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Juárez-Vela R, Quintana-Diaz M, Rodríguez-Calvo A, Santos-Sánchez JÁ, Gero-Escapa M, Gallego-Curto E, Satústegui-Dordá PJ, Sánchez-González JL, Jericó C, Ruiz de Viñaspre-Hernández R, Gil-Fernández G, García-Erce JA. Profile and characteristics of the adequacy of blood transfusions in Trauma Intensive Care. A cross sectional multicenter study. Front Public Health 2023; 11:1133191. [PMID: 37020819 PMCID: PMC10067921 DOI: 10.3389/fpubh.2023.1133191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/24/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction Major trauma is one of the major health care problems facing modern society, trauma systems require careful planning to achieve an ideal level of coverage for the population. The Patient Blood Management Program is an integrated and global strategy to provide patient care that aims to assess and address, when possible, the etiology of blood abnormalities rather than transfuse without treating the underlying cause. We aimed to describe the factors that are associated with the clinical decision to transfuse polytraumatized patients admitted to the Intensive Care Unit (ICU). Method We performed a cross sectional multicenter study of patients admitted to ICUs for trauma in 14 Spanish hospitals from September 2020 to December 2021. Results A total of 69 patients were treated in the emergency room due to polytrauma, 46% of them were considered serious in the initial triage. Thirty were caused by a fall from considerable height (43.47%), followed by 39 patients admitted due to trac accidents (56.52%). The location of the trauma was mainly cranioencephalic, followed by thoracic trauma. Of the 69 patients, 25 received a blood transfusion during their ICU stay (36.23%). Discussion No significant differences were observed between transfused and non-transfused patients, except for the severity scales, where transfused patients have a higher score on all the scales assessed in the ICU except for the Revised Trauma Score. As we can see, the incidence of kidney failure was also different between the groups analyzed, reaching 44.00% in transfused patients and 13.64% in the group of patients without blood transfusion, p = 0.005. In this sense, 92.00% of the transfusions performed were inadequate according to the criteria of Hb in blood prior to the decision to transfuse (Hb < 9). Our data support the need to consider clinical practice guidelines regarding blood transfusion and its practices.
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Affiliation(s)
- Raúl Juárez-Vela
- Doctoral Program in Medicine and Surgery, Autonomous University of Madrid, Madrid, Spain
- Department of Nursing, Research Group in Care (GRUPAC), University of La Rioja, Logroño, Spain
- Center of Biomedical Research of La Rioja (CIBIR), Logroño, Spain
| | - Manuel Quintana-Diaz
- Doctoral Program in Medicine and Surgery, Autonomous University of Madrid, Madrid, Spain
- Intensive Care Unit, PBM Group, IdiPAZ, Hospital La Paz, Madrid, Spain
| | - Antonio Rodríguez-Calvo
- Complex Hospital University of Salamanca, Salamanca, Spain
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - José Ángel Santos-Sánchez
- Complex Hospital University of Salamanca, Salamanca, Spain
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | | | | | - Pedro José Satústegui-Dordá
- Research Group of the University of Zaragoza B43_20R Water and Environmental Health, Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | | | - Carlos Jericó
- Internal Medicine Department, Complex Hospitalari Moisés Broggi, Sant Joan Despí, Spain
| | - Regina Ruiz de Viñaspre-Hernández
- Department of Nursing, Research Group in Care (GRUPAC), University of La Rioja, Logroño, Spain
- Center of Biomedical Research of La Rioja (CIBIR), Logroño, Spain
- *Correspondence: Regina Ruiz de Viñaspre-Hernández
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Garrote-Cámara ME, Gea-Caballero V, Sufrate-Sorzano T, Rubinat-Arnaldo E, Santos-Sánchez JÁ, Cobos-Rincón A, Santolalla-Arnedo I, Juárez-Vela R. Clinical and Sociodemographic Profile of Psychomotor Agitation in Mental Health Hospitalisation: A Multicentre Study. Int J Environ Res Public Health 2022; 19:15972. [PMID: 36498042 PMCID: PMC9735933 DOI: 10.3390/ijerph192315972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Psychomotor agitation is characterised by an increase in psychomotor activity, restlessness and irritability. People with psychomotor agitation respond by over-reacting to both intrinsic and extrinsic stimuli, experiencing stress and/or altered cognition. The objective of this study is to assess the clinical and sociodemographic profile of psychomotor agitation in patients with severe mental disorders. The study was carried out in Spain by means of multicentre cross-sectional convenience sampling involving 140 patients who had been admitted to psychiatric hospital units and had experienced an episode of psychomotor agitation between 2018 and 2021.Corrigan's Agitated Behaviour Scale was used to assess psychomotor agitation. The results show that the predominant characteristic in psychomotor agitation is aggressiveness, which is also the most reported factor in patients with severe mental disorder. Patients who also have anxiety develop psychomotor agitation symptoms of moderate/severe intensity. The clinical and sociodemographic profile found in our study is consistent with other studies on the prevalence of psychomotor agitation.
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Affiliation(s)
- María Elena Garrote-Cámara
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Vicente Gea-Caballero
- Research Group on Community Health and Care, Faculty of Health Science, Valencia International University, 46002 Valencia, Spain
| | - Teresa Sufrate-Sorzano
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Esther Rubinat-Arnaldo
- Society, Health, Education and Culture Study Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, 25003 Lleida, Spain
| | | | - Ana Cobos-Rincón
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Iván Santolalla-Arnedo
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
| | - Raúl Juárez-Vela
- Care and Health Research Group, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain
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Hernández-Pascual C, Santos-Sánchez JÁ, Hernández-Rodríguez J, Silva-Viamonte CF, Pablos-Hernández C, Villanueva-Martínez M, Mirón-Canelo JA. New Prognostic Factors in Operated Extracapsular Hip Fractures: Infection and GammaTScore. Int J Environ Res Public Health 2022; 19:11680. [PMID: 36141949 PMCID: PMC9517159 DOI: 10.3390/ijerph191811680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
There is no universal postoperative classification of extracapsular hip fractures (ECFs). We wondered if infection (according to infection after fracture fixation criteria (IAFF)), immediate partial weight bearing (PWB) and/or the new GammaTScore tool could predict early cut-out. We also examined the correlation between GammaTScore and time to consolidation and studied long-term survival. This was a retrospective cohort study of low-energy complete ECFs operated with Gamma3T nailing in 2014 and fully monitoring, in patients aged over 65. Ten not distally locked cases, one late cut-out, one cut-through, one osteonecrosis and one pseudarthrosis were discarded. Patients were classified into early cut-out (7/204; 3.55%) and no early cut-out (197/204; 96.45%). There was a lower percentage of A2 fractures according to the AO Foundation/Orthopaedic Trauma Association classification (AO/OTA, 1997) in early cut-out. IAFF and only the GammaTScore reduction parameter were different for early cut-out, in opposition to immediate PWB, tip-to-apex distance (TAD) or the Baumgaertner-Fogagnolo classification. GammaTScore inversely correlated with consolidation (p < 0.01). Long-term survival time was not statistically significantly lower in the early cut-out group. Small sample of cases may limit our results. Apart from an important role of IAFF, GammaTScore would be useful for predicting consolidation, avoiding complications and reducing costs. Further studies are needed for reliability.
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Affiliation(s)
- Carlos Hernández-Pascual
- Department of Human Anatomy and Histology, Faculty of Medicine, Campus Miguel de Unamuno, Universidad de Salamanca, Avda, Alfonso X el Sabio s/n, 37007 Salamanca, Spain
- Department of Traumatology and Orthopaedic Surgery, Hospital Universitario de Salamanca, Pso. San Vicente 58-182, 37004 Salamanca, Spain
| | - José Ángel Santos-Sánchez
- Department of Biomedical and Diagnostic Sciences (Area of Radiology and Physical Medicine), Faculty of Medicine, Campus Miguel de Unamuno, Universidad de Salamanca, Avda, Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Jorge Hernández-Rodríguez
- Department of Biomedical and Diagnostic Sciences (Area of Radiology and Physical Medicine), Faculty of Medicine, Campus Miguel de Unamuno, Universidad de Salamanca, Avda, Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Carlos Fernando Silva-Viamonte
- Department of Statistics, Faculty of Medicine, Campus Miguel de Unamuno, Universidad de Salamanca, Avda, Alfonso X el Sabio s/n, 37007 Salamanca, Spain
| | - Carmen Pablos-Hernández
- Department of Geriatrics, Hospital Universitario de Salamanca, Pso. San Vicente 58-182, 37004 Salamanca, Spain
| | | | - José Antonio Mirón-Canelo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Campus Miguel de Unamuno, Universidad de Salamanca, Avda, Alfonso X el Sabio s/n, 37007 Salamanca, Spain
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Jorge-Samitier P, Juárez-Vela R, Santolalla-Arnedo I, Cobos-Rincón A, Santos-Sánchez JÁ, Gea-Caballero V, Satústegui-Dorda PJ, Anguas-Gracia A, Tejada-Garrido CI, Urcola-Pardo F, Fernández-Rodrigo MT. Clinical and Epidemiological Approach to Delirium in an Acute Care Unit: A Cross-Sectional Study. IJERPH 2022; 19:ijerph19159406. [PMID: 35954759 PMCID: PMC9368652 DOI: 10.3390/ijerph19159406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
During hospital admissions, the union of various factors, those related to acute pathology, dependency conditions, cognitive impairment, change of habitual environment, and others, can cause delirium. Acute delirium in the elderly (ADE) occurs in around a third of patients over 70 years of age. The syndrome generates serious complications that increase hospital morbidity and mortality and a high cost for the health administration. This study aimed to determine the clinical and epidemiological profile of ADE in an internal medicine unit. A descriptive cross-sectional study was carried out using a convenience test. A total of 356 patients participated between September and November 2021. Sociodemographic variables, predisposing and precipitating factors of ADE, methods of action against ADE, and the impact on functional and cognitive deterioration were analyzed. A total of 35.1% of the patients developed ADE, mostly of the hyperactive type and of nocturnal appearance. ADE was mainly treated with psychoactive drugs and 22% required mechanical restraint, with non-pharmacological preventive strategies, support, and caregiver training being the main tools for controlling ADE during hospital admission.
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Affiliation(s)
- Pablo Jorge-Samitier
- Hospital Clínico Lozano Blesa, Avda. San Juan Bosco, 15, 50009 Zaragoza, Spain;
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain
| | - Raúl Juárez-Vela
- GRUPAC, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain; (R.J.-V.); (I.S.-A.); (C.I.T.-G.)
| | - Iván Santolalla-Arnedo
- GRUPAC, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain; (R.J.-V.); (I.S.-A.); (C.I.T.-G.)
| | - Ana Cobos-Rincón
- GRUPAC, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain; (R.J.-V.); (I.S.-A.); (C.I.T.-G.)
- Correspondence: (A.C.-R.); (J.Á.S.-S.)
| | - José Ángel Santos-Sánchez
- Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
- Radiodiagnostic Unit, Castilla Leon Health Care Service (SACYL), University Hospital of Salamanca, 37008 Salamanca, Spain
- Correspondence: (A.C.-R.); (J.Á.S.-S.)
| | - Vicente Gea-Caballero
- Community Health and Care Research Group, Faculty of Health Sciences, Valencia International University, 46003 Valencia, Spain;
| | - Pedro José Satústegui-Dorda
- Research Group Water and Environmental Health (B43_20R), Department of Physiatry and Nursing, University of Zaragoza, Calle Domingo Miral, s/n, 50009 Zaragoza, Spain; (P.J.S.-D.); (A.A.-G.); (F.U.-P.); (M.T.F.-R.)
| | - Ana Anguas-Gracia
- Research Group Water and Environmental Health (B43_20R), Department of Physiatry and Nursing, University of Zaragoza, Calle Domingo Miral, s/n, 50009 Zaragoza, Spain; (P.J.S.-D.); (A.A.-G.); (F.U.-P.); (M.T.F.-R.)
| | - Clara Isabel Tejada-Garrido
- GRUPAC, Department in Nursing, University of La Rioja, C/Duquesa de la Victoria 88, 26004 Logroño, Spain; (R.J.-V.); (I.S.-A.); (C.I.T.-G.)
| | - Fernando Urcola-Pardo
- Research Group Water and Environmental Health (B43_20R), Department of Physiatry and Nursing, University of Zaragoza, Calle Domingo Miral, s/n, 50009 Zaragoza, Spain; (P.J.S.-D.); (A.A.-G.); (F.U.-P.); (M.T.F.-R.)
| | - María Teresa Fernández-Rodrigo
- Research Group Water and Environmental Health (B43_20R), Department of Physiatry and Nursing, University of Zaragoza, Calle Domingo Miral, s/n, 50009 Zaragoza, Spain; (P.J.S.-D.); (A.A.-G.); (F.U.-P.); (M.T.F.-R.)
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Juárez-Vela R, García-Erce JA, Gea-Caballero V, Ruiz de Viñaspre-Hernandez R, Santos-Sánchez JÁ, Sánchez-González JL, Andrés-Esteban EM, Czapla M, Tejada CI, Nanwani-Nanwani KL, Serrano-Lázaro A, Quintana-Díaz M. A Cohort Study in Intensive Care Units: Health Decisions Related to Blood Transfusion during the COVID-19 Pandemic. J Clin Med 2022; 11:jcm11154396. [PMID: 35956012 PMCID: PMC9368991 DOI: 10.3390/jcm11154396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
Critically ill polytrauma patients with hemorrhage require a rapid assessment to initiate hemostatic resuscitation in the shortest possible time with the activation of a massive transfusion or a critical hemorrhage management protocol. The hospital reality experienced during the COVID-19 pandemic in all countries was critical, as it was in Spain; according to the data published daily by the Ministry of Health on its website, during the period of this study, the occupancy rate of intensive care units (ICUs) by patients diagnosed with the novel coronavirus disease (COVID-19) rose to 23.09% in Spain, even reaching 45.23% at the end of January 2021. We aimed to analyze the changes observed during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic period regarding the effectiveness of Spanish ICUs in terms of mortality reduction. We present a cross-sectional study that compares two cohorts of patients admitted to ICUs across all autonomous communities of Spain with a diagnosis of polytrauma. Results: Only age was slightly higher at admission during the first wave of the pandemic (47.74 ± 18.65 vs. 41.42 ± 18.82 years, p = 0.014). The transfusion rate during the pandemic increased by 10.4% compared to the previous stage (p = 0.058). Regarding hemostatic components, the use of tranexamic acid increased from 1.8% to 10.7% and fibrinogen concentrates from 0.9% to 1.9%. In the case of prothrombin complex concentrates, although there was a slight increase in their use, there were no significant differences during the pandemic compared to the previous period. Conclusion: Mortality showed no difference before and during the pandemic, despite the observed change in the transfusion policy. In summary, the immediate and global implementation of patient blood management (PBM) based on clinical transfusion algorithms should be mandatory in all hospitals in our country.
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Affiliation(s)
- Raúl Juárez-Vela
- Doctoral Program in Medicine and Surgery, Faculty of Medicine, Autonomous University of Madrid, 28049 Madrid, Spain; (R.J.-V.); (M.Q.-D.)
- Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain; (R.R.d.V.-H.); (M.C.); (C.I.T.)
- Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain; (V.G.-C.); (E.M.A.-E.); (K.L.N.-N.); (A.S.-L.)
| | - José Antonio García-Erce
- Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain; (V.G.-C.); (E.M.A.-E.); (K.L.N.-N.); (A.S.-L.)
- Bank of Blood and Tissue of Navarra, Government of Navarra, 31008 Pamplona, Spain
- Correspondence:
| | - Vicente Gea-Caballero
- Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain; (V.G.-C.); (E.M.A.-E.); (K.L.N.-N.); (A.S.-L.)
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
| | - Regina Ruiz de Viñaspre-Hernandez
- Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain; (R.R.d.V.-H.); (M.C.); (C.I.T.)
| | - José Ángel Santos-Sánchez
- Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain;
- Salamanca Hospital Complex, 37008 Salamanca, Spain
| | | | - Eva María Andrés-Esteban
- Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain; (V.G.-C.); (E.M.A.-E.); (K.L.N.-N.); (A.S.-L.)
- Department of Business Economics and Applied Economy, Faculty of Legal and Economic Sciences, University Rey Juan Carlos, 28032 Madrid, Spain
| | - Michał Czapla
- Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain; (R.R.d.V.-H.); (M.C.); (C.I.T.)
- Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
- Institute of Heart Diseases, University Hospital, 50-566 Wroclaw, Poland
| | - Clara Isabel Tejada
- Research Group in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, C/Duquesa Victoria 88, 26006 Logrono, Spain; (R.R.d.V.-H.); (M.C.); (C.I.T.)
| | - Kapil Laxman Nanwani-Nanwani
- Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain; (V.G.-C.); (E.M.A.-E.); (K.L.N.-N.); (A.S.-L.)
- La Paz Hospital Intensive Care Unit, 28046 Madrid, Spain
| | - Ainhoa Serrano-Lázaro
- Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain; (V.G.-C.); (E.M.A.-E.); (K.L.N.-N.); (A.S.-L.)
- Intensive Care Unit, Hospital Clinico de Valencia, 46010 Valencia, Spain
| | - Manuel Quintana-Díaz
- Doctoral Program in Medicine and Surgery, Faculty of Medicine, Autonomous University of Madrid, 28049 Madrid, Spain; (R.J.-V.); (M.Q.-D.)
- Blood Management Patient Group, Research Institute Idi-Paz, 28046 Madrid, Spain; (V.G.-C.); (E.M.A.-E.); (K.L.N.-N.); (A.S.-L.)
- La Paz Hospital Intensive Care Unit, 28046 Madrid, Spain
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Hernández-Pascual C, Santos-Sánchez JÁ, García-González JM, Silva-Viamonte CF, Pablos-Hernández C, Ramos-Pascua L, Mirón-Canelo JA. Long-term outcomes of distal locking in extracapsular fractures treated with trochanteric Gamma3 nails. J Orthop Traumatol 2021; 22:48. [PMID: 34825977 PMCID: PMC8620307 DOI: 10.1186/s10195-021-00609-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/31/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Few publications have assessed long-term results of distal locking of short endomedullary nails for extracapsular hip fracture. Virtually all of them focus on immediate differences. Criteria for the use of static or dynamic locking are unclear in most nailing systems, and use is advised in unstable fracture patterns or with risk of bell-clapper effect, but often influenced by the "orthopaedic school". MATERIALS AND METHODS This is a historical cohort study on patients diagnosed and operated in 2014 and followed up until endpoint, considered as consolidation or major complication, plus evaluation of overall long-term survival. They were categorised as static distal locking (ST) or dynamic distal locking (DN). Both are comparable, except for all stable pre-operative classifications, Fracture Mobility Score (FMS) at discharge, and immediate post-operative loading, all of which were in favour of DN. RESULTS Consolidation took place in > 95% of patients, with a non-statistically significant delay trend in ST. Less than 6% in both ST and DN had major complications, with no differences. Most cases suffered early cut-out. Significant fracture collapse was the most frequent minor complication. There were more statistically significant minor and total complications in ST. Infection, without differences, can precede cut-out. Lateral thigh pain was similar and could be related to back-out. In DN, 21.1% of cases were truly dynamised. We did not find differences in mobility or in long-term survival. CONCLUSIONS Any type of distal locking seems to be safe for consolidation, despite a slightly longer consolidation time in static locking. Early cut-out was the main complication, while others were very infrequent, which is an advantage over helical blade devices. There was a higher rate of minor and overall mechanical complications in ST, but infection and lateral thigh pain were similar. Most non-traumatic mechanical complications occurred around 5-6 weeks. About one in five of the DN truly dynamised, with all cases occurring before 8 weeks. Mobility until endpoint and overall long-term survival were not influenced by the locking mode used. LEVEL OF EVIDENCE Therapeutic study, level 2b.
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Affiliation(s)
- Carlos Hernández-Pascual
- Department of Trauma and Orthopaedic Surgery, Hospital Universitario de Salamanca, Pso. San Vicente 58-182, 37004, Salamanca, Spain.
| | - José Ángel Santos-Sánchez
- Department of Radiology, Hospital Universitario de Salamanca, Pso. San Vicente 58-182, 37004, Salamanca, Spain
| | | | - Carlos Fernando Silva-Viamonte
- Department of Statistics, Faculty of Medicine, Universidad de Salamanca, Campus Miguel de Unamuno, Avda. Alfonso X el Sabio s/n, 37007, Salamanca, Spain
| | - Carmen Pablos-Hernández
- Department of Geriatrics, Hospital Universitario de Salamanca, Pso. San Vicente 58-182, 37004, Salamanca, Spain
| | - Luis Ramos-Pascua
- Department of Trauma and Orthopaedic Surgery, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n, 28041, Madrid, Spain
| | - José Antonio Mirón-Canelo
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad de Salamanca, Campus Miguel de Unamuno, Avda. Alfonso X el Sabio s/n, 37007, Salamanca, Spain
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