European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2017
Temporal changes in hematologic markers after splenectomy, splenic embolization, and observation for trauma.
The spleen is one of the most commonly injured abdominal solid organs during blunt trauma. Modern management of splenic trauma has evolved to include non-operative therapies, including observation and angioembolization to preclude splenectomy in most cases of blunt splenic injury. Despite the shift in management strategies, relatively little is known about the hematologic changes associated with these various modalities. The aim of this study was to determine if there are significant differences in hematologic characteristics over time based on the treatment modality employed following splenic trauma. We hypothesized that alterations seen in hematologic parameters would vary between observation (OBS), embolization (EMB), and splenectomy (SPL) in the setting of splenic injury. ⋯ This study describes important trends and patterns among fundamental hematologic parameters following traumatic splenic injuries managed with SPL, EMB, or OBS. As expected, observed WBC counts were highest following SPL, then EMB, and finally OBS. No differences were noted in RBC count between the three groups, but RDW was significantly greater following SPL compared to EMB and OBS. We also found that MCV was highest following OBS, when compared to EMB or SPL. Finally, our data indicate that platelet counts are similarly elevated for both SPL and EMB, when compared to the OBS group. These results provide an important foundation for further research in this still relatively unexplored area.
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Eur J Trauma Emerg Surg · Jun 2017
The survival impact of plasma to red blood cell ratio in massively transfused non-trauma patients.
High ratios of Plasma to Packed Red Blood Cells (FFP:PRBC) improve survival in massively transfused trauma patients. We hypothesized that non-trauma patients also benefit from this transfusion strategy. ⋯ In non-trauma patients undergoing massive transfusion, increasing FFP:PRBC ratio was associated with improved survival. A ratio >1:3 significantly improved survival probability.
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Eur J Trauma Emerg Surg · Jun 2017
Severe intimate partner violence affecting both young and elderly patients of both sexes.
Intimate partner violence (IPV) affects 25-35 % of women and men in Western countries. Despite the high prevalence of IPV among trauma patients, very little is known about the associated injuries. Most previous studies excluded male victims and IPV is often limited to violence against women. Few reports on IPV among elderly patients exist. ⋯ IPV leads to severe injury across all age groups among both male and female patients. The injury mechanism should be clearly defined for all trauma patients, keeping IPV in mind as a potential cause despite patient age or gender.
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Eur J Trauma Emerg Surg · Jun 2017
The ability of emergency physicians to diagnose and score acute pancreatitis on computed tomography.
The aim of this study is to determine the ability of emergency physicians' (EP) interpreting contrast-enhanced computed tomographies (CECTs) performed in patients diagnosed or suspected acute pancreatitis (AP), using the modified computed tomography severity index (MCTSI) scoring system. ⋯ EPs can diagnose the AP on CECTs and score CECTs with MCTSI scoring system correctly.
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Eur J Trauma Emerg Surg · Jun 2017
Observational StudysTREM-1, sIL-2Rα, and IL-6, but not sCD163, might predict sepsis in polytrauma patients: a prospective cohort study.
To investigate whether sTREM-1, sIL-2Rα, sCD163, and IL-6 predict septic complications following polytrauma. Prospective observational study in a university hospital intensive care unit. ⋯ Level II-Diagnostic tests and criteria.