scholarly journals ATRIAL FIBRILLATION IS INDEPENDENTLY ASSOCIATED WITH INCREASED MORBIDITY AND MORTALITY IN ELDERLY TRAUMA PATIENTS

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A314
Author(s):  
Krishna Akella ◽  
Gunjan Joshi ◽  
Daisy Young ◽  
Liana Tatarian ◽  
Samer Ibrahim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Morbidity And Mortality ◽  
Trauma Patients ◽  
Elderly Trauma Patients

Morbidity and Mortality in Elderly Trauma Patients

1999 ◽  
Vol 46 (4) ◽  
pp. 702-706 ◽  
Author(s):  
Paul Tornetta ◽  
Hamid Mostafavi ◽  
Joseph Riina ◽  
Cliff Turen ◽  
Barry Reimer ◽  
...  
Keyword(s):  
Morbidity And Mortality ◽  
Trauma Patients ◽  
Elderly Trauma Patients

Undertriage Despite Use of Geriatric-Specific Trauma Team Activation Guidelines

2020 ◽  
pp. 000313482095145
Author(s):  
Ram V. Anantha ◽  
Matthew D. Painter ◽  
Franck Diaz-Garelli ◽  
Andrew M. Nunn ◽  
Preston R. Miller ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Tertiary Care ◽  
Trauma Team ◽  
Morbidity And Mortality ◽  
Trauma Patients ◽  
Care Hospital ◽  
Severely Injured ◽  
Hemorrhage Control ◽  
Trauma Team Activation ◽  
Elderly Trauma Patients

Background Elderly trauma patients are at risk for undertriage, resulting in substantial morbidity and mortality. The objective of this study was to determine whether implementation of geriatric-specific trauma team activation (TTA) protocols appropriately identified severely-injured elderly patients. Methods This single-center retrospective study evaluated all severely injured (injury severity score [ISS] >15), geriatric (≥65 years) patients admitted to our Level 1 tertiary-care hospital between January 2014 and September 2017. Undertriage was defined as the lack of TTA despite presence of severe injuries. The primary outcome was all-cause in-hospital mortality; secondary outcomes were mortality within 48 hours of admission and urgent hemorrhage control. A multivariable logistic regression analysis was performed to identify predictors of appropriate triage in this study. Results Out of 1039 severely injured geriatric patients, 628 (61%) did not undergo TTA. Undertriaged patients were significantly older and had more comorbidities. In-hospital mortality was 5% and 31% in the undertriaged and appropriately triaged groups, respectively ( P < .0001). One percent of undertriaged patients needed urgent hemorrhage control, compared to 6% of the appropriately triaged group ( P < .0001). One percent of undertriaged patients died within 48 hours compared to 19% in the appropriately triaged group ( P < .0001). Predictors of appropriate triage include GCS, heart rate, systolic blood pressure, lactic acid, ISS, shock, and absence of dementia, stroke, or alcoholism. Discussion Geriatric-specific TTA guidelines continue to undertriage elderly trauma patients when using ISS as a metric to measure undertriage. However, undertriaged patients have much lower morbidity and mortality, suggesting the geriatric-specific TTA guidelines identify those patients at highest risk for poor outcomes.

Atrioesophageal Fistula as a Complication of Radiofrequency Ablation for Atrial Fibrillation

2021 ◽  
pp. 1-3
Author(s):  
Mustafa Emin Canakci ◽  
Cengiz Ovali ◽  
İrem Aydogdu ◽  
Betul Tiryaki Bastug ◽  
Obaidullah Ahmadzai ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Radiofrequency Ablation ◽  
Gastrointestinal Bleeding ◽  
Male Patient ◽  
Delayed Diagnosis ◽  
Infectious Complications ◽  
Morbidity And Mortality ◽  
Important Complication ◽  
Atrioesophageal Fistula

Abstract Atrioesophageal fistula (AEF) is an important complication of radiofrequency ablation (RFA). Delayed diagnosis is associated with increased morbidity and mortality. Despite the name “atrioesophageal fistula,” fistulas functionally act esophageal to atrial, which accounts for the neurologic and infectious complications. This report presents the management of a 60-year-old male patient who was admitted to the emergency department (ED) with AEF-caused gastrointestinal bleeding. The patient was operated urgently, but he had serious comorbidities and died after the operation. The aim of this case was to evaluate patients who underwent RFA, within 10 days to two months, carefully in the ED and to know the possible complications.

Field Triage Protocol in Elderly Trauma Patients: What Level of Care?

2012 ◽  
Vol 215 (5) ◽  
pp. 740 ◽  
Author(s):  
Jean-Pierre Tourtier ◽  
Charles Pierret ◽  
Sylvain Vico ◽  
Daniel Jost ◽  
Laurent Domanski
Keyword(s):  
Level Of Care ◽  
Trauma Patients ◽  
Field Triage ◽  
Triage Protocol ◽  
Elderly Trauma Patients

Atrial Fibrillation and Morbidity and Mortality in a Cohort of Long-term Hemodialysis Patients

2008 ◽  
Vol 51 (2) ◽  
pp. 255-262 ◽  
Author(s):  
Simonetta Genovesi ◽  
Antonio Vincenti ◽  
Emanuela Rossi ◽  
Daniela Pogliani ◽  
Irene Acquistapace ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Hemodialysis Patients ◽  
Morbidity And Mortality

scholarly journals Management of Occult Hypoperfusion Syndrome in Trauma Patients: A Narrative Review

2020 ◽  
Vol 9 (3) ◽  
pp. 1-12
Author(s):  
Krishna Prasad G V
Keyword(s):  
Management Practices ◽  
Traumatic Injury ◽  
Lactate Concentration ◽  
Central Venous Oxygen Saturation ◽  
Serum Lactate ◽  
Review Article ◽  
Morbidity And Mortality ◽  
Trauma Patients ◽  
Negative Results ◽  
Patients At Risk

Occult hypoperfusion (OH) is connected with higher levels of morbidity and mortality after trauma. Occult hypoperfusion, defined as serum lactate concentration of more than 2.5 mmol / L persisting in the intensive care unit for more than 12 hours after admission. This refers to the reversible risk factor for negative results after traumatic injury. Occult hypoperfusion can be observed and patients at risk of complications should be classified other than frequently regulated metrics (blood pressure and heart rate), central venous oxygen saturation, and blood lactate levels. An elevated hospital duration of stay (LOS) and a greater incidence of postoperative difficulties are linked with OH. The focus of this review article is to assess the different approaches and methods involved in the management of OH syndrome in trauma patients. Identification of OH treatment methods can be helpful in reducing morbidity in patients with various injuries. The outcomes from this review article may prove beneficial to patients by rapid resuscitation and aggressive monitoring of OH. These management practices will severely reduce OH-associated morbidity and mortality. LOS, ICU readmission incidence and post-operative complications per patient was decreased by early treatment of OH.

scholarly journals Individual Pharmacotherapy Management (IPM) - I: a group-matched retrospective controlled clinical study on prevention of complicating delirium in the elderly trauma patients and identification of associated factors

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Luise Drewas ◽  
Hassan Ghadir ◽  
Rüdiger Neef ◽  
Karl-Stefan Delank ◽  
Ursula Wolf
Keyword(s):  
Clinical Study ◽  
Associated Factors ◽  
Intervention Group ◽  
The Elderly ◽  
Control Group ◽  
Trauma Patients ◽  
Effective Prevention ◽  
Multivariable Regression ◽  
Elderly Trauma Patients ◽  
Controlled Clinical Study

Abstract Background Delirium is one of the most frequent complications in hospitalized elderly patients with additional costs such as prolongation of hospital stays and institutionalization, with risk of reduced functional recovery, long-term cognitive impairment, and increased morbidity and mortality. We analyzed the effect of individual pharmacotherapy management (IPM) in the University Hospital Halle in geriatric trauma patients on complicating delirium and aimed to identify associated factors. Methods In a retrospective controlled clinical study of 404 hospitalized trauma patients ≥70 years we compared the IPM intervention group (IG) with a control group (CG) before IPM implementation. Delirium was recorded from the hospital discharge letter. The medication review and data records included baseline data, all medications, diagnoses, electrocardiogram (ECG), laboratory and vital parameters during hospitalization. The IPM internist and the senior trauma physician guaranteed personnel and structural continuity in the implementation of the interdisciplinary patient rounds. Results There was a highly matched congruence between CG and IG in terms of age, gender, residency, BMI, most diagnoses, and injury patterns to compare the two groups. The total number of medications per patient was 11.1 ± 4.9 (CG) versus 10.4 ± 3.6 (IG). Our targeted IPM focus on 6 frontline aspects with reduction of antipsychotics, anticholinergic burden, benzodiazepines, serotonergic opioids, elimination of pharmacokinetic and pharmacodynamic drug interactions and overdosage reduced complicating delirium from 5% to almost zero at 0.5%. The association of IPM with a significant 10-fold reduction, OR = 0.09 [95% CI 0.01–0.7], in univariable regression, maintained of clinical relevance in multivariable regression OR = 0.1 [95% CI 0.01–1.1]. Factors most strongly associated with complicating delirium in univariable regression were cognitive dysfunction, nursing home residency, muscle relaxants, antiparkinsonian agents, xanthines, transient disorientation documented in the fall risk scale, antibiotic-requiring infections, antifungals, antipsychotics, and intensive care stay, the two latter maintaining significance in multivariable regression. Conclusions IPM is associated with a highly effective prevention of complicating delirium in the elderly trauma patients. For patient safety it should be integrated as an essential preventative contribution. The associated factors help identify patients at risk.

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