition (LTC), complex LTC/disability and injury/trauma were considered manageable within OOHM...
October 26, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29065782/the-use-of-regression-tree-analysis-for-predicting-the-functional-outcome-following-traumatic-spinal-cord-injury
#13
Yann Facchinello, Marie Beauséjour, Andreane Richard-Denis, Cynthia Thompson, Jean-Marc Mac-Thiong
Predicting the long-term functional outcome following traumatic spinal cord injury is needed to adapt medical strategies and to plan an optimized rehabilitation. This study investigates the use of regression tree for the development of predictive models based on acute clinical and demographic predictors. This prospective study was performed on 172 patients hospitalized following traumatic spinal cord injury. Functional outcome was quantified using the Spinal Cord Independence Measure collected within the first-year post injury...
October 25, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29061970/white-matter-microstructure-is-associated-with-functional-cognitive-and-emotional-symptoms-12-months-after-mild-traumatic-brain-injury
#14
Torgeir Hellstrøm, Lars T Westlye, Tobias Kaufmann, Nhat Trung Doan, Helene L Søberg, Solrun Sigurdardottir, Wibeke Nordhøy, Eirik Helseth, Ole A Andreassen, Nada Andelic
Identifying patients at risk of poor outcome after mild traumatic brain injury (MTBI) is essential to aid prognostics and treatment. Diffuse axonal injury (DAI) may be the primary pathologic feature of MTBI but is normally not detectable by conventional imaging technology. This lack of sensitivity of clinical imaging techniques has impeded a pathophysiologic understanding of the long-term cognitive and emotional consequences of MTBI, which often remain unnoticed and are attributed to factors other than the injury...
October 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29061476/long-term-changes-of-patient-reported-quality-of-life-after-major-trauma-the-importance-of-the-time-elapsed-after-injury
#15
Evi Fleischhacker, Heiko Trentzsch, David Kuppinger, Franziska Meigel, Felix Beyer, Wolfgang H Hartl
BACKGROUND: Numerous studies have identified various risk factors for a poor health-related quality of life (HRQOL) after severe trauma. The relative importance of the time elapsed after injury, however, is unknown and results of clinical studies have been conflicting. METHODS: A cross-sectional study was performed in two trauma centres using data from the German TraumaRegister DGU(®), which contained prospectively collected information on the type and severity of the injury, on critical care, and on outcome...
October 12, 2017: Injury
https://www.readbyqxmd.com/read/29049422/thoracic-trauma-now-and-then-a-10-year-experience-from-16-773-severely-injured-patients
#16
Klemens Horst, Hagen Andruszkow, Christian D Weber, Miguel Pishnamaz, Christian Herren, Qiao Zhi, Matthias Knobe, Rolf Lefering, Frank Hildebrand, Hans-Christoph Pape
BACKGROUND AND PURPOSE: Thoracic trauma remains to be a relevant injury to the polytraumatised patient. However, literature regarding how far changes in clinical guidelines for pre- and in-hospital trauma management and diagnostic procedures affect the outcome of multiple injured patients with severe chest injury during a long-term observation period is sparse. METHODS: Multiple traumatised patients (age≥16y) documented in the TraumaRegister DGU® (TR-DGU) from January 1st 2005 to December 31st 2014 with severe chest trauma (AIS≥3) were included in this study...
2017: PloS One
https://www.readbyqxmd.com/read/29042263/facility-level-factors-and-outcomes-after-skilled-nursing-facility-admission-for-trauma-and-surgical-patients
#17
Lucas W Thornblade, Saman Arbabi, David R Flum, Qian Qiu, Vanessa J Fawcett, Giana H Davidson
OBJECTIVE: Patients discharged to skilled nursing facilities (SNFs) have worse outcomes than those discharged to home, but whether this is due to differences in facility-level factors in addition to patient characteristics is not known. We aimed to determine whether SNF-level factors including nurse staffing and patient density are associated with outcomes after acute hospitalization for trauma or surgery. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Retrospective study of patients discharged to Medicare-certified SNFs after trauma or major surgery from 2007 to 2009...
October 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29032972/long-term-cardiovascular-impacts-after-burn-and-non-burn-trauma-a-comparative-population-based-study
#18
Janine M Duke, Sean M Randall, Mark W Fear, Emily O'Halloran, James H Boyd, Suzanne Rea, Fiona M Wood
OBJECTIVE: To compare post-injury cardiovascular disease (CVD) hospital admissions experienced by burn patients with non-burn trauma patients and people with no record of injury, adjusting for socio-demographic, health and injury factors. METHODS: Linked hospital and death data were analysed for a cohort of burn patients (n=30,997) hospitalised in Western Australia during the period 1980-2012 and age and gender frequency matched comparison cohorts (non-burn trauma: n=28,647; non-injured: n=123,399)...
October 9, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29029642/post-trauma-morbidity-measured-as-sick-leave-is-substantial-and-influenced-by-factors-unrelated-to-injury-a-retrospective-matched-observational-cohort-study
#19
Erik von Oelreich, Mikael Eriksson, Olof Brattström, Andrea Discacciati, Lovisa Strömmer, Anders Oldner, Emma Larsson
BACKGROUND: Mortality as an endpoint has been the focus of trauma research whereas few studies investigate long-term outcomes in terms of morbidity. An adequate analysis of post-injury morbidity includes several dimensions, for this reason sick leave has been used as a proxy for morbidity in the current study. The aim of this retrospective matched observational cohort study was to investigate sick leave before and after trauma and factors associated with prolonged sick leave. METHODS: Patients from a level one trauma centre 2005-2010 were matched in a 1:5 ratio with uninjured controls...
October 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29027061/scleral-fixated-intraocular-lens-implantation-with-a-modified-z-suture-technique
#20
Erdem Dinç, Mustafa Vatansever, Özer Dursun, H Görkem Markirt, Bahri Aydın, Ayça Yılmaz, Ufuk Adıgüzel
PURPOSE: To evaluate visual outcomes and complications in scleral fixated intraocular lens (IOL) implantation with the modified Z-suture technique. MATERIALS AND METHODS: Thirty-five eyes of 35 patients (20 male, 15 female) were included in the study. Patients underwent scleral fixated IOL implantation using the modified Z-suture technique and were followed in terms of visual acuity and complications. RESULTS: Mean postoperative follow-up time was 12...
October 13, 2017: International Ophthalmology
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