Publications by authors named "Mark G van Vledder"

Background: Injury prevalence is a metric which can be used to understand healthcare utilisation and prioritise injuries based on the magnitude of the injury rate. Given the ageing population in high-income countries and subsequently ageing of the injured population, the probability of long-term or permanent consequences of injuries is also likely to increase. By understanding past trends and exploiting patterns of prevalence injury rates (PIRs), future PIRs can be predicted.

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Importance: Early administration of supplemental oxygen for all severely injured trauma patients is recommended, but liberal oxygen treatment has been associated with increased risk of death and respiratory complications.

Objective: To determine whether an early 8-hour restrictive oxygen strategy compared with a liberal oxygen strategy in adult trauma patients would reduce death and/or major respiratory complications.

Design, Setting, And Participants: This randomized controlled trial enrolled adult trauma patients transferred directly to hospitals, triggering a full trauma team activation with an anticipated hospital stay of a minimum of 24 hours from December 7, 2021, to September 12, 2023.

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Background: Bone-anchored protheses (BAPs) by means of osseointegrated implants are increasingly being used in amputees with socket-related issues. Clinical advancements are being published by more and more centers worldwide. Although the number of publications and interest in BAP is growing, a systematic evaluation of scholarly output is lacking.

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Objectives: Physician staffed Helicopter Emergency Medical Services (P-HEMS) care in the Netherlands has transitioned from predominantly trauma management to handling a variety of medical conditions. Relevant outcome parameters for Dutch P-HEMS research have not been previously defined. National consensus was sought to identify relevant long term patient outcome parameters, process outcome parameters and performance outcome parameters for Dutch P-HEMS care.

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Introduction: Severely injured patients are often incapacitated to provide informed consent for clinical studies. Deferred consent could facilitate unbiased enrollment in studies involving these patients. Little is known about how healthcare professionals (HCPs) perceive deferred consent and how this impacts patient enrollment.

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Background: The rising popularity and use of a bone-anchored prosthesis (BAP) involving an osseointegrated implant for patients with lower-limb amputations experiencing socket-related issues have led to increased interest in the measurement of clinical and functional outcomes. However, the value of BAP treatment characteristics from the patient perspective has not yet been investigated. This study aimed to determine the relative importance of specific BAP characteristics, and the effect of complications in quality-of-life (QoL) points and monetary utility decrement (loss [€]), using a 2-center discrete choice experiment (DCE) conducted in The Netherlands.

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Background: While current preoperative and postoperative assessment of the fractured and surgically reconstructed calcaneus relies on computed tomography (CT)-imaging, there are no established methods to quantify calcaneus morphology on CT-images. This study aims to develop a semi-automated method for morphological measurements of the calcaneus on three-dimensional (3D) models derived from CT-imaging.

Methods: Using CT data, 3D models were created from healthy, fractured, and surgically reconstructed calcanei.

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Background: Emergency Reflex Action Drills (ERADs) are meant to decrease stress-associated cognitive demand in high urgency situations. The aim of this study was to develop and test an ERAD for witnessed traumatic cardiac arrest (TCA), an event in which potentially reversible causes need to be systematically addressed and treated in a short period of time. We hypothesize that this ERAD (the TCA-Drill) helps ground Emergency Medical Services (EMS) nurses in overcoming performance decline during this specific high-pressure situation.

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Article Synopsis
  • A consistent coordinate system is essential for accurately analyzing the calcaneus before and after surgery to address its critical role in weight-bearing and biomechanical alignment.
  • The study tested four methods for creating a talus-derived coordinate system in 3D modeling of the calcaneus, demonstrating that the atlas-based method provided the closest alignment with reference measurements.
  • The findings indicate that talus-derived coordinate systems are promising for improving measurements and could enhance clinical outcomes for fractured and surgically reconstructed calcanei, warranting further investigation.
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Background: Truncal and junctional hemorrhage is the leading cause of potentially preventable deaths in trauma patients. To reduce this mortality, the application of advanced bleeding control techniques, such as resuscitative endovascular balloon occlusion of the aorta (REBOA), junctional tourniquets, Foley catheters, or hemostatic agents should be optimized. This study aimed to identify trauma patients with non-compressible truncal and junctional hemorrhage (NCTJH) who might benefit from advanced bleeding control techniques during initial trauma care.

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Introduction: Several studies have shown the additional benefit of point-of-care ultrasound (POCUS) by prehospital Emergency Medical Services (EMS). Since organization of EMS may vary significantly across countries, the value of POCUS likely depends on the prehospital system in which it is used. In order to be able to optimally implement POCUS and develop a tailored training curriculum, it is important to know how often POCUS is currently used, for which indications it is used, and how it affects decision making.

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Introduction: Quality improvement in prehospital emergency medical services (EMS) can only be achieved by high-quality research and critical appraisal of current practices. This study examines current opportunities and barriers in EMS research in the Netherlands.

Methods: This mixed-methods consensus study consisted of three phases.

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Introduction: Supplemental oxygen is commonly used in trauma patients, although it may lead to hyperoxaemia that has been associated with pulmonary complications and increased mortality. The primary objective of this trial, TRAUMOX2, is to compare a restrictive versus liberal oxygen strategy the first 8 hours following trauma.

Methods And Analysis: TRAUMOX2 is an investigator-initiated, international, parallel-grouped, superiority, outcome assessor-blinded and analyst-blinded, randomised, controlled, clinical trial.

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3D-printing has become a promising adjunct in orthopedic surgery over the past years. A significant drop in costs and increased availability of the required hardware and software needed for using the technique, have resulted in a relatively fast adaptation of 3D-printing techniques for various indications. In this review, the role of 3D-printing for deformity corrections of the lower extremity is described.

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Forearm fractures such as distal radius fractures are traditionally treated with a plaster or synthetic cast. Patients commonly report inconvenience of the cast, skin problems, and occasionally radial sensory nerve numbness. A known issue with casting is that the rate of secondary dislocation is high.

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Background: Circulatory arrest after trauma is a life-threatening situation that mandates urgent action. The aims of this systematic review and meta-analysis on prehospital traumatic cardiac arrest (TCA) were to provide an updated pooled mortality rate for prehospital TCA, to investigate the impact of the time of patient inclusion and the type of prehospital trauma system on TCA mortality rates and neurological outcome, and to investigate which pre- and intra-arrest factors are prognostic for prehospital TCA mortality.

Methods: This review was conducted in accordance with the PRISMA and CHARMS guidelines.

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Background: Traumatic cardiac arrest (TCA) is a severe and life-threatening situation that mandates urgent action. Outcomes after on-scene treatment of TCA in the Netherlands are currently unknown. The aim of the current study was to investigate the rate of survival to discharge in patients who suffered from traumatic cardiac arrest and who were subsequently treated on-scene by the Dutch Helicopter Emergency Medical Services (HEMS).

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Purpose: The aim of this study was to compare the rate of first attempt success of endotracheal intubation performed by ambulance nurses in patients with a Glasgow Coma Scale (GCS)  of 3 using video laryngoscopy versus direct laryngoscopy.

Methods: A prospective cohort study was conducted in a single, independent ambulance service. Twenty of a total of 65 nurse-staffed ambulances were equipped with a video laryngoscope; a classic direct laryngoscope (Macintosh) was available on all 65 ambulances.

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Background: Despite improving survival of patients in prehospital traumatic cardiac arrest (TCA), initiation and/or discontinuation of resuscitation of TCA patients remains a subject of debate among prehospital emergency medical service providers. The aim of this study was to identify factors that influence decision making by prehospital emergency medical service providers during resuscitation of patients with TCA.

Methods: Twenty-five semi-structured interviews were conducted with experienced ambulance nurses, HEMS nurses and HEMS physicians individually, followed by a focus group discussion.

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Background: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures.

Methods: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region.

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Introduction: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated thoracotomy on the accident scene. The aim of this study was to determine the proportion of patients with return of spontaneous circulation and subsequent survival after out of hospital thoracotomy in the Netherlands.

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Background: Long-term complications of previous rectal surgery (e.g., enterovisceral fistula, anastomotic stricture, rectal stenosis) can be challenging problems for which transabdominal or transperineal surgery with or without definitive fecal diversion is often required.

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Background: A reduction in skeletal muscle mass (sarcopenia) independently predicts poor survival in patients with hepatocellular carcinoma (HCC) undergoing treatment with curative intent. Whether this is due to an increased risk of recurrence and disease specific death, or due to an increased risk of postoperative morbidity and mortality is currently unclear. In this study, we investigate the association between sarcopenia and death in a cohort of HCC patients undergoing treatment with curative intent.

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