Background: Management guidelines for pediatric blunt spleen injuries (BSI) include adolescent patients but few studies have compared current management of adolescents with respect to other age groups by center type.
Methods: A retrospective review of 2017-2018 National Trauma Quality Improvement (TQIP) data of children (6-12), adolescents (13-17) and young adults (18-24) with BSI presenting to an adult, pediatric only, or adult/pediatric trauma center, comparing the rate of splenic intervention for adolescents by trauma center was performed.
Results: Children had lower odds of spleen intervention than adolescents at both adult (OR 0.61 95%CI 0.39, 0.95) and adult/pediatric (OR 0.55 95%CI 0.35, 0.87) centers but did not differ at pediatric centers (OR 0.94 95%CI 0.39, 2.2) (n = 10,494). Adolescents adjusted odds of intervention was equal to adults at adult trauma centers (OR 1.2 95%CI 0.95, 1.4).
Conclusion: Adolescents are more likely to undergo interventions for BSI as compared to children at both adult and adult/pediatric trauma centers.
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http://dx.doi.org/10.1016/j.amjsurg.2021.12.010 | DOI Listing |
Neurosurg Rev
January 2025
Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Traumatic Brain Injury (TBI) is a devastating cause of death and disability. Outcomes following TBI have been extensively studied; however, less attention has been given to identifying characteristics of individuals who have a favorable outcome following severe TBI. We conducted a retrospective analysis of a database containing information on TBI patients admitted to a level 1 trauma center between 2015 and 2021.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Department of Anaesthesia & Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Sector-12, Chandigarh, 160012, India.
Purpose: Perioperative metabolic acidosis negatively affects patient outcomes. Perioperative fluid therapy has a clinically significant effect on acid-base balance. This study was conducted to evaluate the effects of isotonic sodium bicarbonate infusion (ISB) versus balanced crystalloid solution (BCS) on perioperative acid-base balance, in terms of postoperative base excess, among patients undergoing emergency laparotomy for perforation peritonitis.
View Article and Find Full Text PDFBMC Emerg Med
January 2025
Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Background: Globally, healthcare institutions have seen a marked rise in workplace violence (WPV), especially since the Covid-19 pandemic began, affecting primarily acute care and emergency departments (EDs). At the University Health Network (UHN) in Toronto, Canada, WPV incidents in EDs jumped 169% from 0.43 to 1.
View Article and Find Full Text PDFInjury
January 2025
Brigham and Women's Hospital, Dpt. of Orthopaedic Surgery, Boston, MA, United States; Harvard Medical School Orthopedic Trauma Initiative, Boston, MA, United States.
Background: Older adults with rib fractures pose an increasing clinical and financial burden on healthcare. Identifying and addressing the increased risk of adverse outcomes has been a key objective in geriatric co-management of surgical patients. The Comprehensive Geriatric Assessment-based Frailty Index (FI-CGA) is a useful predictor of complications and mortality in older adults, but its value in rib fracture management remains unclear.
View Article and Find Full Text PDFGeriatr Gerontol Int
January 2025
Division of Acute Care Surgery, Department of Surgery, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA.
Aim: Pre-injury frailty has been investigated as a tool to predict outcomes of older trauma patients. Using artificial intelligence principles of machine learning, we aimed to identify a "signature" (combination of clinical variables) that could predict which older adults are at risk of fall-related hospital admission. We hypothesized that frailty, measured using the 5-item modified Frailty Index, could be utilized in combination with other factors as a predictor of admission for fall-related injuries.
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