European journal of trauma and emergency surgery : official publication of the European Trauma Society
-
Eur J Trauma Emerg Surg · Aug 2017
The impact of pre-injury direct oral anticoagulants compared to warfarin in geriatric G-60 trauma patients.
Pre-injury oral anticoagulants are associated with worse outcomes in geriatric (G-60) trauma patients, but there are limited data comparing warfarin with direct oral anticoagulants (DOAC). We sought to compare outcomes in G-60 trauma patients taking pre-injury DOACs vs. warfarin. ⋯ Pre-injury DOACs are not associated with worse clinical outcomes compared to warfarin in G-60 trauma patients. Higher use of pharmacologic reversal agents with warfarin may be related to differences in mechanism of action and effect on INR.
-
Eur J Trauma Emerg Surg · Aug 2017
Algorithm for activation of coagulation support treatment in multiple injured patients--cohort study.
Early recognition and management of trauma related coagulopathy improves the outcome. Trauma facilities should implement an algorithm to identify the bleeding trauma patient with coagulopathy. ⋯ The Criteria for activation of coagulation support treatment remain centre dependent. In our settings the CPM is the tool to select patients for ROTEM® analysis. By adding data from blood gas analysis, treatment of coagulopathy is justifiable before complete test results are available.
-
Eur J Trauma Emerg Surg · Aug 2017
Evaluation of efficacy and indications of surgical fixation for multiple rib fractures: a propensity-score matched analysis.
The purpose of this study was to assess the effects of recent surgical rib fixation and establish its indications not only for flail chest but also for multiple rib fractures. ⋯ From the viewpoints of early respiratory stabilization and intensive care unit disposition without any complications, surgical rib fixation is a sufficiently acceptable procedure not only for flail chest but also for repair of severe multiple rib fractures.
-
Eur J Trauma Emerg Surg · Aug 2017
Preventable and potentially preventable deaths in severely injured patients: a retrospective analysis including patterns of errors.
Analyzing preventable and potentially preventable deaths is a well-known procedure for improving trauma care. This study analyzes preventable and potentially preventable deaths in German trauma patients. ⋯ Preventable and potentially preventable errors still occur in the treatment of severely injured patients. Errors in hemorrhage control and airway management are the most common human treatment errors. The knowledge of these errors could help to improve trauma care in the future.
-
Eur J Trauma Emerg Surg · Aug 2017
Gustilo type IIIC open tibia fractures with vascular repair: minimum 2-year follow-up.
Salvage or amputation for grade 3C open fracture of tibia is not well responded question universally because of surgical innovations, cultural believes, difficulties in estimate the outcome, coasts, and different results in the literature. The aim of this study was to evaluate the surgical outcomes of Gustilo grade 3C open tibia fractures with at least two years follow-up in non-military adults. ⋯ Scoring systems and the ischemic time are not the only predictors of amputation. The decision of the treatment mode should be made by the patient and the care team after discussing the options and outcomes rather than relying on a scoring system.