Isr Med Assoc J
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The exact value of follow-up ultrasonography and computed tomography in the non-operative management of blunt splenic injuries is not yet defined. Although follow-up studies have been recommended to detect possible complications of the initial injury, evidence shows that routine follow-up CT scans usually do not affect management of these patients. ⋯ In the present series the follow-up radiological studies did not affect patient management. Follow-up imaging can be omitted in clinically stable patients with blunt splenic trauma grade I-III.
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Transfer to an emergency room and hospitalization of nursing home residents is a growing problem that is poorly defined and reported. ⋯ Treatment of selected nursing home residents admitted directly from the nursing home to an acute-care geriatric unit is feasible, medically effective, results in the safe discharge of almost all such patients and provides an alternative to transfer to an emergency room. This study suggests that quality gains and cost-effective measures may be achieved by such a project, although a randomized controlled trial is necessary to support this hypothesis.