European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2021
Observational StudyReappraising the need for a control CT in mild head injury patients on anticoagulation.
Head injury is a frequent reason for admission to the emergency department. In parallel, there is a growing use of anticoagulants in an increasingly aging population, which renders this particular group of trauma patients more frequent. In several countries, including Portugal, a 24-h surveillance period followed by repetition of head computed tomography (CT) is the standard procedure for these patients. However, these recommendations have not been based on studies of prevalence of intracranial hemorrhages in control head CTs, namely in this group of anticoagulated patients. This study intends to evaluate the prevalence of de novo intracranial hemorrhages in control head CTs in anticoagulated patients. ⋯ In conclusion, de novo intracranial hemorrhage in control head CT of anticoagulated patients is rare. We propose that these patients may be discharged if the admission CT does not reveal intracranial hemorrhage, providing that they are accompanied by a caregiver and informed about red flags.
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Eur J Trauma Emerg Surg · Oct 2021
The use of the E-PASS scoring system in determining complication development in patients with isolated acetabular fractures.
The decision to treat acetabular fractures is occasionally deferred or foregone in patients perceived to be unfit for surgery. The previously validated estimation of physiologic ability and surgical stress (E-PASS) score has been shown to predict outcome in a variety of fractures, and consists of a preoperative risk score (PRS), a surgical stress score (SSS), and a comprehensive risk score (CRS). ⋯ Latent patient factors have a clear influence on adverse outcomes in contrast to controllable factors such as surgical stress indicating an important role for perioperative care in reducing postoperative complications. Integrated orthogeriatric care with assessment of comorbidities, prevention or early recognition, and treatment of perioperative complications is essential.
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Eur J Trauma Emerg Surg · Oct 2021
Severe head injury in elderly: 6-year comparison of treatment and outcome between southern Finland and Navarra (Spain).
To compare the profile, treatment and outcome of elderly patients with severe traumatic brain injuries (TBI) between southern Finland and Navarra (Spain). ⋯ The better adjusted outcome of elderly patients with severe TBI in southern Finland in comparison to Navarra could be due to higher rate of pre-hospital intubation and/or higher rate of ICU admissions in southern Finland. Increasing number of elderly patients with severe TBI necessitate uniformly accepted protocols in pre- and in-hospital management.
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Eur J Trauma Emerg Surg · Oct 2021
Current practice in the management of acromioclavicular joint dislocations; a national survey in the Netherlands.
The aim of this study was to investigate current practice in the management of acromioclavicular joint dislocations in the Netherlands. ⋯ This survey showed a significant individual variation on diagnosis and treatment strategies among surgeons in the Netherlands. The majority of the Dutch surgeons concern a flexible implant the best available technique for patients who require operative treatment.