Articles: traumatic-brain-injuries.
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Long bone fracture is one of the most common concomitant injuries in pediatric traumatic brain injury (TBI) patients, requiring surgical intervention in the form of intramedullary nailing (IMN), open reduction and internal fixation (ORIF), or temporary external fixation, otherwise known as damage control orthopedics (DCO), for transient stabilization before definitive repair. There are no definitive guidelines for femur fracture management in polytrauma TBI pediatric patients. This study investigates the outcomes of patients with TBI and femur fractures who underwent DCO versus early total care (ETC), hypothesizing that delayed fracture fixation is associated with worse outcomes. ⋯ III.
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Eur J Trauma Emerg Surg · Feb 2025
Impact of interhospital transport on outcome in traumatic epidural hematoma: experiences of a level-1 trauma center.
Epidural hematomas (EDH) are associated with a high rate of mortality and morbidity. Good clinical outcome depends on initial Glasgow Coma Scale (GCS), pupillary abnormalities, hematoma volume, age and time to surgery. The latter is mostly influenced by distance to the next level-1-trauma center. ⋯ Interhospital transport did not cause a significant delay of surgical treatment and outcome was comparable between direct and indirect transport to specialized neurosurgical care. Direct transport was more common on severe TBI and in patients with pupillary abnormalities, but secondary transport also allowed for adequate care.
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Scand J Trauma Resus · Feb 2025
ASA score is an independent predictor of 1-year outcome after moderate-to-severe traumatic brain injury.
This study aimed to investigate whether incorporating pre-injury health status, measured by the American Society of Anesthesiologists (ASA) score, improves outcome prediction models for moderate-to-severe traumatic brain injury (msTBI) patients. ⋯ In this retrospective single-center cohort study, we found that ASA score improves existing prognostic models for msTBI. Incorporating this simple comorbidity measure could enhance outcome prediction and support more personalized acute management. Future prospective studies are needed to validate these results.
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Emerg Med Australas · Feb 2025
The determinants for death in hospital following moderate to severe traumatic brain injury in Australia.
To establish the determinants of death in hospital for patients with moderate to severe traumatic brain injury (TBI) in Australia. ⋯ Among people presenting to a major trauma hospital in Australia following moderate to severe TBI, there were multiple factors independently associated with death in hospital. The potentially modifiable determinants of in-hospital death included out-of-hours access to emergency care, mode of transfer from the scene of the injury, prior facility care and pre-definitive hospital endotracheal intubation.
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Pediatric emergency care · Feb 2025
Minor Head Trauma in Children Younger Than 3 Months and Clinical Predictors of Clinically Important Traumatic Brain Injuries.
Major studies have defined clinical rules to regulate the use of computed tomography in children after head trauma. Infants younger than 3 months are considered at higher risk of brain injuries than older children and at the same time at higher risk of radiation-induced damage. Hence, it would be desirable to have clinical decision rules more adapted to this subset of patients. The objectives of this study are to compare the rate of brain injuries in children younger than 3 months or 3 to 24 months and to assess predictors of clinically important traumatic brain injuries (ciTBIs) (the ones causing death, neurosurgical intervention, long intubation, or hospitalization for 2 days or more) in the former group. ⋯ Children younger than 3 months presenting after minor head trauma constitute a relevant population. Available clinical predictors well correlate with ciTBIs in this age group.