Journal: European Journal of Medical Research

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BioMed Central

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2023 - 20252
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Publications 1 - 2 of 2
  • Are the same parameters measured at admission and in the ICU comparable in their predictive values for complication and mortality in severely injured patients?
    Item type: Journal Article
    Gröbli, Lea; Kalbas, Yannik; Kessler, Franziska; et al. (2025)
    European Journal of Medical Research
    Introduction Numerous studies have investigated variables that predict mortality and complications following severe trauma. These studies, however, mainly focus on admission values or a single variable. The aim of this study was to investigate the predictive quality of multiple routine clinical measurements (at admission and in the ICU). Methods Retrospective cohort study of severely injured patients treated at one Level 1 academic trauma centre. Inclusion criteria: severe injury (ISS ≥ 16 points), primary admission and complete data set. Exclusion criteria end-of-life treatment based on advanced directive, secondary transferred patients. Primary outcome: mortality, pneumonia, sepsis. Routine clinical parameters were stratified based on measurement timepoint into Group TB (Trauma Bay, admission) and into Group intensive care unit (ICU, 72 h after admission). Prediction of complications and mortality were calculated using two prediction methods: adaptive boosting (AdaBoost, artificial intelligence, AI) and LASSO regression analysis. Results Inclusion of 3668 cases. Overall mean age 45.5 ± 20 years, mean ISS 28.2 ± 15.1 points, incidence pneumonia 19.0%, sepsis 14.9%, death from haemorrhagic shock 4.1%, death from multiple organ failure 1.9%, overall mortality rate 26.8%. Highest predictive value for complications for Group TB include abbreviated injury scale (AIS), new injury severity score (NISS) and systemic Inflammatory Response Syndrome (SIRS) score. Highest predictive quality for complications for Group ICU include late lactate values, haematocrit, leukocytes, and CRP. Sensitivity and specificity of late prediction models using a 25% cutoff were 73.61% and 76.24%, respectively. Conclusions The predictive quality of routine clinical measurements strongly depends on the timepoint of the measurement. Upon admission, the injury severity and affected anatomical regions are more predictive, while during the ICU stay, laboratory parameters are better predictor of adverse outcomes. Therefore, the dynamics of pathophysiologic responses should be taken into consideration, especially during decision making of secondary definitive surgical interventions. Level of evidence: III (retrospective cohort study).
  • Feasibility and effects of cognitive–motor exergames on fall risk factors in typical and atypical Parkinson’s inpatients: a randomized controlled pilot study
    Item type: Journal Article
    Jäggi, Salome; Wachter, Annina; Adcock, Manuela; et al. (2023)
    European Journal of Medical Research
    Background: People with Parkinson`s disease (PD) often suffer from both motor and cognitive impairments. Simultaneous motor and cognitive training stimulates neurobiological processes which are important especially for people with PD. The aim of this study is to test the feasibility and effects of simultaneous cognitive–motor training in form of exergames in the setting of inpatient rehabilitation of persons with PD. Methods: Forty participants (72.4 ± 9.54 years; Hoehn and Yahr stage 1–4) were randomly assigned to either the intervention group, which trained five times a week in addition to the conventional rehabilitation program, or the control group, which underwent the standard rehabilitation treatment only. Primary outcome was feasibility (measured by adherence rate, attrition rate, occurrence of adverse events, system usability scale (SUS), and NASA TLX score). In addition, various cognitive (Go/No-Go test, reaction time test (RTT), color word interference test (D-KEFS) and Trail Making Test A and B (TMT)) and motor (preferred gait speed, maximum gait speed, dual-task gait speed, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and 5 times Sit-to-Stand (5xStS)) tests were conducted before and after the intervention phase in order to determine training effects Results: Adherence rate was 97%, there were just two dropouts due to reasons unrelated to the study and there were no adverse events. The mean NASA TLX value was 56.2 and the mean value of the SUS was 76.7. Significant time–group interaction effects were observed for the 5xStS, the SPPB, the RTT, the Go/No-Go test and the D-KEFS 2. Discussion: Exergaming, as applied in this study, showed to be feasible, safe and likely effective for the improvement of cognitive and motor functions of PD inpatients. Because of this future randomized controlled trials with a main focus on testing the efficacy of this new intervention are warranted. Trial registration: The study has been registered at ClinicalTrials.gov (ID: NCT04872153).
Publications 1 - 2 of 2