European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2019
Blunt aortic injuries in the new era: radiologic findings and polytrauma risk assessment dictates management strategy.
Blunt aortic injuries (BAI) have historically been considered an indication for emergent surgical intervention. Nevertheless, the observation that the outcome of the concomitant traumatic injuries has a major impact on prognosis and the rise of thoracic endovascular aortic repair (TEVAR) as an effective therapy for BAI have significantly changed in recent years the treatment algorithm of this condition. Our objective was to identify findings associated with the aortic injury which would be the best predictor of prognosis, with the objective of guiding the decision-making process for selecting the optimal timing of aortic repair. ⋯ IV.
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Eur J Trauma Emerg Surg · Dec 2019
Health-related quality of life in trauma patients at 12 months after injury: a prospective cohort study.
Health-related quality of life (HRQOL) is increasingly recognized as a benchmark in trauma outcome research, with few studies having evaluated the HRQOL in trauma patients. The aim of our study was to assess the change in trauma patients' HRQOL at 12 months post-injury and to describe their living situation and return to work status. ⋯ Our study suggests that the quality-of-life of Japanese trauma patients generally improved over time, but remained lower than the Japanese national average. Most trauma patients return to home and work within 12 months post-injury.
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Eur J Trauma Emerg Surg · Dec 2019
Outcome of pubic rami fractures with or without concomitant involvement of the posterior ring in elderly patients.
Pubic rami fractures are common fractures in a growing osteoporotic geriatric population. Concomitant posterior ring fractures (cPRF) are often found when properly looked for. The pain and consequent immobilization leaves this vulnerable patient group at risk for complications. Conservative therapy is usually sufficient, but with cPRF's surgery can be indicated. Although previous studies have pointed out that mortality rates are high, longer term morbidity outcomes are lacking. This study aims to further establish the longer term consequences of these fractures. Risk factors will be identified for complications, also addressing the possible differences between patients with or without a cPRF. ⋯ Pubic fractures with or without involvement of the posterior pelvic ring in patients aged over 65 have a significant impact on mobility and independency. Mortality rates are similar to hip fracture patients. Careful evaluation of every patient's mobility status is necessary to identify patients at risk for complications and determine their future health care needs. Future studies are needed to achieve consensus on diagnostic and treatment protocols and identify ways to decrease the significant impact of this injury.
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Eur J Trauma Emerg Surg · Dec 2019
The role of psychiatric status on pediatric extremity fractures: a prospective analysis.
The aim of the study was to investigate the relationship between attention deficit and hyperactivity disorder (ADHD), anxiety, and depression with pediatric extremity fractures. ⋯ The signs of ADHD, anxiety, and depression were determined to be higher in children with extremity fractures compared with the non-traumatic population. In patients with especially behavioral problems and depressive signs, directing to the child and adolescent psychiatrists will be protective to prevent re-fractures and high-energy traumas.
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Eur J Trauma Emerg Surg · Dec 2019
Contrast-induced nephropathy following CT scan for trauma is not rare and is associated with increased mortality in South African trauma patients.
Acute trauma patients are at risk for the development of acute kidney injury (AKI). One potential nephrotoxic agent, which a trauma patient may be exposed to, is iodinated contrast media (ICM). We aim to review the incidence and outcome of contrast-induced nephropathy (CIN) in trauma patients in a busy trauma service, and to identify potentially modifiable risk factors. ⋯ Contrast-induced nephropathy is a real risk in trauma patients undergoing contrast-enhanced CT scan for blunt trauma in our environment. Further work is needed to define and delineate risk factors.