RepoMed (Medizinische Hochschule Hannover)
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Pathogen spectra in hospitalised and nonhospitalised children with community acquired pneumonia
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Prospektive Untersuchung zum Einsatz von tragbaren Defibrillatoren bei Patienten mit neu diagnostizierter schwerer Linksherzinsuffizienz
Get PDFThe effect of the COVID-19 pandemic lockdown measures on plastic, reconstructive and hand surgery emergency presentations: a comparative retrospective study in a regional referral center in Germany
Get PDFBackground The global COVID-19 pandemic has led to social constraints and changes in injury patterns during the government-imposed restrictions. The aim of this study was to evaluate the effects of the lockdown period on the pattern of emergency presentations in a plastic, hand and reconstructive surgery department in a German referral center. Methods A retrospective cohort study was conducted comparing patients presenting during the enforced lockdown period in 2020 and the same pre-pandemic period during the previous year 2019. All emergency presentations in the emergency unit requiring treatment by plastic, hand and reconstructive surgery were included. Patient demographics, reason for presentation, need for hospital admission, body region affected, location of injury and/or occurrence of first clinical symptoms and injuries of anatomical structures were considered. Results Demographics were comparable among both groups. A 42.7% reduction in emergency cases was observed during the lockdown period. A significant elevation of domestic injuries and symptoms in the pandemic group (51.54% vs. 66.15%, p = 0.007) was registered. Concurrently, a decrease in recreational injuries (27.31% vs. 15.38%, p = 0.009) and workplace injuries (10.57% vs. 7.69%, p = 0.37) was noted. Hospital admission rates and length of stay were comparable. Similarly, no statistically significant differences could be detected regarding injuries of functional anatomical structures. The same holds true for crush injuries, animal bites, fall injuries, finger amputations, disc saw injuries, and distortion injuries. Fractures of the phalanges, the metacarpus/carpus and the forearm exhibited an increase. Conclusions In spite of decreasing total emergency caseloads, there was an unchanged need for plastic, hand and reconstructive in-patient surgery and care during the lockdown period. Resource allocation has to be considered in future pandemic waves. Prevention strategies are warranted and should focus on finding measures to counteract domestic injuries
Sustained high demand for intensive care unit resources for the treatment of burn patients during the COVID-19 pandemic in Northern Germany: a single-centre cross-sectional study
No full textIntroduction The ongoing COVID-19 pandemic caused by SARS-CoV-2 has changed everyday life all over the world. To reduce disease transmission, governments introduced various policies, such as social distancing, stay-at-home orders, and travel restrictions. The goal of this study was to investigate the characteristics of burn patients admitted to the burn intensive care unit before and during the COVID-19 pandemic. Patients and methods A retrospective descriptive analysis of the hospital's burn registry was performed from 1 March 2019 until 1 January 2022. Results A total of 326 patients were included in this study. Eighty-eight patients presented before and 238 patients during the COVID-19 pandemic. The majority of burns occurred during private incidents (80% [2022], 92% [2020]), and burns were most frequently caused by flames (24% [2022], 32.99% [2021]). Work-related injuries occurred less frequently (7.76% [2020], 20% [2022]). Constant results were obtained regarding severity and total body surface area affected (1-80%). Conclusion This study highlights high numbers of burn patients admitted to the burn intensive care unit before and during the COVID-19 pandemic. Consequently, burn intensive care units must keep their special position within the national health system and should not be included in resource relocation during the prioritisation of intensive care resources. Multicentre studies should focus on the national impact of COVID-19 on the treatment of burn patients
Klinische und radiologische Ergebnisse nach Weber B-Fraktur mit und ohne Verletzung der Syndesmose
No full textHörgeräteversorgung nach Stapesoperation im Vergleich zu Direkten Akustischen Cochlea-Implantaten
No full textVerhaltensbasierte Untersuchung von Aufmerksamkeitsleistungen bei Patienten mit Dystonie
No full textPrädiktive Relevanz von Unfallmechanismus und klinischen Befunden des Primary und Secondary Survey in der Indikationsstellung der Polytrauma CT Diagnostik: eine retrospektive Analyse von Mehrfachverletzten mit Schockraumalarmierung
No full textKidney injury after lung transplantation: Long-term mortality predicted by post-operative day-7 serum creatinine and few clinical factors.
No full textBackground Acute kidney injury (AKI) after lung transplantation (LuTx) is associated with increased long-term mortality. In this prospective observational study, commonly used AKI-definitions were examined regarding prediction of long-term mortality and compared to simple use of the serum creatinine value at day 7 for patients who did not receive hemodialysis, and serum creatinine value immediately before initiation of hemodialysis (d7/preHD-sCr). Methods 185 patients with LuTx were prospectively enrolled from 2013-2014 at our center. Kidney injury was assessed within 7 days by: (1) the Kidney Disease Improving Global Outcomes criteria (KDIGO-AKI), (2) the Acute Disease Quality Initiative 16 Workgroup classification (ADQI-AKI) and (3) d7/preHD-sCr. Prediction of all-cause mortality was examined by Cox regression analysis, and clinical as well as laboratory factors for impaired kidney function post-LuTx were analyzed. Results AKI according to KDIGO and ADQI-AKI occurred in 115 patients (62.2%) within 7 days after LuTx. Persistent ADQI-AKI, KDIGO-AKI stage 3 and higher d7/preHD-sCr were associated with higher mortality in the univariable analysis. In the multivariable analysis, d7/preHD-sCr in combination with body weight and intra- and postoperative platelet transfusions predicted mortality after LuTx with similar performance as models using KDIGO-AKI and ADQI-AKI (concordance index of 0.75 for d7/preHD-sCr vs., 0.74 and 0.73, respectively). Pre-transplant reduced renal function, diabetes, higher BMI, and intraoperative ECMO predicted higher d7/preHD-sCr (r2 = 0.354, p < 0.001). Conclusion Our results confirm the importance of AKI in lung transplant patients; however, a simple and pragmatic indicator of renal function, d7/preHD-sCr, predicts long-term mortality equally reliable as more complex AKI-definitions like KDIGO and ADQI