Special Issue "New Diagnostic and Therapeutic Approaches for the Care of the Severely Injured Patient"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 30 June 2020.

Special Issue Editors

Prof. Dr. Frank Hildebrand
E-Mail Website
Guest Editor
Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
Interests: (poly)trauma; risk prediction; treatment strategies; posttraumatic inflammation; genetic polymorphisms
Dr. Klemens Horst
E-Mail Website
Guest Editor
Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany
Interests: (poly)trauma; risk prediction; treatment strategies

Special Issue Information

Dear colleagues,

Trauma represents a leading cause of death particularly in the younger population. Traumatic brain injury and hemorrhage are the most common causes of early death, whereas complications such as infections, (multi-)organ failure and “persistent inflammation, immunosuppression, and catabolism syndrome” (PICS) represent relevant factors for late adverse outcome. Pre- and intrahospital diagnostic and therapeutic standard operating procedures have been shown to beneficially influence posttraumatic outcome. However, development of patient-specific diagnostic and therapeutic strategies remains challenging due to uncertainties regarding the assessment of the individual risk profile. Furthermore, the relevance of prevention and rehabilitation measures to avoid unfavorable long-term consequences of trauma is not fully elucidated.   

For this Special Issue, we would like to invite authors to submit clinical studies that focus on new diagnostic and therapeutic approaches for the care of the severely injured patient from the preclinical setting to rehabilitation. This includes but is not limited to studies investigating the relevance of biomarkers (e.g., cytokines, extracellular vesicles) as new diagnostic tools, presenting scoring systems for risk assessment, optimizing diagnostic procedures or introducing innovative treatment options. Furthermore, clinical studies that concentrate on the presentation of new prevention and rehabilitation measures or investigate trauma-related factors affecting long-term outcome are of major interest.

Prof. Dr. Frank Hildebrand
Dr. Klemens Horst
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Multiple trauma
  • Diagnostic and therapeutic strategy
  • Risk prediction
  • Biomarker
  • Prevention
  • Rehabilitation
  • (Long-term) outcome

Published Papers (1 paper)

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Research

Open AccessArticle
Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS) after Polytrauma: A Rare Syndrome with Major Consequences
J. Clin. Med. 2020, 9(1), 191; https://doi.org/10.3390/jcm9010191 - 10 Jan 2020
Abstract
Nowadays, more trauma patients develop chronic critical illness (CCI), a state characterized by prolonged intensive care. Some of these CCI patients have disproportional difficulties to recover and suffer from recurrent infections, a syndrome described as the persistent inflammation, immunosuppression and catabolism syndrome (PICS). [...] Read more.
Nowadays, more trauma patients develop chronic critical illness (CCI), a state characterized by prolonged intensive care. Some of these CCI patients have disproportional difficulties to recover and suffer from recurrent infections, a syndrome described as the persistent inflammation, immunosuppression and catabolism syndrome (PICS). A total of 78 trauma patients with an ICU stay of ≥14 days (CCI patients) between 2007 and 2017 were retrospectively included. Within this group, PICS patients were identified through two ways: (1) their clinical course (≥3 infectious complications) and (2) by laboratory markers suggested in the literature (C-reactive protein (CRP) and lymphocytes), both in combination with evidence of increased catabolism. The incidence of PICS was 4.7 per 1000 multitrauma patients. The sensitivity and specificity of the laboratory markers was 44% and 73%, respectively. PICS patients had a longer hospital stay (median 83 vs. 40, p < 0.001) and required significantly more surgical interventions (median 13 vs. 3, p = 0.003) than other CCI patients. Thirteen PICS patients developed sepsis (72%) and 12 (67%) were readmitted at least once due to an infection. In conclusion, patients who develop PICS experience recurrent infectious complications that lead to prolonged hospitalization, many surgical procedures and frequent readmissions. Therefore, PICS forms a substantial burden on the patient and the hospital, despite its low incidence. Full article
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