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
Patterns and mechanisms of major trauma injuries during and after the UK Covid-19 Nationwide lockdown: analysis from a UK Major Trauma Centre.
To compare patterns and mechanisms of injuries during and after the UK Nationwide lockdown during the COVID-19 pandemic. ⋯ The lifting of lockdown restrictions resulted in a twofold increase in major trauma admissions that was also associated with significant changes in both the demographic and patterns of injuries with RTA's contributing almost half of all injury presentations.
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Eur J Trauma Emerg Surg · Aug 2022
Empiric antimicrobial therapy for early-onset pneumonia in severe trauma patients.
The bacterial ecology involved in early pneumonia of severe trauma patients is mostly commensal and would allow wide use of narrow-spectrum antibiotics. We describe risk factors for treatment failure of severe trauma patients' pneumonia with the use of narrow-spectrum antimicrobial therapy in order to develop a score that could help clinicians to determine which patients might be treated with narrow-spectrum antibiotics. ⋯ Simple risk factors may help clinicians to identify severe trauma patients at high risk of pneumonia treatment failure with the use of narrow-spectrum antimicrobial therapy and, thus, use better tailored empiric therapy and limit the use of unnecessary broad-spectrum antimicrobial therapy.
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Eur J Trauma Emerg Surg · Aug 2022
Early video-assisted thoracoscopic surgery (VATS) for non-emergent thoracic trauma remains underutilized in trauma accredited centers despite evidence of improved patient outcomes.
Thoracic injury is a major contributor to morbidity in trauma patients. There is limited data regarding practice patterns of video-assisted thoracoscopic surgery (VATS) across trauma-accredited hospitals in the United States. We hypothesized that early VATS remains underutilized affecting patient outcomes. ⋯ Despite established practice guidelines supporting early VATS for thoracic trauma management, there is underutilization with less than half of patients undergoing early VATS. Early VATS is associated with improved patient outcomes.
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Sternal fractures (SF) are commonly associated with other injuries and their incidence is on the rise. The aim was to evaluate injury characteristics and outcomes in patients with all types of SF after blunt trauma. ⋯ SF are present in 2.1% of admissions to trauma centers. Geriatric patients account for half of SF patients and have higher mortality. Concomitant fractures of ribs are present in half and vertebrae fractures in one-third of the SF patients. CSF portend higher mortality and pulmonary co-injuries. The high incidence of concomitant rib and vertebra fractures requires additional diagnostic and treatment considerations.
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Eur J Trauma Emerg Surg · Aug 2022
A deep learning-based system capable of detecting pneumothorax via electrocardiogram.
To determine if an electrocardiogram-based artificial intelligence system can identify pneumothorax prior to radiological examination. ⋯ The present AI system may assist the medical system in the early identification of pneumothorax through 12-lead ECG, and it performs as well with lead I ECG alone as with 12-lead ECG.