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Biomedical subjects

K Solheim

Publications and source records attributed to K Solheim.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Diaphragmatic injuries].

Diaphragmatic injuries are serious, since they can lead to herniation of abdominal organs into the thorax. The injury is simple to treat when diagnosed early. The operation can then be performed with direct suturing. Concomitant injuries are common, however, and complicate diagnosis and treatment in an acute situation. During the period 1980-90, 30 patients with diaphragmatic injuries where treated in Ullevål hospital, 18 after closed and 12 after penetrating trauma. 28 of the 30 patients also had associated injuries. In four patients the diagnosis was initially missed. The majority of the patients were treated by laparotomy. Four patients died during the primary admission to the hospital, one of them suddenly in delirium tremens, two from massive bleeding from a pelvic fracture and one from septicemia and multiorgan failure. One patient died four years later from pneumococcal septicemia. No patient died because of the diaphragmatic injury, and traumatic diaphragmatic hernia due to earlier injuries was not registered during the study period.

Abdominal Injuries↗
PubMed1991

[Severe hemorrhage in pancreatic pseudocyst].

Pseudocysts in the pancreas occur in 10% of patients with pancreatitis and may lead to serious complications, i.e. infection, obstruction of the bile duct, rupture, and hemorrhage. The last complication is highly lethal. Two patients are described, with differing modes of presentation and therapy. In one patient hemostasis was obtained by surgical packing followed by percutaneous embolization. In the other patient embolization failed and surgical resection was necessary.

Adult↗
PubMed1990

[Abdominal injuries after blunt trauma].

We present a series of 331 patients admitted to hospital in 1980-87 with abdominal injuries after blunt trauma. The patients included 230 males and 101 females. The median age was 29 years. More than half of the patients were injured in traffic accidents. 11% were transferred to our Trauma Center from other hospitals, median five hours after the accident. A doctor-manned helicopter transported 52 patients (18%) directly to our hospital. 70% had extra-abdominal injuries as well. A minimum of 20% were intoxicated by alcohol and/or drugs. Severe injuries (AIS greater than 3) were present in 46%. 168 patients underwent laparotomy, in 56% within two hours of admission. In 27 of the 168 laparotomized patients (16%) no intraabdominal injury was encountered that needed repair.

Abdominal Injuries↗
PubMed1990

[Death assistance and terminal care--at the hospital].

Euthanasia, i.e. active termination of life in a seriously ill patient, is not performed in Norway at present. Between active and so-called passive euthanasia there is a "grey zone", and it is discussed where the border should be drawn, how and by whom. The decision to treat or not is becoming increasingly difficult, due to technical advances in the development of life-supporting devices. There is increasing sympathy for the view that it is not the duty of the medical profession to prolong the life of patients under all circumstances. The present paper discusses such problems in relation to hospitalized patients in an acute life-threatening situation, and in patients with, known, chronic disabling, or malignant disease.

Euthanasia↗
PubMed1990

[Triage. Initial diagnosis of life-threatening injuries based on functional state and mechanism of injury].

Functional status expressed as Trauma Score (TS) and mechanism of injury were evaluated as criteria for diagnosing severe trauma in 253 traffic accident victims. An Injury Severity Score (ISS) of greater than or equal to 16 was considered a severe, potentially life-threatening injury. In 67 patients with ISS greater than or equal to 16, either TS was less than or equal to 13 or the history suggested risk of high energy trauma in 72%. When one or both of these criteria were met, ISS was greater than or equal to 16 in 54%. In addition, five patients (3%) with ISS less than 16 had potentially life-threatening injuries in the abdomen or in the thorax. Of these, two had a history indicating high energy trauma. Identifying severely injured patients by assessment of function and mechanism of injury gave an overtriage of 46%, which is acceptable, and an undertriage of 12%. Caution should be exercised in excluding severe trauma on these criteria. Considered together, decreased TS and a history indicating high energy injury, gave high sensitivity (72%) and specificity (78%) for diagnosing severe trauma, ISS greater than or equal to 16.

Accidents, Traffic↗
PubMed1990

[Grading and prognosis of blunt abdominal injuries].

From 1 January 1980 to 31 December 1987, 297 patients were admitted to Ullevål Hospital, Dept. of Surgery, with abdominal injury after blunt trauma. The Injury Severity Score (ISS) was determined in retrospect, and correlated to mortality, morbidity and use of resources. 50 patients (16.8%) died. Mortality increased with increasing ISS, until ISS was above 34. In this group, mortality was 75%. In the survivors, hospital costs (days in the hospital, in the intensive care unit, on mechanical respiration, and number of blood units transfused) increased with increasing ISS. The likelihood of developing septicaemia adult respiratory distress syndrome (ARDS) or multiple organ failure also increased with increasing ISS. Those who died were older and had a higher ISS than the survivors. In patients over 55 years old, the mortality increased significantly. The ISS is well suited for identification of seriously injured patients after blunt abdominal trauma. The ISS can be used to predict mortality, morbidity and cost of treatment in groups of patients.

Abdominal Injuries↗
PubMed1990

[Prognosis for patients involved in traffic injuries].

The outcome in trauma is influenced by the anatomical severity of the injuries as expressed in the Injury Severity Score (ISS), the physiological function as expressed in the Trauma Score (TS) and the patient's age. Based on a statistical analysis, it is possible to estimate the probability of survival. All 202 patients admitted urgently to Ullevål Hospital, Oslo, after traffic accidents in 1987 were assessed. ISS averaged 15 (one to 75). Mean ISS for the dead was 44 (25 to 75). 17 patients (8%) died. When ISS greater than or equal to 16 ('severe injury') mortality was 25%. Patients with TS less than 5 had 100% mortality. Probability of survival was mean 0.95 in survivors and 0.23 for dead. ISS, TS and probability of survival were significantly correlated to death in hospital (p less than 0.0001). Three of 181 patients with probability of survival greater than 0.5 ('avoidable deaths') died, one from an undiscovered aortic rupture, and another from a head/face injury. The third was 83 years old with thoracic injury and died from pneumonia. Two out of three patients with probability of survival between 0.5 and 0.25 ('possibly avoidable deaths') died, while six of 18 patients with probability of survival less than 0.25 ('unavoidable deaths') survived. Risk of dying in hospital was higher in patients with systolic blood pressure below 90 mmHg upon admission. In this case the odd ratio was 40.5, as compared with persons with a systolic blood pressure of 90 mmHg or above. The routines in initial trauma care can be further improved and must include rapid reversal of any hypoperfusion, parallel with quick and complete diagnostic workup.

Accidents, Traffic↗