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Impact of comorbidities on long-term survival of trauma patients

Jordan D Bohnen, David C Chang, Elie P Ramly, Olubode A Olufajo, Ryan T Le, Haytham M A Kaafarani, Daniel Dante Yeh, David R King, Peter J Fagenholz, Kathryn L Butler, Reza Askari, Ali Salim, George C Velmahos, Marc de Moya
OBJECTIVE: The relationship between baseline (i.e., pre-injury) blood pressure and trauma outcomes in elderly patients is unknown. We therefore aimed to identify the independent impact of baseline systolic blood pressure (SBP) on inpatient mortality among elderly trauma patients. METHODS: The 2004 to 2014 trauma registries of two Level I Trauma Centers were linked to electronic health records then reviewed to identify patients ≥65 years old with available baseline vital signs...
December 2016: Journal of Trauma and Acute Care Surgery
Grischa Hoffmann, Christine Friedrich, Moritz Barrabas, Rainer Petzina, Assad Haneya, Bernd Panholzer, Rouven Berndt, Jochen Cremer
OBJECTIVES: Demographic changes lead to a rising incidence of octogenarians undergoing surgical revascularization of coronary artery disease. Minimally invasive direct coronary artery bypass (MIDCAB) represents a surgical treatment with reduced trauma and without the use of cardiopulmonary bypass. The aim of this study was to evaluate short- and long-term outcomes after MIDCAB in octogenarians. METHODS: Between 1998 and 2012, 1060 patients underwent MIDCAB at our department...
September 2016: Interactive Cardiovascular and Thoracic Surgery
François Aspesberro, Rita Mangione-Smith, Jerry J Zimmerman
PURPOSE: The aims of this focused review of the literature on children surviving critical illness were to (1) determine whether health-related quality of life (HRQL) represents a clinically meaningful outcome measure for children surviving critical illness and (2) evaluate the HRQL measures implemented in pediatric critical care studies to date. METHODS: This was a focused review of the literature from 1980 to 2015 based on a search of EMBASE/PubMed, MEDLINE and PsycInfo assessing trends and determinants of HRQL outcomes in children surviving critical illness...
July 2015: Intensive Care Medicine
Jens Chapman, Justin S Smith, Branko Kopjar, Alexander R Vaccaro, Paul Arnold, Christopher I Shaffrey, Michael G Fehlings
STUDY DESIGN: Retrospective, multicenter cohort study. OBJECTIVE: Assess for differences in short- and long-term mortality between operative and nonoperative treatment for elderly patients with type II odontoid fractures. SUMMARY OF BACKGROUND DATA: There is controversy regarding whether operative or nonoperative management is the best treatment for elderly patients with type II odontoid fractures. METHODS: This is a retrospective study of consecutive patients aged 65 years or older with type II odontoid fracture from 3 level I trauma centers from 2003-2009...
June 1, 2013: Spine
Daniel J Niven, Andrew W Kirkpatrick, Chad G Ball, Kevin B Laupland
BACKGROUND: Few studies have assessed the impact of pre-existing medical comorbidities on long-term survival after major trauma. This study investigated the influence of comorbidities as measured by the Charlson Comorbidity Index (CCI) on the 1-year mortality after major traumatic injury. METHODS: Adult patients who survived their initial trauma admission in Calgary, Alberta, Canada, between April 1, 2002, and March 31, 2006, defined the study population. Clinical and outcome information was obtained from regional electronic databases...
August 2012: American Journal of Surgery
Olof Brattström, Emma Larsson, Fredrik Granath, Louis Riddez, Max Bell, Anders Oldner
The impact of host factors, such as gender and co-morbidity, on mortality after trauma has been debated. Quantification of risk factors is dependent on methodological considerations including follow-up time, definitions and adjustment of potential confounders. Optimal follow-up time of trauma patients remains to be elucidated. We investigated the impact of gender and co-morbidity on short and long term mortality in a cohort including 4,051 patients from a level 1 trauma centre. Data from the trauma cohort were linked to validated national registries...
March 2012: European Journal of Epidemiology
Belinda J Gabbe, James E Harrison, Ronan A Lyons, Damien Jolley
BACKGROUND: Injury is a leading cause of the global burden of disease (GBD). Estimates of non-fatal injury burden have been limited by a paucity of empirical outcomes data. This study aimed to (i) establish the 12-month disability associated with each GBD 2010 injury health state, and (ii) compare approaches to modelling the impact of multiple injury health states on disability as measured by the Glasgow Outcome Scale - Extended (GOS-E). METHODS: 12-month functional outcomes for 11,337 survivors to hospital discharge were drawn from the Victorian State Trauma Registry and the Victorian Orthopaedic Trauma Outcomes Registry...
2011: PloS One
Atle Ulvik, Reidar Kvåle, Tore Wentzel-Larsen, Hans Flaatten
BACKGROUND: The aim of this study was to assess the incidence of organ failure in trauma patients treated in an intensive care unit (ICU), and to study the relationship between organ failure and long-term survival and functional status. METHODS: This is a cohort study of all adult ICU trauma patients admitted to a university hospital during 1998 to 2003. Organ failure was quantified by the Sequential Organ Failure Assessment (SOFA) score. A telephone interview was conducted in 2005 (2 to 7 years after trauma) using the Karnofsky Index to measure functional status, and the Glasgow Outcome Score to measure recovery...
2007: Critical Care: the Official Journal of the Critical Care Forum
M M Dolan, W G Hawkes, S I Zimmerman, R S Morrison, A L Gruber-Baldini, J R Hebel, J Magaziner
BACKGROUND: Hip fracture patients are at increased risk of confusion or delirium due to the trauma associated with the injury and the rapid progression to hospitalization and surgery, in addition to the pain and loss of function experienced. Hip fracture patients who develop delirium may require longer hospital stays, are more often discharged to long-term care, and have a generally poor prognosis for returning home or regaining function in activities of daily living (ADL). METHODS: The present study examines the impact of delirium present on hospital admission in a sample of 682 non-demented, aged hip fracture patients residing in the community at the time of their fracture...
September 2000: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
G Poór, E J Atkinson, D G Lewallen, W M O'Fallon, L J Melton
Clinical spectrum, treatment and short-term outcomes were assessed among the 131 Rochester, Minnesota, men who contracted an initial hip fracture due to moderate trauma during 1978-89. Three-fourths of falls leading to hip fracture occurred indoors with little seasonality, and 91% of fractures were in men 65 years of age or older. The ratio of cervical to intertrochanteric femur fractures was 1.4:1, and there was a tendency toward more neurological conditions among the patients with cervical fractures. Hemiarthroplasty and total hip replacement were mostly performed for cervical fractures, while internal fixation was preferred for intertrochanteric fractures...
1995: Osteoporosis International
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