Injury
-
Assault-related injury is a devastating consequence of violence and is a prominent cause of morbidity and mortality in young age. However, reliable data sources are scarce and there has been a paucity of studies examining possible predisposing factors on the incidence of assault-related injury. ⋯ The current study provides evidence of interaction effects among the predisposing factors. Identifying these factors is important to conduct effective preventive measures and trauma management plans focussing on high-risk groups of assault-related injuries in young age.
-
The costs associated with patients discharged with isolated clinician-elicited persistent midline tenderness and negative computed tomography (CT) findings have not been reported. Our aim was to determine the association of acute and post-acute patient and injury characteristics with health resource costs in such patients following road trauma. ⋯ In a homogeneous group of road trauma patients with non fracture-related persistent midline cervical tenderness, health resource costs varied considerably. As long term morbidity is common in this population, a history of resolved neurologic deficit may require greater intervention to mitigate costs. Additionally, adequate communication between acute and community care providers is essential in order to expedite the recovery process through early return to normal daily activities.
-
Comparative Study
Selective non-operative management of penetrating abdominal injury in Great Britain and Ireland: survey of practice.
The selective non-operative management of penetrating abdominal injury is gaining increasing acceptance. In Great Britain and Ireland, the management of trauma remains the responsibility of general surgeons. This study appraises the acceptance and utilisation of selective non-operative management strategies by British and Irish general surgeons, compared with trauma surgeons in the United States of America. ⋯ The selective non-operative management of abdominal stab wounds is generally accepted by British and Irish general surgeons. In contrast, few British and Irish surgeons are comfortable with non-operatively managing patients with abdominal gunshot wounds, reflecting both the rarity of this type of injury, and surgeons' training and experience. This proportion is unlikely to change until the management of torso trauma is recognised as a specialty, and services are concentrated in regional centres.
-
American patients are prescribed more opioid pain medication than Dutch patients after operative treatment of an ankle fracture, but it is possible that pain is undertreated in Dutch patients. This study tests if there is a difference in pain and satisfaction with pain relief between Dutch and American patients after operative treatment of ankle fractures. ⋯ Level I, Prognostic Study with more than 80% follow-up.
-
To derive a clinical decision rule to identify adult emergency department (ED) patients with traumatic intracranial haemorrhage (tICH) who are at low risk for requiring critical care resources during hospitalization. ⋯ This clinical decision rule identifies low risk adult ED patients with tICH who do not need ICU admission. Further validation and refinement of these findings would allow for more appropriate ICU resource utilisation.