Factors Affecting Morbidity in Solid Organ Injuries

Baygeldi, Serdar; Karaköse, Oktay; Özçelik, Kazım Çağlar; Pülat, Hüseyin; Damar, Sedat; Eken, Huseyin; Zihni, İsmail; Çalta, Alpaslan Fedai; Baç, Bilsel

doi:10.1155/2016/6954758

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…Mysore et al have reported that patients with the highest expression of PD-1 + Tim-3 + T cells in the memory compartment before LTx had increased incidence of infections after LTx, especially within the first 90 days [ 13 ]. The evaluation of T cell subsets has played an important role in predicting post-transplant infections and allograft rejections in transplant recipients [ 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Expansion of Double-Negative T Cells in Patients before Liver Transplantation Correlates with Post-Transplant Infections

Lei

Tian

Zhang

et al. 2022

JCM

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Liver transplantation (LTx) is currently the only effective therapy for patients with end-stage liver diseases, but post-transplant infection is a key issue for morbidity and mortality. In this study, we found that pre-transplant patients with an expansion of double-negative T (DNT) cells (CD3+CD4−CD8− T cells) had an increased incidence of infections within the first 6 months after LTx. These DNT cells also negatively correlated with their CD4/CD8 ratio. Compared to patients who had no infections after LTx, these DNT cells expressed more CD25, especially in the memory compartment. The receiver operating characteristic (ROC) analysis showed that the threshold area under the ROC curve of DNT cells which could be used to distinguish LTx patients with post-transplant infections from patients without infections after LTx was 0.8353 (95% CI: 0.6591–1.000). The cut-off for the pre-LTx DNT cell level was 11.35%. Although patients with post-transplant infections had decreased levels of CD4/CD8 T cells, CD8+ T cells in these patients were more exhausted, with higher PD-1 expression and lower IFNγ secretion. The increased levels of DNT cells in patients with post-transplant infections were still observed 2 weeks after LTx, with higher proportions of memory DNT cells. In conclusion, increased levels of DNT cells in pre-LTx patients may be valuable for the prognosis of post-transplant infections, especially within the first 6 months after LTx.

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Section: Introductionmentioning

confidence: 99%

Expansion of Double-Negative T Cells in Patients before Liver Transplantation Correlates with Post-Transplant Infections

Lei

Tian

Zhang

et al. 2022

JCM

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“…Although we did not find a significant difference in the hemoglobin levels between the patients with and without mortality, we found higher transfusion rates in patients with mortality mean 8.8 units of ES versus 3.3 units of ES). Similarly, Baygeldi et al [19] have found four times more erythrocyte transfusion in patents with morbidity following management of solid organ injuries following blunt and penetrating abdominal trauma.…”

Section: Discussionmentioning

confidence: 85%

“…Hemodynamic parameters of the patients have been shown to increase the mortality risk of the patients. [2,3,19] Systolic blood pressure has been frequently reported parameter, and blood pressures below 60-90 mmHg have been shown to increase mortality nearly four times, [2,3] We evaluated the differences in mean arterial pressures between patients with and without mortality. We found that patients with mortality had significantly lower mean arterial pressure when compared to patients without mortality.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Travmada Mortaliteyi Etkileyen Risk Faktörlerinin Analizi

Gönültaş

Kutlutürk

Gök

et al. 2019

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:The present study aims to analyze blunt and penetrating abdominal traumas that were evaluated in our emergency department, the treatment approaches and risk factors of mortality.METHODS: Six hundred and sixty-four patients were admitted to our emergency department for surgical evaluation for trauma between January 2009 and April 2019. After the exclusion of dead on arrival, patients with missing data and patients without abdominal trauma were excluded from this study. Hundred and thirteen patients with abdominal trauma admitted to our department were evaluated in this study. Demographic, clinical, prognostic and mortality related factors were retrospectively analyzed. RESULTS:The mean age of the patients was 36.08±16.1 years. There were 90 male patients. Eighty patients (70.8%) had blunt abdominal trauma (BAT). Twenty-eight patients (24.7%) had isolated liver and two patients (1.7%) had isolated spleen injury. Combined liver and spleen injury was found in two patients (1.7%). Twenty-two (19.4%) patients had mortality. Causes of mortality were an irreversible hemorrhagic shock (40.9%) and central nervous system (13.6%) injuries. BAT was the main mechanism of injury in patients with mortality (86.4% versus 67%; p<0.001). The frequency of retroperitoneal injury was significantly higher in patients with mortality (50% versus 16.5%, p<0.001). The frequency of extra-abdominal injury in patients with mortality was higher (68.1% versus 49.4%; p=0.047). Mean arterial pressure at admission was found to be significantly lower in patients with mortality (67±26.8 mmHg versus 84.3±17 mmHg; p=0.02). The number of packed erythrocytes transfused in patients with mortality was higher (8.8±8.6 versus 3.3±5.9 units; p=0.047). Mean international normalized ratio (INR) was significantly higher in patients with mortality (4.3±7.1 versus 2.7±4; p=0.016). Mean lactate dehydrogenase level was higher in patients with mortality (1685.7±333.8 versus 675.8±565.3 IU/mL; p<0.001). Mean alanine aminotransferase (ALT) was significantly higher in patients with mortality (430±619 versus 244±448 IU/mL; p<0.001). Mean alkaline phosphatase (ALP) level in patients with mortality was higher (76.9±72.8 versus 67.3±27.8 IU/mL; p=0.003). The presence of retroperitoneal injury and ALT >516 IU/mL were independent risk factors o mortality. CONCLUSION:We have found certain laboratory variables to increase in patients with mortality. These are related to the severity of trauma. Retroperitoneal injury and increased ALT levels being risk factors of mortality is the most important finding of this study. Our results can guide other centers in the evaluation of trauma patients, and high-risk groups can be identified.

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“…The importance of early diagnosis using angiography is shown in studies where extravasation at the time of admission was found to be highly associated with the possibility of treatment, such as delayed splenectomy. [ 15 , 16 ]…”

Section: Discussionmentioning

confidence: 99%

Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods

Jang

Park

et al. 2022

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The spleen is a commonly injured intra-abdominal organ from blunt trauma. In cases of traumatic blunt spleen injury, immediate treatment is often required. This study aimed to investigate the prognostic impact of the establishment of a trauma center on the treatment of patients with blunt trauma injury to the spleen. METHODS: We retrospectively reviewed 235 patients who visited our center from 2012 to 2019 for blunt trauma injury to the spleen. The study period was divided into two groups: January 2012 to September 2015 was the pre-center period (PCP), and September 2015 to December 2019 was the trauma center period (TCP). In each period, there were three treatment groups: Surgical group, embolization group, and conservative treatment group. The primary outcome was mortality, and the secondary outcomes were patient characteristics, such as injury severity score and abbreviated injury scale score, time from admission to intervention (both surgery and angiography embolization), and rate of spleen-preserving surgery. RESULTS: In the conservative treatment group, the Hb and hct values were relatively low in the TCP than in the PCP (p=0.007, p=0.008, respectively). The intensive care unit admission rate was relatively high in the TCP (72.9% vs. 90.6%, p=0.031). The ISS was relatively low in the TCP (18 vs. 17, p=0.001). In the surgical group, the time taken to transfer patients to the operating room after admission was greatly reduced in the TCP (151 min vs. 107 min, p=0.028). In the embolization group, the patient’s age and SBP were lower in the PCP than in the TCP (p=0.003, p=0.049, respectively); three patients had undergone embolization with CPR in the PCP, and no patient underwent CPR in the TCP. There were three deaths in PCP and none in the TCP (p=0.05). CONCLUSION: The establishment of a trauma center has led to improvements in the treatment quality and prognosis of patients with blunt trauma injury to the spleen receiving either of the three treatments.

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Factors Affecting Morbidity in Solid Organ Injuries

Cited by 5 publications

References 23 publications

Expansion of Double-Negative T Cells in Patients before Liver Transplantation Correlates with Post-Transplant Infections

Expansion of Double-Negative T Cells in Patients before Liver Transplantation Correlates with Post-Transplant Infections

Abdominal Travmada Mortaliteyi Etkileyen Risk Faktörlerinin Analizi

Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods

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