Articles: trauma.
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Hospital readmissions are considered to be a measure of quality of care, correlate with worse outcomes, and may soon lead to decreased reimbursement. The comorbidity-polypharmacy score (CPS) is the sum of the number of preinjury medications and comorbidities, and may estimate patient frailty more effectively than patient age. This study evaluates the association between CPS and readmission. ⋯ CPS appears to correlate well with readmissions within 30 d. Frailty defined by CPS was a significantly stronger predictor of readmission than was patient age. Early recognition of elevated CPS may improve discharge planning and help guide interventions to decrease readmission rates in older trauma patients.
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Journal of neurosurgery · Nov 2015
Actual and projected incidence rates for chronic subdural hematomas in United States Veterans Administration and civilian populations.
Chronic subdural hematomas (SDHs) are more common among veterans and elderly persons than among members of the general population; however, precise incidence rates are unknown. The purposes of this study were 1) to determine the current incidence of chronic SDH in a US Veterans Administration (VA) population and 2) to create a mathematical model for determining the current and future incidence of chronic SDH as a function of population age, sex, and comorbidity in the United States VA and civilian populations. ⋯ The incidence of chronic SDH is rising; SDH is projected to become the most common cranial neurosurgical condition among adults by the year 2030.
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This study examines the structural integrity of the airway epithelium in autopsy tissues from pediatric burn subjects. ⋯ Airway epithelial loss seen in autopsy tissue is not simply an artifact of tissue fixation. The degree of compromise correlates most strongly with age and degree of burn. Further studies are needed to identify physiological or critical care factors following burn injury that contribute to compromise in the structural and functional properties of the airway epithelium.
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Dubrovnik is one of the most popular destinations in the world for cruise ships. Several cruise ship passengers and crew members who have suffered different injuries have been treated at our department. This was a retrospective study to analyse injuries that occurred to crew members and passengers on cruise ships that docked in Dubrovnik over a three-year period from December 2010 to December 2013. ⋯ Female patients in this study were exposed to osteoporotic trauma. Male patients presented mostly with injuries sustained during physical activities or because of the nature of their job on board. The leading cause of trauma accidents in the present study was falls on the same level.
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Journal of neurosurgery · Nov 2015
Case ReportsParadoxical herniation after decompressive craniectomy provoked by lumbar puncture or ventriculoperitoneal shunting.
Two patients who underwent decompressive craniectomy after head trauma deteriorated secondary to paradoxical herniation, one after lumbar puncture and the other after ventriculoperitoneal shunting. They motivated the authors to investigate further provoked paradoxical herniation. ⋯ Lumbar puncture and ventriculoperitoneal shunting carry substantial risk when performed in a patient after decompressive craniectomy and before cranioplasty. When the condition that prompts decompression (such as brain swelling associated with stroke or trauma) requires time to resolve, risk is associated with lumbar puncture performed ≥ 1 month after decompressive craniectomy.