European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2022
Two-thousand hip fractures treated within 12 h and > 12-24 h after admission: Are survival and adverse events affected?
The effects of immediate operation on hip fracture (HF) are unclear. Therefore, we investigated the influence of time to operation within 12 h vs. > 12-24 h on survival and adverse events. ⋯ Within the limits of single-center analysis, the patients receiving treatment for HF within 12 h were younger and healthier and had the benefits of shorter hospitalizations and a higher 30-day survival rate than patients treated > 12-24 h after admission. At the endpoint 1 year after operation, no differences were observed in adverse events or survival rates.
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Eur J Trauma Emerg Surg · Jun 2022
Acute alcohol consumption increases systemic endotoxin bioactivity for days in healthy volunteers-with reduced intestinal barrier loss in female.
Trauma is the most common cause of death among young adults. Alcohol intoxication plays a significant role as a cause of accidents and as a potent immunomodulator of the post-traumatic response to tissue injury. Polytraumatized patients are frequently at risk to developing infectious complications, which may be aggravated by alcohol-induced immunosuppression. Systemic levels of integral proteins of the gastrointestinal tract such as syndecan-1 or intestinal fatty acid binding proteins (FABP-I) reflect the intestinal barrier function. The exact impact of acute alcohol intoxication on the barrier function and endotoxin bioactivity have not been clarified yet. ⋯ Even relative low amounts of alcohol affect the immune system of healthy volunteers, although these changes appear minor in women. A potential damage to the intestinal barrier and presumed enhanced systemic endotoxin bioactivity after acute alcohol consumption is proposed, which represents a continuous immunological challenge for the organism and should be considered for the following days after drinking.
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Suboccipital decompression has been established as standard therapeutic procedure for raised intracranial pressure caused by mass-effect associated pathologies in posterior fossa. Several different surgical techniques of dural closure have been postulated to achieve safe decompression. The aim of this study was to examine the differences between fibrin sealant patch (FSP) and dural reconstruction (DR) in suboccipital decompression for acute mass-effect lesions. ⋯ Rapid closure technique in suboccipital decompression is feasible and safe. Operative time is hereby reduced, without increasing complication rates.
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Eur J Trauma Emerg Surg · Jun 2022
External validation of the Almelo Hip Fracture Score, a prediction model for early mortality following hip fracture surgery.
Early mortality (< 30 days) in hip fracture patients is as high as 9.6%. Several risk assessment tools have been developed to identify patients at high risk for early mortality. Among them, the Almelo Hip Fracture Score (AHFS) was developed recently and showed promising results. Until now, this tool has not been validated; therefore, we aim to perform an external validation of the AHFS. ⋯ The validity of the score was acceptable and comparable to the values in the Almelo cohort. This score might be used to identify patients at high risk for early mortality.
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Gun violence is a global health problem. Population-based research on firearm-related injuries has been relatively limited considering the burden of disease. The aim of this study was to analyze nationwide epidemiological trends of firearm injuries. ⋯ This nationwide study shows an annual increase of firearm-related injuries and fatalities. Firearm injuries affect people of all ages but more frequently young males in major cities. One in six patients succumbed from their injuries within 30 days with most deaths occurring within 24 h of hospital admission. Given the impact of firearm-related injuries on society additional research on a national level is critical.