Injury
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A proposed new system of coding and injury classification for arteries in the trunk and extremities.
Retrospective review of arterial injury with prospective intra-observer and inter-observer analyses. ⋯ The preliminary data demonstrate that the new coding and injury classification system for arteries in the trunk and extremities are reliable and efficient for data storage and retrieval, and provide a favourable environment for discussion among different physicians or centres.
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To describe radiological appearances of systemic air emboli versus intravascular air from putrefaction. ⋯ We propose to consider pulmonary alveoli-venous fistula as a possible cause of systemic air emboli, as identified on CT autopsy by large amounts of gas in the arterial circulation, coupled with severe pulmonary injury.
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Multicenter Study
Missed injuries during the initial assessment in a cohort of 1124 level-1 trauma patients.
Despite the presence of diagnostic guidelines for the initial evaluation in trauma, the reported incidence of missed injuries is considerable. The aim of this study was to assess the missed injuries in a large cohort of trauma patients originating from two European Level-1 trauma centres. ⋯ Despite guidelines to avoid missed injuries, this problem is hard to prevent, especially in the severely injured. The present study showed that the rate of missed injuries was comparable with the literature and their consequences not severe. A high index of suspicion remains warranted, especially in multitrauma patients.
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Major liver trauma in polytraumatic patients accounts for significant morbidity and mortality. We aimed to assess prognostic factors for morbidity and mortality in patients with severe liver trauma undergoing perihepatic packing. ⋯ Revised Trauma Score, haemodynamic instability, blood pH and BE are important prognostic factors influencing morbidity and mortality in polytrauma patients with grade IV/V liver injury. Furthermore, fast and effective surgical damage control procedure with perihepatic packing, followed by early ICU admission is associated with lower complication rate and shorter ICU stays in this patient population.