European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2022
Are the rib fracture score and different computed tomography measures of obesity predictors for mortality in patients with rib fractures? A retrospective cohort study.
There is missing knowledge about the association of obesity and mortality in patients with rib fractures. Since the global measure of obesity (body mass index [BMI]) is often unknown in trauma patients, it would be convenient to use local computed tomography (CT)-based measures (e.g., umbilical outer abdominal fat) as a surrogate. The purpose of this study was to assess (1) whether local measures of obesity and rib fractures are associated with mortality and abdominal injuries and to evaluate (2) the correlation between local and global measures of obesity. ⋯ RFS > 4 was an independent risk factors for increased mortality. Local and global measures of obesity were not associated with mortality, rib fractures or liver injuries. If the BMI is not available in trauma patients, CT-based measures of obesity may be considered as a surrogate.
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Eur J Trauma Emerg Surg · Feb 2022
β1-Blocker improves survival and ventricular remodelling in rats with lethal crush injury.
Crush injury/crush syndrome (CI/CS) is the second most common cause of death during earthquakes. Most studies of CI/CS have mainly focused on kidney injury after decompression. Few studies have focused on myocardial injury caused by crush injury and its potential mechanisms. ⋯ Our findings demonstrated the presence of myocardial injury in the early stage of compression in rats with a crush injury. Pretreatment with a β1-blocker (bisoprolol) with fluid resuscitation significantly reduced mortality, decreased myocardial tissue damage, and improved ventricular remodelling in rats with a lethal crush injury.
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Eur J Trauma Emerg Surg · Feb 2022
Reconstruction of motorcycle spokes wheel injury fingertip amputations with reposition flap technique: a report of 40 cases.
Replantation of the distal fingertip amputation poses a technical challenge to the treating hand surgeon especially dealing with motorcycle spokes wheel injury causing Allen's type III and IV amputation. The reason being the pulp charred and severely crushed. Various reconstructive options have been described in the literature. We analyze the surgical option of repositioning the amputated stump with local pedicle flaps in such injuries and interpreting the results and functional outcome. ⋯ IV.
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Eur J Trauma Emerg Surg · Dec 2021
Meta AnalysisInferior vena cava filters reduce symptomatic but not fatal pulmonary emboli after major trauma: a meta-analysis with trial sequential analysis.
The prophylactic use of inferior vena cava filters among patients with major trauma is researched by several controlled studies with contradicting results. We performed an updated meta-analysis with trial sequential analysis of controlled studies probing the prophylactic use of inferior cava filters on the development of symptomatic and fatal pulmonary embolism (PE) in patients with major trauma. ⋯ The use of inferior vena cava filters curtailed the risk of symptomatic PE, the result further strengthened by trial sequential analysis. However, the present evidence fails to delineate a beneficial role of prophylactic inferior vena cava filter placement in reducing fatal PE among patients with major trauma. The possibility of Type II error cannot be excluded from this estimate.
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Eur J Trauma Emerg Surg · Dec 2021
Outcomes of omental patch repair in large or giant perforated peptic ulcer are comparable to gastrectomy.
Perforated peptic ulcer (PPU) complicates 2 to 10% of patients with peptic ulcer disease and has mortality risk of up to 20%. Omental patch repair is the mainstay of surgical management and gastric resectional procedures are advocated for a large/giant ulcer or suspected malignancy. Emergency gastrectomy is associated with increased morbidity and mortality. The aim of this study is to compare the outcomes of omental patch repair with gastrectomy in patients with large PPU (≥ 20 mm). ⋯ Omental patch repair confers similar perioperative outcomes as compared to gastrectomy in patients with large PPU.