Surgical management of life-threatening thyroid haematoma following occult blunt neck trauma.

A 42-year-old man arrived at the emergency department in severe respiratory distress, requiring immediate intubation and ventilation. An emergency computed tomography (CT) neck scan identified a substantial haematoma within a multinodular goitre, necessitating an emergency total thyroidectomy. It was later discovered that the patient had been the victim of an assault involving blunt trauma to the anterior neck. Five days postoperatively the patient was extubated and was well enough to self-discharge the following day. Pathology revealed the lesion to be a ruptured follicular adenoma within his multinodular goitre. Signs of this rare but life-threatening condition may be subtle on initial presentation, particularly if the patient is obtunded. Patients with suspected blunt neck trauma should be observed for signs of respiratory distress. If this develops, the patient should be intubated to facilitate CT scan, and if thyroid haematoma is confirmed, emergency thyroidectomy is the definitive treatment

Impact of surgery on older patients hospitalized with an acute abdomen : findings from the Older Persons Surgical Outcome Collaborative

Acknowledgments: We thank our collaborator (Professor Susan Moug) and data collectors listed below.Peer reviewedPublisher PD

The Clinical Frailty Scale : estimating the prevalence of frailty in older patients hospitalised with COVID-19. The COPE study

Acknowledgments: The COPE study collaborators.Peer reviewedPublisher PD

Prior Routine use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19

Acknowledgments: We gratefully acknowledge the collaborators of the study listed below: Ross Alexander, Emma Bhatti, Carly Bisset, Alice Cavenagh, Jemima Collins, Charlotte Davey, Siobhan Duffy, Jenny Edwards, Alice G Einarsson, Norman Galbraith, Madeline Garcia, James Hesford, Mark Holloway, Tarik Jichi, Joanna Kelly, Sheila Jones, Thomas Kneen, Thomas Lee, Kiah Lunstone, Emma Mitchell, Dolcie Paxton, Lyndsay Pearce, Terence J Quinn, Frances Rickard, Shefali Sangani, Rebecca Simmons, Sandeep Singh, Charlotte Silver, Thomas Telford, Alessia Verduri.Peer reviewedPublisher PD

The prevalence of hyperglycaemia and its relationship with mortality, readmissions and length of stay in an older acute surgical population : a multicentre study

Funding statement This research received no specific grant from any funding agency in the public, commercial or not-for-profit sector.Peer reviewedPostprin

Prevalence of multimorbidity and its association with outcomes in older emergency general surgical patients : an observational study

Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.Peer reviewedPublisher PD

FMALE score: combining practical risk scales to improve preoperative predictive accuracy in emergency general surgery: a multi-centre prospective cohort study

Our increasingly aging population is associated with older people being admitted to surgical wards at a rate surpassing population growth. 1 Although frailty is not exclusive to older adults, its prevalence is positively associated with age. 2 Hewitt et al. observed frailty to independently predict increased length of hospital stay (LOS), 30-day and 90-day mortality for adults aged ≥65 years admitted to emergency general surgery (EGS). 3 Recent evidence has shown that the association between frailty and poor outcomes, is not limited to older adults, but extends to all adult EGS patients. 4 Although risk stratification tools have been derived for EGS patients, none have included a measure for frailty. 5 Previously, Ablett et al. suggested the MALE score to identify older patients at risk of poorer outcomes who may benefit from comprehensive geriatric assessment based on four characteristics obtained at the point of care: Male, Anaemic, Low albumin, and age Eight-five and over. 6 We aimed to investigate whether the accuracy of MALE score could be augmented, through incorporating physical frailty defined by the Clinical Frailty Scale (CFS), and applied to all EGS adults

The role of C-reactive protein (CRP) as a prognostic marker in COVID-19

Funding declaration This study received no specific funding. The study was partially supported through the NIHR Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust in partnership with King's College London (BC)Peer reviewedPostprin