European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2021
Evaluating tourniquet use in Swedish prehospital care for civilian extremity trauma.
The use of tourniquet (TQ) is today a well-documented and lifesaving adjunct to control bleeding from extremity trauma in the military setting. Since August 2015, the ambulance services in Stockholm, Sweden are equipped with TQs. The implementation and potential complications related to TQ use have so far not been evaluated. The primary aim of this study was to evaluate the prehospital use of TQ for haemorrhage control in extremity trauma. Possible complications following the use of TQ were analysed. ⋯ This study shows TQs to be an effective but overused tool in haemorrhage control. The use of TQ was not associated with any severe complications, implying the safety and effectiveness of the device in the civilian setting if TQ time is kept under 100 min.
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Eur J Trauma Emerg Surg · Dec 2021
ReviewNeck of femur fracture: who gets a total hip replacement? A review of 230 eligible patients.
To investigate patient-specific factors that predict Total Hip Replacement (THR) in patients with fracture neck of femur (NOF), fulfilling the National Institute of Health and Care Excellence (NICE) criteria. ⋯ NHFS and walking ability can be used as an adjunct to the NICE criteria for selecting patients for THR after fracture NOF. Carefully selected patients treated with THR survive longer and have a better outcome in comparison to HA.
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Eur J Trauma Emerg Surg · Dec 2021
Short-term outcome following significant trauma: increasing age per se has only a relatively low impact.
Ongoing demographic changes go hand in hand with an increasing number of elderly injured. Given the conflicting literature we wanted to know how much age per se, apart from other factors, actually explains the outcome for elderly trauma patients. ⋯ This monocenter evaluation showed a significant decline in short-term outcome and an increase in hospital resource requirements by the trauma patients investigated after the age of 60 years. Even so, after controlling for demographic, injury and treatment variables, age per se only added less than 2% to the prediction of hospital mortality.
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Eur J Trauma Emerg Surg · Dec 2021
Safety and efficacy of 2D-fluoroscopy-based iliosacral screw osteosynthesis: results of a retrospective monocentric study.
Iliosacral screw osteosynthesis is a well-accepted procedure for stabilization of sacral fractures and iliosacral (fracture) dislocations. ⋯ A thorough preoperative evaluation of the morphology of the upper sacrum and careful operative procedure are indispensable. Fluoroscopic views in AP, lateral, inlet and outlet must allow recognition of all anatomical landmarks. The indication for double screw osteosynthesis in S1 should be taken with caution. Screw malalignments do not inevitably correlate with complaints.
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Eur J Trauma Emerg Surg · Dec 2021
Trauma patients eligible for resuscitative endovascular balloon occlusion of the aorta (REBOA), a retrospective cohort study.
Non-compressible torso hemorrhage is a major but potentially preventable cause of trauma-related mortality. REBOA has rapidly emerged as an adjunct for hemorrhage control. However, little is known about the proportion of trauma patients in which REBOA may be indicated. The aim of our study was to determine this proportion. ⋯ The study suggests a potential indication for REBOA (incidence) of 2.5 per one million inhabitants per year according to the used criteria. Local REBOA guidelines may vary but a significant number of trauma centers use similar criteria. Although the total mortality within this group is high, the number of patients that theoretically may benefit from the use of REBOA is low.