Abstract

There is growing evidence to recommend the use of whole body computed tomography (WBCT) scanning in the early management of severe blunt polytrauma patients. One recent study reported a survival advantage when using WBCT compared to a conventional imaging approach [1]. A number of UK NHS institutions already utilise WBCT protocols based upon either injury mechanism-related or physiological factors, or a combination of these. However, the UK Royal College of Radiologists is yet to provide recommendations on the use of WBCT in polytrauma. We present the results of our analysis of a large retrospective case series from 2005 to 2010 taken from the Trauma Audit and Research Network (TARN) database. We believe this is the first analysis of its kind involving UK trauma cases and provides important evidence to support the use of WBCT and guide best clinical practice.

Highlights

  • Sepsis is primarily a disease of the aged and 60% of sepsis occurs in patients older than 65 years, 80% of deaths due to sepsis occur in this age group

  • The purpose of the study is to elucidate the immunological changes that occur in Klotho mice after sepsis in order to identify therapeutic targets for sepsis that occurs in aged individuals

  • Poor survival in Klotho-septic mice may be associated with impaired bacterial clearance with decreased recruitment of neutrophils/macrophages in peritoneal cavity, elevated cytokines in serum, and increased apoptosis in thymus and spleen, following to impaired innate and adaptive immunity

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Summary

Introduction

Sepsis is primarily a disease of the aged and 60% of sepsis occurs in patients older than 65 years, 80% of deaths due to sepsis occur in this age group. The aim of this study was to determine the reasons behind out-of-hours discharges in our hospital and the effect this has on mortality This audit reviewed the discharge process of patients from an adult general ICU to the general wards before and after the introduction of a liaison nurse post over a 3-year, 3-month time period. The aim of this study was to establish and compare the quality and value of the summaries as judged by ICU doctors and GPs. The relationship between provider volume and patient outcome has been demonstrated for many medical and surgical services, including critical care. Methods In this single-centre observational study we aimed to quantify functional dependency at three different time points: discharge from ICU (DI), discharge from hospital (DH) and discharge from nursing home rehabilitation unit (DR) To this end we retrospectively assed Barthel scores (BS) for individual patients [1], with a duration of mechanical ventilation >48 hours.

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