Trauma Associated with Cardiac Conduction Abnormalities: Population-Based Perspective, Mechanism and Review of Literature

Objectives:   

Various cardiac conduction abnormalities have been described as being a result of trauma in many case reports. The aim of this research was to look at the association between trauma (thoracic and cardiac) and conduction abnormalities in a large hospitalized population.     

High-velocity penetrating thoracic trauma with suspected cardiac involvement in a combat support hospital

Purpose  

The most common cardiac injuries in the United States are blunt trauma from motor vehicle accidents or low-velocity trauma from stabbings. During military conflict, high-velocity injuries, including gunshot wounds (GSW) and fragment injury from improvised explosive devices (IED), are relatively more common.     

Implantable cardioverter defibrillators and permanent pacemakers: prevalence and patient outcomes after trauma

Background

The prevalence and outcomes of older trauma patients with implantable cardioverter defibrillators (ICDs) or permanent pacemakers (PPMs) is unknown.

Methods

The trauma registry at a regional trauma center was reviewed for blunt trauma patients, aged ≥ 60 years, admitted between 2007 and 2014. Medical records of cardiac devices patients were reviewed.

Results

Of 4,193 admissions, there were 146 ICD, 233 PPM, and 3,814 no device patients; median Injury Severity Score was 9. Most cardiac device patients had substantial underlying heart disease. Patients with ICDs (13.0%) and PPMs (8.6%) had higher mortality rates than no device patients (5.6%, P = .0002). Among cardiac device patients who died, the device was functioning properly in all that were interrogated; the most common cause of death was intracranial hemorrhage. On propensity score analysis, cardiac devices were not independent predictors of mortality but rather surrogate variables associated with other predictors of mortality.

Conclusions

Approximately 9.0% of admitted older patients had cardiac devices. Their presence identified patients who had higher mortality rates, likely because of their underlying comorbidities, including cardiac dysfunction.     

Temporal profiles of aquaporin 4 expression and astrocyte response in the process of brain damage in fat embolism model in rats

Purpose  

Fat embolism syndrome is a serious complication observed after trauma, orthopedic surgery, and cardiac surgery. We investigated brain damage in relationship to temporal profiles of water channel aquaporin 4 (AQP4) and astrocyte response to fat embolism in rats.     

Assessment of cardiac injury in patients with blunt chest trauma

Background  

There has been difficulty in the appropriate determination of blunt cardiac injury (BCI) related to blunt thoracic trauma (BTT). The aim of this study is to assess BCI and the effectiveness of diagnostic tests in BTT in patients admitted to the emergency department (ED).     

Traumatic adrenal gland injury: epidemiology and outcomes in a major Australian trauma center

Introduction  

Adrenal gland injury (ADGI) is quite rare and mostly associated with other organ injuries secondary to blunt thoracoabdominal trauma. Bilateral ADGI has severe consequences if not discovered in the treatment course of trauma victims.     

Trauma in a Teaching Hospital Outpost: Comprehensive Health Centre, Okoyong, Cross River State, Nigeria

Background:   

Road traffic injuries and other forms of trauma have become a major health problem worldwide, but Africa is the worst hit. This study was designed to evaluate the characteristics of trauma injuries in order to offer solutions for planning in terms of policy formulation and implementation.     

Penetrating Bile Duct Injury Successful Treatment by Endobiliary Stenting

Background:   

Cases of extrahepatic biliary tree trauma are not as common as other intraabdominal injuries and may pose a diagnostic and therapeutic challenge.     

Technological advancements in the care of the trauma patient

Introdution  

Medical technology has benefited many types of patients, but trauma care has arguably benefited more from technologic development than almost any other field.     

The association between depressive mood and pain amongst individuals with limb amputations

Introduction  

The purpose of this study was to evaluate the relationship between pain and depressive mood amongst persons with limb amputations, and to examine the relationship between the etiology (work-related trauma or other types) and depressive mood.     

The impact of trauma mechanism on outcome: a follow-up study on health-related quality of life after major trauma

Objectives  

To relate the trauma mechanism in a trauma population to health-related quality of life outcomes and mortality rates.     

A Quarter Century Experience in Liver Trauma: A Plea for Early Computed Tomography and Conservative Management for all Hemodynamically Stable Patients

Background  

Advances in diagnostic imaging and the introduction of damage control strategy in trauma have influenced our approach to treating liver trauma patients. The objective of the present study was to investigate the impact of change in liver trauma management on outcome.     

Operative exposure and management of axillary vessel injuries

Introduction  

Axillary vessel injuries are uncommon and challenging injuries encountered by trauma surgeons. Proximity of this vessel to other adjacent veins including the axillary vein, brachial plexus and the osseous structures of the shoulder and upper arm account for a large number of associated injuries.     

Mortality after trauma laparotomy in geriatric patients

Background

Geriatric patients are at higher risk for adverse outcomes after injury because of their altered physiological reserve. Mortality after trauma laparotomy remains high; however, outcomes in geriatric patients after trauma laparotomy have not been well established. The aim of our study was to identify factors predicting mortality in geriatric trauma patients undergoing laparotomy.

Methods

A retrospective study was performed of all trauma patients undergoing a laparotomy at our level 1 trauma center over a 6-y period (2006–2012). Patients with age ≥55 y who underwent a trauma laparotomy were included. Patients with head abbreviated injury scale (AIS) score ≥ 3 or thorax AIS ≥ 3 were excluded. Our primary outcome measure was mortality. Significant factors in univariate regression model were used in multivariate regression analysis to evaluate the factors predicting mortality.

Results

A total of 1150 patients underwent a trauma laparotomy. Of which 90 patients met inclusion criteria. The mean age was 67 ± 10 y, 63% were male, and median abdominal AIS was 3 (2–4). Overall mortality rate was 23.3% (21/90) and progressively increased with age (P = 0.013). Age (P = 0.02) and lactate (P = 0.02) were the independent predictors of mortality in geriatric patients undergoing laparotomy.

Conclusions

Mortality rate after trauma laparotomy increases with increasing age. Age and admission lactate were the predictors of mortality in geriatric population undergoing trauma laparotomies.     

The Epidemiology of Traumatic Hemothorax in a Level I Trauma Center: Case for Early Video-assisted Thoracoscopic Surgery

Objective:   

Hemothorax is a common sequela of chest trauma. Complications after chest trauma include retained hemothorax and empyema requiring multiple interventions. We studied the epidemiology of hemothorax and its complications at a level I trauma center.     

Outcomes in Pediatric Trauma Care in the Stockholm Region

Background:   

Although trauma is a leading cause of pediatric mortality and morbidity in Sweden, few studies have examined the outcome of pediatric trauma.     

Evaluation of the Long-term Trend in Mortality from Injury in a Mature Inclusive Trauma System

Background  

Organized trauma systems are designed to improve the quality and efficiency of trauma care. Several studies have reported mortality reductions during or immediately after implementation of a trauma system but little data are available on long-term trends. The aim of this study was to evaluate the long-term trend in risk-adjusted mortality in a mature inclusive trauma system.     

Five years experience of trauma care in a German urban level I university trauma center

Background:   

A regionalized approach to trauma care with the implementation of designated level I trauma centers has been shown to improve survival after multiple injuries. Our study aimed to describe the current reality in an urban German level I university trauma center concerning the primary admission of patients into the emergency room.     

Helicopter Evacuation of Trauma Victims in Los Angeles: Does it Improve Survival?

Background  

The purpose of this study was to investigate the relationship between the method of transport after injury and survival among trauma patients admitted to a Level 1 trauma facility in Los Angeles, California.     

Pancreatic injury in 284 patients with severe abdominal trauma: outcome,course, and treatment algorithm

Purpose  

The relevance of pancreatic trauma in severely injured patients within a large collective has not been thoroughly analyzed yet. This study aimed at assessing the prevalence of pancreatic trauma in relation to the outcome and the currently established algorithm of treatment.