ABSTRACT
OBJECTIVE: To reduce the incidence of postoperative complications and mortality after conversion of external fixation device into various types of submerged osteosynthesis in patients with polytrauma. MATERIAL AND METHODS: A retrospective and prospective analysis of treatment outcomes in 351 patients with polytrauma was divided into 2 stages. At the first stage, we analyzed significant predictors of complications after conversion of osteosynthesis in the 1st group (retrospective analysis). At the second stage, we estimated the efficacy of the developed scale for assessing the risk of complications after conversion of osteosynthesis in a prospective group of patients. RESULTS: According to the complication risk assessment scale for conversion of osteosynthesis, analysis of time to surgical treatment depending on objective criteria in patients with polytrauma can significantly reduce the incidence of postoperative complications by 14% and mortality rate by 1.7%. CONCLUSION: The complication risk assessment scale after conversion of osteosynthesis will personalize the approach to timing and methods of conversion. This measure will eliminate the «second hit¼ in damage control orthopedics and improve the results of treatment.
Subject(s)
Fracture Fixation, Internal , Multiple Trauma , Postoperative Complications , Humans , Male , Female , Multiple Trauma/surgery , Multiple Trauma/mortality , Postoperative Complications/prevention & control , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Fracture Fixation, Internal/methods , Fracture Fixation, Internal/adverse effects , Middle Aged , Adult , Russia/epidemiology , Risk Assessment/methods , Retrospective StudiesABSTRACT
AIM: To analyze treatment of victims with multiple trauma in multi-field hospital. MATERIAL AND METHODS: Retrospective analysis of 2139 medical records of patients with multiple trauma (NISS score over 17) was performed. In-hospital mortality, patient transfer time, dominant injury, hospital-stay, gender and age of victims were assessed. RESULTS: New diagnostic and treatment options allowed achieving significant decrease of mortality from 39.7% (2004) to 10.8% (2016). CONCLUSION: Improved mortality was achieved due to organized work of the 'regional traumatological systems'. Mortality rate was below 10.7% if victims were transferred to the hospital within 6 hours after trauma. The highest mortality was observed in patients who were transferred to the hospital within 6-12 hours after injury (20.3%).
Subject(s)
Mobile Health Units/organization & administration , Multiple Trauma/mortality , Multiple Trauma/therapy , Trauma Centers/organization & administration , Hospital Mortality , Humans , Mobile Health Units/statistics & numerical data , Multiple Trauma/diagnosis , Multiple Trauma/epidemiology , Retrospective Studies , Time Factors , Trauma Centers/statistics & numerical dataABSTRACT
AIM: To objectify timing of DCS stages implementation in advanced age patients through lethal outcome risk assessment. MATERIAL AND METHODS: 128 advanced age patients with polytrauma were enrolled. RESULTS: It was concluded that specialized prognosis scale for advanced age patients with polytrauma allowed to objectify the transition time between DCS stages that led to decrease of mortality by 10.6%.
Subject(s)
Multiple Trauma , Patient Care Management/methods , Risk Assessment/methods , Aged , Female , Humans , Male , Multiple Trauma/diagnosis , Multiple Trauma/mortality , Outcome Assessment, Health Care , Prognosis , Russia , Trauma Severity IndicesABSTRACT
In this work the results of treatment of 116 patients with polytrauma older age groups was analysed, the comparison group consisted of 55 patients with multiple injuries aged 20 to 40 years. The objective of the study was the search of criteria of the objectification assess the severity of condition of patients of elderly and senile age with polytrauma on the basis of laboratory parameters and evaluation of the influence of concomitant somatic pathology on the level of lethality. We analysed the significance of each of the selected indicators and their entirety, thereby simplifying the formation of evidence-informed way to predict fatal outcome in patients of elderly and senile age with polytrauma.
