Increased morbidity and mortality in elderly patients with lower extremity trauma and associated injuries: A review of 420,066 patients from the national trauma database

Sharfman, Zachary T.; Parsikia, Afshin; Rocker, Ta'ir N.; Kahn, Mani; Sokol, Shima; Stone, Melvin E.; McNelis, John; Sen, Milan; Dimitroulias, Apostolos

doi:10.1016/j.injury.2020.10.037

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…[14,15] The National Trauma Data Bank (NTDB) is the largest repository for traumatic injuries. [16][17][18][19][20][21][22][23][24][25][26][27][28] Using the NTDB, Phillips et al analyzed data from 777 patients with penetrating injuries to determine mortality, injury patterns, and predictors of prognosis; however, they did not focus on PP. Similarly, another database study covering the 2008 to 2010 NTDB was published in 2014 and reported that pancreaticoduodenectomy did not improve outcomes.…”

Section: Introductionmentioning

confidence: 99%

Injury characteristics and predictors of mortality in patients undergoing pancreatic excision after abdominal trauma: A National Trauma Data Bank (NTDB) study

Alzerwi

2023

Medicine

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Pancreatic tumors and pancreatitis are the main indications for pancreatic excision (PE). However, little is known about this type of intervention in the context of traumatic injuries. Surgical care for traumatic pancreatic injuries is challenging because of the location of the organ and the lack of information on trauma mechanisms, vital signs, hospital deposition characteristics, and associated injuries. This study examined the demographics, vital signs, associated injuries, clinical outcomes, and predictors of in-hospital mortality in patients with abdominal trauma who had undergone PE. Following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, we analyzed the National Trauma Data Bank and identified patients who underwent PE for penetrating or blunt trauma after an abdominal injury. Patients with significant injuries in other regions (abbreviated injury scale score ≥ 2) were excluded. Of the 403 patients who underwent PE, 232 had penetrating trauma (PT), and 171 had blunt trauma (BT). The concomitant splenic injury was more prevalent in the BT group; however, the frequency of splenectomy was comparable between groups. In particular, concomitant kidney, small intestine, stomach, colon, and liver injuries were more common in the PT group (all P < .05). Most injuries were observed in the pancreatic body and tail regions. The trauma mechanisms also differed between the groups, with motor vehicles accounting for most of the injuries in the BT group and gunshots accounting for most of the injuries in the PT group. In the PT group, major liver lacerations were approximately 3 times more common (P < .001). The in-hospital mortality rate was 12.4%, with no major differences between the PT and BT groups. Furthermore, there was no difference between BT and PT with respect to the location of the injuries in the pancreas, with the pancreatic tail and body accounting for almost 65% of injuries. Systolic blood pressure, Glasgow Coma Scale score, age, and major liver laceration were revealed by logistic regression as independent predictors of mortality, although trauma mechanisms and intent were not linked to mortality risk.

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Section: Introductionmentioning

confidence: 99%

Injury characteristics and predictors of mortality in patients undergoing pancreatic excision after abdominal trauma: A National Trauma Data Bank (NTDB) study

Alzerwi

2023

Medicine

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“…This will constitute a major healthcare problem worldwide and specifically in developed countries that boast higher life expectancies. Indeed, studies have shown that older patients after burn trauma (hereafter referred to as older burn patients) have a higher risk of death and severe disability after trauma, despite having similar comorbidities and severity scores to their younger counterparts (2)(3)(4). Many believe that the increase in morbidity and mortality that is seen in older trauma patients is partially due to the substantial decline of cellular function that leads to their impaired capacity to respond to severe injuries.…”

Section: Introductionmentioning

confidence: 99%

Adipose browning response to burn trauma is impaired with aging

Abdullahi¹,

Knuth²,

Auger³

et al. 2021

JCI Insight

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Сhronic heart failure impact on stroke index and ejection fraction during polytrauma

Lutska

2022

USMYJ

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Study of the effect of heart failure on the course of hypovolemia during polytrauma with the absence of traumatic myocardial injury. The study involved 95 patients, who were divided into 3 groups. The first Control group (C), 29 patients had no heart failure. The second group was Standard (S), 33 patients suffered from chronic heart failure and received standard therapy according to the protocol. The third group (E) of 33 patients with chronic heart failure who, in addition to standard therapy according to protocol, received Ethylmethihydroxypyridine succinate. Patients of groups S and E had equal inclusion criteria, namely the main disease leading to chronic heart failure was arterial hypertension, which had existed for more than 5 years. Three groups of patients had no traumatic myocardial injury. The stroke index (SI) during admission of group C is 24.7±4.8 ml/m2, on the 3rd day 32.8±5.0 ml/m2, (p <0.001), and on the 7th day - up to 39.1±6.0 ml/m2, (p <0.001). SI of group S during admission was 22,9±3,7 ml/m2, on the 3rd day 26,9±4,7 ml/m2 (p <0,001), and on the 7th day — 34,6±5,5 ml/m2 (p <0,001). SI of group E patients during admission was 23.4±2.7 ml/m2, on the 3rd day 26.1±1.5 ml/m2 (p < 0.01), and on the 7th - up to 36.8±2.2 ml/m2 (p < 0.01). Cardiac index (CI) of group C within admission was 2,26±0,35 l/min∙m2, on the 3rd day - 2.73±0.37 l/min∙m2 (p <0,001), and by the end of the study - up to 3.08±0.40 l/min∙m2 (p <0,001). CI of group S during admission amounted to 1,99±0,39 l/min∙m2, on the 3rd day - 2,22±0,31 l/min∙m2 (p <0,02), on 7th — up to 2.67±0.33 l/min∙m2 (p <0.001). CI of group E - 2,0±0,38 l/min∙m2. Until the 3rd day — 2,06±0,30 l/min∙m2 (p> 0.4), at the 7th reached 2.97±0.32 l/min∙m2 (p <0,001). Ejection fraction (EF) of group C within admission amounted to 53.7±3.4%. In the future, EF has significantly increased, reaching 59.6±5.2% (p <0.001) and 63.3±6.4% by the 7th day (p <0.01). EF of group S during admission was 47,9±4.7%, on the 3rd day it increased to 52.2±5.2% (p <0.001), and on the 7th - to 56.8±6.9% (p <0.001). EF of patients group E within the admission was - 47.5±6.9%. On the 3rd day, the EF authentically increased to 52.3±5.3% (p<0.003), and on the 7th day - to 61.5±6.4% (p <0.001). The inclusion of Ethylmethylhydroxypyridine succinate (EMGPS) in the intensive care scheme of E group patients with chronic heart failure during polytrauma without acute myocardial injury gradually improves myocardial contractility activity (MCA). On the 3rd day after patient’s admission, a significant impact of EMGPS on the study of mechanics and energy indicators was not observed. But from the 7th day there was an increase in SI on 6.4% (36.8±1.2 contrary 34.6±5.5 ml/m2, p = 0.03), an increase in EF on 8.3% (61.5± 6.4 contrary 56.8±6.9%, p = 0.005), CI increased on 11.2% (2.94±0.32 contrary 2.67±0.33 l/min∙m2, p < 0.001). Thus, the addition of EMGPS to the intensive care scheme to patients with chronic heart failure during polytrauma without acute myocardium injury optimizes blood circulation and its energy efficiency. Ethylmethylhydroxypyridine succinate optimizes the energy efficiency of blood circulation in patients with chronic heart failure during polytrauma without acute myocardial injury.

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Increased morbidity and mortality in elderly patients with lower extremity trauma and associated injuries: A review of 420,066 patients from the national trauma database

Cited by 4 publications

References 18 publications

Injury characteristics and predictors of mortality in patients undergoing pancreatic excision after abdominal trauma: A National Trauma Data Bank (NTDB) study

Injury characteristics and predictors of mortality in patients undergoing pancreatic excision after abdominal trauma: A National Trauma Data Bank (NTDB) study

Adipose browning response to burn trauma is impaired with aging

Сhronic heart failure impact on stroke index and ejection fraction during polytrauma

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