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Background: Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 - 44 years. There is a dearth of information on polytrauma from developing countries such as ours. Hence, this topic was studied at our institute. The objective is to study the coagulation parameters in polytrauma patients at our institute and to correlate the findings with the prognosis.
Methods: A prospective study was carried out in the department of pathology in a tertiary care center, during a period of 20 months from December 2012 to July 2014. All the polytrauma patients (injury severity score (ISS) ≥ 15) with injuries to head and neck, face, thorax, abdomen, extremities and external (skin) were included. Sampling was done within 20 min of arrival during primary survey of the patient. Screening tests like bleeding time (BT) and clotting time (CT) were carried out bedside. Other tests carried out were complete blood count (CBC), prothrombin time (PT), activated thromboplastin time (aPTT), thrombin time (TT) and D-dimer assay. Tests were carried out on fresh samples within 2 h of collection.
Results: The incidence of coagulopathy was 59.86%. There was significant prolongation of PT, aPTT and TT in those patients who developed coagulopathy. PT was found to be a stronger predictor of mortality among polytrauma patients.
Conclusion: A significant proportion of polytrauma patients were coagulopathic. Initial coagulation profile is very useful in predicting outcomes for major polytrauma patients. This study emphasizes the importance of early suspicion and basic screening for coagulopathy in polytrauma patients in developing countries.
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http://dx.doi.org/10.14740/jh432w | DOI Listing |
Clin Nutr ESPEN
September 2025
Duke University, Department of Surgery, Division of Trauma, Acute, and Critical Care Surgery, Durham, NC, USA. Electronic address:
Background: Up to 70% of lung cancer may be malnourished. This study aims to examine the effects of malnutrition on outcomes in lung cancer patients undergoing resection using modified GLIM criteria.
Methods: The study utilized the mGLIM criteria to identify malnourished patients.
Injury
August 2025
Department of Trauma Surgery, University and University Hospital of Zurich, Raemistr. 100, 8091 Zurich, Switzerland; Center for Preclinical Development, University and University Hospital of Zurich, Raemistr. 100, 8091 Zurich, Switzerland. Electronic address:
Background: Critical size bone defects represent a clinical challenge, associated with considerable morbidity, and frequently trigger the requirement of secondary procedure. To fill osseous gaps, multiple steps are required, such as proliferation and differentiation on the cellular level and the building of extracellular matrix. In addition, the osteogenic potential of cell-derived extracellular matrices (CD-ECM) is known to enhance bone healing.
View Article and Find Full Text PDFDiabetes Metab Res Rev
September 2025
Department of Nephrology, Daping Hospital, Army Medical University, Chongqing, China.
Chronic kidney disease (CKD) substantially increases cardiovascular risk, with endothelial dysfunction as its central pathological mechanism. This review summarises the molecular regulatory mechanisms underlying endothelial dysfunction in CKD and highlights recent advances in treatment strategies. The pathophysiology of endothelial injuries involves a complex network of multiple factors and mechanisms, including oxidative stress, inflammation, glycocalyx damage, ischaemia, hypoxia, cellular senescence and endothelial-mesenchymal transition (EndMT).
View Article and Find Full Text PDFHand (N Y)
September 2025
Duke University, Durham, NC, USA.
Background: Dorsal wrist spanning plate (DWSP) fixation in distal radius fractures (DRFs) has been proposed to allow earlier mobilization in polytraumatized patients by enabling early weightbearing (WB) through the injured wrist. The purpose of this study is to compare radiographic and clinical outcomes in patients who bore weight through the injured wrist within the early postoperative period with patients who did not bear weight.
Methods: Patients who underwent DWSP fixation at a single institution were retrospectively identified.
Am J Med
September 2025
Russell H. Morgan Department of Radiology and Radiological Science; Department of Oncology; Department of Urology; Johns Hopkins University School of Medicine, Baltimore, MD, Johns Hopkins Health System, Baltimore, MD. Electronic address:
Prior authorization requirements by health insurance plans have become a barrier to healthcare delivery in the United States in terms of clinical efficiency, patient and provider experience. Surveyed physicians report associations with care delays, reduced clinical effectiveness and compromised patient outcomes. In this systematic review, we synthesized the published evidence regarding harmful effects of prior authorization on disease management and patient outcomes.
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