Articles: mortality.
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Anesthesia and analgesia · Jan 2025
Anesthesia Trauma Guidelines: A Systematic Review of Global Accessibility and Quality.
This systematic review describes the available clinical practice guidelines (CPGs) for the anesthetic management of trauma and appraises the accessibility and quality of these resources. This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted across 8 databases (MEDLINE, Embase, Web of Science, CABI Digital Library, Global Index Medicus, SciELO, Google Scholar, and National Institute for Health and Care Excellence) for guidelines from 2010 to 2023. ⋯ Though many countries and societies have contributed to the development of anesthesia CPGs for trauma, there has been a disproportionate lack of representation from LMICs, where the burden of trauma mortality is highest. In this study, we identify barriers to accessibility and areas for improving future guideline quality. We recommend ongoing efforts to incorporate perspectives from diverse settings and to increase the availability of high-quality, open-access guidelines to improve worldwide health outcomes in trauma.
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Aims/Background The Geriatric Nutritional Risk Index (GNRI) is an effective tool for identifying malnutrition, and helps monitor the prognosis of patients undergoing maintenance hemodialysis. However, the association between the GNRI and cardiovascular or all-cause mortality in hemodialysis patients remains unclear. Therefore, this study investigated the correlation of the GNRI with all-cause and cardiovascular mortality in patients undergoing maintenance hemodialysis. ⋯ ROC curve analysis revealed that GNRI, age, and serum creatinine had moderate predictive value for mortality, with GNRI indicating an area under the curve (AUC) of 0.605 for all-cause mortality and 0.565 for cardiovascular mortality. Moreover, the N2 and N3 groups had a significantly reduced risk of cardiovascular mortality compared to the N1 group. Conclusion A lower GNRI is closely associated with a higher risk of all-cause and cardiovascular mortality in hemodialysis patients.
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Observational Study
Higher mortality risk from lung and hematological neoplasms in patients with rheumatoid arthritis: An observational study from the Spanish National Registry.
Evaluating the impact of solid organ neoplasms (SON) and hematological neoplasms (HN) on mortality among RA patients in a nationwide study. ⋯ RA patients might have a higher mortality risk from lung and hematologic neoplasms. Reducing immunosuppressive burden and developing early-detection programs should be primary goals in this population.
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Children are among the most vulnerable populations affected by armed conflicts, yet there is limited data on the preparedness of military medical personnel to care for pediatric combat trauma casualties in austere or large-scale combat operations. This study aimed to assess the confidence, training needs, and resource requirements of military medical providers who have managed pediatric patients during deployment. ⋯ Many recently deployed military medical providers reported low confidence in resuscitating pediatric patients in the combat environment, because of drug dosing, anatomic and physiologic differences, and inexperience. Regardless of specialty, almost all providers requested additional pediatric training to improve baseline preparedness. These results can guide future predeployment training and inform policy to reduce unnecessary pediatric mortality on the battlefield.
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To determine the prognostic impacts of the characteristics in routine plasma and blood tests for patients with traumatic brain injury (TBI). ⋯ TBI patients receiving diverse treatments might have different pathophysiologic conditions and different influencing factors of prognosis.