Introduction: Elevated intracranial pressure(ICP)can cause secondary brain injury after severe traumatic brain injury(TBI), and ICP is the key factor that determines the outcome. Therefore, prediction of elevation of ICP during the course of the injury would allow for more effective care of patients with severe TBI. In this study, we investigated predictive factors for elevation of ICP in patients with severe acute subdural hematoma(ASDH).
Methods: Twenty patients with severe isolated ASDH were admitted to our hospital between January 2009 and April 2016. The patients were divided into two groups with a maximum ICP of ≥20mmHg(elevated ICP group)and <20mmHg(normal ICP group). Age, mechanism of injury, Glasgow Coma Scale score on admission, initial head computed tomography findings, vital signs, serological and blood gas examinations, initial ICP, and clinical outcome were evaluated.
Results: The elevated ICP group had significantly higher initial ICP(5.0±3.1 vs. 30±22.4mmHg, p<0.01), arterial oxygen pressure(151.2±68.3 vs. 314.2±197.1mmHg, p<0.05), and activated partial thromboplastin time(APTT;28.17±3.1 vs. 35.96±8.0, p<0.05)at admission, and significantly lower fibrinogen level(273.3±65.1 vs. 188.1±82.4mg/dL, p<0.05)and favorable outcome rate(p<0.01).
Conclusions: Our results show that high initial ICP, APTT, and arterial oxygen and low fibrinogen levels are associated with ICP elevation in patients with severe ASDH. These factors might be useful for the indication of therapeutic methods such as decompressive craniectomy.
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http://dx.doi.org/10.11477/mf.1436204019 | DOI Listing |
S Afr J Surg
December 2024
Division of Surgery, Tygerberg Hospital, Stellenbosch University, South Africa.
Background: Bowel trauma, encompassing injuries to the small and large intestine, represents a significant medical challenge due to its potential for morbidity and mortality. Management of bowel injuries remains surgical, but multiple factors influence the outcome in these patients. This study provides an in-depth analysis of the high-risk features of hollow visceral trauma in the ICU setting and the corresponding mortality rates, shedding light on the critical factors that influence outcomes in these cases.
View Article and Find Full Text PDFS Afr J Surg
December 2024
Trauma and Burns Unit, Inkosi Albert Luthuli Central Hospital, South Africa.
Background: Data on trauma burden and outcome varies amongst the nine South African Provinces. In Limpopo Province there is a paucity of data which this study aimed to quantify and characterise the severe trauma burden in the province.
Methods: A retrospective chart review for all patients with injury severity score (ISS) > 16 over a 6-year period (Jan 2015-Dec 2020) at two central hospitals in Limpopo province.
S Afr J Surg
December 2024
Department of Surgical Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, South Africa.
Background: KwaZulu-Natal bears a significant trauma burden, with polytrauma patients often experiencing traumatic limb amputations. This study investigates traumatic limb amputations in the subgroup of severely injured polytrauma patients admitted to the trauma ICU in KwaZulu-Natal. This study aims to describe the management and outcomes of traumatic limb amputations in polytrauma patients at the trauma ICU.
View Article and Find Full Text PDFCurr Stem Cell Res Ther
January 2025
Department of Immunology, Immunology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Background: Since there is currently no cure for amyotrophic lateral sclerosis (ALS), it is essential to search for diagnostic biomarkers and novel treatments to reduce the severity of this disease. One of these treatment approaches is stem cell transplantation.
Objective: This study aims to evaluate the safety and efficacy of repeated transplantation of autologous bone marrow-derived mesenchymal stem cells (BM-MSCs) in patients with ALS by analyzing clinical and molecular data.
Circulation
January 2025
Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China (J.D., J.Z., X.X., Y.C., S.S., S.L., L.C., Y.W., L.L., R.G., D.H., X.M., R.Z., H.Y., T.C., J.T., X.L., S.J., J.H., C.F.B.Y.).
Background: Patients with acute myocardial infarction and angiographically obstructive non-culprit lesions are at high risk for recurrent major adverse cardiac events (MACEs). However, it remains largely unknown whether events are due to stenosis severity or due to the underlying high-risk lesion morphology.
Methods: Between January 2017 and December 2021, 1312 patients with acute myocardial infarction underwent optical coherence tomography of all the 3 main epicardial arteries after successful percutaneous coronary intervention.
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