Introduction: The trauma registry of the German Society of Trauma Surgery is a multicentric prospective record of the treatment of severely injured patients.
Methods: The present study examines the effect of a quality management system on key processes and outcomes, in hospitals included in the trauma registry. The study is based on data of 11 013 severely injured patients (injury severity score = 16) who were treated in 105 hospitals between 1993 and 2005. A variety of parameters relating to early diagnosis and treatment were considered. Outcome quality was measured by a comparison between observed and calculated mortality (revised injury severity classification).
Results: During the 13 year long study period mortality could be significantly reduced from 22.8% to 18.7%. The time to initial radiological and ultrasound diagnosis was reduced, the use of computed tomography increased, the time until emergency operations in hemorrhagic shock was reduced, and damage limiting orthopedic interventions were performed more frequently.
Discussion: The German Trauma Registry records processes and treatment results in severely injured patients. This information is fed back to participating hospitals. The continuous data feedback is associated with a continuous improvement of process and outcome quality in the treatment of severely injured patients.
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http://dx.doi.org/10.3238/arztebl.2008.0225 | DOI Listing |
Nat Cell Biol
January 2025
State Key laboratory of Genetic Engineering, School of Life Sciences, Liver Cancer Institute of Zhongshan Hospital, Fudan University, Shanghai, China.
Severe damage to the intrahepatic biliary duct (IHBD) network occurs in multiple human advanced cholangiopathies, such as primary sclerosing cholangitis, biliary atresia and end-stage primary biliary cholangitis. Whether and how a severely damaged IHBD network could reconstruct has remained unclear. Here we show that, although the gallbladder is not directly connected to the IHBD, there is a common hepatic duct (CHD) in between, and severe damage to the IHBD network induces migration of gallbladder smooth muscle cells (SMCs) to coat the CHD in mouse and zebrafish models.
View Article and Find Full Text PDFAnasthesiol Intensivmed Notfallmed Schmerzther
January 2025
After severe trauma, but also perioperatively, massive bleeding is associated with increased morbidity and mortality. In severely injured patients, hemorrhagic shock remains to be the main cause of death in addition to traumatic brain hemorrhage. In non-cardiac surgery, a surgical bleeding complication increases perioperative morbidity (intensive care length of stay, acute renal failure, infections, thromboembolic complications) by a factor of three to four and mortality by a factor of six.
View Article and Find Full Text PDFJ Pediatr Surg
December 2024
Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. Electronic address:
Introduction: Indications for extracorporeal membrane oxygenation (ECMO) in pediatric trauma continue to evolve. This study evaluates trends and practices in ECMO use for injured children and identifies factors associated with mortality using the National Trauma Data Bank (NTDB).
Methods: We conducted a retrospective review of children ≤18 years who underwent ECMO therapy following trauma, recorded in the NTDB from 2007 to 2018.
Radiologie (Heidelb)
January 2025
Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51107, Köln, Deutschland.
Criteria for assessment of the significance of scientific articles are presented. The focus is on research design and methodology, illustrated by the classical study on prehospital volume treatment of severely injured individuals with penetrating torso injuries by Bickell et al. (1994).
View Article and Find Full Text PDFJ Mater Chem B
January 2025
Centre for 3D Models of Health and Disease, Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK.
The significance of three-dimensional (3D) bioprinting in the domain of regenerative medicine and tissue engineering is readily apparent. To create a multi-functional bioinspired structure, 3D bioprinting requires high-performance bioinks. Bio-inks refer to substances that encapsulate viable cells and are employed in the printing procedure to construct 3D objects progressive through successive layers.
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