Deep learning-based quantitative visualization and measurement of extraperitoneal hematoma volumes in patients with pelvic fractures: Potential role in personalized forecasting and decision support

INTRODUCTION Admission computed tomography (CT) is a widely used diagnostic tool for patients with pelvic fractures. In this pilot study, we hypothesized that pelvic hematoma volumes derived using a rapid automated deep learning-based quantitative visualization and measurement algorithm predict interventions and outcomes including (a) need for angioembolization (AE), pelvic packing (PP), or massive transfusion (MT), and (b) in-hospital mortality. METHODS We performed a single-institution retrospective analysis of 253 patients with bleeding pelvic fractures who underwent admission abdominopelvic trauma CT between 2008 and 2017. Included patients had hematoma volumes of 30 mL or greater, were 18 years and older, and underwent contrast-enhanced CT before surgical or angiographic intervention. Automated pelvic hematoma volume measurements were previously derived using a deep-learning quantitative visualization and measurement algorithm through cross-validation. A composite dependent variable of need for MT, AE, or PP was used as the primary endpoint. The added utility of hematoma volume was assessed by comparing the performance of multivariable models with and without hematoma volume as a predictor. Areas under the receiver operating characteristic curve (AUCs) and sensitivities, specificities, and predictive values were determined at clinically relevant thresholds. Adjusted odds ratios of automated pelvic hematoma volumes at 200 mL increments were derived. RESULTS Median...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research

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ConclusionPatients with reactive pupils and/or mild to moderate GCS may have benefited from TXA in the CRASH-3 trial because they had less intracranial bleeding at baseline. However, because bleeding occurs soon after injury, treatment delay reduces the benefit of TXA.
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
g H Abstract A 2.5-month-old boy and a 2-month-old girl were admitted to a pediatric intensive care unit with impaired consciousness. Both infants had subdural hemorrhages. Because of presumed non-accidental head injury (NAHI) funduscopy was performed, which revealed unilateral hemorrhage in both children. After intensive differential diagnostics NAHI was suspected in both cases and a forensic medical examination was initiated. This case series is important because it shows that unilateral retinal bleeding does not exclude NAHI. PMID: 31996999 [PubMed - as supplied by publisher]
Source: Der Ophthalmologe - Category: Opthalmology Authors: Tags: Ophthalmologe Source Type: research
CONCLUSIONS Our study, in which no X-ray examination revealed possible intracranial bleeding, clearly shows that nowadays the plain radiograph of the skull does not bring any benefit in the diagnosis of minor traumatic brain injury. Key words:skull X-ray, CT of the head, head injury, minor traumatic brain injury. PMID: 31748109 [PubMed - in process]
Source: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca - Category: Orthopaedics Tags: Acta Chir Orthop Traumatol Cech Source Type: research
Publication date: Available online 14 October 2019Source: The LancetAuthor(s): The CRASH-3 trial collaboratorsSummaryBackgroundTranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI.MethodsThis randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracran...
Source: The Lancet - Category: General Medicine Source Type: research
Researchers say tranexamic acid treatment has potential to save tens of thousands of livesA cheap and widely available drug could reduce the risk of death from common head injuries and save tens of thousands of lives each year, researchers say.Tranexamic acid slows down the breakdown of blood clots, and is already used to control heavy bleeding in people who have experienced trauma elsewhere in the body – for example from being shot or stabbed.Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Medical research Drugs Science Health Society UK news Source Type: news
_______________ For Banner Health, one of the largest non-profit health system in the United States, finding ways to make health care easier and better for our patients is at the root of everything we do. That’s why we are making significant investments into the digital health and neurotech space, trying to answer some common pain points. Let me give you an example. Last year, Banner Urgent Care turned to an innovative device, BrainScope One, to provide better care and to help save patients money and time, as it helps clinicians identify traumatic brain injuries and concussions. This is an area of growing concern. St...
Source: SharpBrains - Category: Neuroscience Authors: Tags: Cognitive Neuroscience Health & Wellness Professional Development Technology Banner Health Banner Urgent Care BrainScope BrainScope One computerized tomography concussions digital health electrical signals electrodes head trauma Source Type: blogs
A gap exists in the literature regarding the best practice for ED triage assessment in children below age 2 who have sustained suspected minor head injuries. Head injuries are a frequent reason for children ’s ED visits,1,2 and children below age 2 account for approximately 25% of these visits.3 Although most children who present to emergency departments for evaluation of head injuries have not sustained underlying skull fractures or intracranial injury (closed head injury [CHI]), identifying those w ho may have sustained CHIs is important because secondary injuries (eg, increased bleeding or swelling of the brain) a...
Source: Journal of Emergency Nursing: JEN - Category: Nursing Authors: Tags: Clinical Source Type: research
Rationale: Plasmacytoma as the 1st presentation of skull tumors is a rare disorder. When it is combined with brain trauma or dramatic changes in intracranial pressure, patients are more prone to misdiagnosis. Patient concerns: A 67-year-old woman complaining of a headache presented with a history of head trauma for the past 1 hour. Emergency head computed tomography initially suggested an epidural hematoma. Diagnosis: Emergency surgery was performed to remove the intracranial hematoma, but a tumor-like mass was found during surgery, and pathologic assessment confirmed plasmacytoma. Surgery was difficult because of ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSION: Our case illustrates the importance of a comprehensive systematic approach to investigate causes other than abusive head injury when intracranial bleeding is a significant finding. PMID: 31083836 [PubMed - in process]
Source: WMJ - Category: General Medicine Authors: Tags: WMJ Source Type: research
The correlation between direct oral anticoagulants (DOACs) or Vitamin K Antagonist (VKAs) intake and the incidence of intracranial complications after minor head injury (MHI) is still object of debate: preliminary observation seems to demonstrate lower incidence in intracranial bleeding complications (ICH) in patients taking DOACs than VKA. METHODS. This prospective and observational study was performed to clarify the incidence of ICH in patients in DOACs compared to VKAs. Between January 2016 and April 2018 we have recorded in our ED patients with MHI taking oral anticoagulants.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
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