European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Oct 2021
A proposed amendment to the current guidelines for mild traumatic brain injury: reducing computerized tomographies while maintaining safety.
Head trauma is a common complaint in emergency departments. Identifying patients with serious injuries can be difficult and generates many computerized tomographies. Reducing the number of computerized tomographies decreases both cost and radiation exposure. The aim of this study was to evaluate whether the current Scandinavian Neurotrauma Committee guidelines could be revised in such a way that would enable hospitals to perform fewer computerized tomographies while maintaining the ability to identify all patients requiring neurological intervention. ⋯ For patients with mild and moderate traumatic brain injuries, application of the Scandinavian Neurotrauma Committee guidelines amended with the low-risk proposal may result in a significant reduction of computerized tomographies without missing any patients in need of neurological intervention.
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Eur J Trauma Emerg Surg · Oct 2021
Obesity associated with increased postoperative pulmonary complications and mortality after trauma laparotomy.
Patient-related risk factors for the development of postoperative pulmonary complications (PPCs) include age ≥ 60-years, congestive heart failure, hypoalbuminemia and smoking. The effect of obesity is unclear and has not been shown to independently increase the likelihood of PPCs in trauma patients undergoing trauma laparotomy. We hypothesized the likelihood of mortality and PPCs would increase as body mass index (BMI) increases in trauma patients undergoing trauma laparotomy. ⋯ Obese trauma patients undergoing emergent trauma laparotomy have a high likelihood for both PPCs and mortality, with morbidly obese trauma patients having the highest likelihood for both. This suggests obesity should be accounted for in risk prediction models of trauma patients undergoing laparotomy.
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Eur J Trauma Emerg Surg · Oct 2021
Mortality and functional outcome after surgical evacuation of traumatic acute subdural hematomas in octa- and nonagenarians.
The incidence of acute subdural hematomas (aSDH) is rising. However, beneficial effects of surgery for the oldest aSDH patients remain unclear. We hence describe the postoperative outcome of octa- and nonagenarians with aSDH in comparison to a younger patient cohort. ⋯ Outcome after surgical treatment of aSDH in octa- and nonagenarians is not detrimental per se. Predictors for a favorable outcome are a non-comatose state on admission (GCS > 8), ≤ 1 preexisting comorbidity and a lower aSDH volume in patients aged ≥ 80 years. In individual patients, surgical evacuation of aSDH might remain a treatment option even in high ages.
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Eur J Trauma Emerg Surg · Oct 2021
Severe head injury in elderly: 6-year comparison of treatment and outcome between southern Finland and Navarra (Spain).
To compare the profile, treatment and outcome of elderly patients with severe traumatic brain injuries (TBI) between southern Finland and Navarra (Spain). ⋯ The better adjusted outcome of elderly patients with severe TBI in southern Finland in comparison to Navarra could be due to higher rate of pre-hospital intubation and/or higher rate of ICU admissions in southern Finland. Increasing number of elderly patients with severe TBI necessitate uniformly accepted protocols in pre- and in-hospital management.
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Eur J Trauma Emerg Surg · Oct 2021
Impact on polytrauma patient prehospital care during the first wave of the COVID-19 pandemic: a cross-sectional study.
The extraordinary situation caused by the onset of COVID-19 has meant that at prehospital level, the number of treatments, profile and time taken to respond for treating time-dependent pathologies has been greatly affected. However, it is not known whether the prehospital profile of polytrauma patients (PTP) has been affected. ⋯ During the first wave of the pandemic, the number of polytrauma patients decreased and there was a change in the profile of severity and type of accident.