Injury最新文献

{"title":"Prevalence and clinical outcomes of acute myocardial infarction in patients presenting with major trauma.","authors":"Riley J Batchelor, Joanna F Dipnall, David Read, Peter Cameron, Mark Fitzgerald, Dion Stub, Jeffrey Lefkovits","doi":"10.1016/j.injury.2024.111996","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111996","url":null,"abstract":"<p><strong>Background: </strong>The occurrence and sequelae of acute myocardial infarction (AMI) in major trauma patients is underexplored across both trauma and cardiology specialties. Coronary reperfusion greatly reduces the risk of significant morbidity and mortality in AMI. However, in patients presenting with significant injuries, concurrent AMI presents a competing management priority given the increase in risk of bleeding with standard anticoagulation and antiplatelet therapy, which may be contraindicated. This study aimed to evaluate the epidemiology and clinical outcomes associated with AMI in a contemporary major trauma cohort.</p><p><strong>Methods: </strong>This study used data from the Victorian State Trauma Registry (VSTR). All adult patients with major trauma from 1 January 2013 to 31 December 2022 were included. Patients that died prior to hospital arrival were excluded. AMI was identified by ICD-10-AM diagnosis codes recorded against the first hospital admission. Clinical outcomes included in-hospital mortality, length of stay, and discharge destination.</p><p><strong>Results: </strong>28,928 patients were identified over the 10-year study period. AMI occurred in 401 patients (1.4 %). AMI patients were older, had more comorbidities and were more frequently on anticoagulation or antiplatelet therapy. Low impact fall was the most common trauma mechanism in AMI patients. Patients with AMI experienced longer hospital stays (12 [7-20] versus 7 [4-12] days, p < 0.001) and higher rates of in-hospital mortality (adjusted RR 1.45, 95 % CI 1.25-1.65).</p><p><strong>Conclusion: </strong>AMI in the setting of major trauma occurs in an older, more comorbid, and vulnerable group of patients. AMI is associated with an increased risk of in-hospital mortality and prolonged hospital stay in the setting of major trauma, underscoring the importance of identifying and treating major trauma associated AMI in a timely and effective manner.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111996"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The double 90 rule: A new strategy for resuscitation in non-academic level II trauma centers.","authors":"David L Ciresi, Jaime W Street, Jill K Albright, Clinton E Hagen, Jason Beckermann","doi":"10.1016/j.injury.2024.111980","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111980","url":null,"abstract":"<p><strong>Background: </strong>Efficient resuscitation after trauma and shorter time to definitive hemorrhage control help improve trauma outcomes. We aimed to improve the speed and efficiency of resuscitation for critically ill trauma patients in the emergency department by involving interventional radiology and a second surgeon.</p><p><strong>Study design: </strong>In 2017 our community, non-academic level II trauma center implemented the Double 90 rule-for trauma patients with 2 confirmed systolic blood pressures <90 mm Hg-which involves a second activation including the interventional radiology team, backup trauma surgeon, and operating room charge nurse. We retrospectively reviewed our trauma registry to compare data for high-level trauma patients before (2016, \"Pre-Dbl90\") and 3 consecutive years after intervention (2018-2020, \"Dbl90\").</p><p><strong>Results: </strong>Among 613 patients who met criteria for our highest level of trauma activation, 100 either had activation of the Double 90 rule (Dbl90 patients, n = 76) or met Double 90 rule criteria (Pre-Dbl90 patients, n = 24). The groups were similar in age, sex, injury severity score, penetrating trauma incidence, and admission vitals. Median time to computed tomography decreased throughout the study period, from 34 min in 2016 to 18 min in 2020 (P < .001). Median time to first hemorrhage control procedure decreased from 118 min (2016) to 43 min (2020), (P = .013). Mean packed red blood cell transfusion decreased from 9.1 to 4.8 units (P = .016). Mortality rates were similar between groups.</p><p><strong>Conclusion: </strong>The Double 90 rule is effective for expediting trauma care starting in the emergency department, shortening the times to computed tomography, hemorrhage control intervention, and decreasing packed red blood cell transfusion.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111980"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes following intensive allied health therapy in the acute hospital for trauma patients.","authors":"L Kimmel, M Webb, D McCaskie, V Maric, M Fitzgerald, B Gabbe","doi":"10.1016/j.injury.2024.111942","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111942","url":null,"abstract":"<p><p>The majority of patients hospitalised for trauma survive their injuries, with the quality of the survival potentially influenced by early acute hospital rehabilitation. The aim of this study was to review the outcomes of patients managed under an intensive Allied Health Model of Care (AHMOC) compared to a baseline cohort.</p><p><strong>Methods: </strong>The AHMOC was commenced in February 2020 on the Trauma ward at Alfred Health for 12 months. The baseline group included patients admitted to the trauma ward in 2019. All patients who were registered by either the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) or the Victorian State Trauma Registry (VSTR). The association between the groups (AHMOC and baseline) and outcomes were assessed using logistic (discharge destination, 12-month return to work) and linear (length of stay (LOS)) regression.</p><p><strong>Results: </strong>There were 1644 in the baseline group and 1732 in the AHMOC group, of which 70 % and 76 % respectively were discharged directly home from the acute hospital (p value < 0.001). The trauma ward LOS was 4.0 days for each group (p value 0.77). After accounting for confounders, the adjusted odds of discharge home and RTW at 12 months were 53 % (AOR 1.53 95 % CI 1.29, 1.82) and 65 % (AOR 1.65 95% CI 1.24, 2.21) higher for the AHMOC group compared to baseline, respectively. There was also a 6 % reduction in the LOS in the AHMOC group compared to baseline (Adjusted mean difference 6 %; 95 % CI (0.881, 0.999) p value = 0.050).</p><p><strong>Conclusion: </strong>This study shows an association between an AHMOC for trauma patients with a focus on early and intensive therapy and improved odds of discharge directly home, as well as improved 12 month return to work outcomes.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111942"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experiences of working-age polytrauma patients in Germany - A qualitative Analysis.","authors":"Anne Neubert, Sebastian Hempe, Carina Jaekel, Catharina Gaeth, Christopher Spering, Katharina Fetz, Joachim Windolf, Erwin Kollig, Dan Bieler","doi":"10.1016/j.injury.2024.111938","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111938","url":null,"abstract":"<p><strong>Background: </strong>Survivors of a major trauma experience a range of difficulties in relation to the reduction in physical, psychosocial, and cognitive functions, which can result in a reduced health-related quality of life. This study aims to explore lived experiences of major trauma survivors in the German healthcare system.</p><p><strong>Methods: </strong>Semi-structured exploratory interviews were performed with nine major trauma survivors (18-55 years; Injury Severity Score ≥16). For exploratory analyses, an artificial intelligence-based coding software was used. Further, results were clustered by using the International Classification of Functioning, Disability and Health framework (ICF).</p><p><strong>Results: </strong>Communication was one of the major topics concerning amongst others diverting opinions between different healthcare disciplines and a general lack of information. The participants showed a high demand for a contact person. Furthermore, social support was essential during recovery for those interviewed. Social network was not only important as emotional and physical support but also for overcoming of gaps in the healthcare system. The support by employers and colleagues seemed to be beneficial for our participants in relation to returning to work. Further, psychological consequences of trauma, and that mobility is a key factor for quality of life, self-efficacy and return to work were discussed.</p><p><strong>Discussion: </strong>The qualitative analyses highlight several topics such as communication, burden of sickness, support systems that the participants mentioned as important along their journey through the German healthcare system during recovery. Through the ICF model the interplay of certain components that influenced the outcome of the major trauma survivors was visualized.</p><p><strong>Implications: </strong>These results might offer a deepened understanding of modifiable components of a patient pathway in recovery process such as improvements of patient communication, provision of a contact person and others.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111938"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global, regional, and national burden of burns: An analysis of injury by fire, heat, and hot substances in the global burden of disease study 2019.","authors":"Xi Yin, Shengyu Huang, Zhihao Zhu, Qimin Ma, Yusong Wang, Xiaobin Liu, Tuo Shen, Feng Zhu","doi":"10.1016/j.injury.2024.111955","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111955","url":null,"abstract":"<p><strong>Background: </strong>Burn caused by exposure to hot substances is a common occurrence but there is little data on prevalence trends and disease burden. This research report the burden of burn injuries globally, regionally, and nationally from 1990 to 2019, identify hotspots, and analyze factors affecting disease burden with data from Global Burden of Disease 2019 survey.</p><p><strong>Methods: </strong>The Global Burden of Disease 2019 estimated the incidence, death rate, and disease-adjusted life years (DALY) for injuries due to exposure to fire, heat, and hot substances from 1990 to 2019. For comparison, all rates were age standardized. And the estimated annual percentage change (EAPC) was used to reflect the degree of change of the annual rate.</p><p><strong>Results: </strong>Globally, there were an estimated 8,378,122 (95 % uncertainty interval [UI]: 6,531,887-10,363,109) burn injuries in 2019, with age-standardized incidence, death, and DALY rates of 118 (95 % UI: 89-147), 1.44 (95 % UI: 1.14-1.72), and 96.6 (95 % UI: 75.03-123.05) per 100,000 people, which were 22 %, 43 %, and 43 % lower than those in 1990, respectively. Regionally, age-standardized incidence rate showed a positive association with Socio-demographic Index (SDI) from 1990 to 2019, whereas age-standardized death and DALY rates were negatively associated with SDI. The variation in the age-standardized incidence rate was intrinsic, and the variation in the age-standardized death rate was related to the human development index in the country. The global burn incidence population was skewed, with peaks mainly in the 5 to 19 years age group, but age-specific death rates and disease burden were higher in the under-5 and older age groups.</p><p><strong>Conclusions: </strong>The results of this study indicate the need to consider regional differences in burns when allocating health resources. Despite the reduced global burden of burns, incidence and deaths remain high. Moreover, there are significant differences between regions which are associated with the SDI and the human development index. Additionally, differences exist in the age and sex of the affected populations. Although the exact causes require further study, there is no doubt that the prevention of burns requires serious attention.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111955"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effect on major trauma patients during simultaneous or overlapping presentations at an urban level I trauma center in Korea.","authors":"Chang Won Park, Woo Young Nho, Tae Kwon Kim, Sung Hoon Cho, Jae Yun Ahn, Kang Suk Seo","doi":"10.1016/j.injury.2024.111954","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111954","url":null,"abstract":"<p><strong>Objective: </strong>Overcrowding in an emergency department (ED) or intensive care unit (ICU) of the trauma center (TC) is an important issue for timely acute health care of a critically injured patient. Accumulated scientific evidence has indicated the negative influence of overcrowding to the process and clinical outcome of trauma care.</p><p><strong>Method: </strong>The institutional trauma registry at an urban level I TC was retrospectively evaluated for 5 years (2018-2022). Major trauma was defined as an injury severity score (ISS) of >15. We determined simultaneous or overlapping presentations of major trauma (SOMT) in two or more patients with ISS of >15 who presented within a 4-h time window. When only two patients were included within a single time window, they were classified as SOMT-2, whereas when three or more patient clusters were identified in a single time window, they were classified as SOMT-3. The outcome measurement included process and clinical variables, such as trauma team activation (TTA) ratio, ED length of stay (LOS), time to blood product transfusion (TF), time to emergency surgery or intervention (ESI), ICU LOS, and mortality.</p><p><strong>Result: </strong>A total of 2,815 patients were included, of which 39.6% (N = 1,116) classified as SOMT. The SOMT group had lower TTA ratio than the non-SOMT group (69.4% vs. 73.4%, P = 0.022). The TTA ratio exhibited a decreasing trend in non-SOMT, SOMT-2, and SOMT-3 groups (P = 0.006). The time to TF was significantly delayed in the SOMT group (129 vs. 91 min, P < 0.001).</p><p><strong>Conclusion: </strong>SOMT regularly occurs and results in fewer trauma team activation and a delayed time to blood transfusion. The current intensive trauma care system should be strategically modified to improve critical trauma care and enhance disaster preparedness.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111954"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The MOST (Mortality Score for TBI): A novel prediction model beyond CRASH-Basic and IMPACT-Core for isolated traumatic brain injury.","authors":"Mert Karabacak, Pemla Jagtiani, Kristen Dams-O'Connor, Eric Legome, Zachary L Hickman, Konstantinos Margetis","doi":"10.1016/j.injury.2024.111956","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111956","url":null,"abstract":"<p><strong>Background: </strong>Due to significant injury heterogeneity, outcome prediction following traumatic brain injury (TBI) is challenging. This study aimed to develop a simple model for high-accuracy mortality risk prediction after TBI.</p><p><strong>Study design: </strong>Data from the American College of Surgeons (ACS) Trauma Quality Program (TQP) from 2019 to 2021 was used to develop a summary score based on age, the Glasgow Coma Scale (GCS) component subscores, and pupillary reactivity data. We then compared the predictive accuracy to that of the Corticosteroid Randomisation After Significant Head Injury Trial (CRASH)-Basic and International Mission for Prognosis and Analysis of Clinical Trial in TBI (IMPACT)-Core models. Two separate series of sensitivity analyses were conducted to further assess our model's generalizability. We evaluated predictive performance of the models with discrimination [the area under the receiver-operating characteristic curves (AUC), sensitivity, specificity] and calibration (Brier score). Discriminative ability was compared with DeLong tests.</p><p><strong>Results: </strong>259,404 patients were included in the present study (mean age, 60 years; 93,495 (36 %) female). The mortality score after TBI (MOST) model (AUC = 0.875) had better discrimination (DeLong test p values < 0.00001) than CRASH-Basic (AUC = 0.837) and IMPACT-Core (AUC = 0.821) models, and superior calibration (MOST = 0.02729, CRASH-Basic = 0.02962, IMPACT-Core = 0.02962) in predicting in-hospital mortality. The MOST model similarly outperformed in predicting 3-, 7-, 14-, and 30-day mortality.</p><p><strong>Conclusion: </strong>The MOST model can be rapidly calculated and outperforms two widely used models for predicting mortality in TBI patients. It utilizes a larger, contemporaneous dataset that reflects modern trauma care.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111956"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in a multidisciplinary approach for management of traumatic haemorrhagic shock: 10-year retrospective experience from a French level 1 trauma centre.","authors":"Jonathan Charbit, Geoffrey Dagod, Simon Darcourt, Emmanuel Margueritte, François-Regis Souche, Laurence Solovei, Valérie Monnin-Barres, Ingrid Millet, Xavier Capdevila","doi":"10.1016/j.injury.2024.111952","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111952","url":null,"abstract":"<p><strong>Background: </strong>The present study investigated an institutional multidisciplinary strategy for managing traumatic haemorrhagic shock by integrating the placement of REBOA (resuscitative endovascular balloon occlusion of the aorta) by anaesthesiologist-intensivists.</p><p><strong>Methods: </strong>All severe trauma patients who received percutaneous REBOA placement between January 2013 and December 2022 in our level 1 trauma centre were retrospectively analysed. The data collected included the clinical context, indications and location of REBOA, durations of aortic occlusion (AO), choice of haemostatic procedures and surgical teams, and specific complications.</p><p><strong>Results: </strong>In total, 38 trauma patients were included in the present study (mean age = 41 years [standard deviation = 21 years], 31 [82 %] were male, and median injury severity score was 62.5 [inter-quartile range (IQR) = 45-75]). REBOA was always placed by anaesthesiologist-intensivists, who comprised 68 % of the senior physicians (13/19) in our trauma team over the period. Twenty-eight AOs (74 %) were performed in zone 1 and 10 (26 %) in zone 3. Twelve patients (32 %) received REBOA upon circulatory arrest. Routes following REBOA placement comprised: computed tomography scan = 47 %, operating room = 34 %, angiography = 3 %, emergency room thoracotomy = 5 %, and prematurely died = 11 %. Duration of AO was 38 min (IQR = 32-44 min) in zone 1 and 78 min (IQR = 48-112 min) in zone 3. Mortality rate was 66 % (95 % CI 51-81 %) and higher in cases of AO in zone 1 (79 % versus 30 %, p = 0.018) or concomitant with circulatory arrest (92 % versus 54 %, p = 0.047). No ischemic limb needed an intervention and three endothelial injuries required delayed endovascular stenting.</p><p><strong>Conclusions: </strong>Percutaneous REBOA placement by anaesthesiologist-intensivists included in the multidisciplinary management of traumatic haemorrhagic shock was associated with acceptable time of AO and local complications similar to those observed in other series.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111952"},"PeriodicalIF":0.0,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variables for reporting studies on extended - focused assessment with sonography for trauma (E-FAST): An international delphi consensus study.","authors":"Federico Moro, Valentina Chiarini, Tommaso Scquizzato, Etrusca Brogi, Marco Tartaglione","doi":"10.1016/j.injury.2024.111931","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111931","url":null,"abstract":"<p><strong>Background: </strong>The Extended Focused Assessment with Sonography for Trauma (E-FAST) is a diagnostic ultrasound technique used in hospital and pre-hospital settings for patients with torso trauma. While E-FAST is common in emergency departments, its pre-hospital use is less routine. This study aims to establish a set of variables for designing studies on pre-hospital E-FAST through a Delphi consensus process involving international experts.</p><p><strong>Methods: </strong>A Delphi consensus process was utilized, involving four rounds of e-mail to the experts. The experts proposed variables for each category, assessed them using a 5-point Likert scale, and voted on whether they should be included in the final template.</p><p><strong>Results: </strong>Out of 14 invited experts, 9 participated in the study. In total, the experts proposed 247 variables. After four rounds, a final list of 32 variables was approved by all experts. These variables related to the system, patient, process, training, imaging, outcome, and others.</p><p><strong>Conclusions: </strong>This Delphi consensus study presents a list of 32 variables for future research studies concerning the use of E-FAST ultrasound in pre-hospital settings. The results of this study are significant as they provide a standardized set of variables that will facilitate the comparison of data obtained from various studies. This will ultimately contribute to the advancement of pre-hospital E-FAST research and practice.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111931"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of non-vascular injuries in patients admitted in trauma ICU secondary to polytrauma with major vascular injury - Institutional experience.","authors":"V C Ntola, T C Hardcastle, N M Nkwanyana","doi":"10.1016/j.injury.2024.111941","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111941","url":null,"abstract":"<p><strong>Background: </strong>Vascular injuries are associated with high morbidity and mortality. The management is exceedingly demanding and requires involvement of senior clinician. There are known complications associated with vascular injury ranging from limb loss, stroke, and death. There are limited studies examining other injuries that are associated with vascular trauma. This study aimed to review the pattern, management and outcomes of the other injuries associated with vascular injuries.</p><p><strong>Method: </strong>A retrospective cross-sectional study chart review of patients with vascular trauma requiring ICU admission between January 2013 and December 2021. Additional data was prospectively collected from January 2022 to December 2022. All patients admitted to trauma ICU with polytrauma including a vascular injury were reviewed, except patients who died prior the confirmation of vascular injury. The injury was either confirmed by imaging or via exploration. The non-vascular injuries were identified. The pattern, management and outcomes were documented. A pre-designed data proforma was used identifying injury type, management strategy, and outcomes.</p><p><strong>Results: </strong>Out of 2805 patients that were admitted in trauma ICU from 2013 to 2022, 153 (5 %) patients had vascular injuries. There were 154 documented vascular injuries and 212 associated injuries. This study found that fractures are the most common injuries to be associated with vascular injury CONCLUSION: The nature of vascular injury and delay to intervention determines outcome of patients, however associated injuries also play an important role in affecting outcomes. The presence of associated injury encourages the multi-disciplinary approach to optimise outcomes.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"111941"},"PeriodicalIF":0.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}