European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jan 2025
Predictors of prolonged hospitalization among geriatric trauma patients using the modified 5-Item Frailty index in a Middle Eastern trauma center: an 11-year retrospective study.
Using a validated tool, we explored the prevalence, risk factors, and predictors of longer hospitalization among hospitalized geriatric patients. ⋯ One out of eleven trauma admissions was aged > 55. Head injury and bleeding were the leading causes of mortality in the study cohort. There was a significant decrease in the trend of geriatric trauma over the years. The modified FI-5 performs well as a predictive tool of prolonged hospitalizaion in trauma patients with different age groups.
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Eur J Trauma Emerg Surg · Jan 2025
Surgeon attitudes toward risk stratification in emergency surgery for the elderly: an ESTES cross-sectional survey.
Our study explores the utilization of objective tools for preoperative assessment of elderly patients by Emergency General Surgeons (EGS). ⋯ Preoperative risk assessment tool and frailty score use for elderly patients requiring emergency surgery remains limited among ESTES surgeons. Our study highlights the need for focused education and tool workflow integration to improve risk stratification, decision-making and outcomes. Institutional approaches coupled with targeted educational interventions using implementation science principles are recommended to bridge this knowledge-to-action gap. Future research should focus on developing comprehensive, user-friendly tools and evaluating their impact on patient-centered outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Outcomes of popliteal artery injuries in a level 1 trauma centre: a 6-year review.
To determine modifiable and non-modifiable factors contributing to limb loss in PAI the relevance and accuracy of published scoring systems for PAI within a South African State hospital. ⋯ Compared to international literature, our rate of primary amputation is high (10% vs. 28.8%) and prolonged ischaemia is the likely cause. Only 17 (26.6%) patients presented before 6 h. Of the 45 patients that had an attempt at revascularisation, 7.8% had a secondary amputation. Thus, despite prolonged ischaemia, revascularisation should be attempted in patients with at least two viable compartments on fasciotomy. The MESS and POPSAVEIT scoring systems should not be relied on in patients with delayed presentations. Strengthening referral triage for suspected PAI to Level 1 Trauma centres directly will decrease the delays and likely improve the outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Long-term impact of emergency laparotomy on health-related quality of life.
Emergency laparotomy can result in a range of physical and neuropsychiatric postoperative complaints, potentially impacting quality of life. This study aimed to assess the effect of emergency laparotomy on health-related quality of life (HRQoL) and how HRQoL influences the risk of readmission. ⋯ For most patients, HRQoL has returned to normal within 180 days after emergency laparotomy. However, patients who acquired low HRQoL after the procedure had an increased risk of long-term readmission.
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Eur J Trauma Emerg Surg · Jan 2025
Effects of early propranolol administration on mortality from severe, traumatic brain injury: a retrospective propensity score-matched registry study.
The role of beta-blockers in severe, traumatic brain injury (TBI) management is debated. Severe TBI may elicit a surge of catecholamines, which has been associated with increased morbidity and mortality. We hypothesize administering propranolol, a non-selective beta-blocker, within 48 h of TBI will reduce patient mortality within 30 days of injury. The TriNetX database was leveraged to determine if administering a propranolol within 48 h of severe TBI improves outcomes within 30 days of injury. ⋯ The results of this study demonstrate significantly reduced mortality within 30 days of injury and fewer neurosurgical interventions, seizures, and episodes of cardiac arrest in severe TBI patients who received propranolol within 48 h of injury.