RESUMEN
Bullet embolization from a gunshot wound is a rare entity in trauma patients. We report a case of a 37-year-old female patient who was brought to the trauma unit after sustaining multiple gunshots to the chest and abdomen. Followed by embolization of the bullet from the right subclavian artery to the right common femoral artery. Had successful retrieval of the bullet via a transverse arteriotomy.
RESUMEN
OBJECTIVES: To assess the outcomes of emergency colorectal surgeries in elderly patients over the age of 65 years. METHODS: This is a retrospective chart review study. We studied 99 patients over the age of 65 years and 142 patients younger than 65 years who underwent emergency colorectal surgery at our institute. In this study, patient demographics, operative results, length of hospital stay, and survival were analyzed. RESULTS: Emergency colorectal surgery was performed on a total of 145 men and 96 women. Patients over the age of 65 years were found to have a significantly greater proportion of pulmonary, cardiac, and endocrine comorbidities (27.3%, 84.8%, and 65.7%, respectively). The mean length of hospital stay was 26.0±32.1 days in the group of elderly patients and 17.8±22.0 days in the group of patients under the age of 65. The length of postoperative hospital stay was significantly greater in the group of elderly patients with a p-value (0.00). The length of hospital stay in the intensive care unit was 8.86±17.1 days, which was longer in the group of elderly patients, while it was 3.65±11.4 days for the group of younger patients. However, after logistic regression, the difference in the length of post-operative hospital and intensive care unit stays between elderly and non-elderly patients was not statistically significant in elderly patients. CONCLUSION: Our study suggests that the elderly population are associated with longer hospital stay and higher rates of postoperative pulmonary and cardiovascular complications compared to those under the age of 65. However, after logistic regression, age by itself was not found to be an independent risk factor for worse outcome indicating that patient comorbidities as a whole increase the risk of worse outcomes. Therefore, the care of elderly patients undergoing emergency colorectal surgery should be individualized based on several factors rather than age alone.