Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2012
Prognostic value of various intracranial pathologies in traumatic brain injury.
Various intracranial pathologies in traumatic brain injury (TBI) can help to predict patient outcomes. These pathologies can be categorised using the Marshall Classification or the Abbreviated Injury Scale (AIS) dictionary or can be described through traditional descriptive terms such as subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural haemorrhage (EDH) etc. The purpose of this study is to assess the prognostic value of AIS scores, the Marshall Classification and various intracranial pathologies in TBI. ⋯ In this relatively recent dataset, each of the brain injury classification systems enhanced equally the performance of an early mortality prediction model in traumatic brain injury patients. The significant effect of brain swelling and brain stem injury on the outcome in comparison to injuries such as SAH suggests the need to improve therapeutic approaches to patients who have sustained these injuries.
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About half of all trauma-related deaths occur after hospital admission. The present study tries to characterize trauma deaths according to the time of death, and, thereby, contributes to the discussion about factors considered as the cause of death. ⋯ The time to death after severe trauma does not follow a trimodal distribution but shows a constantly decreasing incidence.
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Eur J Trauma Emerg S · Feb 2012
Optic nerve sheath measurement and raised intracranial pressure in paediatric traumatic brain injury.
The optimal management of children ventilated for more than 4 h with traumatic brain injury (TBI) necessitates invasive intracranial pressure (ICP) monitoring, though some patients never have raised ICP. If non-invasive screening can reliably rule out elevated ICP, invasive devices can be limited to those in whom neuro-intensive care measures are indicated. ⋯ All children with clinically significantly raised ICP had abnormal ONSD, whereas those with normal ICP did not. Despite the small numbers, this study suggests that the ONSD may be useful in identifying children with TBI and normal ICP and, so, help avoid the insertion of unnecessary ICP monitors.
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Eur J Trauma Emerg S · Feb 2012
Multiple blunt trauma after suicidal attempt: an analysis of 4,754 multiple severely injured patients.
The suicidal attempt is a significant cause for multiple severe injuries in Germany. The aim of the present study was to obtain information regarding injury patterns, clinical treatment, and outcome. ⋯ Falls from a height are a common cause of injury among severely injured patients. The resulting trauma composes a particular form of blunt trauma with severe and multiple injuries, which depends on the fact of whether the free fall from a height was caused by an accident or as a result of a suicidal attempt. Taking the injury severity into consideration, there is no difference in the prognosis of the patients.
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Eur J Trauma Emerg S · Feb 2012
Gastrointestinal tract perforation following blunt abdominal trauma: an institution's experience.
Traumatic perforation of the gastrointestinal tract (GIT) poses numerous challenges for surgeons worldwide. We aimed to review our institution's experience and highlight the pertinent issues in managing this problem. ⋯ Prompt and early surgery for traumatic gastrointestinal perforation is advised. Any abnormal CT scans warrants either surgery or close monitoring. Direct repair of the perforation is preferred, if possible.