Injury
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No sufficiently validated disease-specific instrument is available to assess patient outcome after polytrauma. The aim of this investigation was to test the recently published Trauma Outcome Profile (TOP) in the longer-term outcome of multiply injured patients. ⋯ This first clinical and methodological evaluation in a well defined cohort of polytrauma patients found the TOP to be a reliable and well discriminating score covering both relevant general and trauma-specific aspects of longer-term outcome. Despite these promising primary results, until further validation, the TOP should be used together with already accepted HRQoL measures to allow adequate international comparison of data in the future.
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Total body surface area (TBSA) burned, expressed as percentage is one of the most important aspects of the initial care of a burn victim. It determines whether transfer to a burn centre is necessary as well as the need for, and amount of, intravenous fluid resuscitation. Numerous studies, however, have highlighted inaccuracies in TBSA assessment. Therefore, the differences in burn size estimates between referrers and burn centre's in children and its consequences in terms of transfer and intravenous fluid resuscitation were investigated. ⋯ Referring physicians overestimate burn size in children admitted to Dutch burn centres. This has little negative consequences, however, in terms of unindicated transfers to a burn centre or unnecessary fluid resuscitation.
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Damage control surgery increasingly requires serial operations and a staged abdominal repair (STAR) for ultimate abdominal closure. The effects of multiple operations on quality of life are unknown. We hypothesized that this population of patients had a lower quality of life than the general U.S. population. ⋯ The significant impact of severe abdominal injuries continues to affect the physical and mental health of patients years later. Injuries of this type are associated with lower quality of life than those observed in patients experiencing non-STAR trauma.
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To prospectively study the incidence, mechanism, distribution of injury, and outcome of patients admitted to Al-Ain Hospital with camel bite injuries in Al-Ain, United Arab Emirates. ⋯ The behaviour of the camel is occasionally unpredictable, especially during the rutting season. The mechanism of camel bite injuries, which are usually severe, are complex including penetrating and crushing injuries by the camel jaw and blunt injuries when patients are picked up and thrown away. Care should be taken when handling camels, particularly in the rut.
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Review Meta Analysis
Meta-analysis of predictive factors and outcomes for failure of non-operative management of blunt splenic trauma.
This study aimed to analyse predictive factors and outcomes of failure of non-operative management (NOM) following blunt splenic trauma. ⋯ fNOM leads to increased resource use and increased mortality. Methods of preventing fNOM, such as angioembolisation, warrant further assessment. Patients with increasing age, AAST scores and moderate or large haemoperitoneums may benefit from closer monitoring.