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"Trauma" AND "Mechanism Of Injury"

Lisette Dekker, Hansje M Heller, Jessica E van der Meij, Annelies E J Toor, Leo M G Geeraedts
BACKGROUND: A medical-psychiatric unit (MPU) is a special ward where staff is trained in caring for patients with psychiatric or behavioural problems that need hospitalisation for physical health problems. It is well known that these patients are at higher risk of complications and have a longer length of stay resulting in higher costs than patients without psychiatric comorbidity. The objective of this study was to analyse the trauma patient population of the first 10 years of existence of the MPU in a level I trauma center...
February 15, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Avi Benov, Irena Shkolnik, Elon Glassberg, Roy Nadler, Sami Gendler, Ben Antebi, Jacob Chen, Noam Fink, Tarif Bader
BACKGROUND: The Israeli Defense Force Medical Corps (IDF-MC) is routinely collecting pre-hospital data to establish a pre-hospital registry. Since February 2013, Israel has been providing medical care to Syrian refugees. This unique humanitarian aid begins in pre-hospital settings and typically culminates in Israeli civilian hospitals. This report describes the accumulated experience of the IDF-MC to provide Syrian refugees with prehospital treatment. METHODS: Care provided by IDF-MC medical teams, including pre-hospital casualty care, is regularly documented and after-action reports are conducted...
February 13, 2019: Journal of Trauma and Acute Care Surgery
Eric Rosenfeld, Patricio Lau, Wei Zhang, Robert T Russell, Sohail R Shah, Bindi Naik-Mathuria, Adam M Vogel
PURPOSE: The purpose of this study was to identify an optimal definition of massive transfusion (MT) in civilian pediatric trauma. METHODS: Severely injured children (age ≤18 years, injury severity score ≥25) in the Trauma Quality Improvement Program research datasets 2014-2015 that received blood products were identified. Children with traumatic brain injury and non-survivable injuries were excluded. Early mortality was defined as death within 24 h and delayed mortality as death after 24 h from hospital admission...
January 31, 2019: Journal of Pediatric Surgery
M Pape, G F Giannakópoulos, W P Zuidema, E S M de Lange-Klerk, E J Toor, M J R Edwards, M H J Verhofstad, T N Tromp, E M M van Lieshout, F W Bloemers, L M G Geeraedts
INTRODUCTION: Little evidence suggest that female gender is associated with a lower risk of mortality in severely injured patients, especially in premenopausal women. Previous clinical studies have shown contradictory results regarding protective effects of gender on outcome after severe trauma. The objective of this study was to determine the association between gender and outcome (mortality and Intensive Care Unit (ICU) admission) among severely injured patients in the Netherlands. METHODS: A retrospective multicentre study was performed including all polytrauma patients (Injury Severity Score (ISS) ≥16) admitted to the ED of three level 1 trauma centres, between January 1st, 2006 and December 31st, 2014...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Frank V Bensch, Elina A Varjonen, Tuomo T Pyhältö, Seppo K Koskinen
PURPOSE: BCVI may lead to ischemic stroke, disability, and death, while being often initially clinically silent. Screening criteria for BCVI based on clinical findings and trauma mechanism have improved detection, with Denver criteria being most common. Up to 30% of patients do not meet BCVI screening criteria. The aim of this study was to analyze the effect of augmented Denver criteria on detection, and to determine the relative risk for ischemic stroke. METHODS: Denver screening criteria were augmented by any high-energy trauma of the cervical spine, thorax, abdomen, or pelvis...
February 12, 2019: Emergency Radiology
Pablo Carnero-Martín de Soto, David Bautista-Enrique, Abel Gómez-Cáceres, Alfredo Rodríguez-León, María José Bravo-Zurita, María Teresa Santos-Maraver
Avulsion fractures of the posterior calcaneal tuberosity are rare injuries, and little is known about the underlying factors, outcomes, and prognosis. Furthermore, classifications described previously focus on fracture morphology, with uncertain clinical utility. We present the results of a retrospective study of 21 patients treated for this pathology from January 2002 to December 2015. Features analyzed were age; sex; mechanism of injury; medical comorbidities; type of fracture, as proposed by Beavis; fracture displacement; fragment size; type of treatment; complications; need for secondary surgery; and the American Orthopaedic Foot and Ankle Society score after treatment and follow-up care...
February 8, 2019: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Sorena Keihani, Douglas M Rogers, Bryn E Putbrese, Rachel A Moses, Chong Zhang, Angela P Presson, James M Hotaling, Raminder Nirula, Xian Luo-Owen, Kaushik Mukherjee, Bradley J Morris, Sarah Majercik, Joshua Piotrowski, Christopher M Dodgion, Ian Schwartz, Sean P Elliott, Erik S DeSoucy, Scott Zakaluzny, Brenton G Sherwood, Bradley A Erickson, Nima Baradaran, Benjamin N Breyer, Brian P Smith, Barbara U Okafor, Reza Askari, Brandi Miller, Richard A Santucci, Matthew M Carrick, Jurek F Kocik, Timothy Hewitt, Frank N Burks, Marta E Heilbrun, Jeremy B Myers
BACKGROUND: The management of high-grade renal trauma (HGRT) and the indications for intervention are not well-defined. The American Association for the Surgery of Trauma (AAST) renal grading does not incorporate some important clinical and radiologic variables associated with increased risk of interventions. We aimed to use data from a multi-institutional contemporary cohort to develop a nomogram predicting risk of interventions for bleeding after HGRT. METHODS: From 2014 to 2017, data on adult HGRT (AAST grades III-V) were collected from 14 Level-1 trauma centers...
February 7, 2019: Journal of Trauma and Acute Care Surgery
Gökhan Torun, Vahide Aslihan Durak
INTRODUCTION: Posttraumatic injuries are among the most frequent reasons of admission to emergency room services (ERs). In the first assessment of the cases, ATLS protocols recommends use of triage decision scheme consisting of parametres of abnormal physiologic findings, anatomic injury site, pathogenic mechanism of injury, concomitant diseases and conditions, and activation of trauma teams in line with these criteria. The aim of this study is to evaluate TEWS(Triage Early Warning Score) as a marker for predicting mortality in trauma patients who presented to Emergency Services...
February 4, 2019: Annali Italiani di Chirurgia
Sami AlEissa, Suhail Saad AlAssiri, Rayed Meshal AlJehani, Faisal Mohammedsaleh Konbaz, Mohammed Jassim AlSalman, Majed Abaalkhail, Mohammed Hassan AlShehri, Ibrahim Alfaris, Suliman Abdulah Alghnam
BACKGROUND: A traumatic spinal fracture (TSF) is a serious condition that has a tremendous impact on patients and their families. Understanding the causes and patterns of TSF is critical in developing prevention programs. OBJECTIVES: Identify causes and patterns of TSF and explore predictors of neurological disability in Saudi Arabia. DESIGN: A retrospective medical record review. SETTING: Level 1 trauma center in Riyadh...
January 2019: Annals of Saudi Medicine
Nandish G Shah, Abhishek Keraliya, Diego B Nunez, Andrew Schoenfeld, Mitchel B Harris, Christopher M Bono, Bharti Khurana
The biomechanical stability of the spine is altered in patients with a rigid spine, rendering it vulnerable to fracture even from relatively minor impact. The rigid spine entities are ankylosing spondylitis (AS), diffuse idiopathic skeletal hyperostosis, degenerative spondylosis, and a surgically fused spine. The most common mechanism of injury resulting in fracture is hyperextension, which often leads to unstable injury in patients with a rigid spine per the recent AOSpine classification system. Due to the increased risk of spinal fractures in this population, performing a spine CT is the first step when a patient with a rigid spine presents with new back pain or suspected spinal trauma...
February 1, 2019: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Margaret M Mansbridge, James Ryan, David C Hill, Martin Wullschleger
BACKGROUND: Limited data Exists ? on the Australian epidemiology of renal trauma, with very few studies published in the literature. The authors aim to detail the trends of renal trauma in the coastal city of the Gold Coast. METHODS: Retrospective data collection yielded 81 patients who sustained renal trauma from our 3-year period. Data included information on demographics, mechanism, American Association for the Surgery of Trauma (AAST) grade, presence of haematuria, associated injuries, management, and complications...
January 30, 2019: ANZ Journal of Surgery
Pol Maria Rommens, Daniel Wagner, Alexander Hofmann
Fragility fractures of the pelvis are occurring with increasing frequency. These fractures, occurring in the geriatric patient population, are low-energy injuries and are dissimilar in many ways from those caused by high-energy trauma. For example, the mechanism of injury is different and emergency treatment is usually not necessary. Having diminished bone strength, fragility fracture lines follow areas of low bone mineral density and loss of pelvic stability may increase over time. Based on our clinical experience, we propose a comprehensive classification of pelvic fragility fractures separate from the existing pelvic ring injury classification to provide a framework for distinguishing the different fragility fracture types and their recommended treatment...
February 2019: Journal of Orthopaedic Trauma
Megan Cox, Timothy Becker, Mpapho Motsumi
This study aims to present and discuss acute Head Injury (HI) presentations including etiology, referral patterns and disposition in patients presenting to a major referral hospital in Gaborone, Botswana. Cross-sectional, retrospective data collection from July 2015 through September 2015 extracted descriptions of patient demographics, mechanism of injury, comorbidities, diagnosis and disposition from Emergency Centre (EC) records. 360 HI patients presented in three months, averaging four per day and increasing on weekends and end of the month...
October 1, 2018: Journal of Public Health in Africa
Robert J Vandewalle, Shawn J Barker, Jodi L Raymond, Brandon P Brown, Thomas M Rouse
OBJECTIVES: Injuries associated with bicycles can generally be categorized into 2 types: injuries from falling from/off bicycles and injuries from striking the bicycle. In the second mechanism category, most occur as a result of children striking their body against the bicycle handlebar. The purpose of this study was to evaluate the presentation, body location, injury severity, and need for intervention for pediatric handlebar injuries at a single level one pediatric trauma center and contrast these against other bicycle-related injuries in children...
January 21, 2019: Pediatric Emergency Care
Susan E Smith, Susan E Hamblin, Bradley M Dennis
INTRODUCTION: The appropriate level of sedation in patients with an open abdomen following damage control laparotomy (DCL) is debated. Chemical paralysis with neuromuscular blocking agents (NMBA) has been used to decrease time to abdominal closure. We sought to evaluate the effect of NMBA use on sedation requirements in patients with an open abdomen and to determine the effect of sedation on patient outcomes. METHODS: A retrospective cohort study was conducted at an American College of Surgeons-verified level one trauma center...
January 23, 2019: Pharmacotherapy
Yaakov Daskal, Alexander Beicker, Mickey Dudkiewicz, Boris Kessel
Electrical injury is an infrequent but potentially devastating form of multisystem injury associated with high morbidity and mortality. Despite significant improvement in injury prevention and implementation of safety protocols at work places, electrical injury accounts for more than 500 deaths per year in the United States with a mortality rate of 10-30%. Electrical injuries are traditionally divided into low-voltage electric power injuries (less than 1,000V) and high-voltage )more than 1,000V). In contrast with other types of trauma, high voltage injuries present some rather unique problems that require a high index of suspicion and awareness of all possible manifestations...
January 2019: Harefuah
Ashley Jordan, Philip Salen, Thomas R Wojda, Marissa S Cohen, Aliaskar Hasani, Joshua Luster, Jacqueline Seoane, Stanislaw P Stawicki, Holly Stankewicz
Introduction: Polysubstance abuse (PSA) is a significant problem affecting our society. In addition to negatively affecting the health and well-being of substance users, alcohol and/or drug abuse is also associated with heavy injury burden. The goal of this study was to determine if elevated serum alcohol (EtOH) levels on initial trauma evaluation correlate with the simultaneous presence of other substances of abuse (SOAs). We hypothesized that PSA would be more common among patients who present with EtOH levels in excess of the legal blood alcohol content (BAC) (≥0...
October 2018: International Journal of Critical Illness and Injury Science
Joscelyn M Tatro, Lisa K Schroder, Beth A Molitor, Emily D Parker, Peter A Cole
BACKGROUND: This 10 year retrospective study of the NTDB is the first to describe trends in scapula fracture diagnosis frequency, epidemiology, injury mechanisms and the type of hospital where the condition is treated. METHODS: Demographics, ISS scores, hospital data, mechanism of injury, complications, and hospital length of stay were recorded for patients with diagnosed scapula fractures (ICD-9, 811.0) recorded in the NTDB, v7.2 (2002-2012). Mean and standard deviation for continuous variables and proportions for binary variables are calculated...
January 14, 2019: Injury
Saksham Gupta, Monty Khajanchi, Vineet Kumar, Nakul P Raykar, Blake C Alkire, Nobhojit Roy, Kee B Park
OBJECTIVETraumatic brain injury (TBI) is a global epidemic with an increasing incidence in low- and middle-income countries (LMICs). The time from arrival at the hospital to receiving appropriate treatment ("third delay") can vary widely in LMICs, although its association with mortality in TBI remains unknown.METHODSA retrospective cohort analysis with multivariable logistic regression was conducted using the Toward Improved Trauma Care Outcomes in India database, which contains data from 4 urban trauma centers in India from 2013-2015...
January 18, 2019: Journal of Neurosurgery
Ayse Basaran, Seda Ozkan
AIM: In our study we investigated characteristics and degree of intra-abdominal solid organ injuries according to tomographic imaging in pediatric patients who presented to our emergency clinic with possible abdominal injuries and to whom US and/or abdominal tomography were applied. MATERIALS AND METHODS: 1066 pediatric patients were included in the study. The age, gender, injury localization, injury type, injury mechanism, abdominal US and CT results, and treatment specifics of patients were evaulated...
January 15, 2019: Acta Bio-medica: Atenei Parmensis
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