26 results on '"Waleboer M"'
Search Results
2. Comparing health status after major trauma across different levels of trauma care
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van der Veen, A., Stevens, C., Vos, D., van Eijck, F., van Geffen, E., van Eerten, P., Haagh, W., Sintenie, J.B., Poelhekke, L., Soesman, N.M.R., Jakma, T.S.C., Waleboer, M., Staarink, M., Bruijninckx, M.M.M., Cardon, A.Y.M.V.P., den Hoed, P.T., Roukema, G.R., van der Vlies, C.H., Schep, N.W.L., van de Schoot, L., Van Ditshuizen, J.C., De Munter, L., Verhofstad, M.H.J., Lansink, K.W.W., Den Hartog, D., Van Lieshout, E.M.M., and De Jongh, M.A.C.
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- 2023
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3. Identifying the severely injured benefitting from a specific level of trauma care in an inclusive network: A multicentre retrospective study
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Rojer, L.A., primary, van Ditshuizen, J.C., additional, van Voorden, T.A.J., additional, Van Lieshout, E.M.M., additional, Verhofstad, M.H.J., additional, Hartog, D.Den, additional, Sewalt, C.A., additional, Soesman, N.M.R., additional, Jakma, T.S.C., additional, Waleboer, M., additional, Staarink, M., additional, Bruijninckx, M.M.M., additional, Cardon, A.Y.M.V.P., additional, den Hoed, P.T., additional, Vermeulen, J., additional, van der Vlies, C.H., additional, and van de Schoot, L., additional
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- 2024
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4. Health-related quality of life and return to work 1 year after major trauma from a network perspective.
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van Ditshuizen, Jan C., van Lieshout, Esther M. M., van Beeck, Ed F., Verhofstad, Michiel H. J., den Hartog, Dennis, Dutch Trauma Registry Southwest, Soesman, N. M. R., Jakma, T. S. C., Waleboer, M., Staarink, M., Bruijninckx, M. M. M., Cardon, A. Y. M. V. P., den Hoed, P. T., Roukema, G. R., van der Vlies, C. H., Schep, N. W. L., and van de Schoot, L.
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PAIN ,UNEMPLOYMENT ,TIME ,TRAUMA centers ,HEALTH status indicators ,COGNITION ,PATIENTS ,ACTIVITIES of daily living ,PATIENTS' attitudes ,QUALITY of life ,EMERGENCY medical services ,QUESTIONNAIRES ,PHYSICAL mobility ,MENTAL depression ,DESCRIPTIVE statistics ,WOUNDS & injuries ,EMPLOYMENT reentry ,ANXIETY ,HEALTH self-care - Abstract
Introduction: Major trauma often results in long-term disabilities. The aim of this study was to assess health-related quality of life, cognition, and return to work 1 year after major trauma from a trauma network perspective. Methods: All major trauma patients in 2016 (Injury Severity Score > 15, n = 536) were selected from trauma region Southwest Netherlands. Eligible patients (n = 365) were sent questionnaires with the EQ-5D-5L and questions on cognition, level of education, comorbidities, and resumption of paid work 1 year after trauma. Results: A 50% (n = 182) response rate was obtained. EQ-US and EQ-VAS scored a median (IQR) of 0.81 (0.62–0.89) and 70 (60–80), respectively. Limitations were prevalent in all health dimensions of the EQ-5D-5L; 90 (50%) responders reported problems with mobility, 36 (20%) responders reported problems with self-care, 108 (61%) responders reported problems during daily activities, 129 (73%) responders reported pain or discomfort, 70 (39%) responders reported problems with anxiety or depression, and 102 (61%) of the patients reported problems with cognition. Return to work rate was 68% (37% full, 31% partial). A median (IQR) EQ-US of 0.89 (0.82–1.00) and EQ-VAS of 80 (70–90) were scored for fully working responders; 0.77 (0.66–0.85, p < 0.001) and 70 (62–80, p = 0.001) for partial working respondents; and 0.49 (0.23–0.69, p < 0.001) and 55 (40–72, p < 0.001) for unemployed respondents. Conclusion: The majority experience problems in all health domains of the EQ-5D-5L and cognition. Return to work status was associated with all health domains of the EQ-5D-5L and cognition. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Effect of the Dutch Hip Fracture Audit implementation on mortality, length of hospital stay and time until surgery in elderly hip fracture patients; a multi-center cohort study
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Voorden, T.A.J. (Tea) van, Hartog, D. (Dennis) den, Schep, N.W.L. (Niels), Soesman, N.M.R. (Nicolaj), Jakma, T.S. (Tijs), Waleboer, M. (Marco), Staarink, M. (Maarten), Bruijninckx, M.M.M. (Milko), Nijman, F.E.H. (Frank), Knops, S.P. (Simon), Lieshout, E.M.M. (Esther) van, Voorden, T.A.J. (Tea) van, Hartog, D. (Dennis) den, Schep, N.W.L. (Niels), Soesman, N.M.R. (Nicolaj), Jakma, T.S. (Tijs), Waleboer, M. (Marco), Staarink, M. (Maarten), Bruijninckx, M.M.M. (Milko), Nijman, F.E.H. (Frank), Knops, S.P. (Simon), and Lieshout, E.M.M. (Esther) van
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Background: In 2040 the estimated number of people with a hip fracture in the Netherlands will be about 24,000. The medical care for this group of patients is complicated and challenging. Multidisciplinary approaches aim to improve clinical outcome. Quality indicators that gain insight in the treatment and outcome of hip fracture patients may help to optimize and monito
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- 2020
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6. Effect of the Dutch Hip Fracture Audit implementation on mortality, length of hospital stay and time until surgery in elderly hip fracture patients; a multi-center cohort study
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van Voorden, Tea, den Hartog, Dennis, Soesman, NMR, Jakma, TSC, Waleboer, M, Staarink, M, Bruijninckx, MMM, Nijman, F, Knops, SP, van Lieshout, Esther, Schep, NWL, van Voorden, Tea, den Hartog, Dennis, Soesman, NMR, Jakma, TSC, Waleboer, M, Staarink, M, Bruijninckx, MMM, Nijman, F, Knops, SP, van Lieshout, Esther, and Schep, NWL
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- 2020
7. Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial
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Lieshout, E.M.M. van, Iordens, G.I.T., Polinder, S., Eygendaal, D., Verhofstad, M.H.J., Schep, N.W.L., Hartog, D. den, Breederveld, R.S., Bronkhorst, M.W.G.A., Haan, J. de, Vries, M.R. de, Dwars, B.J., Haverlag, R., Meylaerts, S.A.G., Mulder, J.W.R., Patka, P., Ponsen, K.J., Roerdink, W.H., Roukema, G.R., Schipper, I.B., Schouten, M.A., Sintenie, J.B., Sivro, S., Tuinebreijer, W.E., Brand, J.G.H. van den, Linden, F.M. van der, Meulen, H.G.W.M. van der, Verleisdonk, E.J.M.M., Vroemen, J.P.A.M., Waleboer, M., Willems, W.J., FuncSiE Trial Investigators, Orthopedic Surgery and Sports Medicine, AMS - Fundamental Research, AMS - Sports & Work, AMS - Sports, Surgery, and Public Health
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Adult ,Quality of life ,medicine.medical_specialty ,Cost effectiveness ,Cost-Benefit Analysis ,Trauma Surgery ,Joint Dislocations ,Cost utility ,law.invention ,03 medical and health sciences ,Indirect costs ,0302 clinical medicine ,Randomized controlled trial ,law ,Elbow Joint ,medicine ,Elbow dislocation ,Humans ,Orthopedic Procedures ,Orthopedics and Sports Medicine ,Function ,030222 orthopedics ,Intention-to-treat analysis ,business.industry ,030229 sport sciences ,General Medicine ,Orthopedic Fixation Devices ,Orthopedic surgery ,Physical therapy ,Early mobilization ,Surgery ,Cost-effectiveness ,business - Abstract
Introduction The primary aim was to assess and compare the total costs (direct health care costs and indirect costs due to loss of production) after early mobilization versus plaster immobilization in patients with a simple elbow dislocation. It was hypothesized that early mobilization would not lead to higher direct and indirect costs. Materials and methods This study used data of a multicenter randomized clinical trial (FuncSiE trial). From August 25, 2009 until September 18, 2012, 100 adult patients with a simple elbow dislocation were recruited and randomized to early mobilization (immediate motion exercises; n = 48) or 3 weeks plaster immobilization (n = 52). Patients completed questionnaires on health-related quality of life [EuroQoL-5D (EQ-5D) and Short Form-36 (SF-36 PCS and SF-36 MCS)], health care use, and work absence. Follow-up was 1 year. Primary outcome were the total costs at 1 year. Analysis was by intention to treat. Results There were no significant differences in EQ-5D, SF-36 PCS, and SF-36 MCS between the two groups. Mean total costs per patient were €3624 in the early mobilization group versus €7072 in the plaster group (p = 0.094). Shorter work absenteeism in the early mobilization group (10 versus 18 days; p = 0.027) did not lead to significantly lower costs for loss of productivity (€1719 in the early mobilization group versus €4589; p = 0.120). Conclusion From a clinical and a socio-economic point of view, early mobilization should be the treatment of choice for a simple elbow dislocation. Plaster immobilization has inferior results at almost double the cost.
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- 2019
8. Patterns of injury and outcomes in the elderly patient with rib fractures: a multicenter observational study
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van Vledder, Mark, Kwakernaak, V, Hagenaars, Tjebbe, van Lieshout, Esther, Verhofstad, Michiel, Boonstra, O, den Hoed, PT, Schweitzer, TJA, van Niekerk, JLM, de Rijcke, PAR, Roukema, GR, de Ridder, VA, Schmidt, GB, Waleboer, M, van Vledder, Mark, Kwakernaak, V, Hagenaars, Tjebbe, van Lieshout, Esther, Verhofstad, Michiel, Boonstra, O, den Hoed, PT, Schweitzer, TJA, van Niekerk, JLM, de Rijcke, PAR, Roukema, GR, de Ridder, VA, Schmidt, GB, and Waleboer, M
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- 2019
9. The definition of major trauma using different revisions of the abbreviated injury scale.
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Van Ditshuizen, Jan C., Sewalt, Charlie A., Palmer, Cameron S., Van Lieshout, Esther M. M., Verhofstad, Michiel H. J., Den Hartog, Dennis, Dutch Trauma Registry Southwest, Soesman, N. M. R., Jakma, T. S. C., Waleboer, M., Staarink, M., Bruijninckx, M. M. M., Cardon, A. Y. M. V. P., den Hoed, P. T., Roukema, G. R., van der Vlies, C. H., Schep, N. W. L., and van de Schoot, L.
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Background: A threshold Injury Severity Score (ISS) ≥ 16 is common in classifying major trauma (MT), although the Abbreviated Injury Scale (AIS) has been extensively revised over time. The aim of this study was to determine effects of different AIS revisions (1998, 2008 and 2015) on clinical outcome measures. Methods: A retrospective observational cohort study including all primary admitted trauma patients was performed (in 2013–2014 AIS98 was used, in 2015–2016 AIS08, AIS08 mapped to AIS15). Different ISS thresholds for MT and their corresponding observed mortality and intensive care (ICU) admission rates were compared between AIS98, AIS08, and AIS15 with Chi-square tests and logistic regression models. Results: Thirty-nine thousand three hundred seventeen patients were included. Thresholds ISS08 ≥ 11 and ISS15 ≥ 12 were similar to a threshold ISS98 ≥ 16 for in-hospital mortality (12.9, 12.9, 13.1% respectively) and ICU admission (46.7, 46.2, 46.8% respectively). AIS98 and AIS08 differed significantly for in-hospital mortality in ISS 4–8 (χ
2 = 9.926, p = 0.007), ISS 9–11 (χ2 = 13.541, p = 0.001), ISS 25–40 (χ2 = 13.905, p = 0.001) and ISS 41–75 (χ2 = 7.217, p = 0.027). Mortality risks did not differ significantly between AIS08 and AIS15. Conclusion: ISS08 ≥ 11 and ISS15 ≥ 12 perform similarly to a threshold ISS98 ≥ 16 for in-hospital mortality and ICU admission. This confirms studies evaluating mapped datasets, and is the first to present an evaluation of implementation of AIS15 on registry datasets. Defining MT using appropriate ISS thresholds is important for quality indicators, comparing datasets and adjusting for injury severity. Level of evidence: Prognostic and epidemiological, level III. [ABSTRACT FROM AUTHOR]- Published
- 2021
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10. Patterns of injury and outcomes in the elderly patient with rib fractures: a multicenter observational study
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van Vledder, Mark, Kwakernaak, V, Hagenaars, Tjebbe, van Lieshout, Esther, Verhofstad, Michiel, Boonstra, O, den Hoed, PT, Schweitzer, TJA, van Niekerk, JLM, de Rijcke, PAR, Roukema, GR, de Ridder, VA, Schmidt, GB, Waleboer, M, and Surgery
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Male ,medicine.medical_specialty ,Sports medicine ,Rib Fractures ,Thoracic Injuries ,Disease ,Critical Care and Intensive Care Medicine ,Wounds, Nonpenetrating ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Geriatric trauma ,Risk Factors ,Internal medicine ,Head Injuries, Closed ,medicine ,Humans ,Orthopedics and Sports Medicine ,Hospital Mortality ,Registries ,Elderly patient ,Registry study ,Aged ,Netherlands ,Retrospective Studies ,Aged, 80 and over ,030222 orthopedics ,COPD ,Cardiovascular History ,business.industry ,030208 emergency & critical care medicine ,Pneumonia ,medicine.disease ,Hospitalization ,Spinal Injuries ,Emergency Medicine ,Surgery ,Observational study ,Accidental Falls ,Female ,Original Article ,business - Abstract
Background: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures. Methods: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region. Data regarding demographics, mechanism of injury, pulmonary and cardiovascular history, pattern of extra-thoracic and intrathoracic injuries, ICU admission, length of stay, and morbidity and mortality following admission were collected. Results: Eight hundred eighty-four patients were included. Median age was 76 years (P25–P75 70–83). 235 patients (26.6%) were 81 years or older. Moderate or worse extra-thoracic injuries were present in 456 patients (51.6%), of whom 146 (16.6%) had severe head injuries and 45 (5.1%) severe spinal injuries. Median ISS was 9 (P25–P75 5–18). The rate of pneumonia was 10% (n = 84). Ten percent of patients (n = 88) died. Risk factors for in-hospital mortality included age (OR 3.4; p = 0.003), presence of COPD (OR 1.3; p = 0.01), presence of cardiac disease (OR 2.6; p = 0.003), severe or worse head (OR 3.5; p < 0.001), abdominal (OR 6.8; p = 0.004) and spinal injury (OR 4.6; p = 0.011) by AIS, number of rib fractures (OR 2.6; p = 0.03), and need for chest tube drainage (OR 2.1; p = 0.021). Conclusions: Pneumonia and death occur in about 10% of elderly patients with rib fractures. Apart from the severity of thoracic injuries, the presence and severity of extra-thoracic injuries and cardiopulmonary comorbidities are associated with poor outcome.
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- 2018
11. Patterns of injury and outcomes in the elderly patient with rib fractures: a multicenter observational study
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Vledder, M.G. (Mark) van, Kwakernaak, V. (Vicky), Hagenaars, T. (Tjebbe), Lieshout, E.M.M. (Esther) van, Verhofstad, M.H.J. (Michiel), Boonstra, O. (Onno), Hoed, P.Th. (Pieter) den, Jakma, T.S. (Tijs), van Niekerk, J.L.M. (Jan L. M.), Rijcke, P.A.R. (Piet), Roukema, G.R. (Gert), de Ridder, V.A. (Vicktor A.), Schmidt, G.B. (Georg B.), Waleboer, M. (Marco), Vledder, M.G. (Mark) van, Kwakernaak, V. (Vicky), Hagenaars, T. (Tjebbe), Lieshout, E.M.M. (Esther) van, Verhofstad, M.H.J. (Michiel), Boonstra, O. (Onno), Hoed, P.Th. (Pieter) den, Jakma, T.S. (Tijs), van Niekerk, J.L.M. (Jan L. M.), Rijcke, P.A.R. (Piet), Roukema, G.R. (Gert), de Ridder, V.A. (Vicktor A.), Schmidt, G.B. (Georg B.), and Waleboer, M. (Marco)
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Background: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures. Methods: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region. Data regarding demographics, mechanism of injury, pulmonary and cardiovascular history, pattern of extra-thoracic and intrathoracic injuries, ICU admission, length of stay, and morbidity and mortality following admission were collected. Results: Eight hundred eighty-four patients were included. Median age was 76 years (P25–P75 70–83). 235 patients (26.6%) were 81 years or older. Moderate or worse extra-thoracic injuries were present in 456 patients (51.6%), of whom 146 (16.6%) had severe head injuries and 45 (5.1%) severe spinal injuries. Median ISS was 9 (P25–P75 5–18). The rate of pneumonia was 10% (n = 84). Ten percent of patients (n = 88) died. Risk factors for in-hospital mortality included age (OR 3.4; p = 0.003), presence of COPD (OR 1.3; p = 0.01), presence of cardiac disease (OR 2.6; p = 0.003), severe or worse head (OR 3.5; p < 0.001), abdominal (OR 6.8; p = 0.004) and spinal injury (OR 4.6; p = 0.011) by AIS, number of rib fractures (OR 2.6; p = 0.03), and need for chest tube drainage (OR 2.1; p = 0.021). Conclusions: Pneumonia and death occur in about 10% of elderly patients with rib fractures. Apart from the severity of thoracic injuries, the presence and severity of extra-thoracic injuries and cardiopulmonary comorbidities are associated with poor outcome.
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- 2018
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12. Epidemiology of injuries, treatment (costs) and outcome in burn patients admitted to a hospital with or without dedicated burn centre (Burn-Pro)
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Lieshout, E.M.M. (Esther) van, Yperen, D.T. (Daan) van, Baar, M.E. (Margriet) van, Polinder, S. (Suzanne), Boersma, D. (Doeke), Cardon, A.Y.M.V.P. (Anne), Rijcke, P.A.R. (Piet), Guijt, M. (Marc), Klem, T.M.A.L. (Taco), Lansink, K.W.W. (Koen), Ringburg, A.N. (Akkie), Staarink, M. (Maarten), Schoot, L. (Léon) van de, Veen, A.H. (Alexander) van der, Eijck, F.C. (Floortje) van, Eerten, P. (Percy) van, Vegt, P.A. (Paul), Vos, D.I. (Dagmar), Waleboer, M. (Marco), Verhofstad, M.H.J. (Michiel), Vlies, C.H. (Cornelis) van der, Lieshout, E.M.M. (Esther) van, Yperen, D.T. (Daan) van, Baar, M.E. (Margriet) van, Polinder, S. (Suzanne), Boersma, D. (Doeke), Cardon, A.Y.M.V.P. (Anne), Rijcke, P.A.R. (Piet), Guijt, M. (Marc), Klem, T.M.A.L. (Taco), Lansink, K.W.W. (Koen), Ringburg, A.N. (Akkie), Staarink, M. (Maarten), Schoot, L. (Léon) van de, Veen, A.H. (Alexander) van der, Eijck, F.C. (Floortje) van, Eerten, P. (Percy) van, Vegt, P.A. (Paul), Vos, D.I. (Dagmar), Waleboer, M. (Marco), Verhofstad, M.H.J. (Michiel), and Vlies, C.H. (Cornelis) van der
- Abstract
INTRODUCTION: The Emergency Management of Severe Burns (EMSB) referral criteria have been implemented for optimal triaging of burn patients. Admission to a burn centre is indicated for patients with severe burns or with specific characteristics like older age or comorbidities. Patients not meeting these criteria can also be treated in a hospital without burn centre. Limited information is available about the organisation of care and referral of these patients. The aims of this study are to determine the burn injury characteristics, treatment (costs), quality of life and scar quality of burn patients admitted to a hospital without dedicated burn centre. These data will subsequently be compared with data from patients with<10% total bodysurface area (TBSA) burned who are admitted (or secondarily referred) to a burn centre. If admissions were in agreement with the EMSB, referral criteria will also be determined. METHODS AND ANALYSIS: In this multicentre, prospective, observational study (cohort study), the following two groups of patients will be followed: 1) all patients (no age limit) admitted with burn-related injuries to a hospital without a dedicated burn centre in the Southwest Netherlands or Brabant Trauma Region and 2) all patients (no age limit) with<10% TBSA burned who are primarily admitted (or secondarily referred) to the burn centre of Maasstad Hospital. Data on the burn injury characteristics (primary outcome), EMSB compliance, treatment, treatment costs and outcome will be collected from the patients' medical files. At 3 weeks and at 3, 6 and 12 months after trauma, patients will be asked to complete the quality of life questionnaire (EuroQoL-5D), and the patient-reported part of the Patient and Observer Scar Assessmen
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- 2018
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13. Epidemiology of injuries, treatment (costs) and outcome in burn patients admitted to a hospital with or without dedicated burn centre (Burn-Pro): protocol for a multicentre prospective observational study
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Van Lieshout, Esther M.M., van Yperen, Daan, Baar, Margriet, Polinder, Suzanne, Boersma, D, Cardon, A, de Rijcke, PAR, Guijt, M, Klem, T, Lansink, KWW, Ringburg, AN, Staarink, M, van de Schoot, L, Veen, AH, Eijck, FC, Van Eerten, PV, Vegt, PA, Vos, DI, Waleboer, M, Verhofstad, Michiel, van der Vlies, Kees, Van Lieshout, Esther M.M., van Yperen, Daan, Baar, Margriet, Polinder, Suzanne, Boersma, D, Cardon, A, de Rijcke, PAR, Guijt, M, Klem, T, Lansink, KWW, Ringburg, AN, Staarink, M, van de Schoot, L, Veen, AH, Eijck, FC, Van Eerten, PV, Vegt, PA, Vos, DI, Waleboer, M, Verhofstad, Michiel, and van der Vlies, Kees
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- 2018
14. Early mobilisation versus plaster immobilisation of simple elbow dislocations: Results of the FuncSiE multicentre randomised clinical trial
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Iordens, G.I.T. (Gijs), Lieshout, E.M.M. (Esther) van, Schep, N.W.L. (Niels), Haan, J. (Jeroen) de, Tuinebreijer, W.E. (Wim), Eygendaal, D. (Denise), Beeck, E.F. (Ed) van, Patka, P. (Peter), Verhofstad, M.H.J. (Michiel), Hartog, D. (Dennis) den, Breederveld, R.S. (Roelf S.), Bronkhorst, M.W.G.A. (Maarten), Vries, M.R. (Mark) de, Dwars, B.J. (Boudewijn), Haverlag, R. (Robert), Meylaerts, S.A.G. (Sven), Mulder, J.W. (Jan-Willem), Ponsen, K.J. (Kees-jan), Roerdink, W.H. (Herbert), Roukema, G.R. (Gert), Schipper, I.B. (Inger), Schouten, M.A. (Michel), Sintenie, J.B. (Jan Bernard), Sivro, S. (Senail), Brand, J.G.H. (Johan) van den, Linden, F.M. (Frits) van der, Meulen, H.G.W.M. (Hub), Verleisdonk, E.J.M.M. (Egbert), Vroemen, J.P.A.M. (Jos), Waleboer, M. (Marco), Willems, W.J. (Jaap), Iordens, G.I.T. (Gijs), Lieshout, E.M.M. (Esther) van, Schep, N.W.L. (Niels), Haan, J. (Jeroen) de, Tuinebreijer, W.E. (Wim), Eygendaal, D. (Denise), Beeck, E.F. (Ed) van, Patka, P. (Peter), Verhofstad, M.H.J. (Michiel), Hartog, D. (Dennis) den, Breederveld, R.S. (Roelf S.), Bronkhorst, M.W.G.A. (Maarten), Vries, M.R. (Mark) de, Dwars, B.J. (Boudewijn), Haverlag, R. (Robert), Meylaerts, S.A.G. (Sven), Mulder, J.W. (Jan-Willem), Ponsen, K.J. (Kees-jan), Roerdink, W.H. (Herbert), Roukema, G.R. (Gert), Schipper, I.B. (Inger), Schouten, M.A. (Michel), Sintenie, J.B. (Jan Bernard), Sivro, S. (Senail), Brand, J.G.H. (Johan) van den, Linden, F.M. (Frits) van der, Meulen, H.G.W.M. (Hub), Verleisdonk, E.J.M.M. (Egbert), Vroemen, J.P.A.M. (Jos), Waleboer, M. (Marco), and Willems, W.J. (Jaap)
- Abstract
Background/aim To compare outcome of early mobilisation and plaster immobilisation in patients with a simple elbow dislocation. We hypothesised that early mobilisation would result in earlier functional recovery. Methods From August 2009 to September 2012, 100 adult patients with a simple elbow dislocation were enrolled in this multicentre randomised controlled trial. Patients were randomised to early mobilisation (n=48) or 3 weeks plaster immobilisation (n=52). Primary outcome measure was the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score. Secondary outcomes were the Oxford Elbow Score, Mayo Elbow Performance Index, pain, range of motion, complications and activity resumption. Patients were followed for 1 year. Results Quick-DASH scores at 1 year were 4.0 (95% CI 0.9 to 7.1) points in the early mobilisation group versus 4.2 (95% CI 1.2 to 7.2) in the plaster immobilisation group. At 6 weeks, early mobilised patients reported less disability (Quick-DASH 12 (95% CI 9 to 15) points vs 19 (95% CI 16 to 22); p<0.05) and had a larger arc of flexion and extension (121° (95% CI 115° to 127°) vs 102° (95% CI 96° to 108°); p<0.05). Patients returned to work sooner after early mobilisation (10 vs 18 days; p=0.020). Complications occurred in 12 patients; this was unrelated to treatment. No recurrent dislocations occurred. Conclusions Early active mobilisation is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier without increasing the complication rate. No evidence was found supporting treatment benefit at 1 year.
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- 2017
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15. Reliability, validity, responsiveness, and minimal important change of the Disablities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture
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Mahabier, Kiran, den Hartog, Dennis, Theyskens, Nina, Verhofstad, Michiel, Van Lieshout, Esther M.M., Bos, Koen, Bronkhorst, M, Bruijninckx, MMM, de Haan, J, den Hoed, PT, Eversdijk, MG, Goslings, JC, Haverlag, R, Heetveld, MJ, Kerver, AJH, Kolkman, KA, Leenhouts, PA, Meylaerts, SAG, Onstenk, R, Poeze, M, Poolman, RW, Punt, BJ, Ritchie, ED, Roerdink, WH, Roukema, GR, Sintenie, JB, Soesman, NMR, van der Elst, M, van der Heijden, F, Van der Linden, FM, Van der Zwaal, P, van Dijk, JP, Van Jonbergen, HPW, Verleisdonk, E, Vroemen, J, Waleboer, M, Wittich, P, Zuidema, WP, Mahabier, Kiran, den Hartog, Dennis, Theyskens, Nina, Verhofstad, Michiel, Van Lieshout, Esther M.M., Bos, Koen, Bronkhorst, M, Bruijninckx, MMM, de Haan, J, den Hoed, PT, Eversdijk, MG, Goslings, JC, Haverlag, R, Heetveld, MJ, Kerver, AJH, Kolkman, KA, Leenhouts, PA, Meylaerts, SAG, Onstenk, R, Poeze, M, Poolman, RW, Punt, BJ, Ritchie, ED, Roerdink, WH, Roukema, GR, Sintenie, JB, Soesman, NMR, van der Elst, M, van der Heijden, F, Van der Linden, FM, Van der Zwaal, P, van Dijk, JP, Van Jonbergen, HPW, Verleisdonk, E, Vroemen, J, Waleboer, M, Wittich, P, and Zuidema, WP
- Published
- 2017
16. HUMeral Shaft Fractures: MEasuring Recovery after Operative versus Non-operative Treatment (HUMMER): A multicenter comparative observational study
- Author
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Mahabier, K.C. (Kiran), Lieshout, E.M.M. (Esther) van, Bolhuis, H.W. (Hugo), Bos, P.K. (Koen), Bronkhorst, M.W.G.A. (Maarten), Bruijninckx, M.M.M. (Milko), Haan, J. (Jeroen) de, Deenik, W. (Wendy), Dwars, B.J. (Boudewijn), Eversdijk, M.G. (Martin), Goslings, J.C. (Carel), Haverlag, R. (Robert), Heetveld, M.J. (Martin), Kerver, A.J.H. (Albert J.H.), Kolkman, K.A. (Karel), Leenhouts, K. (Kees), Meylaerts, S.A.G. (Sven), Poeze, H., Poolman, R.W. (Rudolf), Punt, B.J. (Bas), Roerdink, W.H. (Herbert), Roukema, G.R. (Gert), Sintenie, J.B. (Jan Bernard), Soesman, N.M.R. (Nicolaj), Tanka, A.F.K. (Andras), Holder, E.J.T. (Edgar) ten, Elst, M. (Maarten) van der, Heijden, F.H.W.M. (Frank) van der, Linden, F.M. (Frits) van der, Zwaal, P. (Peer) van der, Dijk, J.P. (Johannes) van, Jonbergen, H.P.W. van, Verleisdonk, E.J.M.M. (Egbert), Vroemen, J.P.A.M. (Jos), Waleboer, M. (Marco), Wittich, P. (Philippe), Zuidema, W.P. (Wietse), Polinder, S. (Suzanne), Verhofstad, M.H.J. (Michiel), Hartog, D. (Dennis) den, Onstenk, R. (Ron), Mahabier, K.C. (Kiran), Lieshout, E.M.M. (Esther) van, Bolhuis, H.W. (Hugo), Bos, P.K. (Koen), Bronkhorst, M.W.G.A. (Maarten), Bruijninckx, M.M.M. (Milko), Haan, J. (Jeroen) de, Deenik, W. (Wendy), Dwars, B.J. (Boudewijn), Eversdijk, M.G. (Martin), Goslings, J.C. (Carel), Haverlag, R. (Robert), Heetveld, M.J. (Martin), Kerver, A.J.H. (Albert J.H.), Kolkman, K.A. (Karel), Leenhouts, K. (Kees), Meylaerts, S.A.G. (Sven), Poeze, H., Poolman, R.W. (Rudolf), Punt, B.J. (Bas), Roerdink, W.H. (Herbert), Roukema, G.R. (Gert), Sintenie, J.B. (Jan Bernard), Soesman, N.M.R. (Nicolaj), Tanka, A.F.K. (Andras), Holder, E.J.T. (Edgar) ten, Elst, M. (Maarten) van der, Heijden, F.H.W.M. (Frank) van der, Linden, F.M. (Frits) van der, Zwaal, P. (Peer) van der, Dijk, J.P. (Johannes) van, Jonbergen, H.P.W. van, Verleisdonk, E.J.M.M. (Egbert), Vroemen, J.P.A.M. (Jos), Waleboer, M. (Marco), Wittich, P. (Philippe), Zuidema, W.P. (Wietse), Polinder, S. (Suzanne), Verhofstad, M.H.J. (Michiel), Hartog, D. (Dennis) den, and Onstenk, R. (Ron)
- Abstract
Background: Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not. Since randomized controlled trials for this injury have shown feasibility issues, this study is designed to provide the best achievable evidence to answer this unresolved problem. The primary aim of this study is to evaluate functional recovery after operative versus non-operative treatment in adult patients who sustained a humeral shaft fracture. Secondary aims include the effect of treatment on pain, complications, generic health-related quality of life, time to resumption of activities of daily living and work, and cost-effectiveness. The main hypothesis is that operative treatment will result in faster recovery. Methods/design. The design of the study will be a multicenter prospective observational study of 400 patients who have sustained a humeral shaft fracture, AO type 12A or 12B. Treatment decision (i.e., operative or non-operative) will be left to the discretion of the treating surgeon. Critical elements of treatment will be registered and outcome will be monitored at regular intervals over the subsequent 12 months. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcome measures are the Constant score, pain level at both sides, range of motion of the elbow and shoulder joint at both sides, radiographic healing, rate of complications and (secondary) interventions, health-related quality of life (Short-Form 36 and EuroQol-5D), time to resumption of ADL/work, and cost-effectiveness. Data will be a
- Published
- 2014
- Full Text
- View/download PDF
17. HUMeral Shaft Fractures: MEasuring Recovery after Operative versus Non-operative Treatment (HUMMER): a multicenter comparative observational study
- Author
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Mahabier, Kiran, Van Lieshout, Esther M.M., Bolhuis, HW, Bos, Koen, Bronkhorst, Maarten, Bruijninckx, MMM, de Haan, J, Deenik, AR, Dwars, BJ, Eversdijk, MG, Goslings, JC, Haverlag, R, Heetveld, MJ, Kerver, AJH, Kolkman, KA, Leenhouts, PA (Kees), Meylaerts, SAG, Onstenk, R, Poeze, M, Poolman, RW, Punt, BJ, Roerdink, WH, Roukema, GR, Sintenie, JB, Soesman, NMR, Tanka, AKF, Ten Holder, EJT, van der Heijden, FHWM, van der Elst, M, Van der Linden, FM, Van der Zwaal, P, Van Jonbergen, HPW, van Dijk, JP, Verleisdonk, EJMM, Vroemen, JPAM, Waleboer, M, Wittich, P, Zuidema, WP, Polinder, Suzanne, Verhofstad, Michiel, den Hartog, Dennis, Mahabier, Kiran, Van Lieshout, Esther M.M., Bolhuis, HW, Bos, Koen, Bronkhorst, Maarten, Bruijninckx, MMM, de Haan, J, Deenik, AR, Dwars, BJ, Eversdijk, MG, Goslings, JC, Haverlag, R, Heetveld, MJ, Kerver, AJH, Kolkman, KA, Leenhouts, PA (Kees), Meylaerts, SAG, Onstenk, R, Poeze, M, Poolman, RW, Punt, BJ, Roerdink, WH, Roukema, GR, Sintenie, JB, Soesman, NMR, Tanka, AKF, Ten Holder, EJT, van der Heijden, FHWM, van der Elst, M, Van der Linden, FM, Van der Zwaal, P, Van Jonbergen, HPW, van Dijk, JP, Verleisdonk, EJMM, Vroemen, JPAM, Waleboer, M, Wittich, P, Zuidema, WP, Polinder, Suzanne, Verhofstad, Michiel, and den Hartog, Dennis
- Abstract
Background: Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not. Since randomized controlled trials for this injury have shown feasibility issues, this study is designed to provide the best achievable evidence to answer this unresolved problem. The primary aim of this study is to evaluate functional recovery after operative versus non-operative treatment in adult patients who sustained a humeral shaft fracture. Secondary aims include the effect of treatment on pain, complications, generic health-related quality of life, time to resumption of activities of daily living and work, and cost-effectiveness. The main hypothesis is that operative treatment will result in faster recovery. Methods/design: The design of the study will be a multicenter prospective observational study of 400 patients who have sustained a humeral shaft fracture, AO type 12A or 12B. Treatment decision (i.e., operative or non-operative) will be left to the discretion of the treating surgeon. Critical elements of treatment will be registered and outcome will be monitored at regular intervals over the subsequent 12 months. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcome measures are the Constant score, pain level at both sides, range of motion of the elbow and shoulder joint at both sides, radiographic healing, rate of complications and (secondary) interventions, health-related quality of life (Short-Form 36 and EuroQol-5D), time to resumption of ADL/work, and cost-effectiveness. Data will be a
- Published
- 2014
18. Functional treatment versus plaster for simple elbow dislocations (FuncSiE): A randomized trial
- Author
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Haan, J. (Jeroen) de, Hartog, D. (Dennis) den, Tuinebreijer, W.E. (Wim), Iordens, G.I.T. (Gijs), Breederveld, R.S. (Roelf S.), Bronkhorst, M.W.G.A. (Maarten), Bruijninckx, M.M.M. (Milko), Vries, M.R. (Mark) de, Dwars, B.J. (Boudewijn), Eygendaal, D. (Denise), Haverlag, R. (Robert), Meylaerts, S.A.G. (Sven), Mulder, J.W. (Jan-Willem), Ponsen, K.J. (Kees-jan), Roerdink, W.H. (Herbert), Roukema, G.R. (Gert), Schipper, I.B. (Inger), Schouten, M.A. (Michel), Sintenie, J.B. (Jan Bernard), Sivro, S. (Senail), Brand, J.G.H. (Johan) van den, Meulen, H.G.W.M. (Hub), Thiel, T.P.H. (Tom), Vugt, A.B. (Arie) van, Verleisdonk, E.J.M.M. (Egbert), Vroemen, J.P.A.M. (Jos), Waleboer, M. (Marco), Willems, W.J. (Jaap), Polinder, S. (Suzanne), Patka, P. (Peter), Lieshout, E.M.M. (Esther) van, Schep, N.W.L. (Niels), Haan, J. (Jeroen) de, Hartog, D. (Dennis) den, Tuinebreijer, W.E. (Wim), Iordens, G.I.T. (Gijs), Breederveld, R.S. (Roelf S.), Bronkhorst, M.W.G.A. (Maarten), Bruijninckx, M.M.M. (Milko), Vries, M.R. (Mark) de, Dwars, B.J. (Boudewijn), Eygendaal, D. (Denise), Haverlag, R. (Robert), Meylaerts, S.A.G. (Sven), Mulder, J.W. (Jan-Willem), Ponsen, K.J. (Kees-jan), Roerdink, W.H. (Herbert), Roukema, G.R. (Gert), Schipper, I.B. (Inger), Schouten, M.A. (Michel), Sintenie, J.B. (Jan Bernard), Sivro, S. (Senail), Brand, J.G.H. (Johan) van den, Meulen, H.G.W.M. (Hub), Thiel, T.P.H. (Tom), Vugt, A.B. (Arie) van, Verleisdonk, E.J.M.M. (Egbert), Vroemen, J.P.A.M. (Jos), Waleboer, M. (Marco), Willems, W.J. (Jaap), Polinder, S. (Suzanne), Patka, P. (Peter), Lieshout, E.M.M. (Esther) van, and Schep, N.W.L. (Niels)
- Abstract
Background. Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow. Methods/Design. The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for pro-supination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation), health-related quality of life (Short-Form 36 and EuroQol-5D), radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications), costs, and cost-effectiveness. Discussion. The successful completion of this trial will p
- Published
- 2010
- Full Text
- View/download PDF
19. Functional treatment versus plaster for simple elbow dislocations (FuncSiE): a randomized trial
- Author
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de Haan, J, den Hartog, Dennis, Tuinebreijer, Wim, Iordens, Gijs, Breederveld, RS, Bronkhorst, Maarten, Bruijninckx, MMM, Vries, Merel, Dwars, BJ, Eygendaal, D, Haverlag, R, Meylaerts, SAG, Mulder, JWR, Ponsen, KJ, Roerdink, WH, Roukema, GR, Schipper, IB, Schouten, MA, Sintenie, JB, Sivro, S, Van den Brand, JGH, Van der Meulen, HGWM, Van Thiel, TPH, van Vugt, AB (Arie), Verleisdonk, EJMM, Vroemen, JPAM, Waleboer, M, Willems, WJ, Polinder, Suzanne, Patka, Petr, Van Lieshout, Esther M.M., Schep, Niels, de Haan, J, den Hartog, Dennis, Tuinebreijer, Wim, Iordens, Gijs, Breederveld, RS, Bronkhorst, Maarten, Bruijninckx, MMM, Vries, Merel, Dwars, BJ, Eygendaal, D, Haverlag, R, Meylaerts, SAG, Mulder, JWR, Ponsen, KJ, Roerdink, WH, Roukema, GR, Schipper, IB, Schouten, MA, Sintenie, JB, Sivro, S, Van den Brand, JGH, Van der Meulen, HGWM, Van Thiel, TPH, van Vugt, AB (Arie), Verleisdonk, EJMM, Vroemen, JPAM, Waleboer, M, Willems, WJ, Polinder, Suzanne, Patka, Petr, Van Lieshout, Esther M.M., and Schep, Niels
- Abstract
Background: Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow. Methods/Design: The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for prosupination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation), health-related quality of life (Short-Form 36 and EuroQol-5D), radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications), costs, and cost-effectiveness. Discussion: The successful completion of this trial will pr
- Published
- 2010
20. Functional treatment versus plaster for simple elbow dislocations (FuncSiE): a randomized trial
- Author
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Verleisdonk Egbert JMM, Van Vugt Arie B, Van Thiel Tom PH, Van der Meulen Hub GWM, Van den Brand Johan GH, Sivro Senail, Sintenie Jan, Schouten Michel A, Schipper Inger B, Roukema Gert R, Roerdink W Herbert, Ponsen Kees J, Mulder Jan-Willem R, Meylaerts Sven AG, Haverlag Robert, Eygendaal Denise, Dwars Boudewijn J, De Vries Mark R, Bruijninckx Milko MM, Bronkhorst Maarten WGA, Breederveld Roelf S, Iordens Gijs IT, Tuinebreijer Wim E, den Hartog Dennis, de Haan Jeroen, Vroemen Jos PAM, Waleboer Marco, Willems W Jaap, Polinder Suzanne, Patka Peter, van Lieshout Esther MM, and Schep Niels WL
- Subjects
Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Background Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow. Methods/Design The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for pro-supination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation), health-related quality of life (Short-Form 36 and EuroQol-5D), radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications), costs, and cost-effectiveness. Discussion The successful completion of this trial will provide evidence on the effectiveness of a functional treatment for the management of simple elbow dislocations. Trial Registration The trial is registered at the Netherlands Trial Register (NTR2025).
- Published
- 2010
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21. Effect of the Dutch Hip Fracture Audit implementation on mortality, length of hospital stay and time until surgery in elderly hip fracture patients; a multi-center cohort study.
- Author
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van Voorden TAJ, den Hartog D, Soesman NMR, Jakma TSC, Waleboer M, Staarink M, Bruijninckx MMM, Nijman F, Knops SP, Lieshout EMMV, and Schep NWL
- Subjects
- Aged, Aged, 80 and over, Female, Hospital Mortality, Humans, Logistic Models, Male, Medical Audit, Netherlands, Retrospective Studies, Time Factors, Hip Fractures mortality, Hip Fractures therapy, Length of Stay statistics & numerical data, Quality of Health Care statistics & numerical data
- Abstract
Background: In 2040 the estimated number of people with a hip fracture in the Netherlands will be about 24,000. The medical care for this group of patients is complicated and challenging. Multidisciplinary approaches aim to improve clinical outcome. Quality indicators that gain insight in the treatment and outcome of hip fracture patients may help to optimize and monitor the standard of medical care. The Dutch Hip Fracture Audit (DHFA) is a new multidisciplinary quality indicator that is implemented in the Dutch hospitals in 2017., Aim: The aim of this study was to determine the effect of the implementation of the DHFA on 30-day mortality, length of hospital stay and time until surgery in elderly with a hip fracture in the Netherlands., Methods: A multicenter retrospective comparative cohort study was conducted and data were extracted from the Dutch Nationwide Trauma Registration (LTR). Included were patients aged 60 years and older with a hip fracture (femoral neck and trochanteric) and admitted in one of the ten participating hospitals registered in 2015 and 2017. Data from 2015, before implementation of DHFA, were compared with data from 2017, when the DHFA was implemented. The primary outcome was 30-day mortality; secondary outcomes were length of hospital stay and time until surgery. Multivariable regression models were used to compare outcomes between groups., Results: 3808 patients were included, 1839 in the 2015 cohort and 1969 in the 2017 cohort. 29% was male; mean age 82 years. The multilevel analysis showed a positive non-significant difference between groups on the primary outcome30-day mortality (OR adjusted 1.23, 95%CI 0.93 - 1.63). The secondary outcomes length of hospital stay (adjusted effect estimates -0.002, 95%CI -0.03 - 0.03) and time until surgery (adjusted effect estimates 0.292, 95%CI -2.68 - 3.26) showed no differences between groups., Conclusions: Implementation of the DHFA quality indicator does have a positive non-significant trend on 30-day mortality, but showed no impact on length of hospital stay and time until surgery. More research on relevant quality indicators seems therefore mandatory., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2020
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22. Epidemiology of injuries, treatment (costs) and outcome in burn patients admitted to a hospital with or without dedicated burn centre (Burn-Pro): protocol for a multicentre prospective observational study.
- Author
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Van Lieshout EM, Van Yperen DT, Van Baar ME, Polinder S, Boersma D, Cardon AY, De Rijcke PA, Guijt M, Klem TM, Lansink KW, Ringburg AN, Staarink M, Van de Schoot L, Van der Veen AH, Van Eijck FC, Van Eerten PV, Vegt PA, Vos DI, Waleboer M, Verhofstad MH, and Van der Vlies CH
- Subjects
- Body Surface Area, Burns economics, Burns epidemiology, Cicatrix, Cohort Studies, Health Care Costs, Humans, Netherlands epidemiology, Outcome Assessment, Health Care, Prospective Studies, Quality of Life, Smoke Inhalation Injury epidemiology, Triage, Burn Units, Burns therapy, Hospitals, Referral and Consultation
- Abstract
Introduction: The Emergency Management of Severe Burns (EMSB) referral criteria have been implemented for optimal triaging of burn patients. Admission to a burn centre is indicated for patients with severe burns or with specific characteristics like older age or comorbidities. Patients not meeting these criteria can also be treated in a hospital without burn centre. Limited information is available about the organisation of care and referral of these patients. The aims of this study are to determine the burn injury characteristics, treatment (costs), quality of life and scar quality of burn patients admitted to a hospital without dedicated burn centre. These data will subsequently be compared with data from patients with<10% total bodysurface area (TBSA) burned who are admitted (or secondarily referred) to a burn centre. If admissions were in agreement with the EMSB, referral criteria will also be determined., Methods and Analysis: In this multicentre, prospective, observational study (cohort study), the following two groups of patients will be followed: 1) all patients (no age limit) admitted with burn-related injuries to a hospital without a dedicated burn centre in the Southwest Netherlands or Brabant Trauma Region and 2) all patients (no age limit) with<10% TBSA burned who are primarily admitted (or secondarily referred) to the burn centre of Maasstad Hospital. Data on the burn injury characteristics (primary outcome), EMSB compliance, treatment, treatment costs and outcome will be collected from the patients' medical files. At 3 weeks and at 3, 6 and 12 months after trauma, patients will be asked to complete the quality of life questionnaire (EuroQoL-5D), and the patient-reported part of the Patient and Observer Scar Assessment Scale (POSAS). At those time visits, the coordinating investigator or research assistant will complete the observer-reported part of the POSAS., Ethics and Dissemination: This study has been exempted by the medical research ethics committee Erasmus MC (Rotterdam, The Netherlands). Each participant will provide written consent to participate and remain encoded during the study. The results of the study are planned to be published in an international, peer-reviewed journal., Trial Registration Number: NTR6565., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2018
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23. HUMeral shaft fractures: measuring recovery after operative versus non-operative treatment (HUMMER): a multicenter comparative observational study.
- Author
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Mahabier KC, Van Lieshout EM, Bolhuis HW, Bos PK, Bronkhorst MW, Bruijninckx MM, De Haan J, Deenik AR, Dwars BJ, Eversdijk MG, Goslings JC, Haverlag R, Heetveld MJ, Kerver AJ, Kolkman KA, Leenhouts PA, Meylaerts SA, Onstenk R, Poeze M, Poolman RW, Punt BJ, Roerdink WH, Roukema GR, Sintenie JB, Soesman NM, Tanka AK, Ten Holder EJ, Van der Elst M, Van der Heijden FH, Van der Linden FM, Van der Zwaal P, Van Dijk JP, Van Jonbergen HP, Verleisdonk EJ, Vroemen JP, Waleboer M, Wittich P, Zuidema WP, Polinder S, Verhofstad MH, and Den Hartog D
- Subjects
- Activities of Daily Living, Clinical Protocols, Cost-Benefit Analysis, Disability Evaluation, Fracture Fixation economics, Health Care Costs, Humans, Humeral Fractures diagnosis, Humeral Fractures economics, Humeral Fractures physiopathology, Humeral Fractures surgery, Netherlands, Pain Measurement, Prospective Studies, Recovery of Function, Return to Work, Surveys and Questionnaires, Time Factors, Treatment Outcome, Fracture Fixation methods, Fracture Healing, Humeral Fractures therapy, Research Design
- Abstract
Background: Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not. Since randomized controlled trials for this injury have shown feasibility issues, this study is designed to provide the best achievable evidence to answer this unresolved problem. The primary aim of this study is to evaluate functional recovery after operative versus non-operative treatment in adult patients who sustained a humeral shaft fracture. Secondary aims include the effect of treatment on pain, complications, generic health-related quality of life, time to resumption of activities of daily living and work, and cost-effectiveness. The main hypothesis is that operative treatment will result in faster recovery., Methods/design: The design of the study will be a multicenter prospective observational study of 400 patients who have sustained a humeral shaft fracture, AO type 12A or 12B. Treatment decision (i.e., operative or non-operative) will be left to the discretion of the treating surgeon. Critical elements of treatment will be registered and outcome will be monitored at regular intervals over the subsequent 12 months. The primary outcome measure is the Disabilities of the Arm, Shoulder, and Hand score. Secondary outcome measures are the Constant score, pain level at both sides, range of motion of the elbow and shoulder joint at both sides, radiographic healing, rate of complications and (secondary) interventions, health-related quality of life (Short-Form 36 and EuroQol-5D), time to resumption of ADL/work, and cost-effectiveness. Data will be analyzed using univariate and multivariable analyses (including mixed effects regression analysis). The cost-effectiveness analysis will be performed from a societal perspective., Discussion: Successful completion of this trial will provide evidence on the effectiveness of operative versus non-operative treatment of patients with a humeral shaft fracture., Trial Registration: The trial is registered at the Netherlands Trial Register (NTR3617).
- Published
- 2014
- Full Text
- View/download PDF
24. Functional treatment versus plaster for simple elbow dislocations (FuncSiE): a randomized trial.
- Author
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de Haan J, den Hartog D, Tuinebreijer WE, Iordens GI, Breederveld RS, Bronkhorst MW, Bruijninckx MM, De Vries MR, Dwars BJ, Eygendaal D, Haverlag R, Meylaerts SA, Mulder JW, Ponsen KJ, Roerdink WH, Roukema GR, Schipper IB, Schouten MA, Sintenie JB, Sivro S, Van den Brand JG, Van der Meulen HG, Van Thiel TP, Van Vugt AB, Verleisdonk EJ, Vroemen JP, Waleboer M, Willems WJ, Polinder S, Patka P, van Lieshout EM, and Schep NW
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Braces, Cost-Benefit Analysis, Elbow Joint physiopathology, Female, Humans, Male, Middle Aged, Netherlands, Outcome Assessment, Health Care, Quality of Life, Treatment Outcome, Young Adult, Casts, Surgical, Disability Evaluation, Joint Dislocations therapy, Physical Therapy Modalities, Elbow Injuries
- Abstract
Background: Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow., Methods/design: The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for pro-supination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation), health-related quality of life (Short-Form 36 and EuroQol-5D), radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications), costs, and cost-effectiveness., Discussion: The successful completion of this trial will provide evidence on the effectiveness of a functional treatment for the management of simple elbow dislocations., Trial Registration: The trial is registered at the Netherlands Trial Register (NTR2025).
- Published
- 2010
- Full Text
- View/download PDF
25. Long-term survival after non-small cell lung cancer surgery: development and validation of a prognostic model with a preoperative and postoperative mode.
- Author
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Birim O, Kappetein AP, Waleboer M, Puvimanasinghe JP, Eijkemans MJ, Steyerberg EW, Versteegh MI, and Bogers AJ
- Subjects
- Aged, Carcinoma, Non-Small-Cell Lung complications, Carcinoma, Non-Small-Cell Lung pathology, Female, Humans, Lung Neoplasms complications, Lung Neoplasms pathology, Male, Postoperative Care, Preoperative Care, Prognosis, Retrospective Studies, Survival Rate, Time Factors, Carcinoma, Non-Small-Cell Lung mortality, Carcinoma, Non-Small-Cell Lung surgery, Lung Neoplasms mortality, Lung Neoplasms surgery, Models, Statistical
- Abstract
Objective: At present, there is no prognostic model that is specific for prediction of survival after non-small cell lung cancer surgery. We aimed to develop a prognostic model that can be used to estimate the postoperative survival of individual patients., Methods: A total of 766 patients underwent resection for primary non-small cell lung cancer. Comorbid conditions were scaled according to the Charlson comorbidity index (CCI). Cox proportional hazard analyses were used to determine risk factors for survival. A prognostic model for survival with a preoperative and postoperative mode was established. Performance of the prognostic model, the CCI, and pathologic tumor stage were quantified by a concordance statistic to indicate discriminative ability., Results: The factors associated with an impaired survival were male sex, age, chronic obstructive pulmonary disease, congestive heart failure, any prior tumor, moderate-to-severe renal disease (preoperative and postoperative mode), clinical tumor stage (preoperative mode), type of resection, and pathologic tumor stage (postoperative mode). The discriminative performance was poor for the CCI (c = 0.55), better for pathologic tumor stage (c = 0.60) and for the preoperative mode (c = 0.61), and best for the postoperative mode (c = 0.65). The discriminative performance of the postoperative mode was better than the discriminative performance of the CCI (P < .0001), the preoperative mode (P < .0002), and pathologic tumor stage (P < .0001). The discriminative performance of the preoperative mode was better than the discriminative performance of the CCI (P < .0001) and similar (P = .90) to a model that only included pathologic tumor stage., Conclusions: The prognostic model, particularly the postoperative mode, successfully estimates long-term survival of individual patients and could help clinicians in clinical decision-making and treatment tailoring.
- Published
- 2006
- Full Text
- View/download PDF
26. Prevention and treatment of thrombotic complications in essential thrombocythaemia: efficacy and safety of aspirin.
- Author
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van Genderen PJ, Mulder PG, Waleboer M, van de Moesdijk D, and Michiels JJ
- Subjects
- Adult, Aged, Aged, 80 and over, Aspirin adverse effects, Cohort Studies, Female, Follow-Up Studies, Hemorrhage etiology, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Survival Analysis, Treatment Outcome, Aspirin therapeutic use, Thrombocytopenia complications, Thrombosis prevention & control
- Abstract
The efficacy and safety of aspirin in the prevention and treatment of thrombosis in essential thrombocythaemia (ET) was retrospectively analysed in a cohort of 68 ET patients. 41 patients presented with thrombosis, five patients with bleeding: two patients had a paradoxical combination of bleeding and thrombosis at presentation. At presentation, patients with bleeding had significantly higher platelet and leucocyte counts than patients with thrombosis. During long-term follow-up the incidence of thrombosis was significantly reduced in patients receiving aspirin, either as monotherapy or in combination with cytoreduction. However, treatment with aspirin (500 mg/d) was associated with an increase in (minor) bleeding complications. In patients receiving aspirin, bleeding occurred particularly at platelet counts exceeding 1000 x 10(9)/l. The overall 5- and 10-years survival probability was 93% and 84% respectively, indicating that life expectancy in ET is close to normal. Although our data need confirmation in prospective clinical trials, they suggest that aspirin, particularly in lower doses (100 mg/d), may be a safe antithrombotic agent in ET with an acceptable risk for bleeding, if applied to patients with a platelet count <1000 x 10(9)/l and/or absence of a bleeding history.
- Published
- 1997
- Full Text
- View/download PDF
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