European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2020
Review Meta AnalysisA meta-analysis on anticoagulation after vascular trauma.
There is much debate regarding the use of anticoagulation following vascular trauma. The aim of this meta-analysis was to compare the outcome of trauma following administration of anticoagulation medication. ⋯ There was a statistically significant correlation between the use of anticoagulation and vascular trauma outcome. A major limitation with many of the studies includes a lack of prospective analysis and therefore we recommend prospective studies to properly elucidate prognostic outcomes following use of these anticoagulants. Further studies need to be conducted to assess the effects of timing of anticoagulant delivery, dosages and severity of traumatic injury. Thus, this would prove to be very useful in the formation of guidelines.
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Eur J Trauma Emerg Surg · Oct 2020
Review Meta AnalysisImmune capacity determines outcome following surgery or trauma: a systematic review and meta-analysis.
Immunological functions are altered following physical injury. The magnitude of the immunological response is dependent on the initial injury. However, variability in the immune response exists within and between patients where only some patients are at risk of developing complications such as systemic inflammatory response syndrome after injury. This systematic review and meta-analysis assessed whether lipopolysaccharide (LPS) induced cytokine production capacity of leucocytes can be used as a functional test to predict the risk of developing complications after injury. ⋯ The associations of elevated LPS-induced cytokine production capacity with the risk of developing inflammatory complications are consistent with previous theories that proposed excessive inflammation is accompanied by anti-inflammatory mechanisms that results in a period of immunosuppression and increased risk of secondary complications. However, immunological biomarkers for risk stratification is still a developing field of research where further investigations and validations are required.
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Eur J Trauma Emerg Surg · Aug 2020
Review Meta AnalysisRisk factors for fracture redisplacement after reduction and cast immobilization of displaced distal radius fractures in children: a meta-analysis.
Displaced distal radius fractures in children are common and often reduced if necessary and immobilized in cast. Still, fracture redisplacement frequently occurs. This can be prevented by fixation of fracture fragments with K-wires, but until now, there are no clear guidelines for treatment with primary K-wire fixation. This meta-analysis aimed to identify risk factors for redisplacement after reduction and cast immobilization of displaced distal radius fractures in children, and thereby determine which children will benefit most of primary additional K-wire fixation. ⋯ For children with a displaced distal radius fracture, the presence of a both-bone fracture, complete displacement of the distal radius and non-anatomical reduction are risk factors for redisplacement after reduction of their initially displaced distal radius fracture. Children with one or more of these risk factors probably benefit most of reduction combined with primary K-wire fixation.
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Eur J Trauma Emerg Surg · Apr 2020
Review Meta AnalysisTiming to perform VATS for traumatic-retained hemothorax (a systematic review and meta-analysis).
In this systematic review, we analyzed the optimal time range to evacuate traumatic-retained hemothorax using video-assisted thoracoscopic surgery (VATS). ⋯ Our results indicate that VATS should be considered within the first three days of admission if this intervention is the clinician's choice to evacuate a traumatic-retained hemothorax. Protocol registration number in PROSPERO: CRD42017046856.
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Eur J Trauma Emerg Surg · Feb 2020
Review Meta AnalysisAnkle ultrasound for detecting anterior talofibular ligament tear using operative finding as reference standard: a systematic review and meta-analysis.
To evaluate the diagnostic accuracy of ankle ultrasound for detection of anterior talofibular ligament (ATFL) tear with a reference standard of operative finding. ⋯ Ankle ultrasound may be a useful diagnostic modality in the detection of ATFL tear in adults and children, regardless of injury stage and severity. For correct diagnosis of ATFL tear, a high-frequency ultrasound probe and sufficient experience of the examiner are mandatory.