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
Risk of acute kidney injury following repeated contrast exposure in trauma patients.
This study investigates the risk of contrast-associated acute kidney injury (CA-AKI) in trauma patients, focusing on the impact of cumulative contrast medium doses. ⋯ While repetitive contrast-enhanced examinations are sometimes inevitable, they do come with costs. The CA-AKI risk increases as the amount of contrast medium accumulates in trauma patients who require repetitive examinations.
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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
Inter-facility transfers to an urban level 1 trauma center and rates of secondary overtriage.
Many patients originally transported to non-trauma centers (NTC) require transfer to a trauma center (TC) for treatment. The aim was to analyze injury characteristics and outcomes of transfer patients and investigate the secondary overtriage (SOT). ⋯ Transfers constituted a third of all TC admissions. The main reasons for transfer were head and spine injuries. SOT accounted for one third of transfers and occurred primarily in patients with spine and head injuries.
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Eur J Trauma Emerg Surg · Jan 2025
Impact of obstructive jaundice on outcomes in acute biliary pancreatitis: a retrospective study.
To examine the effects of obstructive jaundice on the outcomes of patients with acute biliary pancreatitis. ⋯ The outcomes of jaundiced and non-jaundiced patients with acute biliary pancreatitis were found to be similar, despite initial predictions of worse outcomes in the jaundiced population. A lower threshold for initiation of rigorous treatment, including more frequent endoscopic procedures, administration of antibiotics and early surgical intervention may facilitate these results. Further studies with a larger sample size and long-term follow-up are warranted to validate these findings.
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Eur J Trauma Emerg Surg · Jan 2025
The misleading terminology of minor amputation of the lower limb.
A pronounced loss of function of the lower limb of various origins, especially with an infection-related course, may require a minor (MIN) or major (MAJ) amputation of the lower limb. Our aim was to contrast the underlying etiology, including previous trauma, surgical procedure, and the subsequent function. ⋯ With MIN and MAJ results comparable in all scores and queries, it emphasizes the fact that even supposedly lower-limb MIN represents a considerable impairment of coping with daily life. If there is no prospect of preserving the limb, early transtibial amputation should be considered. However, our results support the good outcome despite lower-limb MAJ through modern prosthetic fitting.