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Berlin Brandenburg

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  • 1
    Article
    Article
    Language: English
    In: Injury, 2010, Vol.41, pp.S37-S37
    ISSN: 0020-1383
    E-ISSN: 1879-0267
    Source: ScienceDirect Journals (Elsevier)
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  • 2
    Language: English
    In: Injury, 2010, Vol.41, pp.S2-S2
    Keywords: Congresses As Topic ; Wounds and Injuries ; Research Design -- Standards;
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 3
    Language: English
    In: Injury, 2012, Vol.43(1), pp.33-37
    Description: A high ratio of fresh frozen plasma (FFP) to packed red blood cells (PRBC) is currently recognised as the standard of care in some centres during massive transfusion post trauma. The aim of this study was to test whether the presumption of benefit held true for severely injured patients who received a massive transfusion, but did not present with acute traumatic coagulopathy. Data collected in The Alfred Trauma Registry over a 6 year period were reviewed. Included patients were sub-grouped by a high FFP:PRBC ratio (≥1:2) in the first 4 h and compared to patients receiving a lower ratio. Outcomes studied were associations with mortality, hours in the intensive care unit and hours of mechanical ventilation. Of 4164 eligible patients, 374 received a massive transfusion and 179 (49.7%) patients who did not have coagulopathy were included for analysis. There were 66 patients who received a high ratio of FFP:PRBC, and were similar in demographics and presentation to 113 patients who received a lower ratio. There was no significant difference in mortality between the two groups ( = 0.80), and the FFP:PRBC ratio was not significantly associated with mortality, ICU length of stay or mechanically ventilated hours. A small proportion of major trauma patients received a massive blood transfusion in the absence of acute traumatic coagulopathy. Aggressive FFP transfusion in this group of patients was not associated with significantly improved outcomes. FFP transfusion carries inherent risks with substantial costs and the population most likely to benefit from a high FFP:PRBC ratio needs to be clearly defined.
    Keywords: Wounds and Injuries ; Blood Coagulation Disorders ; Blood Transfusion ; Resuscitation
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 4
    Language: English
    In: Injury, February 2013, Vol.44(2), pp.249-252
    Description: Fractures of the tibial plateau present a treatment challenge and are susceptible to both prolonged operative times and high postoperative infection rates. For those fractures treated with open plating, we sought to identify the relationship between surgical site infection and prolonged operative time as well as to identify other surgical risk factors. We performed a retrospective controlled analysis of 309 consecutive unicondylar and bicondylar tibial plateau fractures treated with open plate osteosynthesis at our institution's level I trauma centre during a recent 5-year period. We recorded operative times, injury characteristics, surgical treatment, and need for operative debridement due to infection. Operative times of infected cases were compared to uncomplicated surgical cases. Multivariable logistic regression analysis was performed to identify independent risk factors for postoperative infection. Mean operative time in the infection group was 2.8 h vs. 2.2 h in the non-infected group (p = 0.005). 15 fractures (4.9%) underwent four compartment fasciotomies as part of their treatment, with a significantly higher infection rate than those not undergoing fasciotomy (26.7% vs. 6.8%, p = 0.01). Open fracture grade was also significantly related to infection rate (closed fractures: 5.3%, grade 1: 14.3%, grade 2: 40%, grade 3: 50%, 〈 0.0001). In the bicolumnar fracture group, use of dual-incision medial and lateral plating as compared to single incision lateral locked plating had statistically similar infection rates (13.9% vs. 8.7%, = 0.36). Multivariable logistic regression analysis of the entire study group identified longer operative times (OR 1.78, = 0.013) and open fractures (OR 7.02, 〈 0.001) as independent predictors of surgical site infection. Operative times approaching 3 h and open fractures are related to an increased overall risk for surgical site infection after open plating of the tibial plateau. Dual incision approaches with bicolumnar plating do not appear to expose the patient to increased risk compared to single incision approaches.
    Keywords: Tibia ; Plateau ; Infection ; Operative Time ; Fasciotomy
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 5
    Language: English
    In: Injury, June 2013, Vol.44(6), pp.713-721
    Description: The burden of injury is greatest in developing countries. Trauma systems have reduced mortality in developed countries and trauma registries are known to be integral to monitoring and improving trauma care. There are relatively few trauma registries in developing countries and no reviews describing the experience of each registry. The aim of this study was to examine the collective published experience of trauma registries in developing countries. A structured review of the literature was performed. Relevant abstracts were identified by searching databases for all articles regarding a trauma registry in a developing country. A tool was used to abstract trauma registry details, including processes of data collection and analysis. There were 84 articles, 76 of which were sourced from 47 registries. The remaining eight articles were perspectives. Most were from Iran, followed by China, Jamaica, South Africa and Uganda. Only two registries used the Injury Severity Score (ISS) to define inclusion criteria. Most registries collected data on variables from all five variable groups (demographics, injury event, process of care, injury severity and outcome). Several registries collected data for less than a total of 20 variables. Only three registries measured disability using a score. The most commonly used scores of injury severity were the ISS, followed by Revised Trauma Score (RTS), Trauma and Injury Severity Score (TRISS) and the Kampala Trauma Score (KTS). Amongst the small number of trauma registries in developing countries, there is a large variation in processes. The implementation of trauma systems with trauma registries is feasible in under-resourced environments where they are desperately needed.
    Keywords: Trauma Registry ; Trauma Database ; Trauma Databank ; Developing Countries, Low Income Countries, Middle Income Countries
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 6
    Language: English
    In: Injury, 2010, Vol.41, pp.S29-S30
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 7
    Language: English
    In: Injury, December 2013, Vol.44(12), pp.1838-1842
    Description: There is a paucity of research into the outcomes and complications of cervical spine immobilisation (hard collar or halothoracic brace) in older people. To identify morbidity and mortality outcomes using geriatric medicine assessment techniques following cervical immobilisation in older people with isolated cervical spine fractures. We identified participants using an injury database. We completed a questionnaire measuring pre-admission medical co-morbidities and functional independence. We recorded the surgical plan and all complications. A further questionnaire was completed three months later recording complications and functional independence. Sixteen patients were recruited over a three month period. Eight were immobilised with halothoracic brace, 8 with external hard collar. Three deaths occurred during the study. Lower respiratory tract infection was the most common complication (7/16) followed by delirium (6/16). Most patients were unable to return home following the acute admission, requiring sub-acute care on discharge. The majority of patients were from home prior to a fall, 6/16 were residing there at 3 months. Most participants had an increase in their care needs at 3 months. There was no difference in the type or incidence of complications between the different modes of immobilisation. Geriatric medicine assessment techniques identified the morbidity and functional impairment associated with cervical spine immobilisation. This often results in a prolonged length of stay in supported care. This small pilot study recommends a larger study over a longer period using geriatric medicine assessment techniques to better define the issues.
    Keywords: Cervical Spine Fracture ; Older Adults
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 8
    Article
    Article
    Language: English
    In: Injury, 2009, Vol.40, pp.S3-S3
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 9
    Article
    Article
    Language: English
    In: Injury, 2009, Vol.40, pp.S10-S10
    ISSN: 0020-1383
    E-ISSN: 1879-0267
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  • 10
    Language: English
    In: Injury, Dec, 2014, Vol.45, p.1834(8)
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.injury.2014.06.004 Byline: Lee-anne S. Costello, Fiona E. Lithander, Russell L. Gruen, Lauren T. Williams Abstract: Patients who have sustained traumatic brain injury (TBI) have increased nutritional requirements yet are often unable to eat normally, and adequate nutritional therapy is needed to optimise recovery. The aim of the current scoping review was to describe the existing evidence for improved outcomes with optimal nutrition therapy in adult patients with moderate to severe TBI, and to identify gaps in the literature to inform future research. Author Affiliation: (a) Nutrition and Dietetics, Faculty of Health, The University of Canberra, Bruce, Australian Capital Territory 2601, Australia (b) Discipline of Acute Care Medicine, School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia 5000, Australia (c) National Trauma Research Institute, The Alfred Hospital and Monash University, Melbourne, Victoria 3004, Australia (d) Nutrition and Dietetics, Faculty of Health, Griffith University, Southport, Queensland 4217, Australia Article History: Accepted 6 June 2014
    Keywords: Brain Injuries -- Diet Therapy ; Brain Injuries -- Patient Outcomes ; Nutritional Requirements ; Medical Research
    ISSN: 0020-1383
    Source: Cengage Learning, Inc.
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