Injury
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Multicenter Study
Psychological health status after major trauma across different levels of trauma care: A multicentre secondary analysis.
Concentration of trauma care in trauma network has resulted in different trauma populations across designated levels of trauma care. ⋯ Major trauma patients admitted to a level I trauma centre have more depressive, anxious, and post-traumatic stress symptoms than when admitted to a non-level I trauma centre. These symptoms differed across trauma regions, indicating populations differences. Level of trauma care and trauma region are important when analysing psychological health status.
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Collecting patient-reported outcomes in a systematic fashion is important to understand recovery trajectories and compare performance between different services and fields of care. These outcomes can be collected through a variety of means, but studies comparing different follow-up methods in patients with a variety of injury types are scarce. This study aimed to compare follow-up data from three injury registries to quantify patient preference for telephone versus online follow-up, determine factors associated with choosing online follow-up, and compare response rates based on the patient's preferred follow-up method. ⋯ While follow-up preference and completion were higher for telephone-based follow-ups, the findings suggest a patient's preference for completing post-injury follow-ups differs according to the type of injury they sustained, and that allowing patients a choice of their preferred follow-up method is important. The variety of follow-up methods offered should therefore reflect the needs of different patient groups, which may allow for the development of algorithms or workflow processes. Directing certain patients towards a particular follow-up method could deliver higher and more efficient follow-up rates.
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Patients with chronic lateral ankle instability (CLAI) can be managed with arthroscopic Broström repair and inferior extensor retinaculum augmentation or arthroscopic assisted lateral ligament reconstruction using ipsilateral semitendinosus autograft, with good functional outcomes in patients. It is unclear whether one offers better outcome that the other. This retrospective analysis of prospectively collected data compared the outcomes of repair and reconstruction. ⋯ In CLAI patients, arthroscopic reconstruction yields better outcomes in terms of ATT, AOFAS, and KAFS in the mid-term; however, it is associated with a longer intraoperative time, delayed return to sports, and an extended duration to resume normal ankle function compared to the arthroscopic Broström repair and inferior extensor retinaculum augmentation procedure.
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Recent evidence suggests that frailty may be a more reliable measure than age to predict outcomes following trauma. Frailty leads to prolonged hospitalisation and increased burden on the hospital system in older patients. The aim of this study is to review the prevalence of frailty in our trauma patients and the association of frailty with hospital-based and twelve-month outcomes. ⋯ After adjusting for confounding factors, frailty is associated with nearly five times the increase in odds of a discharge to further inpatient care. Long term outcomes are also significantly poorer for patients with frailty. Identifying frailty on admission may help outcomes by targeting this patient group and optimising healthcare resource usage.
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There is a high level of evidence that a short time to surgery (TTS) improves the outcome for patients with hip fractures. Accordingly, recommendations for timely treatment have been included in national guidelines. As patient characteristics appear to be similar, it seems reasonable that these guidelines are applicable to other fracture entities, such as knee periprosthetic femoral fracture (PPF). This monocentric retrospective study aimed to investigate outcome-related risk factors, particularly TTS, for knee PPF. ⋯ 1-year mortality after knee PPF was 8.3 %. With a high complication rate in the treatment of knee PPF, TTS was identified as a risk factor for general complications. Early treatment appears to be beneficial for patients with knee PPF.