Articles: trauma.
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Trauma is consistently among the top ten causes of death worldwide. The aging population, constituting 15.21% of adults aged over 65 in Taiwan as of November 2019, has significantly impacted healthcare expenditures. This study aimed to explore the prognosis and resource utilization in patients with geriatric trauma. ⋯ Elderly patients had a longer LOS, higher mortality and complication rates, and higher total medical costs. The required medical expenses for elderly trauma cases were relatively higher than those for younger individuals. Relevant authorities should consider patient age when formulating policies for trauma reimbursement. Based on our findings, healthcare resource utilization can be reduced by decreasing the length of hospital stay and mitigating trauma severity. We recommend collecting more detailed data, extending the study period, and engaging in multicenter collaborations to validate our findings and provide a roadmap for further research. We suggested that interventional studies are needed to test strategies aimed at reducing resource utilization and improving outcomes in elderly trauma patients, which would be valuable.
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Whole blood (WB) resuscitation has been shown to provide mortality benefit. However, the impact of whole blood transfusions on the risk of venous thromboembolism (VTE) remains unclear. We sought to compare the VTE risk in patients resuscitated with WB vs component therapy (COMP). ⋯ Using WB as part of resuscitation was associated with a 30% reduction in VTE, while TXA and RBC transfusion increased VTE risk. Further research is needed to evaluate VTE risk with empiric use of TXA in the setting of early WB transfusion capability.
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Post-traumatic brain injury (TBI) lesions, which combine brain atrophy and white matter injuries, can lead to progressive post-traumatic encephalopathy. However, the specific involvement of the cerebellum, which participates in cognitive, executive, and sensory functions, has been little studied. The aim of this work was to explore the long-term cerebellar consequences of severe TBI. ⋯ This work shows that even if direct cerebellar damage is rare, long-term post-TBI cerebellar lesions can be observed. Therefore, clinical correlates of cerebellar lesions should be considered more systematically.
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Journal of neurosurgery · Nov 2024
Impact of preoperative nutritional status on morbidity and mortality in elderly patients undergoing subdural hematoma evacuation: the role of the Geriatric Nutritional Risk Index.
Nutritional status has been shown to impact patient outcomes across several neurosurgical procedures. However, few prior studies have assessed associations between preoperative nutritional status and outcomes in elderly patients undergoing subdural hematoma evacuations. The aim of this study was to identify associations between preoperative nutritional status and short-term outcomes in patients aged 65 years and older undergoing subdural hematoma evacuation. ⋯ The authors' findings suggest that preoperative nutritional status may have implications for short-term outcomes after subdural hematoma evacuation in patients aged 65 years and older. Further studies are necessary to better optimize nutritional status perioperatively in this patient population.