Scand J Trauma Resus
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Scand J Trauma Resus · Nov 2017
Observational StudyThe effect on the patient flow in local health care services after closing a suburban primary care emergency department: a controlled longitudinal follow-up study.
It has not been studied what happens to patient flow to EDs and other parts of local health care system if distances to ED services are manipulated as a part of health policy in urban areas. ⋯ Manipulating distances to ED services can be used to direct patient flows to different parts of the health care system. The correlation between distance to ED and the tendency to use ED by inhabitants is negative. If secondary care ED was available there were no life-threatening side-effects at the level of general public health when a minor ED was closed in a primary care ED system.
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Scand J Trauma Resus · Nov 2017
Observational StudyRoutine blood tests are associated with short term mortality and can improve emergency department triage: a cohort study of >12,000 patients.
Prioritization of acutely ill patients in the Emergency Department remains a challenge. We aimed to evaluate whether routine blood tests can predict mortality in unselected patients in an emergency department and to compare risk prediction with a formalized triage algorithm. ⋯ Routine blood tests were strongly associated with 30-day mortality in acutely ill patients and discriminatory ability was significantly higher than with a formalized triage algorithm. Thus routine blood tests allowed an improved risk stratification of patients presenting in an emergency department.
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Scand J Trauma Resus · Nov 2017
Comment LetterLetter to the Editor regarding the article: "identifying pre-hospital factors associated with outcome for major trauma patients in a regional trauma network: an exploratory study".
The aim of this Letter to the Editor was to report some methodological shortcomings in a recently published article. Issues regarding missing values and overfitting are mentioned. ⋯ Second, there was a high chance of overfitting and lack of model validation. In conclusion, the results of this study should be interpret with caution and further research is necessary.
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Scand J Trauma Resus · Nov 2017
Observational StudyS100A8/A9 and sRAGE kinetic after polytrauma; an explorative observational study.
Following tissue injury after trauma, the activation of innate immune pathways results in systemic inflammation, organ failure and an increased risk of infections. The objective of this study was to characterize the kinetics of the S100A8/S100A9 complex, a new-recognized alarmin, as well as its soluble receptor sRAGE, over time after trauma as potential early biomarkers of the risk of organ damage. ⋯ This work illustrates the importance of following the circulating level of biomarker overtime. The utilization of S1008/9 as a tool to stratify infection risk and trigger early interventions need to be validated prospectively.
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Scand J Trauma Resus · Nov 2017
Treatment of splenic trauma in Norway: a retrospective cohort study.
Non-operative management of splenic injuries has become the treatment of choice in hemodynamically stable patients over the last decades. The aim of the study is to describe the incidence, initial treatment and early outcome of patients with splenic injuries on a national level. ⋯ Most patients with splenic injuries are managed non-operatively. Despite the low number of splenic injuries per hospital, the results indicate satisfactory outcome on a national level.