European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Apr 2022
Evaluation of a standardized instrument for post hoc analysis of trauma-team-activation-criteria in 75,613 injured patients an analysis of the TraumaRegister DGU®.
To improve the quality of criteria for trauma-team-activation it is necessary to identify patients who benefited from the treatment by a trauma team. Therefore, we evaluated a post hoc criteria catalogue for trauma-team-activation which was developed in a consensus process by an expert group and published recently. The objective was to examine whether the catalogue can identify patients that died after admission to the hospital and therefore can benefit from a specialized trauma team mostly. ⋯ The consensus-based criteria identified nearly all patients who died as a result of their injuries. If only one criterion was fulfilled, mortality was relatively low. However, it increased to almost 5% if two criteria were fulfilled. Further studies are necessary to analyse and examine the relative weighting of the various criteria. Our instrument is capable to identify severely injured patients with increased in-hospital mortality and injury severity. However, a minimum of two criteria needs to be fulfilled. Based on these findings, we conclude that the criteria list is useful for post hoc analysis of the quality of field triage in patients with severe injury.
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Eur J Trauma Emerg Surg · Apr 2022
More medications, more problems: results from the Sedation Level after Emergent Exlap with Packing for TRAUMA (SLEEP-TRAUMA) study.
Sedation management of trauma patients after damage control laparotomy (DCL) has not been optimized. We evaluated if shorter sedation exposure was associated with increased proportion of delirium-free/coma-free (DF/CF-ICU) days and change in time to definitive fascial closure (DFC). ⋯ Shorter sedation exposure is associated with increased proportion of DF/CF-ICU days and more rapid DFC after DCL for trauma.
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The aim of this work is to study a cohort of patients of ISS < 15 admitted to a TC, and to determine the number of patients that ultimately benefited from the skills and resources specific of a level 1 trauma center. ⋯ This work demonstrates that in a cohort of patients classified as ISS < 15 admitted to a TC, a considerable amount of TC-specific resources are required, and patients present with severe outcome criteria despite being classified as overtriaged. These results suggest that triage of trauma patients should be based on resource use and clinical outcome rather than anatomic criteria.
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Eur J Trauma Emerg Surg · Apr 2022
Older adults are not more susceptible to acute muscle atrophy after immobilisation compared to younger adults: a systematic review.
To identify if older adults are more susceptible to acute muscle atrophy compared to younger adults. ⋯ The current literature suggests that there is no difference in the rate of muscle atrophy after immobilisation in older people compared to younger people, and therefore that older people are not more susceptible to atrophy in the acute setting. However, the findings are inconsistent and provide statistically significant but opposing results. There is a lack of high-quality research available on the topic, and there is a paucity of literature regarding atrophy rates in women.
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Eur J Trauma Emerg Surg · Apr 2022
Risk factors related to the partial necrosis of the posterior tibial artery perforator-plus fasciocutaneous flap.
The posterior tibial artery perforator-plus fasciocutaneous (PTAPF) flap is commonly used for defects over the distal lower extremity. However, the causes of partial necrosis of the PTAPF flap are unknown. This paper aimed to explore the factors related to the partial necrosis of the PTAPF flap. ⋯ The PTAPF flap can be effectively used to repair small and medium wounds of the lower and middle leg, ankle and foot. As the width of the skin island exceeds 6 cm, the risk of partial flap necrosis significantly increases.