European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Dec 2021
Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses.
Transarterial embolisation (TAE) is an effective intervention for management of arterial haemorrhage associated with pelvic fracture. However, its effects on survival and clinical outcomes are unclear. ⋯ TAE use was associated with improved survival at 28 days in patients with pelvic fracture and should therefore be considered in the management of severely injured patients with pelvic fracture.
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Eur J Trauma Emerg Surg · Dec 2021
Meta AnalysisInferior vena cava filters reduce symptomatic but not fatal pulmonary emboli after major trauma: a meta-analysis with trial sequential analysis.
The prophylactic use of inferior vena cava filters among patients with major trauma is researched by several controlled studies with contradicting results. We performed an updated meta-analysis with trial sequential analysis of controlled studies probing the prophylactic use of inferior cava filters on the development of symptomatic and fatal pulmonary embolism (PE) in patients with major trauma. ⋯ The use of inferior vena cava filters curtailed the risk of symptomatic PE, the result further strengthened by trial sequential analysis. However, the present evidence fails to delineate a beneficial role of prophylactic inferior vena cava filter placement in reducing fatal PE among patients with major trauma. The possibility of Type II error cannot be excluded from this estimate.
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Eur J Trauma Emerg Surg · Dec 2021
Traumatic brain injury and alcohol intoxication: effects on injury patterns and short-term outcome.
A significant number of patients with traumatic brain injuries (TBI) are diagnosed with elevated blood alcohol concentration (BAC). Recent literature suggests a neuroprotective effect of alcohol on TBI, possibly associated with less morbidity and mortality. Our goal is to analyze the association of different levels of BAC with TBI characteristics and outcome. ⋯ The current study suggests that in patients with moderate to severe TBI, increasing BACs are associated with less severe TBI, less ICU admissions and a higher survival. Further research into the pathophysiological mechanism is necessary to help explain these findings.
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Eur J Trauma Emerg Surg · Dec 2021
Safety and efficacy of 2D-fluoroscopy-based iliosacral screw osteosynthesis: results of a retrospective monocentric study.
Iliosacral screw osteosynthesis is a well-accepted procedure for stabilization of sacral fractures and iliosacral (fracture) dislocations. ⋯ A thorough preoperative evaluation of the morphology of the upper sacrum and careful operative procedure are indispensable. Fluoroscopic views in AP, lateral, inlet and outlet must allow recognition of all anatomical landmarks. The indication for double screw osteosynthesis in S1 should be taken with caution. Screw malalignments do not inevitably correlate with complaints.
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Eur J Trauma Emerg Surg · Dec 2021
Short-term outcome following significant trauma: increasing age per se has only a relatively low impact.
Ongoing demographic changes go hand in hand with an increasing number of elderly injured. Given the conflicting literature we wanted to know how much age per se, apart from other factors, actually explains the outcome for elderly trauma patients. ⋯ This monocenter evaluation showed a significant decline in short-term outcome and an increase in hospital resource requirements by the trauma patients investigated after the age of 60 years. Even so, after controlling for demographic, injury and treatment variables, age per se only added less than 2% to the prediction of hospital mortality.