Second Look—Clinical News and Views

New tool to reduce wrong-site surgeries
The Joint Commission has released a new tool designed to help healthcare organizations identify, measure, and reduce risks in key processes that can contribute to a wrong-site surgery. The Targeted Solutions Tool™ can help identify and eliminate risks in all phases of the surgery process. The tool is available to all Joint Commission-accredited hospitals.

Biomarker linked to knee OA
A study in the Journal of Biological Chemistry (Feb. 10) finds that the biomarker deamidated cartilage oligomeric matrix protein (D-COMP) is specific to joint site. Mass spectroscopy was used to analyze cartilage in 450 participants in the Johnston County (N.C.) Osteoarthritis (OA) Project. The presence of D-COMP was associated with radiographic hip OA severity, but not with knee OA severity; in contrast, total COMP was associated with radiographic knee OA severity, but not hip OA severity.

Mortality after pelvic fracture
According to a German study published online in Clinical Orthopaedics and Related Research, predictors of mortality after pelvic fracture include male sex, severe multiple trauma, and major hemorrhage. The authors prospectively collected data on 5,340 patients listed in the German Pelvic Trauma Registry between April 30, 2004 and July 29, 2011. At a median 2 days after trauma, 238 patients (4 percent) had died. The main cause of death was massive bleeding (34 percent), predominantly from the pelvic region. Nonsurvivors were characterized by a higher incidence of complex pelvic injuries, less isolated pelvic ring fractures, lower initial blood hemoglobin concentration and systolic arterial blood pressure, and higher injury severity scores.

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