European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jul 2024
Prognosis of major trauma in patients older than 85 years admitted to the ICU, a registry-based study.
The aging population in France and Western Europe is on the rise, particularly among individuals aged 65 years and older. Although older adults are susceptible to traumatic injuries, they constitute a minority of trauma center admissions especially those aged 85 and above. The aim of our study was to investigate the prognostic factors for mortality among the older old population (aged 85 years and above) managed in ICU of Traumabase group trauma centers. ⋯ Factors such as traumatic brain injury and severe hemorrhage (micromethod hemoglobin < 13) and ISS > 16 are associated with ICU mortality in in patients older than 85 years trauma patient. Early geriatric intervention is crucial for optimizing outcomes in this vulnerable population.
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Eur J Trauma Emerg Surg · Jul 2024
Penetrating trauma on the rise- nine-year trends of severe trauma in Sweden.
Sweden has an established trauma system involving national trauma criteria and the Swedish trauma registry (SweTrau), since over a decade. Meanwhile, the injury panorama has evolved, with an increase in gang-related violence in the Swedish community. In this study, we aimed to investigate long-term trends in mortality, management and trauma type in two major Swedish trauma centers over a nine-year period. ⋯ In this trend analysis at two major Swedish trauma centers during 2013-2021, penetrating trauma increased with over 50% while traffic injuries decreased. The rise in mortality in patients with a TA and NISS < 15 is concerning and requires further evaluation, as do the reduction in ICU admissions.
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Eur J Trauma Emerg Surg · Jul 2024
Seasonal patterns of hip fracture incidence and mortality rates across age groups of older adults in Israel.
This study investigates the seasonal patterns of hip fracture occurrence and mortality rates in the elderly population of Israel. ⋯ While our study highlights significant seasonal variations in hip fracture occurrence and mortality rates among the elderly population in Israel, caution is warranted in interpreting the implications for post-fracture care and resource allocation. The observed heightened incidence of hip fractures during the spring, particularly among younger patients with shorter hospital stays, suggests the need for further investigation into potential risk factors and preventive measures specific to this season. Additionally, our identification of seasonal variations in hip fracture incidence across demographic factors underscores the importance of tailored interventions to address the diverse needs of different populations.
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Eur J Trauma Emerg Surg · Jul 2024
Trauma-related preventable death; data analysis and panel review at a level 1 trauma centre in Amsterdam, the Netherlands.
Trauma-related death is used as a parameter to evaluate the quality of trauma care and identify cases in which mortality could have been prevented under optimal trauma care conditions. The aim of this study was to identify trauma-related preventable death (TRPD) within our institute by an external expert panel and to evaluate inter-panel reliability. ⋯ Multidisciplinary panel review has a moderate inter-observer agreement regarding survivability and low agreement regarding categorical preventable death classification. A valid definition and classification of TRPD is required to improve inter-observer agreement and quality of trauma care.
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Eur J Trauma Emerg Surg · Jul 2024
Assessing outcomes in traumatic brain injury: Helsinki score versus Glasgow coma scale.
The precision of assessment and prognosis in traumatic brain injury (TBI) is paramount for effective triage and informed therapeutic strategies. While the Glasgow Coma Scale (GCS) remains the cornerstone for TBI evaluation, it overlooks critical primary imaging findings. The Helsinki Score (HS), a novel tool designed to incorporate radiological data, offers a promising approach to predicting TBI outcomes. This study aims to evaluate the prognostic efficacy of HS in comparison to GCS across a substantial TBI patient cohort. ⋯ The findings validate the HS in a large German cohort and suggest that radiological assessments alone, as exemplified by HS, can surpass the traditional GCS in predicting TBI outcomes. However, the HS, despite its efficacy, lacks the integration of clinical evaluation, a vital component in TBI management. This underscores the necessity for a holistic approach that amalgamates both radiological and clinical insights for a more comprehensive and accurate prognostication in TBI care.