European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Blunt cerebrovascular injuries (BCVI), which can result in ischemic stroke, are identified in 1-2% of all blunt trauma patients. Computed tomography angiography (CTA) scanning has improved and is the diagnostic modality of choice in BCVI suspected patients. Data about long-term functional outcomes and the incidence of ischemic stroke after BCVI are limited. The aim of this study was to determine BCVI incidence in relation to imaging modality improvements and to determine long-term functional outcomes. ⋯ Improved CTA diagnostic modalities have increased BCVI incidence. Furthermore, BCVI patients reported significant functional impairment at long-term follow-up. Antiplatelet therapy showed a significant effect on in-hospital stroke rate reduction.
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Eur J Trauma Emerg Surg · Feb 2021
Is there a correlation between fragility fractures of the pelvis (FFP) and the morphology of the true pelvis in geriatric patients?
There has been no prior study to demonstrate the relationship between the occurrence of fragility fractures of the pelvis and its morphology. The aim of this study was to investigate the effect of pelvic morphology on fragility fractures of the pelvis caused by low-energy trauma in elderly female patients. ⋯ With digital reconstruction and 3D measurement of normal adult pelvic CT scans, this study obtained a series of DT/DS values describing the shape of true pelvises. Circle-type true pelvis was found to be more common in patients with fragility fracture of the pelvis type II.
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Eur J Trauma Emerg Surg · Feb 2021
Spectral analysis of heart rate variability for trauma outcome prediction: an analysis of 210 ICU multiple trauma patients.
This study aimed to test and compare short-term spectral HRV indices with most used trauma scorings in outcome prediction of multiple trauma, and then to explore the efficacy of their combined application. ⋯ These findings suggest that the short-term spectral analysis of HRV might be a potential early tool to assess injury severity and predict outcome of multiple trauma. Combination of nLF/nHF and conventional trauma scores can provide more accuracy in outcome prediction of multiple trauma.
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Eur J Trauma Emerg Surg · Feb 2021
Observational StudyFactors associated with posttraumatic meningitis among traumatic head injury patients: a nationwide study in Japan.
Posttraumatic meningitis is one of the severe complications that can result in increased mortality and longer hospital stay among trauma patients. Factors such as cerebrospinal fluid (CSF) fistula and basilar skull fracture are associated with posttraumatic meningitis. However, it remains unclear whether procedures such as burr hole surgery in the emergency department and decompressive craniectomy are associated with posttraumatic meningitis. The aim of this study was to assess factors associated with posttraumatic meningitis with a nationwide hospital-based trauma registry in Japan. ⋯ In this population of trauma patients, burr hole surgery in the emergency department and decompressive craniectomy was associated with posttraumatic meningitis.
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Eur J Trauma Emerg Surg · Feb 2021
Progressive instability of bilateral sacral fragility fractures in osteoporotic bone: a retrospective analysis of X-ray, CT, and MRI datasets from 78 cases.
The pathogenetic mechanism, progression, and instability in geriatric bilateral fragility fractures of the sacrum (BFFSs) remain poorly understood. This study investigated the hypothesis of sequential BFFS progression by analysing X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) datasets. ⋯ Our results support the hypothesis of stagewise BFFS progression starting with unilateral sacral disruption followed by a contralateral lesion. Loss of sacral alar support leads to a TFC. Subsequent bone disruption causes iliolumbar ligament avulsion. MRI is recommended to detect bone oedema.