European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2022
Prospective assessment of key factors influencing treatment strategy and outcome of fragility fractures of the pelvis (FFP).
Fragility fractures of the pelvis (FFP) are a clinical entity with an increasing significance in clinical practice. Little is known about the conditions, which influence decision making and outcome. ⋯ Conservative treatment is appropriate in patients with FFP type I as well as in patients with FFP type II, provided that the last ones are hospitalized immediately after the traumatic event. Surgical treatment is recommended in patients with higher fracture types, with delayed presentation or after unsuccessful conservative treatment. In the conservative and operative group, all selected parameters considerably improved between t1 and t4 with a steeper increase in the operative group. The rate of postoperative complications is low. The 1-year mortality rate is the lowest in the operative group. Surgical stabilization of FFP is safe and reliable provided it is performed with care and in the appropriate target group.
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Eur J Trauma Emerg Surg · Aug 2022
Comparison of CATCH, PECARN, and CHALICE clinical decision rules in pediatric patients with mild head trauma.
The present study compares the most frequently used the CATCH, PECARN, and CHALICE clinical decision protocols with an aim to evaluate their effectiveness from the population perspective. ⋯ The present study found that the PECARN and CATCH rules in children with minor head injury were significantly sensitive in detecting CT positivity and the need for hospitalization.
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Eur J Trauma Emerg Surg · Aug 2022
Nonunion of traumatic rib fractures: a suitable indication for surgery?
Nonunion of traumatic rib fractures is a clinical/radiological diagnosis caused by an alteration of bone healing reparative process. Since it is a painful condition, nonunion has a significative impact on patient's morbidity and quality of life. The aim of this study was to evaluate the outcomes after surgical stabilization of ribs affected by nonunion after traumatic fractures. ⋯ Surgical stabilization in patients affected by rib nonunion can be safely performed with few complications, good clinical outcomes and satisfactory quality of life.
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Eur J Trauma Emerg Surg · Aug 2022
Observational StudyImpact of the SARS-CoV-2 pandemic on trauma care: a nationwide observational study.
The SARS-CoV-2 pandemic severely disrupted society and the health care system. In addition to epidemiological changes, little is known about the pandemic's effects on the trauma care chain. Therefore, in addition to epidemiology and aetiology, this study aims to describe the impact of the SARS-CoV-2 pandemic on prehospital times, resource use and outcome. ⋯ The imposed restrictions in response to the SARS-CoV-2 pandemic led to diminished numbers of acute trauma admissions in the Netherlands. The long-lasting pressing demand for resources, including ICU services, has negatively affected trauma care. Further caution is warranted regarding the increased incidence of injuries related to violence and self-harm.
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Eur J Trauma Emerg Surg · Aug 2022
Prognostic value of orthogeriatric assessment parameters on mortality: a 2-year follow-up.
Since the arise of orthogeriatric co-management patients' outcome and survival has improved. There are several assessment parameters that screen the precondition of orthogeriatric patients including mobility, activities of daily living, comorbidities, place of residence and need for care just to name a few. In a 2-year follow-up on an orthogeriatric co-managed ward the fracture-independent predictive value of typical assessment parameters and comorbidities on the associated mortality was examined. ⋯ Age, PMS, BI, CCI, preexisting dementia, sarcopenia, frequent falling, POR and CL are univariate predictors of survival in the orthogeriatric context. An independency could only be found for PMS, BI and age in our multivariate model. This underlines the importance of preexisting mobility and capability of self-support for the patient's outcome in terms of survival.