European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2024
ReviewParameters influencing health-related quality of life after severe trauma: a systematic review (part II).
It is increasingly recognized that health-related quality of life (HRQoL) is a relevant outcome to study in populations comprising severely injured patients. Although some studies have readily demonstrated a compromised HRQoL in those patients, evidence regarding factors that predict HRQoL is scarce. This hinders attempts to prepare patient-specific plans that may aid in revalidation and improved life satisfaction. In this review, we present identified predictors of HRQoL in patients that have suffered severe trauma. ⋯ Age, gender, injured body region, and severity of injury were found to be good predictors of health-related quality of life in severely injured patients. A patient-centered approach, based on individual, demographic, and disease-specific predictors, is highly recommended.
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Eur J Trauma Emerg Surg · Feb 2024
ReviewDiverticulitis, surgery, evidence-based medicine, and the Steve Jobs' dots: a narrative review.
Emergency treatment of acute diverticulitis remains a hazy field. Despite a number of clinical studies, randomized controlled trials (RCTs), guidelines and surgical societies recommendations, the most critical hot topics have yet to be addressed. ⋯ Not only evidence-based medicine but also the contextualization, as also the role of 'competent' surgeons, should guide to novel approach in acute diverticulitis management.
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Eur J Trauma Emerg Surg · Feb 2024
Multicenter StudyMonolateral external fixation versus internal fixation of Gustilo IIIB open tibial fractures: a multicenter comparative study.
Gustilo IIIB open tibial fractures are associated with significant risks of complications particularly nonunion and fracture-related infections (FRI) due to the severity of the injuries. The commonly adopted viewpoint is that a Gustilo IIIB open tibial fracture is a relative contraindication for internal fixation. However, this study aims to assess the veracity of this viewpoint. The objective of this study was to evaluate the impact of the definitive fixation technique on fracture nonunion and FRI rates in Gustilo IIIB open tibial fractures. In this study, we compared the rates of nonunion and FRI rates in grade IIIB open tibial fractures managed definitively with either mono-lateral external fixation or internal fixation. ⋯ Our findings suggest that mono-lateral external fixation and internal fixation do not differ significantly with respect to rates of nonunion and fracture-related infections in Gustilo IIIB open tibial fractures.
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Eur J Trauma Emerg Surg · Feb 2024
Pre-hospital tranexamic acid administration in patients with a severe hemorrhage: an evaluation after the implementation of tranexamic acid administration in the Dutch pre-hospital protocol.
To evaluate the pre-hospital administration of tranexamic acid in ambulance-treated trauma patients with a severe hemorrhage after the implementation of tranexamic acid administration in the Dutch pre-hospital protocol. ⋯ Approximately a quarter of the patients with a severe hemorrhage received tranexamic acid before arriving at the hospital, while a severe hemorrhage was suspected in more than half of the non-treated patients. Severely hemorrhaging patients treated with tranexamic acid before arrival at the hospital had a lower risk to die within 24 h after injury.
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Eur J Trauma Emerg Surg · Feb 2024
Short and long-term readmission after major emergency abdominal surgery: a prospective Danish study.
Major emergency abdominal surgery is associated with severe in-hospital complications and loss of performance. After discharge, a substantial fraction of patients are readmitted emergently; however, limited knowledge exists of the long-term consequences. The aim of this study was to examine the risks and causes of short-term (30-day) and long-term (180-day) readmission among patients undergoing major emergency abdominal surgery. ⋯ Close to 50% of all patients who underwent major emergency abdominal surgery had one or more emergency readmission within 180 days of discharge, and these data points towards the risk factors involved.