European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2023
Time to surgery after proximal femur fracture in geriatric patients depends on hospital size and provided level of care: analysis of the Registry for Geriatric Trauma (ATR-DGU).
Proximal femur fractures predominantly affect older patients and can mark a drastic turning point in their lives. To avoid complications and reduce mortality, expert associations recommend surgical treatment within 24-48 h after admission. Due to the high incidence, treatment is provided at a wide range of hospitals with different size and level of care, which may affect time to surgery. ⋯ In hospitals of larger size and higher level of care the time to surgery for patients with a proximal femur fracture was significantly higher than in smaller hospitals. No negative effects regarding in-house mortality, but for ambulation status during in-hospital stay could be observed. As the number of these patients will constantly increase, specific treatment capacities should be established regardless of the hospitals size.
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Eur J Trauma Emerg Surg · Aug 2023
ReviewThe New Zealand National Trauma Registry: an essential tool for trauma quality improvement.
Trauma registries are essential tools for trauma systems and underpin any quality improvement activities. This paper describes the history, function, challenges, and future goals of the New Zealand National Trauma Registry (NZTR). ⋯ The NZTR has proven to be a critical component of trauma quality improvement in New Zealand. A user-friendly portal and a simple minimum dataset have been keys to successes but maintenance of an effective structure in a constrained healthcare system is a challenge.
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Eur J Trauma Emerg Surg · Aug 2023
In-hospital complications after trauma due to road traffic accidents.
The study aimed to verify the association between in-hospital complications and characterization and clinical variables including hospital care and trauma severity. ⋯ Complications were associated with older age, run-overs, greater trauma severity, length of stay and readmission after hospital discharge.
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The purpose was to analyze our trauma population during two periods to assess for predictors of recidivism. ⋯ Recidivism diminished, although more GSW and mental illness were seen. Recidivists are likely to be underinsured. The changing profile of recidivists may be attributed to socioeconomic trends and new programs to improve outcomes after trauma.
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Eur J Trauma Emerg Surg · Aug 2023
ReviewTraumatic brain injury detection performance of the infant scalp score in children younger than 2 years in the pediatric emergency department.
Our study sought to externally validate the Infant Scalp Score (ISS) within an international pediatric emergency department (PED) setting. The ISS for pediatric Closed Head Injury (CHI), includes age, hematoma localization, and size, and has the potential to predict the presence of Traumatic Brain Injury (TBI) on computed tomography. We aimed to describe a potentially low risk cohort of children younger than 24 months with CHI and scalp hematomas, where clinicians may limit diagnostic radiation exposure to this vulnerable patient population. ⋯ Children with ISS scores of ≥ 5 were noted to have increased rates of both TBI and ciTBI. CHI related scalp hematomas located in the temporal/parietal region or with a size greater than 3 cm were associated with increased rates of TBI. Within the context of this study, ISS scores of 4 or less represented a lower risk for TBI and ciTBI. Future research on this potentially low risk pediatric CHI cohort is needed.