European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Oct 2023
Comparison of the prognostic validity of three simplified consciousness assessment scales with the Glasgow Coma Scale.
Various tools simpler than the Glasgow Coma Scale (GCS) have been proposed for the assessment of consciousness. In this study, the validity of three coma scales [Simplified Motor Scale, Modified GCS Motor Response, and AVPU (alert, verbal, painful, unresponsive)] is evaluated for the recognition of coma and the prediction of short- and long-term mortality and poor outcome. The predictive validity of these scales is also compared to the GCS. ⋯ The simplified scales showed inferior validity than the GCS. Their potential role in clinical practice needs further investigation. Thus, the replacement of the GCS as the main scale for consciousness assessment cannot be currently supported.
-
Eur J Trauma Emerg Surg · Oct 2023
The Blunt Liver and Spleen Trauma (BLAST) audit: national survey and prospective audit of children with blunt liver and spleen trauma in major trauma centres.
To compare the reported and observed management of UK children with blunt liver or spleen injury (BLSI) to the American Pediatric Surgical Association (APSA) 2019 BLSI guidance. ⋯ UK management of BLSI differs from many aspects of APSA guidance. A shift towards using clinical features to determine ICU admission and readiness for discharge is demonstrated, in line with a strong evidence base. However, routine bed rest and re-imaging after BLSI is common, contrary to APSA guidance. This disparity may exist due to concern that evidence around the incidence, presentation and natural history of complications after conservatively managed BLSI, particularly bleeding from pseudoaneurysms, is weak.
-
Eur J Trauma Emerg Surg · Oct 2023
The effect of dobutamine treatment on salvage of digital replantation and revascularization.
One of the most common causes of a failure after replantation and revascularization surgeries is 'no reflow' from proximal artery that occurs, especially following crush and avulsion injuries. In this study, we aimed to evaluate the effect of dobutamine treatment on salvage of replanted and revascularized digits. ⋯ It was demonstrated that dobutamine infusion at a rate of 4 µg·kg-1·min-1 intraoperatively and at 2 µg·kg-1·min-1 postoperatively has favorable effects on the vascular compromise derived from no reflow of proximal artery.
-
Eur J Trauma Emerg Surg · Oct 2023
Observational StudyHypoalbuminemia: incidence and its impact on acute respiratory distress syndrome and 28-day outcome in trauma patients.
This prospective observational study explored the effect of early onset hypoalbuminemia (EOH) on the development of adult respiratory distress syndrome (ARDS) in orthopedic trauma victims. ⋯ EOH is a frequent occurrence and has a strong influence development of ARDS and 28-day mortality in trauma patients.
-
Eur J Trauma Emerg Surg · Aug 2023
ReviewThe Australian Trauma Registry (ATR): a leading clinical quality registry.
Operating since 2012 under the auspices of the Australian Trauma Quality Improvement Program (AusTQIP), the Australian Trauma Registry (ATR) has established itself as a leading clinical quality registry (CQR). Initially developed as a national program for improved safety and quality trauma care across Australian trauma centers, it has since expanded to include New Zealand, becoming one of the few bi-national trauma registries. ⋯ The ATR, administered by the National Trauma Research Institute (NTRI), monitors the continuum of trauma care from pre-hospital settings, to discharge from definitive care. Collection and analysis of data about severely injured trauma patients, their injuries, management and outcomes, aims to inform future improvements to health service provision and reduce preventable morbidity and mortality.