World journal of surgery
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Sarcopenia describes a loss of muscle mass and resultant decrease in strength, mobility, and function that can be quantified by CT. We hypothesized that sarcopenia and related frailty characteristics are related to discharge disposition after blunt traumatic injury in the elderly. ⋯ Lower psoas major muscle CSA is related to discharge destination in elderly trauma patients and can be obtained from the admission CT. Lower psoas muscle CSA is related to loss of independence upon discharge in the elderly. The early availability of this variable during the hospitalization of elderly trauma patients may aid in discharge planning and the transition to dependent living.
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World journal of surgery · Feb 2015
The utility of the Kampala trauma score as a triage tool in a sub-Saharan African trauma cohort.
Trauma scoring systems have been developed to assess injury severity and may have triage potential. We sought to evaluate the ability of the Kampala trauma score (KTS) to assess injury severity and its potential as an outcome predictive tool in Malawi. ⋯ Both the KTS and RTS were significantly associated with need for admission and final outcome on logistic regression analysis; however, they may not be strong enough predictors to merit their use as a screening tool in our setting.
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World journal of surgery · Feb 2015
Assessment of the availability of technology for trauma care in India.
We sought to assess the status of availability of technology for trauma care in a state in India and to identify factors contributing to both adequate levels of availability and to deficiencies. We also sought to identify potential solutions to deficiencies in terms of health system management and product development. ⋯ Availability of a range of lower-cost items could be improved by better organization and planning, such as: better procurement and stock management; eliminating mismatch of resources, including optimizing training for use of existing resources; and by strengthening service contracts and in-house repair capabilities. From a product development viewpoint, there is a need for lower cost, more durable, and easier to repair ventilators. Promoting increased capacity for local manufacturing should also be considered as a potential method to decrease cost and increase availability of a range of equipment.
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World journal of surgery · Feb 2015
Observational StudySustainability of an enhanced recovery after surgery program (ERAS) in colonic surgery.
Between 2006 and 2008 the enhanced recovery after surgery (ERAS) program was implemented in colonic surgery in one-third of all hospitals in the Netherlands (n = 33). This resulted in enhanced recovery and a decrease in hospital length of stay (LOS) from a median of 9 days at baseline to 6 days at one-year follow-up. The present study assessed the sustainability of the ERAS program 3-5 years after its implementation. ⋯ Despite a slight decrease in protocol adherence, the ERAS program was sustained reasonably well in the 10 selected hospitals, although there was quite some variation between the hospitals.
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World journal of surgery · Feb 2015
1000 Port-A-Cath ® placements by subclavian vein approach: single surgeon experience.
Totally implantable venous access ports are widely used for the administration of chemotherapy in patients with cancer. Although there are several approaches to implantation, here we describe Port-A-Cath(®) (PAC) placement by percutaneous puncture of the subclavian vein with ultrasonographic guidance. ⋯ This is a very large series of PAC placement with an ultrasound-guided approach for left subclavian vein and X-ray confirmation, performed by a single surgeon, demonstrating both the safety and effectiveness of the procedure.