European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2020
Multicenter Study Observational StudyThe need for red blood cell transfusions in the emergency department as a risk factor for failure of non-operative management of splenic trauma: a multicenter prospective study.
The majority of patients with splenic trauma undergo non-operative management (NOM); around 15% of these cases fail NOM and require surgery. The aim of the current study is to assess whether the hemodynamic status of the patient represents a risk factor for failure of NOM (fNOM) and if this may be considered a relevant factor in the decision-making process, especially in Centers where AE (angioembolization), intensive monitoring and 24-h-operating room are not available. Furthermore, the presence of additional risk factors for fNOM was investigated. ⋯ The current study confirms the contraindication to NOM in case of hemodynamically instability in case of splenic trauma, as indicated by the most recent guidelines; attention should be paid to patients with transient hemodynamic stability, including patients who require transfusion of RBC in the ED. These patients could benefit from AE; in centers where AE, intensive monitoring and an 24-h-operating room are not available, this particular subgroup of patients should probably be treated with operative management.
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Eur J Trauma Emerg Surg · Apr 2020
ReviewElectrical stimulation-based bone fracture treatment, if it works so well why do not more surgeons use it?
Electrical stimulation (EStim) has been proven to promote bone healing in experimental settings and has been used clinically for many years and yet it has not become a mainstream clinical treatment. ⋯ Despite their awareness of EStim's pro-fracture healing effects few orthopedic surgeons use it in their patients. Our review of the literature and survey indicate that this is due to confusion in the literature due to the great variation in methods reported, and the inconsistent results associated with this treatment approach. In spite of this surgeons seem to be open to using this treatment if advancements in the technology were able to provide an easy to use, cost-effective method to deliver EStim in their fracture patients.
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Eur J Trauma Emerg Surg · Apr 2020
Reoperations after surgery for acute subdural hematoma: reasons, risk factors, and effects.
To analyze the reasons and patient-related and injury-related risk factors for reoperation after surgery for acute subdural hematoma (SDH) and the effects of reoperation on treatment outcome. ⋯ Reoperation after acute SDH surgery is associated with a significantly worse prognosis. Recurrent /significant residual SDH and contralateral SDH are the most frequently found reasons for reoperation. None of the analyzed parameters were significant reoperation predictors.
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Eur J Trauma Emerg Surg · Apr 2020
Comparative StudySevere blunt trauma in Finland and Estonia: comparison of two regional trauma repositories.
Evolving trauma system of Estonia has undergone several reforms; however, performance and outcome indicators have not been benchmarked previously. Thus, we initiated a baseline study to compare demographics, management and outcomes of severely injured patients between Southern Finland and Northern Estonia utilizing regional trauma repositories. ⋯ Benchmarking trauma repositories at a national level provides opportunities for quality and performance improvements. We observed comparable demographic profile and outcome indicators in the compared regional trauma systems.
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Eur J Trauma Emerg Surg · Apr 2020
Risk factors for potential pulmonary embolism in the patients with deep venous thrombosis: a retrospective study.
The risk factors for the detachment of big thrombi from the vessel wall in patients with deep venous thrombosis (DVT) are still not clear, which are potential risks for pulmonary embolism (PE). This study was aimed to identify the risk factors for big thrombi detaching from the vessel wall in the patients with lower extremity DVT and to identify the role of the lower limb immobilization. ⋯ The results suggested that major surgery and mobile lower limb were independent risk factors for potential thrombus of PE in patients with DVT. Immobilization of lower limb might play a protective role in preventing big thrombi from detaching from the vessel wall in patients with DVT.