Risk factors and consequences of lower extremity fracture nonunions in Veterans with spinal cord injury

Decubitus ulcer or known as pressure ulcer is one of the types of chronic wounds that are often found. The incidences of decubitus ulcers are quite high in some countries, including in Indonesia. The main cause of decubitus ulcer is, long term immobilization, as example the total bedrest patients. Decubitus ulcers are associated with some diseases that causes immobilization such as spinal cord injury, lower extremity fracture, stroke, etc. The aim of this research is to identify the data of patients with decubitus ulcer in RSUD Dr. Soetomo period 1 January 2017 – 31 December 2017. This research is a descriptive retrospective by collecting 148 secondary data from the medical records in RSUD Dr. Soetomo period 1 January 2017 – 31 December 2017. Decubitus ulcer mostly be found in elderly (>65 years old) and was dominated by women. The most common disease that associated with decubitus ulcer is trauma (spinal cord injury and lower extremity fracture). The onset of decubitus ulcer in RSUD Dr. Soetomo patients is mostly more than 7 days. The prognosis and outcome of patients with decubitus ulcer are mostly dubia, with 2nd degree of ulcer and in alive condition.

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Lower extremity fractures in patients with spinal cord injury characteristics, outcome and risk factors for non-unions

Journal of Spinal Cord Medicine ◽

10.1080/10790268.2017.1329915 ◽

2017 ◽

Vol 41 (6) ◽

pp. 676-683 ◽

Cited By ~ 6

Author(s):

Lukas Grassner ◽

Barbara Klein ◽

Doris Maier ◽

Volker Bühren ◽

Matthias Vogel

Keyword(s):

Risk Factors ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Lower Extremity ◽

Injury Characteristics ◽

Cord Injury

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Venous Thromboembolic Events in Hospitalized Trauma Patients

The American Surgeon ◽

10.1177/000313480707301206 ◽

2007 ◽

Vol 73 (12) ◽

pp. 1228-1231 ◽

Cited By ~ 6

Author(s):

Michelle C. Azu ◽

Jane E. Mccormack ◽

Emily C. Huang ◽

Thomas K. Lee ◽

Marc J. Shapiro

Keyword(s):

Risk Factors ◽

Spinal Cord ◽

Lower Extremity ◽

Trauma Registry ◽

Hospital Length Of Stay ◽

Trauma Centers ◽

Thoracic Injuries ◽

Lower Extremity Fracture ◽

Cord Injury ◽

Venous Thromboembolic Events

Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolus and is a significant cause of morbidity and mortality in injured patients. Absolute risk factors for VTE development are poorly defined. This study aimed to elucidate and evaluate risk factors in a large, population-based trauma registry. The trauma registry for a 10-year period of a single county was examined. VTE risk factors in 10,150 adult patients treated in the county's five trauma centers and seven nontrauma centers were identified. χ2 and Student's t tests were used for statistical analysis. The incidence of VTE was low at 0.493 per cent. The rate was 0.096 per cent at nontrauma centers. Injury severity score (ISS), operative intervention, spinal cord injury, lower extremity fracture, and certain thoracic injuries were significant in VTE development. There were no differences in VTE rate by age, gender, injury mechanism, or admitting service. Hospital length of stay was doubled by VTE. The VTE rate at trauma centers was higher, which was expected, given the complexity of patients treated and higher ISS. Patients with ISS greater than 15, need for operation, spinal cord injuries, lower extremity fractures, and certain thoracic injuries are at risk for VTE.

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Development of Predictive Informatics Tool Using Electronic Health Records to Inform Personalized Evidence-Based Pressure Injury Management for Veterans with Spinal Cord Injury

Military Medicine ◽

10.1093/milmed/usaa469 ◽

2021 ◽

Vol 186 (Supplement_1) ◽

pp. 651-658

Author(s):

Kath M Bogie ◽

Steven K Roggenkamp ◽

Ningzhou Zeng ◽

Jacinta M Seton ◽

Katelyn R Schwartz ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Spinal Cord ◽

Spinal Cord Injury ◽

User Interface ◽

Veterans Health Administration ◽

Study Cohort ◽

Veterans Health ◽

Health Administration ◽

Cord Injury

ABSTRACT Background Pressure injuries (PrI) are serious complications for many with spinal cord injury (SCI), significantly burdening health care systems, in particular the Veterans Health Administration. Clinical practice guidelines (CPG) provide recommendations. However, many risk factors span multiple domains. Effective prioritization of CPG recommendations has been identified as a need. Bioinformatics facilitates clinical decision support for complex challenges. The Veteran’s Administration Informatics and Computing Infrastructure provides access to electronic health record (EHR) data for all Veterans Health Administration health care encounters. The overall study objective was to expand our prototype structural model of environmental, social, and clinical factors and develop the foundation for resource which will provide weighted systemic insight into PrI risk in veterans with SCI. Methods The SCI PrI Resource (SCI-PIR) includes three integrated modules: (1) the SCIPUDSphere multidomain database of veterans’ EHR data extracted from October 2010 to September 2015 for ICD-9-CM coding consistency together with tissue health profiles, (2) the Spinal Cord Injury Pressure Ulcer and Deep Tissue Injury Ontology (SCIPUDO) developed from the cohort’s free text clinical note (Text Integration Utility) notes, and (3) the clinical user interface for direct SCI-PIR query. Results The SCI-PIR contains relevant EHR data for a study cohort of 36,626 veterans with SCI, representing 10% to 14% of the U.S. population with SCI. Extracted datasets include SCI diagnostics, demographics, comorbidities, rurality, medications, and laboratory tests. Many terminology variations for non-coded input data were found. SCIPUDO facilitates robust information extraction from over six million Text Integration Utility notes annually for the study cohort. Visual widgets in the clinical user interface can be directly populated with SCIPUDO terms, allowing patient-specific query construction. Conclusion The SCI-PIR contains valuable clinical data based on CPG-identified risk factors, providing a basis for personalized PrI risk management following SCI. Understanding the relative impact of risk factors supports PrI management for veterans with SCI. Personalized interactive programs can enhance best practices by decreasing both initial PrI formation and readmission rates due to PrI recurrence for veterans with SCI.

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Study on the Risk Factors of Preoperative Deep Vein Thrombosis (DVT) in Patients With Lower Extremity Fracture

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211002900 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110029

Author(s):

Wenjie Chang ◽

Bin Wang ◽

Qiwei Li ◽

Yongkui Zhang ◽

Wenpeng Xie

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Lower Extremity ◽

Color Doppler ◽

Fracture Site ◽

Vein Thrombosis ◽

Lower Extremity Fracture ◽

Extremity Fracture ◽

Deep Vein ◽

D Dimer

Objective: The objective of this work is to discuss and analyze the related factors of lower extremity fracture complicated by preoperative deep vein thrombosis (DVT). Methods: A total of 11,891 patients with closed fractures of lower extremities were selected. By analyzing each patient’s gender, age, presence or absence of diabetes and hypertension, preoperative plasma D-dimer level, and color Doppler ultrasound of the lower extremity vein, the pertinent factors of the patients with lower extremity fractures complicated by preoperative DVT were analyzed. Results: A total of 578 with preoperative DVT were detected, displaying a total incidence of 4.86%. All patients were categorized into either the DVT group or non-DVT group. The results demonstrate that there were statistically significant differences between the 2 groups in age, the presence of diabetes and hypertension, the fracture site, and the preoperative plasma D-dimer level ( P < 0.05). Logistic multivariate analysis revealed that age, the presence of diabetes, and the preoperative plasma D-dimer level of patients were independent risk factors for lower extremity fracture complicated by DVT. Conclusion: Age, the presence of diabetes, the fracture site, and increased D-dimer levels were found to be potential risk factors and indicators for preoperative DVT in patients with lower extremity fractures. In addition, the preoperative plasma D-dimer level has certain guiding significance for the prediction of venous thrombosis after lower extremity fracture, which is conducive to the early prediction and diagnosis of DVT, but it often must be followed with good clinic acumen and examinations.

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