Articles: traumatic-brain-injuries.
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Our study aimed to evaluate whether prehospital endotracheal intubation (ETI) affects the mortality of individuals who sustain traumatic brain injury (TBI) compared with bag-valve mask (BVM) ventilation, as well as to test the interaction effect of ETI on study outcome according to carbon dioxide level. ⋯ Among individuals who experienced severe TBI, prehospital intubation did not have a significant effect on survival outcomes and good functional recovery. Patients exhibiting hypocarbia measured on hospital arrival demonstrated lower survival outcomes in the interaction analysis.
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Recent studies have suggested that skeletal muscle area (SMA) and psoas muscle area (PMA), markers for sarcopenia, are associated with the prognosis of many diseases. However, it remains unclear which of the two is a superior prognostic marker. Thus, the objective of this study was to analyse these markers in patients with traumatic brain injury (TBI). ⋯ Less amount of psoas muscle (PM) was found to be a significant risk factor for the prognosis of patients with TBI. PM was a better prognostic marker than skeletal muscle (SM) in patients with TBI. Further studies are needed to increase our understanding of sarcopenia and TBI.
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Trauma is the leading cause of death especially in children and young adults. Prehospital care following trauma emphasizes swift transport to a hospital following initial care. Previous studies have shown conflicting results regarding the effect of time on the survival following major trauma. In our study we investigated the effect of prehospital time-intervals on 30-day mortality on trauma patients that received prehospital critical care. ⋯ prognostic/therapeutic/diagnostic test.
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Invasive neuromonitoring is a mainstay of modern management of severe traumatic brain injury (TBI). Complication rates of neuromonitor placement are widely reported, but their effects on long-term outcomes are less studied. We evaluated the association of neuromonitor complications on long-term outcomes in a prospective severe TBI cohort. ⋯ Complications of neuromonitoring in severe TBI are associated with delayed recovery but not long-term outcomes.
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Computerized tomography (CT) imaging is a standard part of traumatic brain injury (TBI) evaluation but not all patients require it after mild head injury. Given the increasing incidence of TBI in the United States, there is an urgent need to better characterize CT head imaging utilization in evaluating trauma patients, especially patients at low risk of requiring intervention, such as those presenting with a normal GCS. ⋯ Few patients had moderate/severe head injury when presenting with a GCS 15. However, patients ≥ 50 years, men, and those who suffered falls were at higher risk. Anti-coagulation use was not associated with moderate/severe head injury but did increase the risk of procedural TBI management. Given the cost and associated radiation, reducing CT utilization for younger patients while using a more liberal head CT strategy for high-risk patients may provide substantial patient value.