European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2021
Muscle fat content in the intact infraspinatus muscle correlates with age and BMI, but not critical shoulder angle.
Muscle fat content of the rotator cuff increases after a tear. In the healthy rotator cuff, the influence of age, body mass index (BMI) and critical shoulder angle (CSA) on muscle fat content is unknown. The primary aim was to correlate muscle fat content with age, BMI and CSA. The secondary aims were (1) to correlate muscle fat content in the entire muscle and slice Y (most lateral sagittal slice with scapular spine) and (2) assessed the reliability for CSA measurement in MRI. ⋯ III.
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Eur J Trauma Emerg Surg · Apr 2021
Different approaches towards geriatric trauma care for hip fracture patients: an inter-hospital comparison.
Hip fractures in geriatric patients have high morbidity and mortality rates. The implementation of a multidisciplinary geriatric care pathway (GCP) may improve treatment for this patient population. This study focusses on two level II hospitals with a different treatment protocols. A comparison was made between a multidisciplinary GCP and extensive standard care with a focus on geriatric hip fracture patients to assess if a multidisciplinary GCP leads to lower mortality and morbidity. ⋯ Mortality, major complications, HLOS and the amount of secondary surgical interventions showed no differences between both hospitals. This inter-hospital comparison of two types of geriatric care models showed no outcome that favours one specific geriatric care model over another. This provides opportunities for future studies to get a better understanding of what specific factors of geriatric care models contribute most to an improvement in the treatment of this patient population and decide which approach is most cost effective.
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Eur J Trauma Emerg Surg · Apr 2021
Observational StudyCentral venous oxygen saturation/lactate ratio: a novel predictor of outcome following emergency open laparotomy.
Emergency laparotomy is associated with high rates of morbidity and mortality. The need for highly sensitive readily prognostic biomarkers is necessary to improve the outcome. We investigated the usefulness of post-operative arterial lactate and ScvO2/lactate ratio as predictors of outcome after post-operative emergency open laparotomy. To the best of our knowledge, the novel ScvO2/lactate ratio was not investigated before in emergency open laparotomy patients. ⋯ Serial blood lactate as well as the novel ScvO2/lactate ratio can be useful for early predictors of mortality at 7 days. Serial lactate levels correlate to admission ICU scores APACHE II; MODS and SOFA in post-operative emergency open laparotomy patients.
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Eur J Trauma Emerg Surg · Apr 2021
Critical incident reporting systems (CIRS) in trauma patients may identify common quality problems.
Critical incident reporting systems (CIRS) are considered to be a valid instrument to identify typical errors in various clinical settings as well as in prehospital emergency medicine. Our aim was to review incidents and errors in the care of trauma patients during the period of emergency trauma room treatment before their transfer to the intensive care unit or the operation room. ⋯ Our results demonstrate that using CIRS is able to reveal individual or rare errors and allows for the identification of systematic errors and deficiencies in the acute care of trauma patients in the trauma room. This may guide quality control and quality improvement measures to be focused on the most common fields of demand.