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Long-term survival of trauma patients

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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
#1
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/29121816/long-term-prognosis-and-causes-of-death-after-pleural-infections
#2
J A Khan, A I Lehtomäki, V J Toikkanen, M T Ukkonen, R M Nevalainen, J O Laurikka
BACKGROUND AND AIMS: The development of pleural infection may imply a worse state of health and prognosis. The objective of this study was to ascertain the long-term survival and causes of death after pleural infections and to compare them to those of matched controls. MATERIAL AND METHODS: Altogether 191 patients treated for pleural infections at a single University Hospital between January 2000 and December 2008 and 1910 age- and gender-matched controls were included...
November 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29102747/endoscopic-versus-open-great-saphenous-vein-harvesting-for-femoral-to-popliteal-artery-bypass
#3
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/29063224/predictors-and-time-based-hospital-mortality-in-patients-with-isolated-and-polytrauma-brain-injuries
#4
Ayman El-Menyar, Rafael Consunji, Husham Abdelrahman, Rifat Latifi, Bianca M Wahlen, Hassan Al-Thani
BACKGROUND: Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. We studied the predictors and time-based mortality in patients with isolated and polytrauma brain injuries in a rapidly developing country. We hypothesized that TBI-related 30-day mortality is decreasing over time. METHODS: A retrospective analysis was conducted for all patients with moderate-to-severe TBI who were admitted directly to a level 1 trauma center between 2010 and 2014...
October 23, 2017: World Journal of Surgery
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
#5
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/29017766/survival-and-health-related-quality-of-life-after-severe-trauma-a-15-years-follow-up-study
#6
Morten S Wad, Thomas Laursen, Sidsel Fruergaard, Søren Schmidt Morgen, Benny Dahl
INTRODUCTION: As the primary treatment of patients with severe trauma continues to improve, increasing interest has been directed towards long-term survival and Health Related Quality of Life (HRQoL). In trauma patients, there are few studies describing long-term outcome using tools specifically directed at HRQoL. HYPOTHESIS: HRQoL measured with EQ-5D is significantly reduced compared to the Danish norm score 15 years after severe injury. MATERIALS AND METHODS: All patients more than 18 years of age, admitted to a level 1 trauma center from March 1996 to September 1997 were prospectively included and scored with Injury Severity Score (ISS)...
October 5, 2017: Injury
https://www.readbyqxmd.com/read/28953670/poor-prognosis-after-surgery-for-intertrochanteric-fracture-in-elderly-patients-with-clopidogrel-treatment-a-cohort-study
#7
Jianzheng Zhang, Xiaobin Chen, Juan Wang, Zhi Liu, Xiaowei Wang, Jixin Ren, Tiansheng Sun
Choice of surgical approach in patients under clopidogrel treatment is controversial. Intertrochanteric fractures are common in the elderly, who also suffer from a number of comorbidities.The aim of this study is to assess the prognosis of elderly patients with clopidogrel treatment after surgery for intertrochanteric fracture.This was a cohort study of 238 elderly patients who underwent proximal femur intramedullary nailing for intertrochanteric fracture between January 2012 and December 2013 at the Geriatric Trauma Center of the Beijing Army General Hospital...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28953508/impact-of-regional-anesthesia-on-recurrence-metastasis-and-immune-response-in-breast-cancer-surgery-a-systematic-review-of-the-literature
#8
Oscar Pérez-González, Luis F Cuéllar-Guzmán, José Soliz, Juan P Cata
BACKGROUND AND OBJECTIVES: The perioperative period is critical in the long-term prognosis of breast cancer patients. The use of regional anesthesia, such as paravertebral block (PVB), could be associated with improvements in long-term survival after breast cancer surgery by modulating the inflammatory and immune response associated with the surgical trauma, reducing opioid and general anesthetic consumption, and promoting cancer cells death by a direct effect of local anesthetics. METHODS: A systematic literature search was conducted for studies of patients who received PVB for breast cancer surgery...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28882372/reduced-survival-for-uncemented-compared-to-cemented-total-hip-arthroplasty-after-operatively-treated-acetabular-fractures
#9
John Clarke-Jenssen, Marianne Westberg, Olav Røise, Stein Arne Øvre Storeggen, Tone Bere, Ingunn Silberg, Jan Erik Madsen
BACKGROUND: Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs. With this cohort study, we aimed to investigate the medium to long term arthroplasty survival and clinical results of total hip arthroplasty after operatively treated acetabular fractures...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28837430/the-epidemiology-of-chronic-critical-illness-after-severe-traumatic-injury-at-two-level-one-trauma-centers
#10
Juan C Mira, Joseph Cuschieri, Tezcan Ozrazgat-Baslanti, Zhongkai Wang, Gabriela L Ghita, Tyler J Loftus, Julie A Stortz, Steven L Raymond, Jennifer D Lanz, Laura V Hennessy, Babette Brumback, Philip A Efron, Henry V Baker, Frederick A Moore, Ronald V Maier, Lyle L Moldawer, Scott C Brakenridge
OBJECTIVE: To determine the incidence and risk factors of chronic critical illness after severe blunt trauma. DESIGN: Prospective observational cohort study (NCT01810328). SETTING: Two-level one trauma centers in the United States. PATIENTS: One hundred thirty-five adult blunt trauma patients with hemorrhagic shock who survived beyond 48 hours after injury. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Chronic critical illness was defined as an ICU stay lasting 14 days or more with evidence of persistent organ dysfunction...
August 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28822457/-meta-analysis-of-clinical-safety-and-efficacy-evaluation-of-peripheral-arterial-disease-patients-with-critical-limb-ischemia-who-accepted-bypass-surgery-or-endovascular-therapy
#11
S K Shen, D M Wu, C G Wang, L K Zhang, Q W Gang
Objective: To evaluate the safety and efficacy of peripheral arterial disease patients with critical limb ischemia who accepted BSX or EVT. Methods: According to the requirements of systematic review, we searched MEDLINE (1980-2014), Emabse (1980-2014), Journals @ Ovid Full Text (1980-2014) databases, selected literature and extracted data, meta-analysis was performed through STATA11.2. Results: A total of 17 studies (3 RCTs, 14 non-randomized studies) and 5 515 patients (BSX group: 2 454, EVT group: 2 769) were deemed eligible...
August 8, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28810991/posterior-cruciate-ligament-injuries-associated-with-military-survival-swim-training
#12
Michael S Crowell, John S Mason, Matthew A Posner, Chad A Haley
OBJECTIVES: Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28765125/sepsis-and-critical-illness-research-center-investigators-protocols-and-standard-operating-procedures-for-a-prospective-cohort-study-of-sepsis-in-critically-ill-surgical-patients
#13
Tyler J Loftus, Juan C Mira, Tezcan Ozrazgat-Baslanti, Gabriella L Ghita, Zhongkai Wang, Julie A Stortz, Babette A Brumback, Azra Bihorac, Mark S Segal, Stephen D Anton, Christiaan Leeuwenburgh, Alicia M Mohr, Philip A Efron, Lyle L Moldawer, Frederick A Moore, Scott C Brakenridge
INTRODUCTION: Sepsis is a common, costly and morbid cause of critical illness in trauma and surgical patients. Ongoing advances in sepsis resuscitation and critical care support strategies have led to improved in-hospital mortality. However, these patients now survive to enter state of chronic critical illness (CCI), persistent low-grade organ dysfunction and poor long-term outcomes driven by the persistent inflammation, immunosuppression and catabolism syndrome (PICS). The Sepsis and Critical Illness Research Center (SCIRC) was created to provide a platform by which the prevalence and pathogenesis of CCI and PICS may be understood at a mechanistic level across multiple medical disciplines, leading to the development of novel management strategies and targeted therapies...
August 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28756045/increasing-use-of-endovascular-therapy-in-pediatric-arterial-trauma
#14
Bernardino C Branco, Bindi Naik-Mathuria, Miguel Montero-Baker, Ramyar Gilani, Charles A West, Joseph L Mills, Jayer Chung
BACKGROUND: Endovascular therapy has been increasingly used for critically injured adults. However, little is known about the epidemiology and outcomes of endovascularly managed arterial injuries in children. We therefore aimed to evaluate recent trends in the endovascular management of pediatric arterial injuries and its association with early survival. METHODS: An 8-year analysis of the National Trauma Databank (2007-2014) was performed to extract all pediatric trauma patients (aged ≤16 years) with arterial injuries...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28755968/surgical-and-medical-approach-to-patients-requiring-total-small-bowel-resection-managing-the-no-gut-syndrome
#15
Ruy J Cruz, Laurie Butera, Kristine Poloyac, Jenee McGurgan, William Stein, David Binion, Abhinav Humar
BACKGROUND: Total resection of the jejunum and ileum, a rarely performed procedure, is indicated after mesenteric vascular events, trauma, or resection of abdominal neoplasms. We describe our recent experience with the operative and medical management of patients with "no gut syndrome." METHODS: We retrospectively reviewed 341 adult patients who were referred to our center between January 2013 and December 2016. RESULTS: Thirteen patients with a mean age of 42...
October 2017: Surgery
https://www.readbyqxmd.com/read/28740457/perioperative-increase-in-neutrophil-cd64-expression-is-an-indicator-for-intra-abdominal-infection-after-colorectal-cancer-surgery
#16
Milena Kerin Povsic, Bojana Beovic, Alojz Ihan
BACKGROUND: Colorectal surgery is associated with a high incidence of postoperative infections. Early clinical signs are difficult to distinguish from the systemic inflammatory response related to surgical trauma. Timely diagnosis may significantly improve the outcome. The objective of this study was to compare a new biomarker index CD64 for neutrophils (iCD64n) with standard biomarkers, white blood cell (WBC) count, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) and procalcitonin (PCT) for the early detection of postoperative infection...
June 2017: Radiology and Oncology
https://www.readbyqxmd.com/read/28730332/-a%C3%A2-phase-model-of-trauma-rehabilitation-how-can-we-avoid-the-rehab-hole
#17
Stefan Simmel, Wolf-Dieter Müller, Christoph Reimertz, Christian Kühne, Jean-Jacques Glaesener
Advances in the rescue chain and first aid of polytrauma patients, which have consequently increased their chance of survival, have led to an increase in demands for rehabilitation. However, there is still a large hole in the continuity of rehabilitation between acute patient care and in-patient rehabilitation, the so-called "rehab-hole". The consequences are untapped rehabilitation potential, loss of strength, endurance and motivation as well as impairment of function of the patient.Based on the phase model of neurological/neurosurgical rehabilitation, we propose a step model for the rehabilitation of polytrauma patients that ensures an uninterrupted chain of rehabilitation...
July 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28715416/signatures-of-inflammation-and-impending-multiple-organ-dysfunction-in-the-hyperacute-phase-of-trauma-a-prospective-cohort-study
#18
Claudia P Cabrera, Joanna Manson, Joanna M Shepherd, Hew D Torrance, David Watson, M Paula Longhi, Mimoza Hoti, Minal B Patel, Michael O'Dwyer, Sussan Nourshargh, Daniel J Pennington, Michael R Barnes, Karim Brohi
BACKGROUND: Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28688950/ten-year-outcome-of-zirconia-ceramic-cantilever-resin-bonded-fixed-dental-prostheses-and-the-influence-of-the-reasons-for-missing-incisors
#19
Matthias Kern, Nicole Passia, Martin Sasse, Christine Yazigi
OBJECTIVES: This clinical study evaluated the long-term outcome and survival rate of all-ceramic cantilever resin-bonded fixed dental prostheses (RBFDPs) made of zirconia-ceramic with a single-retainer design to replace missing incisors. In addition, whether the reason for missing incisors has an influence on the longevity of RBFDPs was analyzed. MATERIALS AND METHODS: One hundred and eight zirconia ceramic cantilever RBFDPs were provided for 87 patients. Seventy-five RBFDPs replaced maxillary incisors and 33 mandibular incisors...
July 5, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/28678814/long-term-health-status-and-trajectories-of-seriously-injured-patients-a-population-based-longitudinal-study
#20
Belinda J Gabbe, Pam M Simpson, Peter A Cameron, Jennie Ponsford, Ronan A Lyons, Alex Collie, Mark Fitzgerald, Rodney Judson, Warwick J Teague, Sandra Braaf, Andrew Nunn, Shanthi Ameratunga, James E Harrison
BACKGROUND: Improved understanding of the quality of survival of patients is crucial in evaluating trauma care, understanding recovery patterns and timeframes, and informing healthcare, social, and disability service provision. We aimed to describe the longer-term health status of seriously injured patients, identify predictors of outcome, and establish recovery trajectories by population characteristics. METHODS AND FINDINGS: A population-based, prospective cohort study using the Victorian State Trauma Registry (VSTR) was undertaken...
July 2017: PLoS Medicine
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