Articles: trauma.
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Eur J Trauma Emerg Surg · Feb 2024
The most critically injured polytrauma patient mortality: should it be a measurement of trauma system performance?
The risk of death after traumatic injury in developed trauma systems is at an all-time low. Among 'major trauma' patients (injury severity score, ISS > 15), the risk of dying is less than 10%. This group contains critical polytrauma patients (ISS 50-75), with high risks of death. We hypothesized that the reduction in trauma mortality was driven by reduction in moderate injury severity and that death from critical polytrauma remained persistently high. ⋯ The improvement in trauma mortality over the past 20 years has not been experienced equally. The ISS50-75 critical polytrauma mortality is a practical group to capture. It could be a group for deeper study and reporting to drive improvement.
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Eur J Trauma Emerg Surg · Feb 2024
Outcomes of resuscitative and emergent thoracotomies following injury at the largest trauma center in Estonia.
An emergency department thoracotomy (EDT) is performed in critically injured patients after a recent or in an imminent cardiac arrest following trauma. Emergent thoracotomy (ET) or operation room thoracotomy is reserved for more stable patients. However, the number of these interventions performed in an European settings is limited. Thus, we initiated the current study to investigate outcomes and risk factors for mortality of patients required EDT or ET at the largest trauma center in Estonia. ⋯ EDT and ET outcomes in Estonian trauma system are comparable to similar advanced trauma systems in Europe. Patients with GCS > 8, signs of life in the ED and with isolated penetrating chest injury had the most favorable outcomes.
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Eur J Trauma Emerg Surg · Feb 2024
Venous thromboembolism chemoprophylaxis in geriatric trauma patients with isolated severe traumatic brain injury.
Low-molecular-weight-heparin (LMWH) has been shown to be associated with a decreased risk of venous thromboembolism (VTE) and mortality compared to unfractionated heparin (UH) in severe traumatic brain injury (TBI). The aim of this study was to see if this association persists among a subset of patients, namely elderly patients with isolated TBI. ⋯ LMWH was associated with a decreased risk of overall mortality and reduced risk of PE compared to UH among geriatric patients with a severe head injury.
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Most major trauma admissions are older adults, many of whom are living with frailty - a recognised risk factor for post-injury mortality. ⋯ Frailty predicts long-term mortality in older trauma. Our findings have implications for clinician-patient discussions of prognosis and therapy goals. Furthermore, our results lend support to the routine provision of geriatrician input in trauma pathways.
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There have been several studies about the increasing accident risks and injuries of standing electric scooters, but there is no study about the dental traumatic injuries related with standing electric scooter so far. ⋯ The standing electric scooter-related dental trauma resulted in an increased prevalence of relatively severe dental trauma. Supplementation and reinforcement of the related policies as well as strict enforcement of the laws on electric scooter users will be needed to prevent severe dental and craniofacial trauma.