Study of the peri-operative mortality in trochanteric fractures in elderly patients (60 years and above) visiting department of orthopedics at  Dr. RPGMC Tanda

Background: In elderly, trochanteric fractures are frequent and typically result from mild to moderate trauma in osteoporotic bones while in young adults these fractures are generally due to high energy trauma such as road side accidents.Methods: The present study was conducted in elderly patients with trochanteric fractures (age 60 years and above) presenting to the department of orthopedics, Dr. RPGMC Kangra at Tanda. All cases presenting to the department and fulfilling the inclusion criteria were studied for three months period from the day of surgery. All cases fulfilling the inclusion criteria who were operated over the period of one year from the date of start of study were included.Results: Our study observed that out of 176 patients, 10.23% (n=18/176) patients could not survive within 90 days of surgery while 89.8% (n=158/176) patients survived. Perioperative mortality was 10.23%.Conclusions: In our study, peri-operative mortality is lower than reported earlier. We also found that perioperative mortality was influenced by older age.

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Cases of Missed Posterior Fracture-Dislocation of the Shoulder

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v5i3.4290 ◽

2020 ◽

Author(s):

Morteza Nakhaei Amroodi ◽

Farzad Amouzadeh Omrani ◽

Naser Ghanbari ◽

Melika Alaedini

Keyword(s):

Young Adults ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Rare Condition ◽

High Energy ◽

Posterior Dislocation ◽

Humerus Fracture ◽

Fracture Dislocation ◽

High Energy Trauma ◽

X Ray

Proximal humerus fracture-dislocation is a rare condition that occurs mostly in young adults due to high energy trauma and about 60-79 percent of misdiagnosis is occurred in the first diagnosis. In this article, we present two patients with proximal humerus fracture-posterior dislocation the fractures of whom were diagnosed, but after the radiographic studies including x-ray and computer tomography (CT) scan, the posterior dislocation was misdiagnosed. In addition, complications, management, and avoidance of this misdiagnosis were discussed.

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High-Energy Trauma and Damage Control in the Lower Limb

10.21236/ada554076 ◽

2010 ◽

Cited By ~ 1

Author(s):

Charles J. Fox ◽

Peter Kreishman

Keyword(s):

Lower Limb ◽

Damage Control ◽

High Energy ◽

High Energy Trauma

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CT density of cervical thymus, in comparison with mediastinal thymus

Insights into Imaging ◽

10.1186/s13244-019-0781-z ◽

2019 ◽

Vol 10 (1) ◽

Author(s):

Anitha Sen ◽

Jiji Valsalamony ◽

Jubie Raj

Keyword(s):

Young Adults ◽

Soft Tissue ◽

Older Age ◽

List Type ◽

Age Group ◽

Positive Correlation ◽

Children And Young Adults ◽

Criteria For Diagnosis ◽

Ct Density ◽

Moderate Positive Correlation

Abstract Objectives Cervical component of thymus is noted more in children and young adults than in older age group. CT texture (lobules of soft tissue interspersed with fat), similarity with CT density of mediastinal thymus and continuity with mediastinal thymus on sagittal/coronal images, are given as the criteria for diagnosis of the cervical thymus. But CT densities of cervical and mediastinal components of the thymus may vary. The purpose of our study was to compare CT densities of cervical and mediastinal parts of the thymus, in cases where ultrasonography correlation was available. Methods We retrospectively identified 22 patients who had undergone CT between May 2015 and May 2017 and in whom ultrasonography (USG) correlation was available. CT densities of cervical and mediastinal components of thymus were measured. Results CT density of cervical thymus is lower than the CT density of mediastinal thymus by ~ 25 HU. There is a moderate positive correlation between CT densities of cervical and mediastinal parts of the thymus. CT densities of both cervical and mediastinal thymus were found to reduce with age, but the reduction was statistically significant only in the cervical thymus in this study. Conclusions CT densities of cervical and mediastinal components of the thymus may vary, with CT density of cervical thymus being lower. There is a positive correlation between CT densities of cervical and mediastinal parts of the thymus. CT density of cervical thymus reduces with age. Understanding these may help avoid confusion on CT and avoid the need for correlative USG, saving time and effort.

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Benefit of lag screw placement by a single- or two-screw nailing system in elderly patients with AO/OTA 31-A2 trochanteric fractures

Journal of International Medical Research ◽

10.1177/03000605211003766 ◽

2021 ◽

Vol 49 (3) ◽

pp. 030006052110037

Author(s):

Fulong Zhao ◽

Lijuan Guo ◽

Xuefei Wang ◽

Yakui Zhang

Keyword(s):

Blood Loss ◽

Elderly Patients ◽

Fracture Healing ◽

Healing Time ◽

Harris Hip Score ◽

Intraoperative Blood Loss ◽

Trochanteric Fractures ◽

Surgical Time ◽

Gamma3 Nail ◽

Intertan Nail

Objective To retrospectively analyze the clinical outcomes of two intramedullary fixation devices, the INTERTAN nail and Gamma3 nail, for treatment of AO/OTA 31-A2 trochanteric fractures in elderly patients. Methods In total, 165 elderly patients underwent treatment for AO/OTA 31-A2 trochanteric fractures in our hospital from June 2017 to June 2018 (INTERTAN group, n = 79; Gamma3 group, n = 86). All patients underwent radiological and clinical investigations and were followed up for an average of 12 months. Age, sex, fracture type, surgical time, intraoperative blood loss, fracture healing time, and complications were compared between the two groups. Results The surgical time was significantly shorter and the intraoperative blood loss volume was significantly lower in the Gamma3 than INTERTAN group (58.2 ± 2.5 vs. 81.7 ± 14.2 minutes and 170 ± 29 vs. 220 ± 16 mL, respectively). However, there were no significant differences in the reduction quality, hospital stay, fracture healing time, Harris hip score, postoperative complications, or 1-year postoperative mortality. Conclusion Both INTERTAN and Gamma3 nails may be effective for surgical treatment of AO/OTA 31-A2 trochanteric fractures in elderly patients. However, the Gamma3 nail was superior to the INTERTAN nail in terms of surgical time and intraoperative blood loss.

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The current treatment and predictors of outcome in elderly patients with non-ST-elevation myocardial infarction in an all comers population: the POPular Age registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.3248 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M.E Gimbel ◽

D.R.P.P Chan Pin Yin ◽

R.S Hermanides ◽

F Kauer ◽

A.H Tavenier ◽

...

Keyword(s):

Myocardial Infarction ◽

Elderly Patients ◽

Major Bleeding ◽

Oral Anticoagulation ◽

Dual Antiplatelet Therapy ◽

Bleeding Risk ◽

Cardiovascular Death ◽

St Elevation ◽

One Year

Abstract Background Elderly patients form a large and growing part of the patients presenting with non-ST-elevation myocardial infarction (NSTEMI). Choosing the optimal antithrombotic treatment in these elderly patients is more complicated because they frequently have characteristics indicating both a high ischaemic and high bleeding risk. Purpose We describe the treatment of elderly patients (>75 years) admitted with NSTEMI, present the outcomes (major adverse cardiovascular events (MACE) and bleeding) and aim to find predictors for adverse events. Methods The POPular AGE registry is an investigator initiated, prospective, observational, multicentre study of patients aged 75 years or older presenting with NSTEMI. Patients were recruited between August 1st, 2016 and May 7th, 2018 at 21 sites in the Netherlands. The primary composite endpoint of MACE included cardiovascular death, non-fatal myocardial infarction and non-fatal stroke at one-year follow-up. Results A total of 757 patients were enrolled. During hospital stay 76% underwent coronary angiography, 34% percutaneous coronary intervention and 12% coronary artery bypass grafting (CABG). At discharge 78.6% received aspirin (non-users mostly because of the combination of oral anticoagulant and clopidogrel), 49.7% were treated with clopidogrel, 34.2% with ticagrelor and 29.6% were prescribed oral anticoagulation. Eighty-three percent of patients received dual antiplatelet therapy (DAPT) or dual therapy consisting of oral anticoagulation and at least one antiplatelet agent for a duration of 12 months. At one year, the primary outcome of cardiovascular death, myocardial infarction or stroke occurred in 12.3% of patients and major bleeding (BARC 3 or 5) occurred in 4.8% of the patients. The risk of MACE and major bleeding was highest during the first month and stayed high over time for MACE while the risk for major bleeding levelled off. Independent predictors for MACE were age, renal function, medical history of CABG, stroke and diabetes. The only independent predictor for major bleeding was haemoglobin level on admission. Conclusion In this all-comers registry, most elderly patients (≥75 years) with NSTEMI are treated with DAPT and undergoing coronary angiography the same way as younger NSTEMI patients from the SWEDEHEART registry. Aspirin use was lower as was the use of the more potent P2Y12 inhibitors compared to the SWEDEHEART which is very likely due to the concomitant use of oral anticoagulation in 30% of patients. The fact that ischemic risk stays constant over 1 year of follow-up, while the bleeding risk levels off after one month may suggest the need of dual antiplatelet therapy until at least one year after NSTEMI. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): AstraZeneca

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Clinical and economic effects of selective radiological evaluation of high-energy trauma patients: a prospective experience of a level 1 busy trauma centre

Emergency Medicine Journal ◽

10.1136/emermed-2014-204083 ◽

2014 ◽

Vol 32 (7) ◽

pp. 535-538 ◽

Cited By ~ 2

Author(s):

Shahram Paydar ◽

Armin Ahmadi ◽

Behnam Dalfardi ◽

Alireza Shakibafard ◽

Hamidreza Abbasi ◽

...

Keyword(s):

High Energy ◽

Trauma Centre ◽

Economic Effects ◽

Trauma Patients ◽

Radiological Evaluation ◽

High Energy Trauma ◽

Level 1

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Angiography in patients with pelvic fractures and contrast extravasation on CT following high-energy trauma

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-021-01628-w ◽

2021 ◽

Author(s):

Jonathan Hammerschlag ◽

Yehuda Hershkovitz ◽

Itamar Ashkenazi ◽

Zahar Shapira ◽

Igor Jeroukhimov

Keyword(s):

High Energy ◽

Pelvic Fractures ◽

Contrast Extravasation ◽

High Energy Trauma

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Driving While Impaired and Riding with an Impaired Driver among Recent Latinx Immigrants

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/03611981211014894 ◽

2021 ◽

pp. 036119812110148

Author(s):

Eduardo Romano ◽

Mariana Sanchez ◽

Eileen P. Taylor ◽

Rosa Babino

Keyword(s):

Young Adult ◽

Latin American ◽

National Institutes Of Health ◽

Dade County ◽

Baseline Assessment ◽

Drinking And Driving ◽

Inclusion Criteria ◽

Driving While Impaired ◽

One Year ◽

Significant Factors

The overarching aim of this study is to assess driving while impaired by alcohol (DWI) and riding with an impaired driver (RWID) rates among young adult Latinx immigrants to Miami-Dade County, Florida, within a year of arrival in the U.S.A. More specifically, this study aims to: (i) describe the demographic and socioeconomic characteristics of Latinx immigrants to Miami-Dade County within a year of arrival; (ii) examine their alcohol use, DWI, and RWID; and (iii) identify factors influencing these behaviors. This study uses baseline data from an ongoing National Institutes of Health-funded longitudinal study examining drinking and driving trajectories among young adult recent Latinx immigrants to Miami-Dade County. During the baseline assessment, retrospective pre-immigration data and post-immigration data were obtained via personal interviews. Inclusion criteria included being a Latinx immigrant, 18–34 years old, who recently immigrated (within one year before baseline assessment) to the U.S.A. from a Latin American country with the intention of staying in the U.S.A. for at least three years beyond baseline. Respondent-driven sampling was applied. Results showed that since arriving in the U.S.A. approximately 6.3% of all participants had engaged in DWI at least once and 20% reported RWID. Although household income and being male were significant factors, the factor that influenced post-immigration DWI/RWID the most was pre-immigration DWI (odds ratio = 13.1) and pre-immigration RWID (odd ratio = 24.5). Interventions aimed to prevent recent immigrants from engaging in DWI and RWID should take cultural factors and pre-immigration behaviors into account.

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