Jan Luitse

• Managing Director at Academisch Medisch Centrum Universiteit van Amsterdam

Studies on the long-term prevalence of parental posttraumatic stress symptoms (PTSS) following child accidental injury are scarce, and findings on risk factors vary. In this follow-up study (T2, n = 69) we determined the prevalence of parental PTSS 2–4 years after accidental injury of their child, compared with 3 months after the accident (T1, n =...

Objectives Initial trauma care could potentially be improved when conventional imaging and selective CT scanning is omitted and replaced by immediate total-body CT (iTBCT) scanning. Because of the potentially increased radiation exposure by this diagnostic approach, proper selection of the severely injured patients is mandatory. Methods In the REA...

Purpose: This study attempted to determine the clinical effectiveness of the intraoperative use of 3-dimensional fluoroscopy compared with conventional 2-dimensional fluoroscopy in patients with distal radius fractures. Methods: We performed a multicenter randomized clinical trial in which 206 patients were randomized between the use of 3-dimens...

In this study, we determined the long-term prevalence of posttraumatic stress disorder (PTSD) in children and adolescents after accidental injury and gained insight into factors that may be associated with the occurrence of PTSD. In a prospective longitudinal study, we assessed diagnosed PTSD and clinically significant self-reported posttraumatic s...

Previous research suggests that acute pain is a risk factor for later posttraumatic stress symptoms (PTSS). In a prospective cohort study, we examined the association between acute pain from accidental injury and PTSS in children and adolescents, taking into account factors potentially related to pain or posttraumatic stress. Participants were 135...

Objectives: The aim of this study was to determine the correlation of the intra-operative fluoroscopic 2D- and 3D-images compared with a postoperative CT-scan, in terms of quality of reduction and fixation of calcaneal fractures. Methods: Patients requiring open reduction and internal fixation (ORIF) of a calcaneal fracture were recruited as part o...

Background Immediate total-body CT (iTBCT) is often used for screening of potential severely injured patients. Patients requiring emergency bleeding control interventions benefit from fast and optimal trauma screening. The aim of this study was to assess whether an initial trauma assessment with iTBCT is associated with lower mortality in patients...

The published online version contains a mistake in the author list for the name of the author "J. Carel Goslings" was incorrectly presented in the HTML version.

Background: The optimal surgical approach for displaced intra-articular calcaneal fractures (DIACF) is subject of debate. The primary aim of this systematic review and meta-analysis was to assess wound-healing complications following the sinus tarsi approach (STA) compared to the extended lateral approach (ELA). Secondary aims were to assess time...

The published online version contain mistake in the author list for the name of the author "J. Carel Goslings" was incorrectly presented in the HTML version.

Purpose: Infectious complications following lower extremity fracture surgery are a major concern and account for a substantial socio-economic burden to society. The aim of this pilot study was to investigate the feasibility of a new portable single-use negative pressure wound therapy device in patients undergoing major foot ankle surgery. Methods...

Introduction Previous studies demonstrated that intra-operative fluoroscopic 3D-imaging (3D-imaging) in calcaneal fracture surgery is promising to prevent revision surgery and save costs. However, these studies limited their focus to corrections performed after 3D-imaging, thereby neglecting corrections after intra-operative fluoroscopic 2D-imaging...

Calcaneal fractures are notoriously difficult to treat and wound complications occur often. However, owing to the rare nature of these fractures, clinical trials on this subject are lacking. Thus, biomechanical studies form a viable source of information on this subject. With our systematic review of biomechanical studies, we aimed to provide an ov...

Background: Calcaneal fractures are uncommon and have a substantial impact on hindfoot function and quality of life. Several surgical treatment options are available; both in surgical approach and type of operation. The aim of this study was to compare functional outcome and quality of life following ORIF and primary arthrodesis. Furthermore, pred...

Purpose: Total-body CT scanning (TBCT) could improve the initial in-hospital evaluation of severe trauma patients. Indications for TBCT, however, differ between trauma centers, so more insight in how to select patients that could benefit from TBCT is required. The aim of this review was to give an overview of currently used indications for total-b...

Objectives: To investigate whether the sinus tarsi approach (STA) allows for a similar anatomical reduction of the posterior talocalcaneal facet as the extended lateral approach (ELA) and compare the rate of postoperative wound complications. Design: Retrospective. Setting: Level 1 Trauma Center. Patients: All consecutive patients from 2012 to 2015...

Background: Suicide is currently a topic of high priority for policy-makers, researchers and clinicians. The World Health Organization estimated 804.000 suicide deaths worldwide in 2012. Some studies that focused on patients with self-inflicted injury revealed that mortality in this group is higher than for patients who sustain unintentional injur...

Background: There are currently few preventive interventions available for posttraumatic stress disorder (PTSD). Intranasal oxytocin administration early after trauma may prevent PTSD, because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors, including neural fear responsiveness, peripheral stress reac...

Background and purpose: Time is brain: benefits of intravenous thrombolysis (IVT) in ischemic stroke last for 4.5 hours but rapidly decrease as time progresses following symptom onset. The goal of the Acute Brain Care (ABC) intervention study was to reduce the door-to-needle time (DNT) to ≤30 minutes by optimizing in-hospital stroke treatment. Me...

Objectives To determine whether there is a difference in frequency and clinical relevance of incidental findings detected by total-body computed tomography scanning (TBCT) compared to those by the standard work-up (STWU) with selective computed tomography (CT) scanning. Methods Trauma patients from five trauma centres were randomized between April...

Objective: To investigate the impact of pediatric traumatic brain injury (TBI) on multisensory integration in relation to general neurocognitive functioning. Method: Children with a hospital admission for TBI aged between 6 and 13 years (n = 94) were compared with children with trauma control (TC) injuries (n = 39), while differentiating between mi...

Objective: 1) to identify predictors of both nonunion and postoperative wound infections (POWI ) and 2) to assess the union- and complication rate following post-traumatic subtalar arthrodesis (STA). Design: Retrospective comparative cohort study. Setting: level 1 trauma center PATIENTS:: All consecutive adult patients with subtalar arthrodesi...

The most important goal of surgical management of displaced intra-articular calcaneal fractures is anatomic correction. This reduction is usually stabilized using plate and screw osteosynthesis. In addition, Kirschner wires (K-wires) can be used to maintain the surgical reduction or stability of the construct. In the present study, we evaluated the...

The standard operative treatment of Lisfranc fracture dislocations currently consists of open reduction and transarticular fixation. Recently, bridge plating has been used more often. Using joint spanning, the reduced fracture dislocation is temporary stabilized to minimize articular damage. The present study describes the outcomes of patients trea...

Background: Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. We aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in patients with trauma. Methods: We unde...

Background: Feedback learning is essential for behavioral development. We investigated feedback learning in relation to behavior problems after pediatric traumatic brain injury (TBI). Method: Children aged 6-13 years diagnosed with TBI (n = 112; 1.7 years post-injury) were compared with children with traumatic control (TC) injury (n = 52). TBI s...

This study describes how many detainees have been referred to emergency departments for further evaluation or emergency care while in police custody in Amsterdam (years 2012/2013). It provides insights into the diagnoses assigned by forensic doctors and hospital specialists and the appropriateness of the referrals. We made use of the electronic reg...

Axonal injury after traumatic brain injury (TBI) may cause impaired sensory integration. We aim to determine the effects of childhood TBI on visual integration in relation to general neurocognitive functioning.We compared children aged 6-13 diagnosed with TBI (n = 103; M = 1.7 years post-injury) to children with traumatic control (TC) injury (n = 4...

Replication of reported findings on FSIQ using the SES-matched TBI group. Note. TBI = traumatic brain injury; TC = trauma control; FSIQ = full-scale intelligence quotient; M = mean; SD = standard deviation. (DOCX)

Replication of reported findings on the mild RF+ TBI group, while excluding children with intracranial injury or psychiatric conditions. Note. TBI = traumatic brain injury; TC = trauma control; FSIQ = full-scale intelligence quotient; M = mean; SD = standard deviation. (DOCX)

Working memory in the TBI and TC groups. Note. TBI = traumatic brain injury; TC = trauma control; M = mean; SD = standard deviation. aDigit Span score calculated as the number of correct responses multiplied by the maximum correct span, in the forward and backward conditions separately (n = 2 missing data) according to Verburgh L, Scherder EJ a, va...

Non-decision time during the Visual Integration Test in the whole sample. Note. M = mean; SD = standard deviation. (DOCX)

Introduction: Metal implants placed during fracture surgery are often removed for various reasons (i.e. pain, prominent material, patients request). The removal of implants is considered a 'clean' procedure and as low risk surgery. The incidence of wound infections following implant removal has received little attention in the literature. The aim...

Purpose The goal of calcaneal fracture surgery is to restore its anatomy and good foot function. However, loss of height of the subtalar joint can occur post-operatively, as expressed by a decrease in Böhler’s angle (BA). The aim of this study was to identify potential factors associated with a post-operative decrease in BA. Methods All consecut...

To investigate whether a mental disorder increases the occurrence of complications in patients after 'a fall from a height'. Retrospective descriptive study. Data on all patients admitted following a 'fall from a height' in the period 2004-2012 was retrieved from the trauma registry of the Academic Medical Center (AMC) in Amsterdam, the Netherlands...

We investigated the impact of pediatric traumatic brain injury (TBI) on attention, a prerequisite for behavioral and neurocognitive functioning. Children aged 6 to 13 years who were diagnosed with TBI (n = 113; mean 1.7 years postinjury) were compared with children with a trauma control injury (not involving the head) (n = 53). TBI severity was def...

Objective 1) Determine the prevalence of Intimate Partner Violence (IPV) in women visiting the outpatient trauma clinic of the Academic Medical Center or Onze Lieve Vrouwe Gasthuis after a traumatic injury. 2) Determine if the populations of the two hospitals differ. 3) Identify predictors for IPV. Study design A cross-sectional study, as part of a...

Children and their parents are at risk of posttraumatic stress disorder (PTSD) following injury due to pediatric accidental trauma. Screening could help predict those at greatest risk and provide an opportunity for monitoring so that early intervention may be provided. The purpose of this study was to evaluate the Screening Tool for Early Predictor...

High rates of postoperative wound infections (POWI) are reported following the operative treatment of calcaneal fractures. This leads to additional therapy, prolonged hospital stay, burden for patients and increased costs. The primary aim of this study is to evaluate the effect of POWI following the extended lateral approach of displaced intra-arti...

Background: Talar and calcaneal fractures and their treatment can cause severe postoperative pain. We hypothesized that a continuous peripheral nerve block (CPNB) would reduce pain scores more effectively than systemic analgesics, improve recovery, and lead to reduced length of stay (LOS). Methods: Over a 3-year period patients undergoing open r...

Currently few evidence based interventions are available for the prevention of PTSD within the first weeks after trauma. Increased risk for PTSD development is associated with dysregulated fear and stress responses prior to and shortly after trauma, as well as with a lack of perceived social support early after trauma. Oxytocin is a potent regulato...

Post-operative wound infections (PWI) following calcaneal fracture surgery can lead to prolonged hospital stay and additional treatment with antibiotics, surgical debridement or implant removal. Our aim was to determine the incidence of superficial and deep PWI and to identify risk factors (RF). This study is a retrospective case series. All consec...

Background: Acute musculoskeletal trauma, including strains, sprains or contusions, occur frequently. Pain management is a crucial component of treatment. However, there is no convincing evidence which drug is superior in managing pain in these patients. The aim of the PanAM Study is to compare analgesic efficacy of three strategies of pain manage...

In recent years computed tomography (CT) has become faster and more available in the acute trauma care setting. The aim of the present study was to compare injured patients who underwent immediate total-body CT (TBCT) scanning with patients who underwent the standard radiological work-up with respect to 30-day mortality. Between January 2009 and Ap...

Implant removal following operative calcaneal fracture treatment has received little attention in the literature. The aim of the current retrospective cohort study was to assess the indications and number of wound complications following calcaneal plate removal. All consecutive adult patients who had their plate and screws removed following the ope...

Locked fracture-dislocations of the calcaneus are uncommon, and a substantial number of these injuries is not recognised or is misdiagnosed at first presentation. The primary aim of this study was to evaluate the long-term outcome in patients with this injury. This is a retrospective cohort study of adult patients who sustained a uni- or bilateral...

Background Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. Objective To determine whether Trauma TIPS is effective in preventing the onset o...

Postoperative radiological assessment of the quality of reduction and fixation of calcaneal fractures is essential when evaluating treatment success. However, a universally accepted radiological evaluation protocol is currently unavailable. The aim of this study was to obtain an expert-based consensus on the most important criteria for the radiolog...

Little is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a population that visited the A&E Department after a fall (A...

Posttraumatic stress disorder (PTSD) affects a minority of trauma-exposed persons and is associated with significant impairment. This longitudinal study examined risk factors for PTSD. We tested whether the presence of injuries resulting from trauma exposure predicted the course of PTSD symptoms. In addition, we tested whether gender, trauma type,...

Background Quality indicators have become increasingly important in the healthcare sector. Data from a trauma registry (TR) should be accurate and reliable as they are used to describe and evaluate (the quality of) trauma care. Objective To investigate the reliability of injury coding, injury severity scoring and survival status in a regional TR. T...

The objective of the present study was to review the current data on the long-term outcomes of calcaneal fractures, with special emphasis on the role of the type of treatment, surgical approach, and reduction and internal fixation. The search was limited to skeletally mature patients. Major databases were searched from 1978 to 2011 to identify stud...

The objective of the present study was to evaluate our complications of screw stabilization and to formulate recommendations for clinical practice. Using a prospectively collected fracture database, the data from 236 consecutive adult patients were analyzed who had undergone syndesmotic screw stabilization from January 1979 to December 2000 at our...

Purpose Locking Compression Plates (LCPs) have been introduced in the last decade. Clinicians have the impression that hardware removal of LCPs are more difficult and associated with more complications than conventional (non-locking) plates. Therefore, this study compares the complication rates of Locking Compression Plate (LCP) removal and convent...

Body packing is a way to deliver packets of drugs across international borders by ingestion. The aim of the study was to provide an estimate of the medical risks of body packing, describe predictors for hospital referral in detained body packers and provide an estimate for the prevalence of body packing in the Amsterdam area. From May 2007 to Decem...

Objectives: To compare waiting time, treatment time, length of stay (LOS), patient satisfaction and distribution of waiting times over levels of urgency before and after the implementation of the Manchester Triage system (MTS) at an emergency department (ED). Methods: Before and after study, by means of timeline measurements and questionnaires o...

Computed tomography (CT) scanning has become essential in the early diagnostic phase of trauma care because of its high diagnostic accuracy. The introduction of multi-slice CT scanners and infrastructural improvements made total-body CT scanning technically feasible and its usage is currently becoming common practice in several trauma centers. Howe...

The aim of this review was to assess the value of immediate total-body computed tomography (CT) during the primary survey of injured patients compared with conventional radiographic imaging supplemented with selective CT. A systematic search of the literature was performed in MEDLINE, Embase, Web of Science and Cochrane Library databases. Reports w...

Immediate total body computed tomography (CT) scanning has become important in the early diagnostic phase of trauma care because of its high diagnostic accuracy. However, literature provides limited evidence whether immediate total body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scannin...

Computed tomography (CT) of injured patients in the radiology department requires potentially dangerous and time-consuming patient transports and transfers. It was hypothesized that CT in the trauma room would improve patient outcome and workflow. A randomized trial compared the effect of locating a CT scanner in the trauma room versus the radiolog...

A former healthy 22 year old man developed chronic hematogenous osteomyelitis of his right fibula. Ongoing disease unresponsive to antibiotic treatment led to operative debridement, despite the CT scan that showed no sequester formation. During the operation however, a large sequester of the fibula incorporated by an involu-crum was found. We belie...

The objective was to compare the validity of an existing informally structured triage system with the Emergency Severity Index (ESI) and the Manchester Triage System (MTS). A total of 900 patients were prospectively triaged by six trained triage nurses using the three systems. Triage ratings of 421 (48%) patients treated only by emergency departmen...

Posttraumatic osteoarthritis can develop after an intra-articular extremity fracture, leading to pain and loss of function. According to international guidelines, anatomical reduction and fixation are the basis for an optimal functional result. In order to achieve this during fracture surgery, an optimal view on the position of the bone fragments a...

The purpose of this study was to evaluate the added value of plain radiographs on top of clinical assessment in unselected patients presenting with acute abdominal pain at the emergency department (ED). In a multicenter prospective trial, patients with abdominal pain more than 2 hours and less than 5 days presented at the ED were evaluated clinical...

Action research (AR) is increasingly being used to study the improvement of healthcare delivery. Ensuring that all the stakeholders in the AR are willing to take action, however, can be difficult. Especially in healthcare contexts, action plans may challenge the autonomy of the healthcare professionals and the positions of the different stakeholder...

Worldwide, many hospitals experience problems in patient outflow from the emergency department into the clinical wards, and therefore, implement an observation unit. Literature and practical experiences, however, show that medical management in these units can be problematic. A university hospital in the Netherlands that considered implementation f...

During operative treatment of intra-articular fractures of the extremities, 2D fluoroscopy is often used for assessing the quality of fracture reduction and fixation and for making any necessary corrections. Post-operative radiographs or CT scans, however, frequently reveal suboptimal reduction or fixation of the fracture. To help prevent this, a 3...

Doel: Vaststellen of bij fracturen aan de extremiteiten peroperatieve driedimensionale beeldvorming, 3-Dimensional Rotational X-ray (3D-RX), meer inzicht verschaft in de positie van de fractuurfragmenten en het osteosynthesemateriaal dan het peroperatieve gebruik van tweedimensionale (2D) röntgendoorlichting. Met de 3D-RX-scan kunnen tweedimensiona...

In the prevention of posttraumatic stress disorder (PTSD) after severe traumatic injury, easily applicable, accessible, cost-efficient early interventions are needed that use well-established techniques for decreasing acute psychological stress reactions. Whereas most studies delivered cognitive behavioral techniques face-to-face or as a curative t...

The aim of this study was to evaluate patient related outcome and shoulder stability following open reduction and internal fixation (ORIF) in patients with glenoid rim fractures. After a median follow-up of four years, 14 patients completed the Rowe Shoulder Stability Score and Quick DASH questionnaire. The median Rowe score was 90 (Q1: 88, Q3: 100...

Patients who are admitted with a suspicion of a severe infection usually enter the hospital through the emergency department (ED). The recognition of prognostic factors in an early stage affects further treatment and might improve clinical outcomes. WE EXAMINED POSSIBLE PROGNOSTIC FACTORS FOR FOUR IMPORTANT OUTCOMES: intensive care unit (ICU) admis...

Complication registration is an important part of monitoring the quality of health care. The aim of this article was to describe the incidence, type, and impact of complications occurring within 6 months after the initial trauma in multitrauma patients. During a 2-year period, all trauma patients with an Injury Severity Score (ISS) ≥ 16 who were no...

We present three patients, a 55-year-old man, a 69-year-old woman and a 25-year-old man, with a seatbelt sign following a car accident. All 3 patients exhibited various injuries that may occur in the case of a blunt trauma, for example rib fractures. In one patient, however, symptoms of internal abdominal injury occurred several days after the acci...

Method A Delphi study was conducted to obtain consensus on the most important criteria for the radiological evaluation of the reduction and fixation of the wrist and ankle. The Delphi study consisted of a bipartite online questionnaire, focusing on the interpretation of radiographs and CT scans of the wrist and the ankle. Questions addressed imagin...

Mobile medical teams (MMTs) provide specialized care on-scene with the purpose to improve outcome. However, this additional care could prolong the on-scene time (OST), which is related to mortality. The purpose of this study was to assess the effects of MMT involvement on the mortality rate and on the OST, in a Dutch consecutive cohort of Level I t...

Initial treatment of vasovagal syncope (VVS) consists of assuring an adequate fluid and salt intake, regular exercise and application of physical counterpressure manoeuvres. We examined the effects of this non-pharmacological treatment in patients with frequent recurrences. One hundred patients with > or =3 episodes of VVS in the 2 years prior to t...

Monitoring the quality of trauma care is frequently done by analysing the preventability of trauma deaths and errors during trauma care. In the Academic Medical Center trauma deaths are discussed during a monthly Morbidity and Mortality meeting. In this study an external multidisciplinary panel assessed the trauma deaths and errors in management of...

Door-to-needle time (DNT), defined as the time between arrival at the emergency department (ED) and intravenous (iv) antibiotic administration is of crucial importance in the treatment of patients suffering from serious infections. The aim of this project was to reduce the DNT for patients with a serious infection as primary outcome parameter. All...

Conventional C-spine imaging (3-view series) is still widely used in trauma patients, although the utilization of computed tomography (CT) scanning is increasing. The aim of this study was to analyze the value of conventional radiography and the frequency of subsequent CT scanning due to incompleteness of three-view series of the C-spine in adult b...

To compare inter and intra-observer agreement of the Manchester Triage System (MTS) and the Emergency Severity Index (ESI). 50 representative emergency department (ED) scenarios derived from actual cases were presented to 18 ED nurses from three different hospitals. Eight of them were familiar with MTS, six with ESI and four were not familiar but t...

Few data are available about the epidemiology and injury characteristics in staircase falls. The available literature mainly concerns children and autopsy studies. To describe the epidemiology and injury characteristics of staircase falls, and to identify high-risk groups for these falls. All patients who reported to an academic Accident & Emergenc...