European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
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.
-
Eur J Trauma Emerg Surg · Aug 2022
Efficacy of two integrated geriatric care pathways for the treatment of hip fractures: a cross-cultural comparison.
Many studies have focussed on the implementation and outcomes of geriatric care pathways (GCPs); however, little is known about the possible impact of clinical practices on these pathways. A comparison was made between two traumageriatric care models, one Swiss (CH) and one Dutch (NL), to assess whether these models would perform similarly despite the possible differences in local clinical practices. ⋯ This cross-cultural comparison of GCPs for geriatric hip fracture patients showed that quality of care in terms of mortality was equal. The difference in complicated course was mainly caused by a difference in delirium diagnosis. Differences were seen in surgical techniques, operation duration and timing. These clinical practices did not influence the outcome.
-
Eur J Trauma Emerg Surg · Aug 2022
A minimally invasive cerclage of the tibia in a modified Goetze technique: operative technique and first clinical results.
In spiral fractures of the tibia, the stability of an osteosynthesis may be significantly increased by additive cerclages and, according to biomechanical studies, be brought into a state that allows immediate full weight bearing. As early as 1933, Goetze described a minimally invasive technique for classic steel cerclages. This technique was modified, so that it can be used for modern cable cerclages in a soft part saving way. ⋯ In the described technique, cerclages may be inserted additively at the tibia in a minimally invasive manner and with a few complications, thus significantly increasing the stability of an osteosynthesis. How this ultimately affects fracture healing is the subject of an ongoing study.
-
Eur J Trauma Emerg Surg · Aug 2022
The epidemiology of overtransfusion of red cells in trauma resuscitation patients in the context of a mature massive transfusion protocol.
Packed red blood cell (PRBC) transfusion remains an integral part of trauma resuscitation and an independent predictor of unfavourable outcomes. It is often administered urgently based on clinical judgement. These facts put trauma patients at high risk of potentially dangerous overtransfusion. We hypothesised that trauma patients are frequently overtransfused and overtransfusion is associated with worse outcomes. ⋯ More than a quarter of patients in our cohort were potentially given more blood products than required without obvious clinical consequences. There were no clinically relevant associations with overtransfusion.
-
Eur J Trauma Emerg Surg · Aug 2022
Is it possible to improve prediction of outcome and blood requirements in the severely injured patients by defining categories of coagulopathy?
It has been suggested to define the Trauma-induced coagulopathy (TIC) with a PTratio threshold of 1.20. We hypothesized that a more pragmatic classification would grade severity according to the PTratio (or corresponding ROTEM clotting time: EXTEM-CT), and that this would correlate better with the need for blood products (BP) and prognosis. ⋯ In this study, we have described a pragmatic classification of coagulopathy utilizing PTratio and EXTEM-CT where increasing severity was associated with prognosis and the amount of BP administered. This could allow clinicians to better predict the outcome and anticipate the need for blood products.