European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2023
Is hospital volume related to quality of hip fracture care? Analysis of 43,538 patients and 68 hospitals from the Dutch Hip Fracture Audit.
Evidence for a hospital volume-outcome relationship in hip fracture surgery is inconclusive. This study aimed to analyze the association between hospital volume as a continuous parameter and several processes and outcomes of hip fracture care. ⋯ This is the first study analyzing the effect of hospital volume on hip fracture care, treating volume as a continuous parameter. Mortality and turnaround times showed no clinically relevant association with hospital volume. The provision of orthogeriatric co-treatment, however, increased with increasing volumes up to 367 patients per year, but decreased above this threshold. Future research on the effect of volume on complications and functional outcomes is indicated.
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Eur J Trauma Emerg Surg · Jun 2023
Computed tomographic bone mineral density is independently associated with adverse in-hospital outcomes in Dutch level-1 trauma patients.
Aging, inactivity, and malnutrition are risk factors for adverse in-hospital outcomes and can manifest in bone loss. Use of bone mineral density (BMD) as an objective marker might improve early identification of patients at risk for complications. ⋯ Bone mineral density of the first lumbar vertebra is independently associated with in-hospital complications, pneumonia, delirium, and ICU admission. These findings could help identify patients at risk early.
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Eur J Trauma Emerg Surg · Jun 2023
Epidemiology and outcomes of pregnant trauma patients in Japan: a nationwide descriptive study.
Trauma during pregnancy is the leading indirect obstetric cause of death, and its management is challenging owing to its characteristics. We aimed to describe the epidemiology of pregnant trauma patients and explore their characteristics by comparing them with those of non-pregnant patients. ⋯ Transport time and mortality were similar between pregnant and non-pregnant trauma patients. Abdominal trauma and surgery were more common in pregnant relative to non-pregnant patients, while the number of CT scans was less. Further research is required to investigate the effects of trauma on the course of pregnancy and the fetus.
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Eur J Trauma Emerg Surg · Jun 2023
Cardiovascular parameters on computed tomography are independently associated with in-hospital complications and outcomes in level-1 trauma patients.
In-hospital complications after trauma may result in prolonged stays, higher costs, and adverse functional outcomes. Among reported risk factors for complications are pre-existing cardiopulmonary comorbidities. Objective and quick evaluation of cardiovascular risk would be beneficial for risk assessment in trauma patients. Studies in non-trauma patients suggested an independent association between cardiovascular abnormalities visible on routine computed tomography (CT) imaging and outcomes. However, whether this applies to trauma patients is unknown. ⋯ Coronary artery calcification, visible on routine CT imaging, is independently associated with in-hospital complications and an adverse discharge condition in level-1 trauma patients. The findings of this study may help to identify trauma patients quickly and objectively at risk for complications in an early stage without performing additional diagnostics or interventions.