BASE DEFICIT DEVELOPMENT AND ITS PROGNOSTIC SIGNIFICANCE IN POSTTRAUMA CRITICAL ILLNESS: AN ANALYSIS BY THE TRAUMA REGISTRY OF THE DEUTSCHE GESELLSCHAFT FÜR UNFALLCHIRURGIE

Shock ◽  
2001 ◽  
Vol 15 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Dieter Rixen ◽  
Marcus Raum ◽  
Bertil Bouillon ◽  
Rolf Lefering ◽  
Edmund Neugebauer
Keyword(s):  
Critical Illness ◽  
Trauma Registry ◽  
Prognostic Significance ◽  
Base Deficit ◽  
Deutsche Gesellschaft ◽  
Deutsche Gesellschaft Für Unfallchirurgie

scholarly journals Sicherheitsaspekte und Vorbereitung zur Notfallvorsorge und Gefahrenabwehr in Kliniken bei MANV/TerrorMANV

2021 ◽  
Author(s):  
Patrick Hoth ◽  
Dan Bieler ◽  
Benedikt Friemert ◽  
Axel Franke ◽  
Markus Blätzinger ◽  
...  
Keyword(s):  
Deutsche Gesellschaft ◽  
Deutsche Gesellschaft Für Unfallchirurgie

Zusammenfassung Hintergrund Weltweite terroristische Aktivitäten seit „9/11“ und folgend auch im europäischen Raum haben im Rahmen der Bewertung von kritischer Infrastruktur in Deutschland zu einem Umdenken auch hinsichtlich der Sicherheit an und in Kliniken geführt. Ziel der Arbeit Die vorliegende Publikation befasst sich mit der Bewertung vorliegender Konzepte zu Themen wie „Alarmierung“, „Sicherheit“, „Kommunikation“ und „Vorbereitung“ im vorgenannten Kontext. Material und Methoden Anhand einer Literatursichtung sowie einer Umfrage unter den Teilnehmern*innen der 3. Notfallkonferenz der DGU (Deutsche Gesellschaft für Unfallchirurgie) werden diese Thematik und die aktuell vorliegende Situation weiter analysiert und vorgestellt. Ergebnisse Die gewonnenen Daten verdeutlichen, dass ein Großteil der Kliniken zwar über eine Krankenhausalarm- und Einsatzplanung verfügt, jedoch die Frequenz der Aktualisierungen und die innerklinische Kommunikation zur Steigerung der Wahrnehmung eine deutliche Streuung zeigen. Weiterhin verdeutlichen die Ergebnisse eine Heterogenität der vorliegenden innerklinischen Alarmierungskonzepte sowie einen Mangel an Sicherheitskonzepten und Kooperationen mit Sicherheits- und Wachdiensten. Zudem zeigt sich, dass die Thematik einer möglichen CBRN(chemical, biological, radiological, nuclear)-Bedrohung in der Risikoanalyse noch nicht adäquat wahrgenommen wird bzw. umgesetzt ist. Diskussion Zusammenfassend scheint die latente Bedrohung durch terroristische Aktivitäten dazu geführt zu haben, dass sich deutsche Kliniken in der Bewertung als kritische Infrastruktur mit der Thematik „Krankenhausalarm- und Einsatzplanung“ auseinandergesetzt und diese überwiegend auch umgesetzt haben. Allerdings zeigt sich für die nachgeordneten Bereiche und die aus der Alarmplanung ableitbaren Konsequenzen noch nicht die nötige Stringenz, um letztendlich adäquate Reaktionen in diesen besonderen Szenarien im Hinblick auf die Sicherheit in und an deutschen Kliniken zu gewährleisten.

Comparison of the Prognostic Significance of Initial Blood Lactate and Base Deficit in Trauma Patients

2017 ◽  
Vol 126 (3) ◽  
pp. 522-533 ◽  
Author(s):  
Keyword(s):  
Logistic Regression ◽  
Injury Severity Score ◽  
Blood Lactate ◽  
Severity Score ◽  
Injury Severity ◽  
Prognostic Significance ◽  
Base Deficit ◽  
Trauma Patients ◽  
Operating Characteristics ◽  
Initial Blood

Abstract Background Initial blood lactate and base deficit have been shown to be prognostic biomarkers in trauma, but their respective performances have not been compared. Methods Blood lactate levels and base deficit were measured at admission in trauma patients in three level 1 trauma centers. This was a retrospective analysis of prospectively acquired data. The association of initial blood lactate and base deficit with mortality was tested using receiver operating characteristics curve, logistic regression using triage scores (Revised Trauma Score and Mechanism Glasgow scale and Arterial Pressure score), and Trauma Related Injury Severity Score as a reference standard. The authors also used a reclassification method. Results The authors evaluated 1,075 trauma patients (mean age, 39 ± 18 yr, with 90% blunt and 10% penetrating injuries and a mortality of 13%). At admission, blood lactate was elevated in 425 (39%) patients and base deficit was elevated in 725 (67%) patients. Blood lactate was correlated with base deficit (R2 = 0.54; P < 0.001). Using logistic regression, blood lactate was a better predictor of death than base deficit when considering its additional predictive value to triage scores and Trauma Related Injury Severity Score. This result was confirmed using a reclassification method but only in the subgroup of normotensive patients (n = 745). Conclusions Initial blood lactate should be preferred to base deficit as a biologic variable in scoring systems built to assess the initial severity of trauma patients.

Base deficit is a predictor of mortality in organophosphate insecticide poisoning

2017 ◽  
Vol 37 (2) ◽  
pp. 118-124 ◽  
Author(s):  
SB Lee ◽  
C Kang ◽  
DH Kim ◽  
T Kim ◽  
SH Lee ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Medical Problem ◽  
Base Deficit ◽  
Health Evaluation ◽  
Trauma Patients ◽  
Organophosphate Insecticide ◽  
Kaplan Meier ◽  
Number Of Patients ◽  
Increased Risk ◽  
Severity Of Injury

Objective: Organophosphate insecticide (OPI) self-poisoning is a major medical problem in many countries. Several studies have demonstrated that the base deficit (BD) is a prognostic tool that is correlated with the severity of injury and predicted mortality, particularly in trauma patients. Here, we aimed to investigate the prognostic significance of BD in OPI poisoning. Methods: This retrospective observational study was conducted between January 1, 2006, and January 31, 2015, at a single emergency department (ED). The BD values were divided into quartiles according to the number of patients: 3 mEq/L or less, 3–5.9 mEq/L, 6–9.9 mEq/L, and 10 mEq/L or greater. Survival at 30 days from ED admission was estimated using the Kaplan–Meier survival analysis. Results: Among 154 patients, 31 died, yielding a mortality of 20.1%. The highest BD quartile (≥ 10 mEq/L) and the 6–9.9 mEq/L group were associated with an increased risk of 30-day mortality. Patients with a BD of 10 mEq/L or greater had a 5.85-fold higher risk of 30-day mortality and patients with a BD of 6–9.9 mEq/L had a 5.40-fold higher risk of 30-day mortality compared to patients with a BD of 3 mEq/L or less. The area under the curves of the BD and the Acute Physiology and Chronic Health Evaluation II score for mortality were 0.748 (95% confidence interval (CI), 0.660–0.835) and 0.852 (95% CI, 0.789–0.915), respectively. Conclusions: This study showed that the BD is a predictor of 30-day mortality in patients with OPI poisoning.

So einfach wie E-Mail-Schreiben – nur sicherer

2012 ◽  
Vol 17 (03) ◽  
pp. 8-8
Author(s):  
Lilly Schulze
Keyword(s):  
Deutsche Gesellschaft ◽  
E Mail ◽  
Deutsche Gesellschaft Für Unfallchirurgie

Bei der Versorgung von Unfallopfern können Sekunden über Leben oder Tod entscheiden. Die Deutsche Gesellschaft für Unfallchirurgie treibt deshalb die elektronische Vernetzung von Traumazentren voran.

scholarly journals Prognostic significance of low TSH concentration in patients with COVID-19 presenting with non-thyroidal illness syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Gong ◽  
Ding-kun Wang ◽  
Hui Dong ◽  
Qing-song Xia ◽  
Zhao-yi Huang ◽  
...  
Keyword(s):  
Critical Illness ◽  
Proportional Hazards ◽  
Prognostic Significance ◽  
Laboratory Data ◽  
Thyroid Stimulating Hormone ◽  
Cox Proportional Hazards ◽  
Free Triiodothyronine ◽  
Cox Proportional Hazards Models ◽  
Significant Difference ◽  
Tsh Levels

Abstract Background Low free triiodothyronine (FT3) levels are related to a poor prognosis deterioration in patients with COVID-19 presenting with non-thyroidal illness syndrome (NTI). This study was designed to explore whether free thyroxin (FT4) or thyroid stimulating hormone (TSH) levels affected the mortality of patients with COVID-19 presenting with NTI. Methods Patients with COVID-19 complicated with NTI who were treated at our hospital were included in this retrospective study. Patients were divided into low TSH and normal TSH groups, as well as low and normal-high FT4 group, according to the reference range of TSH or FT4 levels. The 90-day mortality and critical illness rates were compared among patients with low and normal TSH levels, as well as among patients with low FT4 levels and normal-high FT4 levels; in addition, differences in demographic and laboratory data were compared. A Kaplan-Meier analysis and Cox proportional hazards models were used to assess the associations of TSH and FT4 levels with mortality. Results One hundred fifty patients with low FT3 levels and without a history of thyroid disease were included, 68% of whom had normal FT4 and TSH levels. Critical illness rates (74.07% VS 37.40%, P = 0.001) and mortality rates (51.85% VS 22.76%, P = 0.002) were significantly higher in the low TSH group than in the normal TSH group. Although no significant difference in the critical illness rate was found (P = 0.296), the mortality rate was significantly higher in the low FT4 group (P = 0.038). Low TSH levels were independently related to 90-day mortality (hazard ratio = 2.78, 95% CI:1.42–5.552, P = 0.003). Conclusions Low FT4 and TSH concentrations were associated with mortality in patients with COVID-19 presenting with NTI; moreover, low TSH levels were an independent risk factor for mortality in these patients.

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