European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2018
Comparative StudyBiomechanical comparison of locked versus non-locked symphyseal plating of unstable pelvic ring injuries.
Locked symphyseal plates are utilized to provide higher levels of construct stiffness than non-locked plates. The current biomechanical study was performed to compare stiffness at the pubic symphysis between locked and non-locked plating systems. ⋯ Locked symphyseal plating systems can provide better stability than non-locked systems for anterior-posterior shear translation. More stability could potentially reduce the risk of failure of the plate or screws.
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Eur J Trauma Emerg Surg · Apr 2018
A retrospective evaluation of the Modified Alvarado Score for the diagnosis of acute appendicitis in HIV-infected patients.
The aim of this study was to evaluate and compare the diagnostic value of a Modified Alvarado Score (MAS) ≥7 for acute appendicitis in both Human Immunodeficiency Virus (HIV)-negative (HIVneg) and positive (HIVpos) patientcohorts. ⋯ A MAS ≥7 is a reliable predictor of acute appendicitis in HIVneg patients. In HIVpos patients, the MAS threshold required to accurately predict appendicitis is 8. The use of a MAS ≥7 in this group of patients will result in unnecessary surgical intervention.
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Eur J Trauma Emerg Surg · Apr 2018
High fibrin/fibrinogen degradation product to fibrinogen ratio is associated with 28-day mortality and massive transfusion in severe trauma.
There is a lack of association between coagulation biomarkers and long-term mortality in severe trauma. We aimed to investigate the association between coagulation biomarkers on admission and outcome of late stage of trauma. ⋯ High FDP/fibrinogen ratio on arrival is a predictor of 28-day mortality and the requirement for massive transfusion in severe trauma.
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Eur J Trauma Emerg Surg · Apr 2018
Multidisciplinary team approach to traumatic spinal cord injuries: a single institution's quality improvement project.
A stepwise multidisciplinary team (MDT) approach to the injured trauma patient has been reported to have an overall benefit, with reduction in mortality and improved morbidity. Based on clinical experience, we hypothesized that implementation of a dedicated Spinal Cord Injury Service (SCIS) would impact outcomes of a patient specific population on the trauma service. ⋯ The application of an SCIS team in addition to the trauma service suggests that a structured coordinated approach can have an expected improvement in hospital outcomes and shorter length of stays. We believe that this clinical collaboration provides distinct specialist perspectives and, therefore, optimizes quality improvement. Level of evidence Epidemiologic study, level III.
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Eur J Trauma Emerg Surg · Apr 2018
Diagnostic value of arterial blood gas lactate concentration in the different forms of mesenteric ischemia.
The role of serum lactate measurement in patients with intestinal ischemia still remains unclear. The aim of this study was to prospectively evaluate the diagnostic performance of arterial blood gas lactate concentrations in the patients with acute mesenteric ischemia and its different forms. ⋯ Arterial blood gas lactate levels seem to show good diagnostic accuracy in diagnosing small bowel arterial and nonocclusive ischemia and poor accuracy in diagnosing secondary mesenteric ischemia, small bowel venous ischemia and ischemic colitis.