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
ReviewPreventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review.
Confounding in observational studies can be mitigated by selecting only those patients, in whom equipoise of both treatments is secured by experts' disagreement over optimal therapy. ⋯ With this review we aim to provide insight into this study design and to stimulate discussions about the potential of expert panels to control for confounding in studies of medical treatments.
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Eur J Trauma Emerg Surg · Jan 2025
Letter Comparative StudyType B ankle fractures with additional medium-sized posterior fragment: mid-term functional and radiological outcome after fixation versus no fixation of the posterior fragment.
Guidelines for treatment of medium-sized posterior fragments in trimalleolar fractures are scarce and show varying advice. Recent trials comparing fixation and no fixation of posterior fragments, show no difference in outcomes one year postoperatively. This study compares functional outcome and development of osteoarthritis in patients with fixation of a posterior malleolar fracture to patients without fixation of the posterior malleolus fracture. ⋯ The value of fixation of medium-sized posterior fragments in type B ankle fractures seems limited after mid-term follow-up, although functional impairment caused by osteoarthritis might develop in the long-term. Because postoperative step-off > 1 mm increases the risk of osteoarthritis, restoration of the tibial plafond seems essential.
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Eur J Trauma Emerg Surg · Jan 2025
Pre-injury narcotic drug use in isolated severe traumatic brain injury: effect on outcomes.
The aim of this study was to explore the association between pre-injury narcotic drug use (opioids, methadone, and/or oxycodone) and outcomes in isolated severe traumatic brain injury (TBI) patients. ⋯ Pre-injury narcotic drug use in isolated severe TBI is not associates with adverse outcomes. Further research is needed to understand the biochemical and physiological effects of narcotic drugs on TBI outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Multicenter Study Observational StudyD-dimer cutoff values for predicting functional prognosis in patients with severe head trauma: a multi-centre prospective observational study.
D-dimer, a fibrinolysis indicator, may predict functional and life outcomes in traumatic brain injury (TBI) patients. We aimed to identify optimal D-dimer cutoff values for poor functional outcomes in severe TBI. ⋯ A cutoff value of 27.2 µg/mL for early-stage D-dimer levels could predict the functional prognosis of patients with severe isolated TBI.
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Eur J Trauma Emerg Surg · Jan 2025
Multicenter StudyImpact of preoperative frailty on outcomes in patients subjected to emergency laparotomy: a prospective study.
Emergency laparotomy (EL) is a high-risk procedure, especially in frail patients. This study investigates the prevalence of frailty in referral facilities, evaluates the impact of frailty on postoperative morbidity and mortality, and assesses the long-term effect of EL on patients' functional status. ⋯ The 180-day mortality after EL is significantly higher for patients on higher levels of frailty. Likewise, the preoperative frailty has a significant negative impact on postoperative outcomes both short- and long-term.