Abstract No. 460 Absence of gluteal necrosis following pelvic embolization in trauma patients

The objective of this study was to evaluate the utility and sensitivity of routine pelvic radiographs (PXR) in the initial evaluation of blunt trauma patients. A retrospective review was performed. One hundred seventy-four patients with a pelvic fracture who had computed tomography (CT) and PXR were included (average age, 36.1; average Injury Severity Score, 16.3). Nine (5%) patients died. Five hundred twenty-one fractures were identified on CT. One hundred sixteen (22%) of these fractures were missed by PXR. Eighty-eight (51%) patients were underdiagnosed by PXR alone. The most common fractures missed by PXR were sacral and iliac fractures. Eight patients required angiograms, with four undergoing therapeutic pelvic embolization. Forty-seven (27%) patients were hypotensive or required a transfusion in the emergency department. These patients were more likely to require an angiogram (17% vs 0%, P < 0.0001) and were more likely to require embolization (9% vs 0%, P < 0.001). This study demonstrates that CT scan is highly sensitive in identifying and classifying pelvic fractures. PXR has a sensitivity of only 78 per cent for identification of pelvic fractures in the acute trauma patient. In hemodynamically stable patients who are going to undergo diagnostic CT scan, PXR is of little value. The greatest use of PXR may be as a screening tool in hemodynamically unstable patients and/or those that require transfusion to allow for early notification of the interventional radiology team.

Download Full-text

Clinical Outcome of Intra-Arterial Embolization for Treatment of Patients with Pelvic Trauma

Radiology Research and Practice ◽

10.1155/2011/935484 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

M. W. Barentsz ◽

E. P. A. Vonken ◽

J. A. van Herwaarden ◽

L. P. H. Leenen ◽

W. P. Th. M. Mali ◽

...

Keyword(s):

Pelvic Fracture ◽

Treatment Success ◽

Arterial Embolization ◽

Hemodynamic Instability ◽

Pelvic Trauma ◽

Trauma Patients ◽

Technical Success ◽

Hemodynamic Status ◽

Contrast Enhanced Ct ◽

Pelvic Embolization

Purpose. To analyse the technical success of pelvic embolization in our institution and to assess periprocedural hemodynamic status and morbidity/mortality of all pelvic trauma patients who underwent pelvic embolization.Methods. A retrospective analysis of patients with a pelvic fracture due to trauma who underwent arterial embolization was performed. Clinical data, pelvic radiographs, contrast-enhanced CT-scans, and angiographic findings were reviewed. Subsequently, the technical success and peri-procedural hemodynamic status were evaluated and described.Results. 19 trauma patients with fractures of the pelvis underwent arterial embolization. Initially, 10/19 patients (53%) were hemodynamically unstable prior to embolization. Technical success of embolization was 100%. 14/19 patients (74%) were stable after embolization, and treatment success was high as 74%.Conclusion. Angiography with subsequent embolization should be performed in patients with a pelvic fracture due to trauma and hemodynamic instability, after surgical intervention or with a persistent arterial blush indicative of an active bleeding on CT.

Download Full-text

Nutritional Needs of Trauma Patients: Challenges, Barriers, and Solutions

Critical Care Nursing Clinics of North America ◽

10.1016/s0899-5885(18)30470-2 ◽

1994 ◽

Vol 6 (3) ◽

pp. 501-514 ◽

Cited By ~ 1

Author(s):

Christine A. Stamatos ◽

Elizabeth Reed

Keyword(s):

Trauma Patients ◽

Nutritional Needs

Download Full-text

Aetiology and Prognostic Implication of Severe Jaundice in Surgical Trauma Patients

Scandinavian Journal of Gastroenterology ◽

10.1080/00365520310000519 ◽

2003 ◽

Vol 38 (1) ◽

pp. 102-108 ◽

Cited By ~ 10

Author(s):

K. J. Labori ◽

B. A. Bjørnbeth ◽

M. G. Ræder

Keyword(s):

Surgical Trauma ◽

Trauma Patients ◽

Prognostic Implication ◽

Severe Jaundice

Download Full-text

Venous thromboembolism in a general hospital. An update with low molecular weight heparin prophylaxis

VASA ◽

10.1024/0301-1526.36.1.17 ◽

2007 ◽

Vol 36 (1) ◽

pp. 17-22

Author(s):

Schulz ◽

Kesselring ◽

Seeberger ◽

Andresen

Keyword(s):

Molecular Weight ◽

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Low Molecular Weight ◽

Trauma Patients ◽

Vte Prophylaxis ◽

Vein Thrombosis ◽

Patients At Risk ◽

Hospital Stays ◽

Event Rates

Background: Patients admitted to hospital for surgery or acute medical illnesses have a high risk for venous thromboembolism (VTE). Today’s widespread use of low molecular weight heparins (LMWH) for VTE prophylaxis is supposed to have reduced VTE rates substantially. However, data concerning the overall effectiveness of LMWH prophylaxis is sparse. Patients and methods: We prospectively studied all patients with symptomatic and objectively confirmed VTE seen in our hospital over a three year period. Event rates in different wards were analysed and compared. VTE prophylaxis with Enoxaparin was given to all patients at risk during their hospital stay. Results: A total of 50 464 inpatients were treated during the study period. 461 examinations were carried out for symptoms suggestive of VTE and yielded 89 positive results in 85 patients. Seventy eight patients were found to have deep vein thrombosis, 7 had pulmonary embolism, and 4 had both deep venous thrombosis and pulmonary embolism. The overall in hospital VTE event rate was 0.17%. The rate decreased during the study period from 0.22 in year one to 0,16 in year two and 0.13 % in year three. It ranged highest in neurologic and trauma patients (0.32%) and lowest (0.08%) in gynecology-obstetrics. Conclusions: With a simple and strictly applied regimen of prophylaxis with LMWH the overall rate of symptomatic VTE was very low in our hospitalized patients. Beside LMWH prophylaxis, shortening hospital stays and substantial improvements in surgical and anasthesia techniques achieved during the last decades probably play an essential role in decreasing VTE rates.

Download Full-text