Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2013
Serial lactate and admission SOFA scores in trauma: an analysis of predictive value in 724 patients with and without traumatic brain injury.
Arterial lactate, base excess (BE), lactate clearance, and Sequential Organ Failure Assessment (SOFA) score have been shown to correlate with outcome in severely injured patients. The goal of the present study was to separately assess their predictive value in patients suffering from traumatic brain injury (TBI) as opposed to patients suffering from injuries not related to the brain. ⋯ Lactate showed the best performance in predicting sepsis or death in all trauma patients except those with isolated TBI, and the differences were greatest in patients with substantial bleeding. Following isolated TBI, SOFA score was the only parameter which could differentiate survivors from non-survivors on admission, although the SOFA score, too, was not an independent predictor of death following multivariate analysis.
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Eur J Trauma Emerg S · Feb 2013
History, development and future of trauma care for multiple injured patients in the Netherlands.
The development of trauma systems all over the world resulted in improved outcome for a broad range of trauma victims. In this review, we demonstrate the developments of an inclusive regionalised trauma system in the Netherlands and the subsequent developments in our level one trauma centre and trauma region in comparison. ⋯ Based on these considerations, a further concentration of the most severely injured patients is proposed in a small country as the Netherlands culminating in one trauma centre for the most severely injured patients, combined with an integrated pre-hospital helicopter system, on top of the current good functioning inclusive trauma system. These developments could be a template for further developments of trauma systems in Europe.
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Eur J Trauma Emerg S · Feb 2013
Evaluation of current treatment regimens for prepatellar and olecranon bursitis in Switzerland.
Bursitis is a common entity. However, evidence for the best treatment procedures is lacking, with management concepts varying internationally. We evaluated current treatment regimens for septic (SB) and nonseptic (NSB) prepatellar (PB) and (OB) olecranon bursitis in Switzerland and compared them to the published literature. ⋯ Therapeutic regimens for OB/PB differed considerably within Switzerland. Surgical intervention and antibiotic treatment was the most common therapy for SB, whereas a conservative approach predominated for NSB, which contrasts with the international literature. Clearly, prospective multicenter and multidisciplinary studies are needed to identify an optimal and cost-saving approach to the treatment of these common clinical entities.
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Eur J Trauma Emerg S · Feb 2013
The prognostic reliability of the Glasgow coma score in traumatic brain injuries: evaluation of MRI data.
To clarify the predictive power of the Glasgow coma score (GCS) after traumatic brain injury (TBI) and in the context of brain stem lesions. ⋯ We only recommend the use of the GCS for prognostic evaluation in a multidimensional model. Study protocols should contain additional brain stem function parameters (BCS, pupil condition, MRI).