European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Aug 2018
Validation of the Baragwanath mortality prediction score for cerebral gunshot wounds: the Pietermaritzburg experience.
Cerebral gunshot wounds (GSW) are highly lethal injuries. To date, only one clinical scoring system to predict mortality in a developing world setting has been described. This is the Baragwanath mortality prediction score ("ABC": admission blood pressure, brain matter spillage and consciousness level). ⋯ The Baragwanath mortality prediction score accurately predicts non survival of patients with a cerebral GSW in our patient cohort. Further validation studies in other populations are required before this system can be widely adopted.
-
Eur J Trauma Emerg Surg · Aug 2018
Searching for mortality predictors in trauma patients: a challenging task.
We aimed to study the value of new physiological variables compared with ISS and GCS as predictors for trauma mortality in a high-income developing country having a young population. ⋯ The physiological variables including GCS and shock index age were better predictors for trauma mortality comparted with ISS in our young population. A large global multi-centric study could possibly define an accurate global formula that uses both anatomical and physiological variables for predicting trauma mortality.
-
Surgery for hip fractures is frequently followed by complications that hinder the rehabilitation of patients. The aim of this study was to describe the incidence rate and type of complications, including mortality, after hip fracture surgery, and to identify the risk factors of these complications that may be amenable to prevention. ⋯ The overall complication rate after hip fracture surgery was high. Only few complications were potentially preventable.
-
Eur J Trauma Emerg Surg · Aug 2018
Evaluation of acute kidney injury (AKI) with RIFLE, AKIN, CK, and KDIGO in critically ill trauma patients.
The aim of our study was to evaluate the effects of AKI development on mortality with four different classification systems (RIFLE, AKIN, CK, KDIGO) in critically ill trauma patients followed in the intensive care unit. ⋯ In this study, the presence of AKI was found to be an independent risk factor in the development of in-hospital mortality according to all classification systems (RIFLE, AKIN, CK, and KDIGO) in critically traumatic patients followed in ICU, and the compatibility between RIFLE, AKIN, and KDIGO was the highest among the classification systems.
-
Current guidelines state that trauma patients at risk of spine injury should undergo prehospital spine immobilization to reduce the risk of neurological deterioration. Although this approach has been accepted and implemented as a standard for decades, there is little scientific evidence to support it. Furthermore, the potential dangers and sequelae of spine immobilization have been extensively reported. The role of the paramedic in this process has not yet been examined. The aim of this study was to evaluate the accuracy of prehospital evaluations for the presence of spine fractures made by paramedics. ⋯ The results of this study suggest that paramedics cannot accurately predict spinal fractures.