scholarly journals 874. Impact of Telehealth in HIV Ambulatory Clinic during COVID-19 Pandemic Impact of Telehealth in HIV Ambulatory Clinic during COVID-19 Pandemic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S528-S529
Author(s):  
Sandhya Nagarakanti ◽  
Eliahu Bishburg ◽  
Donna George ◽  
Kristen Ehlers
Keyword(s):  
Hiv Risk ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Hiv Care ◽  
Intravenous Drug Use ◽  
Ambulatory Clinic ◽  
Viral Loads ◽  
Male Sex ◽  
The Impact ◽  
Clinic Study

Abstract Background HIV outpatient in-person (IN-P) visits were limited during the COVID-19 pandemic, and most patients (pts) were cared for remotely through telehealth (TELE). We sought to evaluate the impact of TELE on HIV infected pts during the pandemic compared to the pre-pandemic IN-P care. Methods Retrospective chart review of pts in an outpatient HIV clinic, study period 03/30/2019 to 03/29/2021. Two periods were defined: pre-COVID (Pre-CO) 3/30/2019 to 3/29/2020 and COVID (CO) 3/30/2020 to 3/29/2021. Data was collected on demographics, HIV risk, type of encounter, number of encounters, CD4, HIV Viral loads (VL) at first, and last visit, treatment regimen information. HIV VL < 200 copies/ml was considered as undetectable. Results A total of 607 pts were evaluated. Mean age 51years; (Range-20-84). Male 306 (50.4%), African American 545(90%), Hispanic 50 (8.2%), white 9 (1.5%), Asian 3(0.5%). HIV risk: heterosexual 437(72%), male sex with male 118(19.4%), intravenous drug use 8 (1.3%). In the Pre-CO period, 530 pts were seen as IN-P; in the CO period 606 pts were encountered of which 304 (50.2%) were TELE visits, 89(14.7%) IN-P, 213(35%) had both TELE and IN-P encounters. Mean number of encounters were 2.59 in the Pre-CO and 2.46 during CO. The number of new pts in the Pre-CO were 36 (7%) vs. 52(8.6%) in the CO (p=0.26). During the pre-CO, 373 pts had CD4 measured at first and last visits, 353(95%) at the first visit and 352 (94.3%) at the last visit had CD4 counts ≥ 200/uL (p=.87); 373 pts had a VL done at first and last visits, 330 (88.5%) at the first visit and 337(90.3%) at last visit were undetectable (p=0.41). During CO, 445 pts had CD4 measured at first and last visits, 402 (90.3%) at the first visit and 445(94.2%) at the last visit had CD4 count ≥200/uL (p=0.03); 448 pts had VL measured at first and last encounters, 389(87%) at the first visit and 417(93%) in the last visit were undetectable (p=0.002). Antiretroviral changes occurred in 29% in the Pre-Co compared to 19% in the CO (p=0 .32). Conclusion In our clinic, more pts were cared for during the CO period compared to the Pre-CO period. Significantly, more pts had undetectable HIV VL during CO period. At least one TELE visit was utilized by over ¾ of the pts. TELE has a potentially important role in future HIV care without compromising patient outcomes. Disclosures All Authors: No reported disclosures

scholarly journals 962. Linkage to Care Outcomes among Known HIV-Positive Patients at a High Prevalence Urban Hospital Emergency Department

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S511-S511
Author(s):  
Alexander W Sudyn ◽  
Jeffrey M Paer ◽  
Swetha Kodali ◽  
Samuel Maldonado ◽  
Amesika Nyaku ◽  
...  
Keyword(s):  
Hiv Risk ◽  
Hiv Transmission ◽  
Univariate Analysis ◽  
Linkage To Care ◽  
Retrospective Chart Review ◽  
Retention In Care ◽  
Patient Navigator ◽  
Urban Hospital ◽  
Opt Out ◽  
The Impact

Abstract Background Retention in care of persons with HIV (PWH) is essential for achieving viral suppression and decreasing community transmission. CDC estimates that the 23% of known PWH not retained in care account for 43% of all new transmissions. This study seeks to describe the impact of an opt-out ED screening with navigator-assisted linkage to care (LTC) protocol for out of care PWH. Methods An IRB-approved retrospective chart review was conducted among PWH (prior positive) inadvertently retested in the ED between 2015 and 2018. Univariate and multivariate logistic regression was used to identify factors associated with LTC with patient navigator (PN) support. Factors with p ≤ 0.1 were included in the multivariate analysis as were age and sex at birth. Patients who died were excluded from statistical analyses. Results Among 464 patients who tested positive, 338 (73%) were known positive with 120 (35%) of those out of care at the time of screening. Mean age for this group was 47 (SD 11.9); 57% male, 81% non-Hispanic black, 10% Hispanic, and 6% non-Hispanic white. Fifty-five (46%) patients were successfully LTC, 54 (45%) referred to the state for linkage, and 11 (9%) died. A total of 109 patients were included in the analysis. Univariate analysis was performed for age (F(1, 107) = 0.98, p = 0.324) and female sex at birth (OR = 1.42 [95% CI 0.66, 3.05], p = 0.373) as well as Hispanic race (OR = 3.33 [95% CI 0.84, 13.04], p = 0.085), heterosexual HIV risk (OR = 2.76 [95% CI 1.27, 5.99], p = 0.011), IDU (OR = 0.49 [95% CI 0.21, 1.11], p = 0.088), and other SUD (OR = 0.42 [95% CI 0.19, 0.94], p = 0.035). Only heterosexual HIV risk (OR = 3.01 [95% CI 1.23, 7.32], p = 0.015) maintained significance in the final multivariate model. Conclusion Opt-out ED screening revealed >30% of known positive PWH were out of care at the time of testing; of whom nearly 50% were LTC with PN support. It is possible that persons reporting heterosexual HIV risk may feel less stigmatized and therefore are more likely to LTC. Similarly, the association with SUD, albeit non-significant, may reflect underrepresentation of individuals with SUD in remission among patient navigators. Future opt-out ED screening protocols should build upon diverse care teams to further engage patients with SUD and those at risk for non-heterosexual HIV transmission. Disclosures All Authors: No reported disclosures

Abstract P305: Post-Stroke Aphasia as a Predictor of 30-Day Readmission Associated With Infection: A Retrospective Chart Review

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Emma M Loebel ◽  
Mary Rojas ◽  
Connor Mensching ◽  
Danielle Wheelwright ◽  
Laura K Stein
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Mount Sinai Hospital ◽  
Index Admission ◽  
Negative Consequences ◽  
Medical Comorbidities ◽  
Post Stroke ◽  
Increased Risk ◽  
Adjusted Model ◽  
The Impact

Introduction: Studies have demonstrated that aphasia may negatively impact morbidity and mortality among ischemic stroke (IS) patients. However, the association between post-stroke aphasia and readmission with infection (RI) is poorly understood. We sought to assess the impact of aphasia on post-stroke RI. We hypothesized that aphasic patients are at increased risk of infection in the 30-day post-stroke period. Methods: We performed retrospective chart review of the Mount Sinai Hospital IS patients with 30-day all cause readmission from January 2016 - December 2019. All variables were abstracted from the index admission (IA) electronic medical records except for aspects related to the readmission (RA). Aphasia was present if a neurologist diagnosed the patient with acquired language dysfunction during IA. We performed chi square and logistic regression analyses to compare readmitted patients with and without aphasia at IA. Our fully adjusted model controlled for age, sex, medical comorbidities, NIHSS ≥ 8, IA LOS > 7, IA infection, discharge to facility. We completed all analyses with SPSS. Results: During IA, 36% (n=42) were diagnosed with aphasia. At IA, there were no significant differences in age (dichotomized at 65), sex, or medical comorbidities between aphasic and non-aphasic cohorts. However, more aphasic patients had admission NIHSS ≥ 8 (89% vs 35%, p<0.0001), LOS > 7 (76% vs 42%, p=0.0004), discharge to facility (79% vs 49%, p=0.0016), and RI (52% vs 19%, p=0.002). The presence of aphasia predicted RI in both unadjusted (OR=4.6, p<0.001) and adjusted (OR= 3.3, p=0.014) multivariate analyses. The Kappa inter-reliability ranged from 0.7-1.0 for the key variables included in our adjusted model. Conclusions: The adjusted odds of 30-day readmission with infection were significantly greater in those with diagnosis of aphasia at the time of index admission compared to those without. Our study provides preliminary evidence that the presence of aphasia may have negative consequences on a patient’s health beyond the language disturbance. Further study is needed to better understand the reasons and risk reduction strategies in this vulnerable population.

scholarly journals The Administration of Prehospital Ketamine for Chemical Restraint does not Prolong On-Scene Times Compared to Haloperidol Based Sedation

2015 ◽  
Vol 12 (1) ◽  
Author(s):  
Aaron Burnett ◽  
Dolly Panchal ◽  
Bjorn Peterson ◽  
Eric Ernest ◽  
Kent Griffith ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
T Test ◽  
Medical Services ◽  
Demographic Differences ◽  
Chemical Restraint ◽  
Emergency Medical ◽  
Clinically Significant ◽  
The Impact

IntroductionAgitated patients who present a danger to themselves or emergency medical services (EMS) providers may require chemical restraints.  Haloperidol is employed for chemical restraint in many EMS services.  Recently, ketamine has been introduced as an alternate option for prehospital sedation.  On-scene time is a unique metric in prehospital medicine which has been linked to outcomes in multiple patient populations. When used for chemical restraint, the impact of ketamine relative to haloperidol on on-scene time is unknown.Objective: To evaluate whether the use of ketamine for chemical restraint was associated with a clinically significant (≥5 minute) increased on-scene time compared to a haloperidol based regimen.MethodsPatients who received haloperidol or ketamine for chemical restraint were identified by retrospective chart review.  On-scene time was compared between groups using an unadjusted Student t-test powered to 80% to detect a ≥5 minute difference in on-scene time.Results110 cases were abstracted (Haloperidol = 55; Ketamine = 55). Of the patients receiving haloperidol, 11/55 (20%) were co-administered a benzodiazepine, 4/55 (7%) received diphenhydramine and 34/55 (62%) received the three drugs in combination. There were no demographic differences between the haloperidol and ketamine groups.  On-scene time was not statistically different for patients receiving a haloperidol based regimen compared to ketamine (18.2 minutes, [95% CI 15.7-20.8] vs. 17.6 minutes, [95% CI 15.1-20.0]; p = 0.71).ConclusionsThe use of prehospital ketamine for chemical restraint was not associated with a clinically significant (≥5 minute) increased on-scene time compared to a haloperidol based regimen.  

scholarly journals Low-Dose Aminophylline for the Treatment of Neonatal Non-Oliguric Renal Failure—Case Series and Review of the Literature

2008 ◽  
Vol 13 (2) ◽  
pp. 80-87
Author(s):  
Bethany A. Lynch ◽  
Peter Gal ◽  
J. Laurence Ransom ◽  
Rita Q. Carlos ◽  
Mary Ann V.T. Dimaguila ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Chart Review ◽  
Low Dose ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Review Of The Literature ◽  
Oliguric Renal Failure ◽  
The Impact

OBJECTIVE Aminophylline is a methylxanthine with multiple physiologic actions. At low doses, aminophylline can antagonize adenosine and improve renal function via increased glomerular filtration rate. Despite its clinical use, little data exists in neonates for this indication. Therefore, the objective of this report is to describe the impact of aminophylline on renal function indices in a series of neonates with acute renal failure. MATERIALS AND METHODS This was a retrospective chart review of 13 neonates with acute renal failure who received aminophylline during a 15-month study period. Aminophylline was administered at 1 mg/kg intravenously or orally every twelve hours. Forty-six percent (n = 6) of the patients received a 5 mg/kg loading dose before initiation of maintenance therapy. Most patients had already received other treatments for renal failure, including diuretics and dopamine. RESULTS Resolution of acute renal failure (with normalization of serum creatinine and blood urea nitrogen) was documented in 10 patients (77%). Four of the thirteen patients died from complications due to their prematurity. Failure of low-dose aminophylline was observed in 3 of the 4 patients who died. CONCLUSIONS Low-dose aminophylline in neonates with acute renal failure is associated with an improvement in renal function indices.

Retrospective Chart Review of Cryopreserved Amniotic Membrane for Knee Pain

2020 ◽  
Author(s):  
Ruben Berrocal Timmons
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Amniotic Membrane ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Mean Values ◽  
Number Of Patients ◽  
The Impact

Objective: Treatment of joint pain with an injection of the amniotic membrane has not been adequately studied. This study retrospectively reviewed Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and analgesic usage data from patients treated with the injection of cryopreserved amniotic membrane (CAM) in their knees to determine the impact of treatment on patients’ pain, quality of life, and analgesic usage. Methods: Chart review was conducted on 40 patients. Institutional Review Board (IRB) approval was obtained prior to initiation of the project. The membrane was utilized as per the FDA guidance of 21CFR1271. Retrospective data, including demographics, medical history, pain score, quality of life score, analgesic usage and adverse events, were collected from their medical records for each consenting patient through 6 months after CAM injection. Results: A total of 40 patients were considered in the final analysis. Mean VAS for pain level improved from 7.0 to 2.6 (p<0.001). WOMAC daily activity function score improved from a mean score of 52 to 28 (p<0.001). Opioid and non-steroidal anti-inflammatory drug (NSAID) usage decreased from 97% to 25% (p<0.001). No adverse events were reported. Conclusion: Mean values for VAS and WOMAC scores significantly improved at all time points and the number of patients who used analgesics decreased as compared to baseline. CAM injection into painful knee joints decreases pain, improves physical function, and decreases the use of analgesics in the absence of adverse events.

Abstract WMP89: Stroke Code De-escalation: Safety and Outcomes

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jessica Jarnot ◽  
Christopher Streib ◽  
Angela Heyer ◽  
Amy Reichert ◽  
David Anderson ◽  
...  
Keyword(s):  
Chart Review ◽  
Healthcare Providers ◽  
Retrospective Chart Review ◽  
Before And After ◽  
Chi Squared ◽  
Cost Implications ◽  
The Impact ◽  
Timely Treatment ◽  
Iv Tpa ◽  
Missed Opportunity

Introduction: “Stroke codes” (SCs) facilitate the timely treatment of acute ischemic stroke (AIS) with IV tPA or intra-arterial thrombectomy (IAT), but are inherently resource-intensive and can expose patients to unnecessary and potentially harmful interventions. While all healthcare providers are encouraged to activate SCs, this might lead to low SC-to-treatment-ratios (SCTR). We examined the impact of de-escalation of stroke codes (DSCs) on SCTR. Methods: DSCs were initiated in our institution in January 2015. All DSCs were reviewed for the patient’s eligibility for IV tPA or IAT, and reason for de-escalation. We reviewed all stroke codes 12 months before and after the initiation of this process and compared the SCTR by chi-squared testing. Results: In 2014, prior to DSCs, 253 SCs resulted in 22 AIS interventions (22 IV tPA) for a SCTR of 8.7%. In 2015, 348 SCs were activated with 64 subsequent DSCs (18.4%) and 45 AIS interventions (38 IV tPA, 7 IAT, 7 both), for a SCTR of 15.8%. The improvement in SCTR after introducing DSCs was statistically significant (p=0.012). When restricting the analysis to IV tPA interventions alone, there remained a trend (p=0.068) towards improvement in SCTR. Retrospective chart review did not reveal any DSC cases that resulted in missed opportunity for IV TPA or IAT treatment. No DSCs were due to an acute ICH. Justifications for de-escalations are summarized in figure 1. Conclusions: The introduction of DSCs resulted in a statistically significant absolute improvement in SCTR of 7.1%. Importantly, DSCs did not result in any eligible AIS patient forgoing IV tPA or IAT, nor missed ICH. More research is needed to increase the yield of stroke codes, refine the criteria for both activating and de-escalating them, and quantify the resource and cost implications of such de-escalations.

scholarly journals 2532. Identifying Educational Needs and Improving Provider Knowledge Regarding the Management of Febrile Neutropenia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S880-S880
Author(s):  
Amy Chang ◽  
Stan Deresinski ◽  
Aruna Subramanian ◽  
Bruno Medeiros ◽  
Emily Mui, PharmD ◽  
...  
Keyword(s):  
Medical Students ◽  
Febrile Neutropenia ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Empiric Therapy ◽  
Myelogenous Leukemia ◽  
Front Line ◽  
National Guidelines ◽  
Gram Positive ◽  
The Impact

Abstract Background In a retrospective chart review of 211 first episodes of febrile neutropenia (FN) in in-patients with acute myelogenous leukemia evaluating rates of appropriate vs. inappropriate management, we identified frequent noncompliance with national guidelines for the management of FN. We utilized these data to develop an educational intervention targeting front-line providers. Methods Based on findings from our chart review, we developed and implemented an interactive, case-based didactic session for advanced practice providers (APPs) and medical students/residents rotating on hematology, targeting inappropriate antibiotic use. Pretest questions were embedded into the lecture, preceding content related to each learning objective. Lecture material included content from national guidelines, literature addressing misconceptions (e.g., vancomycin usage for persistent fever), and data from our institutional antibiogram (Figure 1). A post-test was given directly after the lecture to evaluate knowledge gained. Results Five inappropriate behaviors were identified (Figure 2): (1) changing empiric therapy despite clinical stability, (2) misunderstanding piperacillin/tazobactam’s spectrum of activity, (3) inappropriate initiation of antibiotics active against resistant Gram-positive organisms; (4) failure to de-escalate therapy at 72 hours and (5) failure to add Gram-positive coverage when using aztreonam. Lectures were provided to 13 APPs and 17 medical students/residents over 6 sessions. An improvement in knowledge was noted for most learning objectives except for the third, for which misconceptions remained, especially regarding need for vancomycin in the setting of mucositis (Figures 3 and 4). Higher baseline knowledge was noted for medical students/residents than APPs. 93% of learners rated the lecture very/extremely helpful. Learners recommended future content focus on antifungal therapy. Conclusion We utilized local practice data to develop educational content for front-line providers. We will convert this lecture into a video-format to be incorporated into hematology rotations to reinforce key concepts. A prospective cohort study to evaluate the impact on prescribing behavior is underway. Disclosures All authors: No reported disclosures.

Darbepoetin alfa Maintains Hemoglobin Levels in Patients with Myelodysplastic Syndromes (MDS) after Therapeutic Interchange from Epoetin alfa: Results of a Retrospective Chart Review.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4708-4708 ◽  
Author(s):  
Jeffrey Patton ◽  
Yong Mun ◽  
Joel Wallace
Keyword(s):  
Darbepoetin Alfa ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Epoetin Alfa ◽  
Minor Response ◽  
Therapeutic Substitution ◽  
Kaplan Meier ◽  
Major Response ◽  
A Minor ◽  
The Impact

Abstract Patients with MDS often receive erythropoietic therapy for the treatment of anemia resulting from the disease. This retrospective chart review examined the impact of switching patients from their current dosing regimens of epoetin alfa (Procrit®) to darbepoetin alfa (Aranesp®) 200 mcg every two weeks (Q2W) following the implementation of therapeutic substitution guidelines in September 2003. Key eligibility criteria included: ≥ 18 years old with a diagnosis of MDS, and treatment with epoetin alfa therapy between May 2003 and January 2004. Patients receiving epoetin alfa therapy were either switched to darbepoetin alfa, or allowed to remain on epoetin alfa, depending on whether their treating physician had adopted therapeutic substitution guidelines. To ensure full characterization of the patient population, in the 16 weeks prior to the time of the therapeutic substitution, detailed demographic and disease characteristics were collected, in addition to dose requirements, transfusion status and hemoglobin profiles. To assess the impact on clinical outcomes, data were collected for 16 weeks after the therapeutic substitution guidelines were implemented (defined as the treatment period). Patients identified in the chart review who received at least one dose of study drug during both time periods were included in the analysis. Response was defined according to the international working group on MDS definitions (Cheson et al., Blood, 2000; 96(12):3671–4). Kaplan-Meier estimates (95% CL) for the percentage of patients with a major response (hemoglobin [Hb] change ≥ 2 g/dL over baseline or transfusion independence) or a minor response (Hb increase ≥ 1 g/dL to < 2 g/dL or a 50% reduction in transfusion requirements) during the treatment period were calculated. Data were abstracted from 142 patient charts, 112 (62 darbepoetin alfa; 50 epoetin alfa) of whom had confirmatory evidence of MDS available in their records (a documented bone marrow biopsy, French-American-British [FAB] classification, or karyotype [confirmed MDS population]). Baseline demographics for the confirmed MDS population were similar between the two cohorts. For those patients with data available, the majority had a FAB classification of refractory anemia with ≤ 5% bone marrow blasts. Mean baseline Hb was 11.0 g/dL for the darbepoetin alfa cohort (n=61) and 11.3 g/dL for the epoetin alfa cohort (n=48). The Kaplan-Meier percentage (95% CL) of patients with a major response was 27% (15, 39) for the darbepoetin alfa cohort and 19% (7, 30) for the epoetin alfa cohort; a minor response was noted for 46% (33, 59) and 47% (31, 63) of patients in the darbepoetin alfa and epoetin alfa cohorts, respectively. The Kaplan-Meier (95% CL) proportion of patients receiving red blood cell transfusions was similar between the groups: 8% (1, 15) for the darbepoetin alfa cohort and 12% (3, 22) for the epoetin alfa cohort. This study indicates that darbepoetin alfa achieved comparable clinical outcomes with epoetin alfa for the treatment of anemia in patients with confirmed MDS.

scholarly journals Outcomes of Patients with Intestinal Failure after the Development and Implementation of a Multidisciplinary Team

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sabrina Furtado ◽  
Najma Ahmed ◽  
Sylviane Forget ◽  
Ana Sant’Anna
Keyword(s):  
Multidisciplinary Team ◽  
Chart Review ◽  
Intestinal Failure ◽  
Retrospective Chart Review ◽  
Historical Cohort ◽  
Transplant Program ◽  
Multidisciplinary Program ◽  
Tertiary Center ◽  
The Impact ◽  
Overall Mortality

Aim. A multidisciplinary team was created in our institution to manage patients with intestinal failure (INFANT: INtestinal Failure Advanced Nutrition Team). We aimed to evaluate the impact of the implementation of the team on the outcomes of this patient population.Methods. Retrospective chart review of patients with intestinal failure over a 6-year period was performed. Outcomes of patients followed up by INFANT (2010–2012) were compared to a historical cohort (2007–2009).Results. Twenty-eight patients with intestinal failure were followed up by INFANT while the historical cohort was formed by 27 patients. There was no difference between the groups regarding remaining length of small and large bowel, presence of ICV, or number of infants who reached full enteral feeds. Patients followed up by INFANT took longer to attain full enteral feeds and had longer duration of PN, probably reflecting more complex cases. Overall mortality (14.8%/7.1%) was lower than other centers, probably illustrating our population of “early” intestinal failure patients.Conclusions. Our data demonstrates that the creation and implementation of a multidisciplinary program in a tertiary center without an intestinal and liver transplant program can lead to improvement in many aspects of their care.

scholarly journals Unusual obstetric trauma in newborn

2020 ◽  
Vol 9 ◽  
pp. 21
Author(s):  
Haif Assia ◽  
Ketfi Mounir ◽  
Achouri Djelloul ◽  
Sinacer Samira ◽  
Soualili Zineddine
Keyword(s):  
Umbilical Cord ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Birth Trauma ◽  
The Body ◽  
Facial Trauma ◽  
Bilateral Pneumothorax ◽  
Pertinent Data ◽  
Cord Injury ◽  
The Impact

Background: Birth injuries during delivery are rare but can be the most common cause of morbidity and mortality. All parts of the body can be damaged. The aim of this study is to determine the impact of these uncommon injuries on the newborn. This is a retrospective chart review of 11 newborn babies who had concurrent birth trauma. Pertinent data on the cause of injury treatment and the outcome were recorded. Methods: It is a retrospective chart review of newborns who sustained a birth trauma during delivery. These patients presented to the Department of Pediatric Surgery, SETIF, Algeria from 2010 to 2020. Results: A total of 11 cases with birth trauma occurred during delivery were managed during the study tenure. Of these 11, 9 were males and 2 females. Two cases sustained scalp laceration including one extensive laceration exposing the brain tissue with uncontrollable hemorrhage. One newborn sustained facial trauma secondary to the forceps delivery. One newborn who needed resuscitation and ventilation at birth developed bilateral pneumothorax secondary to the barotrauma. One patient sustained a femur fracture whereas another had a humerus fracture along with brachial plexus injury during delivery. Three cases had umbilical cord injury including two cases of clamped hernia of the umbilical cord resulting in neonatal intestinal obstruction. Two cases had scrotal trauma including one with testicular evisceration. Two cases were expired in this cohort. Conclusion: We have presented a diversity of birth trauma in newborns and their management. Proper antenatal follow-up and better planning for the delivery can avoid such injuries in newborns which often require surgical interventions for the management and at times can lead to mortality as well.

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