European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2019
Eighteen years' experience of traumatic subclavian vascular injury in a tertiary referral trauma center.
Traumatic subclavian vascular injury (TSVI) is rare but often fatal. The precise diagnosis of TSVI remains challenging mainly because of its occult nature, less typical presentations, and being overlooked in the presence of polytrauma. Compared to penetrating injuries, it is even more difficult to identify TSVI in patients who have blunt injuries and no visible bleeding. The risk factors associated with TSVI in patients with thoracic trauma are unclear. The aims of this study were to identify risk factors for TSVI in a cohort of patients with thoracic vascular injuries and to report outcomes after clinical treatment. ⋯ Our results suggest that GCS ≤ 12, AIS of the head ≥ 3 and the presence of clavicular or scapular fractures were independent risk factors for TSVI in patients with thoracic vascular injuries. For patients with thoracic trauma, TSVI should be considered for prompt management when patients exhibit concurrent injuries to the head, clavicle or scapula.
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Eur J Trauma Emerg Surg · Dec 2019
Comparative StudyComparative analysis of non-simultaneous bilateral fractures of the proximal femur.
We performed a monocenter cohort study to determine surgical revision and mortality after sustaining an initial and a non-simultaneous contralateral proximal femoral fracture. ⋯ Contralateral femoral fracture was accompanied by a higher revision and mortality rate-but patients were also 5 years older. Dementia and male gender were significant negative variables for the survival time. In the future, the highest priority will be the prophylaxis of falling to avoid or at least to decline the number of these fractures in geriatric patients.
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Eur J Trauma Emerg Surg · Dec 2019
Deceleration thoracic aortic ruptures in trauma center level I areas: a 6-year retrospective study.
This retrospective study aimed to analyze the trend of mortality due to thoracic aortic ruptures caused by deceleration injuries that occurred within the catchment area of Hradec Kralove University Hospital. ⋯ Our results suggested that the lethality of thoracic aortic injuries might be minimized by transporting triage-positive patients directly to trauma centers. Accurate diagnoses and treatments were supported by admission chest X-rays, a massive transfusion protocol, and particularly, CT angiography, which is not routinely included in primary surveys. An additional prognostic parameter was clinical collaboration between an experienced trauma surgeon, an interventional radiologist, and a vascular or thoracic surgeon.
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Eur J Trauma Emerg Surg · Dec 2019
Health-related quality of life in trauma patients at 12 months after injury: a prospective cohort study.
Health-related quality of life (HRQOL) is increasingly recognized as a benchmark in trauma outcome research, with few studies having evaluated the HRQOL in trauma patients. The aim of our study was to assess the change in trauma patients' HRQOL at 12 months post-injury and to describe their living situation and return to work status. ⋯ Our study suggests that the quality-of-life of Japanese trauma patients generally improved over time, but remained lower than the Japanese national average. Most trauma patients return to home and work within 12 months post-injury.
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Eur J Trauma Emerg Surg · Dec 2019
The role of psychiatric status on pediatric extremity fractures: a prospective analysis.
The aim of the study was to investigate the relationship between attention deficit and hyperactivity disorder (ADHD), anxiety, and depression with pediatric extremity fractures. ⋯ The signs of ADHD, anxiety, and depression were determined to be higher in children with extremity fractures compared with the non-traumatic population. In patients with especially behavioral problems and depressive signs, directing to the child and adolescent psychiatrists will be protective to prevent re-fractures and high-energy traumas.