Scand J Trauma Resus
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Scand J Trauma Resus · May 2019
ReviewAcute Dysnatremias - a dangerous and overlooked clinical problem.
Dysnatremias are common electrolyte disturbances with significant morbidity and mortality. In chronic dysnatremias a slow correction rate (<10 mmol/L/24 h) is indicated to avoid neurological complications. In acute dysnatremias (occurring <48 h) a rapid correction rate may be indicated. Most guidelines do not differ between acute and chronic dysnatremias. In this review, we focus on the evidence-based treatment of acute dysnatremias. ⋯ Severe acute dysnatremias have significant mortality and require immediate treatment. A rapid correction rate may be lifesaving and is not associated with neurological complications. Chronic dysnatremias, on the other hand, are often compensated and thus less severe. In these cases a rapid correction rate may lead to severe cerebral complications.
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Scand J Trauma Resus · May 2019
LetterResponse to letter to the editor: "comment on unplanned out-of-hospital birth and risk factors of adverse perinatal outcome: findings from a prospective cohort".
The aim of this Letter to the Editor was to respond to a comment highlighting potential statistical biases in an analysis of our recently published article. We therefore specified the method for selecting the model variables in order to limit overfitting, then we used the Firth method to control the sparse data bias, and finally for checking internal validity we used bootstrapping methods. In total, the conclusions of our model were not changed by these new analyses.
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Scand J Trauma Resus · May 2019
Observational StudyThe effect of a terrorist attack on emergency department inflow: an observation study using difference-in-differences methodology.
The objective of this study was to investigate how the terrorist attack in Stockholm, Sweden affected patient inflow to the general emergency departments (EDs) in close proximity of the attack. The study analyzed if, and to what extent, the attack impacted ED inflow during the following days and weeks. ⋯ The results showed that ED inflow was significantly decreased in the weeks immediately following the Stockholm terrorist attack. The reasons for this cannot be fully explained in this observational study. However, the results suggest that some patients actively choose when, where and if they should go to the ED.
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Scand J Trauma Resus · May 2019
A prospective pilot study using metabolomics discloses specific fatty acid, catecholamine and tryptophan metabolic pathways as possible predictors for a negative outcome after severe trauma.
We wanted to define metabolomic patterns in plasma to predict a negative outcome in severe trauma patients. ⋯ Specific fatty acids, catecholamine synthesis and tryptophan degradation pathways could be implicated in a negative outcome after trauma. The metabolomic study of severe trauma patients could be helpful for biomarker proposal.
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Scand J Trauma Resus · May 2019
Observational StudyDiagnostic error increases mortality and length of hospital stay in patients presenting through the emergency room.
Diagnostic errors occur frequently, especially in the emergency room. Estimates about the consequences of diagnostic error vary widely and little is known about the factors predicting error. Our objectives thus was to determine the rate of discrepancy between diagnoses at hospital admission and discharge in patients presenting through the emergency room, the discrepancies' consequences, and factors predicting them. ⋯ Diagnostic discrepancies are a relevant healthcare problem in patients admitted through the emergency room because they occur in every ninth patient and are associated with increased in-hospital mortality. Discrepancies are not readily predictable by fixed patient or physician characteristics; attention should focus on context.