Abstract：
BACKGROUND:Major bile leak after blunt liver trauma is rare but challenging. It usually requires endoscopic retrograde cholangiography (ERC) for management. However, there is still lack of specific indications. The aim of this study is to elucidate risk factors for major bile leak and indications for early ERC after blunt liver trauma. METHODS:The trauma registry of a level I trauma center in Taiwan was queried, and all blunt liver trauma patients from June, 2008 to June, 2011 were selected for retrospective review. Data collected included demographic data, laboratory data, Injury Severity Score (ISS), liver injury grade and location, management of liver trauma, length of ICU, hospital stay and treatment result. ERC was used to confirm major bile leak. RESULTS:288 blunt liver trauma patients were selected from 2,475 torso trauma patients. There were 214 (74.5%) male and 74 (25.7%) female patients. The mean ISS was 24.2. Most patients received conservative treatment. Transcatheter artery embolization (TAE) and operation were 15.6% and 10.8% respectively. Major bile leak occurred in 14 (4.9%) patients. Risk factors for bile leak include high-grade liver injury, centrally-located liver trauma and use of TAE. A bilirubin level greater than 43.6 μmol/L provides a sensitivity of 100% and specificity of 85.1% for predicting major bile leak. CONCLUSIONS:High injury grade; centrally-located liver trauma; and use of TAE are risk factors for major bile leak after blunt liver trauma. ERC should be arranged early if the patient has risk factors and their plasma bilirubin level is greater than 43.6 μmol/L during admission.
journal_name
Scand J Trauma Resusc Emerg Medauthors
Yuan KC,Wong YC,Fu CY,Chang CJ,Kang SC,Hsu YPdoi
10.1186/1757-7241-22-26subject
Has Abstractpub_date
2014-04-15 00:00:00pages
26issn
1757-7241pii
1757-7241-22-26journal_volume
22pub_type
杂志文章abstract：:After the early implementation of Emergency Medicine (EM) 25 years ago, Iceland became the first Nordic country to nationally realize the benefits of this specialty. However, the road has been rocky as in many other countries. The early years of EM in Iceland were characterized by a significant shortage of resources, ...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-017-0467-9
更新日期：2018-01-03 00:00:00
abstract：:The European HEMS and Air ambulance Committee's Medical working group recently published Best Practice advice on pre-hospital emergency anaesthesia and advanced airway management. We believe that this initiative is important. In our opinion however, the competence requirements recommended by the authors do not meet th...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 信件
doi：10.1186/s13049-019-0613-7
更新日期：2019-03-18 00:00:00
abstract：BACKGROUND:A debate regarding the potential harmful effects of rigid neck collar and backboard usage among prehospital and hospital care providers in Norway provoked the development of an evidence-based guideline. "The Norwegian guideline for the prehospital management of adult trauma patients with potential spinal inj...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-019-0660-0
更新日期：2019-08-29 00:00:00
abstract：:There is a general decline in penetrating abdominal trauma throughout the western world. As a result of that, there is a significant loss of expertise in dealing with this type of injury particularly when the patient presents to theatre with physiological instability. A significant percentage of these patients will no...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/1757-7241-18-40
更新日期：2010-07-14 00:00:00
abstract：BACKGROUND:The current study investigates the incidence, aetiology, and outcome of hypoglycaemia of patients without diabetes in the EMS. METHODS:The study was a retrospective cohort study that utilized electronic EMS patient record system (population of one million). All patients encountered by EMS with plasma glucos...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-018-0480-7
更新日期：2018-02-01 00:00:00
abstract：:The inter-hospital transfer of patients is crucial to a well functioning trauma system, and the transfer process may serve as a quality indicator for regional trauma care. However, the assessment of the transfer process requires high-quality data from various sources. Prospective studies and studies based on single-ce...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 社论
doi：10.1186/1757-7241-18-15
更新日期：2010-03-16 00:00:00
abstract：BACKGROUND:Severely injured trauma patients are exposed to clinically significant radiation doses from computed tomography (CT) imaging in the emergency department. Moreover, this radiation exposure is associated with an increased risk of cancer. The purpose of this study was to determine some effects of a radiation do...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/1757-7241-19-67
更新日期：2011-11-03 00:00:00
abstract：BACKGROUND:A hospital's capacity and preparedness is one of the important parts of disaster planning. Hospital-related incidents, a new phenomenon in Swedish healthcare, may lead to ambulance diversions, increased waiting time at emergency departments and treatment delay along with deterioration of disaster management ...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/1757-7241-17-26
更新日期：2009-06-03 00:00:00
abstract：BACKGROUND:Together with the ambulances staffed with emergency medical technicians (EMTs), general practitioners (GPs) on call are the primary resources for handling emergencies outside hospitals in Norway. The benefit of the GP accompanying the ambulance to pre-hospital calls is a matter of controversy in Norway. The ...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-014-0047-1
更新日期：2014-08-22 00:00:00
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-015-0179-y
更新日期：2015-11-11 00:00:00
abstract：BACKGROUND:After severe polytrauma the dynamic process of coagulation may deteriorate towards a trauma-induced coagulopathy (TIC) promoting a dramatic increase in morbidity and mortality. Recent evidence suggests that microparticles (MPs) play a pivotal role at the interface between cellular and plasmatic coagulation s...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章,多中心研究
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更新日期：2018-04-27 00:00:00
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-017-0418-5
更新日期：2017-07-17 00:00:00
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-018-0477-2
更新日期：2018-02-09 00:00:00
abstract：BACKGROUND:In head trauma cases involving antiplatelet agent treatment, the French Society of Emergency Medicine recommends performing computed tomography (CT) scans to detect brain lesions, 90% of which are normal. The value of CT is still debatable given the scarce number of studies and controversial results. METHOD...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-018-0515-0
更新日期：2018-06-19 00:00:00
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/1757-7241-20-62
更新日期：2012-09-04 00:00:00
abstract：BACKGROUND:Acute pain is a frequent symptom, but little is known about the frequency and causes of acute pain in the prehospital population. The objectives of this study were to investigate the frequency of moderate to severe pain among prehospital patients and the underlying causes according to primary hospital diagno...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-018-0521-2
更新日期：2018-07-03 00:00:00
abstract：BACKGROUND:Fluid therapy is a common and crucial treatment in the emergency department (ED). While fluid responsiveness seems to be a promising method to titrate fluid therapy, the evidence for its value in ED is unclear. We aim to synthesise the existing literature investigating fluid responsiveness in ED. METHODS:ME...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章,评审
doi：10.1186/s13049-017-0370-4
更新日期：2017-03-06 00:00:00
abstract：BACKGROUND:Trauma is a significant cause of death and impairment. The Abbreviated Injury Scale (AIS) differentiates the severity of trauma and is the basis for different trauma scores and prediction models. While the majority of patients do not survive injuries which are coded with an AIS 6, there are several patients ...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-020-00820-y
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-015-0164-5
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-015-0093-3
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-015-0177-0
更新日期：2015-11-06 00:00:00
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章,评审
doi：10.1186/s13049-018-0489-y
更新日期：2018-03-27 00:00:00
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-019-0688-1
更新日期：2019-12-10 00:00:00
abstract：BACKGROUND:Acute dyspnoea is common among ambulance patients, but little is known of the patients' experience of symptom. We aimed to investigate ambulance patients initial perceived intensity of acute dyspnoea, and whether they experienced relief during prehospital treatment. Furthermore, to investigate the validity a...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-020-0715-2
更新日期：2020-04-03 00:00:00
abstract：BACKGROUND:The scientific evidence of a beneficial effect of physicians in prehospital treatment is scarce. The objective of this systematic review of controlled studies was to examine whether physicians, as opposed to paramedical personnel, increase patient survival in prehospital treatment and if so, to identify the ...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章,评审
doi：10.1186/1757-7241-17-12
更新日期：2009-03-05 00:00:00
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journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-018-0570-6
更新日期：2018-11-22 00:00:00
abstract：BACKGROUND:An emergency cricothyrotomy is the last-resort in most airway management protocols and is performed when it is not possible to intubate or ventilate a patient. This situation can rapidly prove fatal, making it important to identify the best method to establish a secure airway. We conducted a systematic revie...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章,评审
doi：10.1186/1757-7241-21-43
更新日期：2013-05-31 00:00:00
abstract：BACKGROUND:Educating lay public can significantly strengthen the Chain of Survival after out of hospital cardiac arrest. Schoolchildren are an accessible population for learning basic life support (BLS) and use of an automated external defibrillator (AED) and can be regarded as multipliers of knowledge that can reach t...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/s13049-019-0683-6
更新日期：2019-12-23 00:00:00
abstract：BACKGROUND:The effect of rescue breathing on neurologic prognosis after cardiopulmonary resuscitation (CPR) is controversial. Therefore, we investigated the cerebral microcirculatory and oxygen metabolism during continuous compression (CC) and 30:2 CPR (VC) in a porcine model of cardiac arrest to determine which is bet...
journal_title：Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type： 杂志文章
doi：10.1186/1757-7241-21-55
更新日期：2013-07-12 00:00:00
