CSRS-ES congress in Kurfu, Greece, May 26–29, 2010

Abstracts

CSRS-ES congress in Kurfu, Greece, May 26–29, 2010     

The Status of Heart Transplantation in Taiwan, 2005–2010

Heart transplantation (HT) is the standard therapy used to treat end-stage heart disease. Taiwan Organ Registry and Sharing Center (TORSC) is a registry and database of organ donations and transplantations. To understand the profiles of heart donors and recipients is crucial for efficient utilization. Data was provided by the TORSC and 487 HT were performed from 2005 to 2010. The main causes of donor brain death were head injury (n = 243; 51.1%) and cerebrovascular accidents/strokes (n = 147; 30.9%). The mean age of the recipients was 46.3 ± 14.6 years, and 80.3% were men (n = 391). Physicians and nurses were responsible for most organ procurement. In multivariate analysis, considering donor and recipient gender, donor and recipient age, and donor-to-recipient weight ratio as independent variables, factors that were significantly predictive of graft survival were donor age (hazard rate [HR], 1.02; 95% confidence interval [CI], 1.00–1.03; P = .01) and recipient age (HR, 1.03; 95% CI, 1.01–1.04; P < .01). Our results showed that age is a determinant of allograft survival and healthcare professionals are the primary impetus for obtaining consent for organ donation.     

US emergency department visits for fireworks injuries, 2006–2010

Background

Most literature regarding fireworks injuries are from outside the United States, whereas US-based reports focus primarily on children and are based on datasets which cannot provide accurate estimates for subgroups of the US population.

Methods

The 2006–2010 Nationwide Emergency Department Sample was used to identify patients with fireworks injury using International Classification of Diseases, Ninth Revision, Clinical Modification external cause of injury code E923.0. International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes were examined to determine the mechanism, type, and location of injury. Sampling weights were applied during analysis to obtain US population estimates.

Results

There were 25,691 emergency department visits for fireworks-related injuries between 2006 and 2010. There was no consistent trend in annual injury rates during the 5-y period. The majority of visits (50.1%) were in patients aged <20 y. Most injuries were among males (76.4%) and were treated in hospitals in the Midwest and South (42.0% and 36.4%, respectively) than in the West and Northeast (13.3% and 8.3%, respectively) census regions. Fireworks-related injuries were most common in July (68.1%), followed by June (8.3%), January (6.6%), December (3.4%), and August (3.1%). The most common injuries (26.7%) were burns of the wrist, hand, and finger, followed by contusion or superficial injuries to the eye (10.3%), open wounds of the wrist, hand, and finger (6.5%), and burns of the eye (4.6%).

Conclusions

Emergency department visits for fireworks injuries are concentrated around major national holidays and are more prevalent in certain parts of the country and among young males. This suggests that targeted interventions may be effective in combating this public health problem.     

Influenza antiviral treatment in spinal cord injury patients, 2007–2010

Objective

This study assessed antiviral medication use for treatment of influenza-like illness (ILI) in Veterans with spinal cord injury or disorder (SCI/D) and examined whether antiviral prescribing improved over time.

Design

Retrospective cohort study of Department of Veterans Affairs (VA) facilities.

Participants

Veterans with SCI/D and matched non-SCI/D controls (matched by facility and date of visit/admission) who were diagnosed by a clinician with ILI during the period 1 October 2007 to 31 May 2010.

Main outcome measures

Antiviral receipt and appropriateness were examined. Appropriate antiviral prescribing was defined as patients who received an antiviral medication within 2 days of collection of a sample for diagnostic testing or within 2 days of symptom onset.

Results

We identified 101 influenza visits/admissions for veterans with SCI/D and 123 for controls. Antiviral prescribing for Veterans with SCI/D increased from 37.1% in 2007/2008 to 67.6% in 2009/2010 (P = 0.01) and appropriate antiviral prescribing increased from 20.0 to 41.2% (P = 0.05). Predictors of antiviral prescribing included being treated in the 2009/2010 influenza season (vs. 2007/2008) and having a cough. Fever, aches/myalgia, or a positive influenza test was associated with appropriate antiviral treatment. SCI/D was an independent predictor of receiving antiviral treatment (adjusted odds ratio = 1.16, 95% confidence interval 1.04–1.29), but having SCI/D was not associated with receiving appropriate treatment.

Conclusions

Influenza antiviral prescribing increased over time and in a larger proportion in veterans with SCI/D (vs. controls). This suggests that providers treating patients with SCI/D recognize treatment guidelines and their importance in a high-risk population. Continued efforts are needed to improve appropriate influenza antiviral prescribing.     

Abstracts from the First International Symposium on Fibrodsyplasia Progressive,September 25–26, 1991, Philadelphia,Pennsylvania

Orthopedic Surgical Forum

Abstracts from the First International Symposium on Fibrodsyplasia Progressive, September 25–26, 1991, Philadelphia, Pennsylvania     

LIST OF REVIEWERS 2009–2010

List of Reviewers 2009–2010

LIST OF REVIEWERS 2009–2010     

List of reviewers 2010–2011

List of Reviewers 2010-2011

List of reviewers 2010–2011     

National trends in hospitalization from indwelling urinary catheter complications, 2001–2010

Purpose

The purpose of this study is to investigate national trends in hospitalization from indwelling urinary catheters complications from 2001 to 2010.

Materials and methods

The Healthcare Utilization Project Nationwide Inpatient Sample database was analyzed for this study. We examine hospitalization rates, patient demographics, hospital stays, insurance provider, hospital type, geographic location, and septicemia rates of patients hospitalized for indwelling urinary catheter complications from 2001 to 2010.

Results

Hospitalization from indwelling urinary catheters almost quadrupled from 11,742 in 2001 to 40,429 in 2010. The increases have been due to patients who are older and predominantly male compared to all hospitalization. The “national bill” increased from $213 million to $1.3 billion (a factor of 6) after adjusting for inflation. Most patients had urinary tract infections, 77 % in 2001 and 87 % in 2010. Septicemia in indwelling urinary catheter hospitalization patients has increased from 21 % in 2001 to 40 % in 2010. In 2010, secondary diseases associated with hospitalization due to indwelling urinary catheters included urinary tract infections (86.5 %), adverse effects of medical care (61.9 %), bacterial infection (48.6 %), and septicemia (40.3 %).

Conclusions

Hospitalization due to indwelling urinary catheter complications has almost quadrupled from 11,742 in 2001 to 40,429 in 2010, and the majority of patients had urinary tract infections. Septicemia is of particular concern since rates have almost doubled (from 21 to 40 % over the period) in these patients. The specific medical indication for urinary catheters used postoperatively should be scrutinized, and the duration of placement should be minimized to reduce future complication rates.     

The 4th International Congress on Early Onset Scoliosis and Growing Spine,November 19–20, 2010, Toronto,Canada

Abstracts

The 4th International Congress on Early Onset Scoliosis and Growing Spine, November 19–20, 2010, Toronto, Canada     

25th Annual Meeting of the Surgical Working Group of Endocrine Surgery (CAEK) of the German Society of Visceral Surgery, 24–25 November 2006, Duisburg, Germany

Abstracts

25th Annual Meeting of the Surgical Working Group of Endocrine Surgery (CAEK) of the German Society of Visceral Surgery, 24–25 November 2006, Duisburg, Germany     

The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007

Sleeve gastrectomy is a rapid and less traumatic operation, which thus far is showing good resolution of comorbidities and good weight loss if a narrower channel is constructed than for the duodenal switch. There are potential intraoperative complications, which must be recognized and treated promptly. Like other bariatric operations, there are variations in the technique used. The laparoscopic sleeve gastrectomy (LSG) is being performed for superobese and high-risk patients, but its indications have been increasing. A second-stage bariatric operation may be performed if necessary, with increased safety. Long-term results of LSG and further networking are anxiously awaited.     

Road Collisions as a Cause of Traumatic Spinal Cord Injury in Ireland, 2001–2010

Background:

Road collisions remain the leading cause of traumatic spinal cord injury (TSCI) in the world. Half of all TSCIs in Ireland in 2000 were caused by road collisions. Since then, there has been a downward trend in road fatalities coincident with implemented road safety strategies.

Objective:

To examine the incidence of TSCI resulting from road collisions from 2001 to 2010.

Method:

This is a retrospective study using the hospital inpatient enquiry database of the tertiary referral center, which houses the national spinal injuries unit. Information retrieved included total numbers of patients with TSCI and number of TSCIs due to road collisions from 2001 through 2010, age groups affected, and the gender balance.

Results:

Over the 10-year period studied, the incidence rate of TSCI due to road collisions declined, although this did not reach statistical significance. The largest numbers of all TSCIs and TSCIs due to road collisions were in the 20- to 29-year age category and the male gender.

Conclusions:

As mortality due to road collisions declined, so did the number of TSCIs from the same etiology. An impactful road safety campaign is likely to have influenced these trends.Key words: epidemiology, road collisions, road safety, traumatic spinal cord injuryWorldwide, road collisions remain the leading cause of traumatic spinal cord injury (TSCI). Except for Eastern Europe, South Asia, and Oceania, road collisions were the most common cause of TSCI in all World Health Organization (WHO) regions from 1959 to 2008.¹ In Western Europe, road collisions accounted for 46% of all TSCIs during that time period.¹ TSCI due to road collision is typically associated with males younger than 30 years of age.^2–5 In Ireland, the only published study of TSCI epidemiology revealed that 23 of 46 (50%) incidents in 2000 were due to road collisions.⁶ Of persons injured in road collisions, 24% were car drivers, 11% were car passengers, 9% were motor bike users, and 4.5% were cyclists; there was a single motor cycle passenger and a single pedestrian.6 March, May, and September were the months associated with the most TSCIs of all causes.⁶In the late 1990s, the need was identified in Ireland for a strategic approach to road safety due to the high number of road fatalities. The first road safety strategy (1998 to 2002) set out the parameters for this approach that centered on the 3 main road safety interventions of education, engineering, and enforcement. The road safety strategy from 2007 to 2012 coincided with the establishment of the Road Safety Authority, a specialist agency under the auspicious of the Department of Transport. Over the last decade, there has been relative success in reducing the impact of road traffic collisions on Irish society. In 2000, there were 110 fatalities and 3,180 injuries per million population and 247 fatalities and 7,159 injuries per million vehicles registered. In 2010, these numbers had fallen to 47 fatalities and 1,850 injuries per million population and 88 fatalities and 3,423 injuries per million vehicles registered. The road safety target of no more than 252 deaths per year by the end of 2012 was achieved 4 years ahead of schedule, with 186 fatalities provisionally reported in 2011.In recent years, the Road Safety Authority’s high-profile media campaigns have been supportive of interventions relating to education, engineering, and enforcement. These interventions correspond to increased resources for the Irish Police (An Garda Síochána). The Garda Traffic Corps increased to 1,200 officers (from 580) in 2008. This enforcement strategy was enhanced by legislation to reduce the legal blood alcohol level for driving from 0.08% to 0.05% and to 0.02% for novice and professional drivers, the introduction of mandatory alcohol testing (a form of random breath testing) and the addition of newer road safety offences to the penalty points system that was originally established in 2002. The use of a comprehensive safety camera initiative, which commenced in 2011, has supported An Garda Siochána in reducing speeding on Irish roads at known locations where speed has been a factor in fatal and serious injury collisions.The education strategy for road safety targets all levels of society. Formal road safety education is now established in primary and secondary schools, at third level institutions, and at a community level, where specific programs exist for individuals not involved in formal education. The Road Safety Authority also supports educational campaigns that focus on improved driver training and testing programs, which are now being implemented in Ireland. The improvement in Ireland’s infrastructure (there are now well-designed motorways connecting the main urban and industrial regions of the country) has also contributed to Ireland’s success in improving road safety. The Road Safety Authority has developed media campaigns to inform older drivers who have not passed their driving test recently about how to safely use this improved infrastructure.It is reasonable to assume that as the number of fatalities and injuries from road traffic collisions have fallen since 2000, so has the number of TSCIs. The objective of this study, therefore, was to examine the incidence of TSCI resulting from road collisions from 2000 to 2010, coincident with the implementation of an impactful road safety strategy.