Objectives: Concomitant injuries play an important role when it comes to clinical management of traumatic brain injury (TBI). We examined the incidence of concomitant injuries and their relevance with respect to hospi...Objectives: Concomitant injuries play an important role when it comes to clinical management of traumatic brain injury (TBI). We examined the incidence of concomitant injuries and their relevance with respect to hospitalization. Methods: Children aged between 0 - 18 years hospitalized for treatment of TBI (ICD 10;S06.0 - 9) during 2010-2011 were included. The data relating to concomitant injuries and the course of treatment were evaluated. Statistical analysis included multivariate regressions at a level of significance of p ≤ 0.05. Results: 794 children were treated for head injury in our hospital. Head injury with other associated injuries had been sustained by 158 (19.9%) children. The face and the extremities were the areas of the body most often affected (p = 0.001). Boys represent the majority within the cohort of multiple injured children (p = 0.0001). The older the child, the higher the percentage of children with concomitant injuries (r = 0.27;p = 0.034). There was a significant correlation between the severity of the head injury and the occurrence of concomitant injuries (r = 0.19;p = 0.046). Children with concomitant injuries were found to suffer significantly more falls (N = 82;51.9%) than road traffic accidents (N = 68;43%) (p = 0.0001). A comparison of different variables revealed that age (7 to 10 years), severity of head injury (mild TBI), and trauma mechanism (fall) were most influential (KB = ?1.55;p = 0.023) for concomitant injuries. Children with concomitant injuries have a significant longer stay in hospital than those without: mean stay 2.5 to 4.5 days (p = 0.0001). Conclusion: Concomitant injuries are hints for more severe head injuries and children should be examined with special care.展开更多
Purpose： Maxillofacial injuries are frequently associated with multiple trauma and can determine func- tional and aesthetic bad outcomes.The severity ofmaxillofacial injuries may be considerable and can divert clinic...Purpose： Maxillofacial injuries are frequently associated with multiple trauma and can determine func- tional and aesthetic bad outcomes.The severity ofmaxillofacial injuries may be considerable and can divert clinicians＇ attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department （ED） of the University Hospital of Messina （North-East Sicily, Italy） for maxillofacial traumas. Methods： We retrospectively evaluated data of 240,833 patients admitted at the ED of the University Hospital of Messina from January 2008 to December 2015 because of maxillofacial injuries leading to hospitalization and surgical treatment. Patients who primarily received treatment care at different in- stitutions, pediatric trauma patients and adult patients who were transferred in accordance with pre- existing agreements in case of paucity of beds were excluded. Finally we included 447 （0.2%） patients over the 8 years. Data were evaluated with emphasis on epidemiology （age, gender, mechanism of trauma）, primary survey and abnormalities and pattern of trauma. Results： The most frequent cause of maxillofacial trauma was road accidents （319 patients, 71.4%）, among which motorcycle ones were prevalent. The maxillofacial injured who presented major lesions were 98 patients and minor lesions occurred in 349 patients： 443 （99.1%） patients underwent maxillofacial surgery, immediate or delayed depending on the severity of concomitant injuries （x^2 = 557.2, p 〈 0.0001）. Five concomitant neglected lesions were found to be associated with severe maxillofacial traumas （x^2 = 17.13, p 〈 0.0001 vs minor lesions）. All of the neglected lesions occurred in pauci- symptomatic patients who showed painless abdomen, no hemodynamic instability, no signs of hema- toma of anterior and posterior abdominal wall or other suspicious clinical signs and symptoms. Conclusion： Among the patients admitted firstly in other surgical wards different from the Maxillofacial Surgery Unit. diagnosis was more difficult, especially for blunt abdominal traumas, in which patients showed only vague and nonspecific symptoms concealing serious and life-threatening injuries. We recommend the routine use of whole body CT scan, when the maxillofacial injuries appear prevalent, mainly in patients affected by maxillofacial maior lesions.展开更多
文摘Objectives: Concomitant injuries play an important role when it comes to clinical management of traumatic brain injury (TBI). We examined the incidence of concomitant injuries and their relevance with respect to hospitalization. Methods: Children aged between 0 - 18 years hospitalized for treatment of TBI (ICD 10;S06.0 - 9) during 2010-2011 were included. The data relating to concomitant injuries and the course of treatment were evaluated. Statistical analysis included multivariate regressions at a level of significance of p ≤ 0.05. Results: 794 children were treated for head injury in our hospital. Head injury with other associated injuries had been sustained by 158 (19.9%) children. The face and the extremities were the areas of the body most often affected (p = 0.001). Boys represent the majority within the cohort of multiple injured children (p = 0.0001). The older the child, the higher the percentage of children with concomitant injuries (r = 0.27;p = 0.034). There was a significant correlation between the severity of the head injury and the occurrence of concomitant injuries (r = 0.19;p = 0.046). Children with concomitant injuries were found to suffer significantly more falls (N = 82;51.9%) than road traffic accidents (N = 68;43%) (p = 0.0001). A comparison of different variables revealed that age (7 to 10 years), severity of head injury (mild TBI), and trauma mechanism (fall) were most influential (KB = ?1.55;p = 0.023) for concomitant injuries. Children with concomitant injuries have a significant longer stay in hospital than those without: mean stay 2.5 to 4.5 days (p = 0.0001). Conclusion: Concomitant injuries are hints for more severe head injuries and children should be examined with special care.
文摘Purpose： Maxillofacial injuries are frequently associated with multiple trauma and can determine func- tional and aesthetic bad outcomes.The severity ofmaxillofacial injuries may be considerable and can divert clinicians＇ attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department （ED） of the University Hospital of Messina （North-East Sicily, Italy） for maxillofacial traumas. Methods： We retrospectively evaluated data of 240,833 patients admitted at the ED of the University Hospital of Messina from January 2008 to December 2015 because of maxillofacial injuries leading to hospitalization and surgical treatment. Patients who primarily received treatment care at different in- stitutions, pediatric trauma patients and adult patients who were transferred in accordance with pre- existing agreements in case of paucity of beds were excluded. Finally we included 447 （0.2%） patients over the 8 years. Data were evaluated with emphasis on epidemiology （age, gender, mechanism of trauma）, primary survey and abnormalities and pattern of trauma. Results： The most frequent cause of maxillofacial trauma was road accidents （319 patients, 71.4%）, among which motorcycle ones were prevalent. The maxillofacial injured who presented major lesions were 98 patients and minor lesions occurred in 349 patients： 443 （99.1%） patients underwent maxillofacial surgery, immediate or delayed depending on the severity of concomitant injuries （x^2 = 557.2, p 〈 0.0001）. Five concomitant neglected lesions were found to be associated with severe maxillofacial traumas （x^2 = 17.13, p 〈 0.0001 vs minor lesions）. All of the neglected lesions occurred in pauci- symptomatic patients who showed painless abdomen, no hemodynamic instability, no signs of hema- toma of anterior and posterior abdominal wall or other suspicious clinical signs and symptoms. Conclusion： Among the patients admitted firstly in other surgical wards different from the Maxillofacial Surgery Unit. diagnosis was more difficult, especially for blunt abdominal traumas, in which patients showed only vague and nonspecific symptoms concealing serious and life-threatening injuries. We recommend the routine use of whole body CT scan, when the maxillofacial injuries appear prevalent, mainly in patients affected by maxillofacial maior lesions.
