Herausforderungen der Digitalisierung in der Traumaversorgung

Trentzsch, Heiko; Osterhoff, Georg; Heller, Raban Arved; Nienaber, Ulrike; Lazarovici, Marc; Digitalisierung, AG; Unfallchirurgie, der Deutschen Gesellschaft für Orthopädie und; Notfall, Intensivmedizin und Schwerverletztenversorgung Sektion

doi:10.1007/s00113-020-00859-7

Cited by 3 publications

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“…Furthermore, digital tools can enable the provision of more personalized and patient centered healthcare ( 3 ). The incorporation of AI systems in orthopaedic surgery can be attributed to emerging advancements in technologies based on navigated, computer guided and robotic assisted input ( 4 ). Interactive, virtual 3D-imaging (in conjunction with robotics) are replacing standard two-dimensional (2D) imaging modalities which has improved pre-operative planning and intra-operative functionality and therefore patient outcome.…”

Section: Introductionmentioning

confidence: 99%

Digitalization in orthopaedics: a narrative review

Youssef,

De Wet,

Back

et al. 2024

Front. Surg.

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Advances in technology and digital tools like the Internet of Things (IoT), artificial intelligence (AI), and sensors are shaping the field of orthopaedic surgery on all levels, from patient care to research and facilitation of logistic processes. Especially the COVID-19 pandemic, with the associated contact restrictions was an accelerator for the development and introduction of telemedical applications and digital alternatives to classical in-person patient care. Digital applications already used in orthopaedic surgery include telemedical support, online video consultations, monitoring of patients using wearables, smart devices, surgical navigation, robotic-assisted surgery, and applications of artificial intelligence in forms of medical image processing, three-dimensional (3D)-modelling, and simulations. In addition to that immersive technologies like virtual, augmented, and mixed reality are increasingly used in training but also rehabilitative and surgical settings. Digital advances can therefore increase the accessibility, efficiency and capabilities of orthopaedic services and facilitate more data-driven, personalized patient care, strengthening the self-responsibility of patients and supporting interdisciplinary healthcare providers to offer for the optimal care for their patients.

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Section: Introductionmentioning

confidence: 99%

Digitalization in orthopaedics: a narrative review

Youssef,

De Wet,

Back

et al. 2024

Front. Surg.

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“…Die rechtlichen Rahmenbedingungen haben sich mit der Einführung der DS-GVO im Mai 2018 gewandelt. Die drohenden Sanktionen aus den Bedingungen der DS-GVO erfordern erhebliche Anstrengungen für die Einhaltung datenschutzrechtlicher Bestimmungen bei der Verarbeitung medizinischer Daten [ 22 , 23 ]. Um eine lückenlose Dokumentation in das TraumaRegister DGU® zu gewährleisten, sind eine hinreichend informierte Einwilligung nebst Aufklärung aller schwer verletzten Patienten und die Beachtung hochdifferenzierter Regelungen zur Datensicherheit erforderlich.…”

Section: Introductionunclassified

Influence of the general data protection regulation on data quality in registry data collection

et al. 2022

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Zusammenfassung Hintergrund Durch die neue Datenschutz-Grundverordnung (DS-GVO) sind die Anforderungen an eine sachgerechte Aufklärung der Patienten über die Dokumentation pseudonymisierter, personenbezogener Daten in einem Register enorm gestiegen. Dies betrifft ganz besonders das TraumaRegister DGU®, da eine schriftliche Aufklärung schwer verletzter Patienten in der Akutsituation nicht immer gelingt. Ziel der Untersuchung war es, den Einfluss der infolge fehlender Aufklärung nichtdokumentierten Fälle auf die standardisierte Mortalitätsrate (SMR) zu untersuchen. Material und Methode Im Jahr 2019 wurden 274 Patienten retrospektiv erfasst, die die Kriterien des Basiskollektivs erfüllen. Darunter waren 72 Sekundärverlegungen, die ausgeschlossen wurden. Bei den verbliebenen 197 Patienten konnte in allen Fällen der RISC II Score erhoben werden. Ergebnisse Von den 197 primär (72 % männlich) versorgten Patienten wurden 147 (74,6 %) schriftlich aufgeklärt oder waren verstorben und wurden folglich dokumentiert. Die prognostizierte Letalität, tatsächliche Letalität und SMR betrug 18,5 %, 19,0 % resp. 1,03. Bei den Patienten, die nicht aufgeklärt wurden (n = 50), lagen die prognostizierte Letalität, tatsächliche Letalität und SMR bei 7,0 %, 0 % resp. 0. Bezieht man diese Fälle mit ein, ergibt sich eine deutlich günstigere SMR mit 0,93. Schlussfolgerung Durch die fehlende schriftliche Einwilligung überlebender Patienten konnten nur etwa 75 % aller Patienten der Uniklinik Leipzig für das TraumaRegister DGU® dokumentiert werden. Da die lokale Gesetzeslage andererseits eine Registerdokumentation verstorbener Patienten zulässt, ergibt sich daraus eine nachteilige Beeinflussung der SMR, die in unserem Kollektiv etwa 10 % höher ausfällt, als sie in Realität ist.

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Effectiveness of the multi-/interdisciplinary neurorehabilitati-on program in young patients with incomplete myeloradicualar injuries after spinal cord injury

Stoica

Anghelescu

Onose

2022

Balneo and PRM Research Journal

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Nowadays young persons may be frequent victims of traumatic cervical spinal cord injury (CSCI). Material and methods A retrospective study (January 2019-March 2021) we conducted with the approval of the Ethics Commission of THEBA, to assess the results of the complex me-dical rehabilitation program during the subacute period. A selected group of 23 young tetraple-gic patients with traumatic CSCI, were admitted to the THEBA Neuromuscular Rehabilitation Clinic with incomplete (AIS-B, -C, -D) myeloradicular injuries. All patients were males, aged between 19 and 57 years (with a mean of 44.35 years, SD 12.9). Patients came from urban areas 11 (48%) and the remaining 12 (52%) from rural areas. Results The spine lesion location was located at C2 vertebral level (4 men), C3 (4 men), C4 (3 men), C5 (6 men); C6 (in 2 patients); C7 (in 2 men); T6 and T7 in 1 patient each. The patients' neurological levels of injury were: C1 (in 2 pati-ents), C2 (in 2 patients), C3 (in 4 patients), C5 (in 7 patients), C6 (in 4 patients) and C7 (in 2 pati-ents). The AIS/ Frankel degree at admission was: incomplete lesion AIS-B 3 patients, AIS-C 11 pa-tients, AIS-D 9 men. The average muscle strength at admission was 60.72 (SD 25.74). In the study group 20 patients were operated: anterior osteosynthesis was performed in 16 patients and pos-terior vertebral approach in 4 patients. The neurological evolution was favorable: at discharge there were only patients with incomplete AIS-C (8 men), respectively AIS-D (15 men) grade type of lesions, and their average muscle strength at discharge was 71.97 (SD 22.30). The following comorbidities were associated: arterial hypertension (in 2 patients), traumatic brain injury (in 14 patients), alcoholism (in 9 patients), pneumonia (in 6 patients), neoplastic disorders (in 1 pati-ent), gastric ulcer (in 2 patients), depression (in 2 patients). Complications of the immobilization syndrome were: enterocolitis (in 3 men), bronchopneumonia (in 3 patients), urinary tract infec-tions (in 13 patients) and bedsores (in 2 patients). Discussion Effectiveness of the final therapeutic approach was assessed (in percentage) by evaluating the progress of the muscle strength (quanti-fied and compared at discharge vs. admission) reported to the number of days of treatment. The external-internal variations of the numeric scores of the quality of life, FIM, Ashworth and Penn were evaluated. Statistics was performed for small groups (Anova and Pearson) to establish the effectiveness of the rehabilitation program, evaluating the level of correlation between the sco-res quantified with the aforementioned the scales. An inversely proportional relationship was found between spasticity and efficacy of physical therapy (F 0.000, Pearson -0.35), between the scores of Penn scale and the effectiveness of physical therapy (F test 0.000, Pearson -0.18), respec-tively directly proportional relationship between the kinetic therapy and FIM (F test 0.000, Pear-son 0.74), similar to the relationship between physical therapy and the scores assessing the quali-ty of life (F test 0.01, Pearson 0.02). Conclusions These results underline the importance of a multi-interdisciplinary team approach in the management of the tetraplegic patients after CSCI during the subacute post-lesional/ post-operative stage. Keywords: neurorehabilitation program, incomplete myeloradicualar injuries, spinal cord injury

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Herausforderungen der Digitalisierung in der Traumaversorgung

Abstract: Gesellschaft für Orthopädie und Unfallchirurgie (DGOU) • Sektion Notfall-, Intensivmedizin und Schwerverletztenversorgung (NIS) der Deutschen Gesellschaft für Unfallchirurgie (DGU)

Cited by 3 publications

References 24 publications

Digitalization in orthopaedics: a narrative review

Digitalization in orthopaedics: a narrative review

Influence of the general data protection regulation on data quality in registry data collection

Effectiveness of the multi-/interdisciplinary neurorehabilitati-on program in young patients with incomplete myeloradicualar injuries after spinal cord injury

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