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
The severely injured older patient: identifying patients at high risk for mortality using the Dutch National Trauma Registry.
The incidence of severely injured older trauma patients is increasing globally, portraying high mortality rates. Exploring the demographics and clinical outcomes of this subgroup is essential to further improve specialised care at the right place. This study was performed to identify severely injured older patients at high risk for mortality by examining their characteristics and identifying prognostic factors contributing to mortality. ⋯ Level III, prognostic/epidemiological.
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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
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
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
Dynamic pathophysiological features of early primary blast lung injury: a novel functional incapacity pig model.
While there is evidence supporting the use of ultrasound for real-time monitoring of primary blast lung injury (PBLI), uncertainties remain regarding the timely detection of early PBLI and the limited data correlating it with commonly used clinical parameters. Our objective is to develop a functional incapacity model for PBLI that better addresses practical needs and to verify the early diagnostic effectiveness of lung ultrasound in identifying PBLI. ⋯ We have successfully developed a novel, and highly reproducible animal model for assessing serious PBLI functional incapacity. This model displays immediate symptoms of hypoxia, decreased cardiac output, decreased blood volume, and abnormal lung ultrasound findings within 0.5 h of injury, with syptoms lasting for up to 6 h. Lung ultrasound evaluation is crucial for the early assessment of injuries, and is comparable to commonly used clinical parameters.