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https://www.readbyqxmd.com/read/28340013/implications-of-thoracic-epidural-analgesia-on-hospital-charges-in-rib-fracture-patients
#1
Courtney D Jensen, Jamie T Stark, Lewis E Jacobson, Jan M Powers, Kathy L Leslie, Jeffrey M Kinsella-Shaw, Michael F Joseph, Craig R Denegar
Objective.:  Rib fractures are present in more than 150,000 patients admitted to US trauma centers each year. Those who fracture two or more ribs are typically treated with oral analgesic drugs and are discharged with few complications. The cost of this care generally reflects its brevity. When a patient fractures three or more ribs, there is an elevated risk of complication. In response, treatments are often broadened and their durations prolonged; this affects cost. While health, function, and survival have been widely explored, patient billing has not...
March 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28328677/genitourinary-injuries-following-traffic-accidents-analysis-of-a-registry-of-162-690-victims
#2
Jean E Terrier, P Paparel, B Gadegbeku, Alain Ruffion, Lawrence C Jenkins, Amina N'Diaye
BACKGROUND: Traffic accidents are the most frequent cause of genitourinary injuries (GUI). Kidney injuries following trauma have been well described. However, there exists a paucity of data on other traumatic genitourinary injuries following traffic accidents. The objective of this study was to analyze the frequency and type of all genitourinary injuries, by user category, following traffic accidents. METHODS: Patient cases were extracted from the trauma registry of the French department of Rhone from 1996 to 2013...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328674/the-value-of-the-injury-severity-score-in-pediatric-trauma-time-for-a-new-definition-of-severe-injury
#3
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS>15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and AIS to predict mortality and define optimal thresholds of severe injury in pediatric trauma. METHODS: Patients from the Pennsylvania trauma registry 2000-2013 were included...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328672/pediatric-trauma-under-triage-in-ohio
#4
Juan P Gurria, Lynn Haas, Md Monir Hossain, Mohammad Alfrad Nobel Bhuiyan, Misty Troutt, Suzanne Moody, Richard A Falcone
BACKGROUND: Appropriate and timely triage is an essential component of a trauma system. In the state of Ohio there are 6 verified pediatric trauma centers (PTC) across 8 state regions. The purpose of this study was to better understand the pediatric under-triage rates in the state. METHODS: We utilized the Ohio Trauma Registry from 2007 - 2012, consisting of 14,045 records of children < 16 years admitted to a hospital for greater than 48 hours or who sustained a traumatic death...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328670/the-trauma-ecosystem-the-impact-and-economics-of-new-trauma-centers-on-a-mature-statewide-trauma-system
#5
David J Ciesla, Etienne E Pracht, Pablo T Leitz, David A Spain, Joseph J Tepas, Kristan L Staudenmayer
INTRODUCTION: Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened along side 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patient profiles. METHODS: A statewide dataset was queried for all injury related discharges from adult acute care hospitals using ICD-9 codes for 2010 and 2014. The dataset, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida department of health in its trauma registry...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28326453/violent-trauma-recidivism-does-all-violence-escalate
#6
R M Nygaard, A P Marek, S R Daly, J M Van Camp
PURPOSE: Rates of trauma patients presenting with history of prior trauma range from 25 to 44%. Outcomes involving recidivists in the setting of intentional trauma, especially penetrating trauma, are conflicting. We hypothesized that if violence does escalate with successive incidence, then injuries due to successive violence should escalate or become increasingly severe with successive admissions. METHODS: The trauma registry from an urban level I adult and pediatric trauma center was queried for injuries due to blunt assault, stabbing, and firearm injury...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28325437/a-new-survival-status-prediction-system-for-severe-trauma-patients-based-on-a-multiple-classifier-system
#7
José Sanz, Daniel Paternain, Mikel Galar, Javier Fernandez, Diego Reyero, Tomás Belzunegui
BACKGROUND AND OBJECTIVE: Severe trauma patients are those who have several injuries implying a death risk. Prediction systems consider the severity of these injuries to predict whether the patients are likely to survive or not. These systems allow one to objectively compare the quality of the emergency services of trauma centres across different hospitals. However, even the most accurate existing prediction systems are based on the usage of a single model. The aim of this paper is to combine several models to make the prediction, since this methodology usually improves the performance of single models...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28321880/group-o-rbcs-where-is-universal-donor-blood-being-used
#8
R L Barty, M Pai, Y Liu, D M Arnold, R J Cook, M P Zeller, N M Heddle
BACKGROUND: There have been recurrent shortages of group O blood due to insufficient inventory and use of group O blood in ABO non-identical recipients. We performed a 12-year retrospective study to determine utilization of group O Rh-positive and Rh-negative red blood cells (RBCs) by recipient ABO group. Reasons for transfusing group O blood to ABO non-identical recipients were also assessed. METHODS: Utilization data from all group O Rh-positive and Rh-negative RBCs transfused at three academic hospitals between April 2002 and March 2014 were included...
March 20, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28319531/examination-of-the-life-expectancy-of-patients-with-burns-over-20-of-their-total-body-surface-area-in-comparison-to-the-rest-of-the-population
#9
Weissman Oren, Wagman Yonathan, Givon Adi, Radomislensky Irina, Peleg Kobi, Stavrou Demetris, Haik Josef, Tessone Ariel
Patients with extensive burn injuries suffer from multisystem trauma, which affects their medical, psychological, and social well-being for many years. Monitoring those patients has revealed changes in the endocrine, cardiac, and respiratory systems years after the injury. Our study tries to examine whether changes manifest as a higher risk of death during their lifespan, compared with the general population. Data from the years 1998 to 2013 regarding two groups of patients was obtained from a national trauma registry: one group had suffered burns over 20% of their TBSA and survived the hospitalization period and the second group was a control group of patients admitted with minimal trauma (Injury Severity Score = 1-minor injury to a single body region)...
March 13, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28318982/vertebral-artery-injury-in-patients-with-isolated-transverse-process-fractures
#10
Phillip A Bonney, Joshua D Burks, Andrew K Conner, Chad A Glenn, Cordell M Baker, Ahmed A Cheema, Jacob B Archer, Bryan E Buster, Roxie M Albrecht, Bradley N Bohnstedt
We sought to assess the rate of CTA-diagnosed vertebral artery injury in patients with isolated transverse process fractures, with and without extension into the transverse foramen, in the blunt-trauma population served by our hospital. We queried our universities trauma registry between January 2009 and July 2014 for ICD-9 codes pertaining to cervical spine fractures. Of 330 patients identified, 45 patients had fractures limited to the transverse process and were selected for the study population. For each patient identified, demographics, injury mechanism, imaging reports, angiography findings, and treatments were recorded...
March 17, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#11
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28314465/data-capture-and-communication-during-transfers-to-definitive-care-in-an-inclusive-trauma-system
#12
Nori L Bradley, Naisan Garraway, Nathaniel Bell, Nasira Lakha, S Morad Hameed
INTRODUCTION: Background trauma survivors in rural areas transferred to urban centers have higher mortality than trauma patients admitted directly to urban centers. Transfer data in trauma registries is important for injury control. Prehospital and early physiologic data may reflect processes of pre-hospital care. British Columbia currently has no standardized process for trauma patient data transfer. PATIENTS AND METHODS: We performed a retrospective data analysis for major trauma patients (ISS>15) transferred to a Level I trauma center over a 1year period (n=243)...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/28302263/lower-limb-amputation-in-germany
#13
Knut Kröger, Christian Berg, Frans Santosa, Nasser Malyar, Holger Reinecke
BACKGROUND: Declining amputation rates have been reported in multiple countries in recent years. It is not yet known whether amputation rates have declined in Germany as well. METHODS: On the basis of DRG (diagnosis-related group) data, we received a list from the German Federal Statistical Office of all major and minor amputations documented in German hospitals from 2005 to 2014. Changes over this period were studied with linear regression. RESULTS: The absolute number of amputations per year in Germany rose slightly from 55 689 in 2005 to 57 637 (+3...
February 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28291446/military-and-civilian-collaboration-the-power-of-numbers
#14
Daniel J Stinner, Joseph C Wenke, James R Ficke, Wade Gordon, James Toledano, Anthony R Carlini, Daniel O Scharfstein, Ellen J MacKenzie, Michael J Bosse, Joseph R Hsu
The purpose of this study was to compare the number and types of extremity injuries treated at civilian trauma centers (CIV CENs) versus military treatment facilities (MTFs) participating in the Major Extremity Trauma Research Consortium (METRC) and to investigate the potential benefits of a clinical research network that includes both civilian trauma centers and MTFs. Two analyses were performed. First, registry data collected on all surgically treated fractures at four core MTFs and 21 CIV CENs over one year were compared...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290957/oral-maxillofacial-injury-surveillance-of-u-s-military-personnel-in-iraq-and-afghanistan-2001-to-2014
#15
Timothy A Mitchener, Rodney Chan, John W Simecek
BACKGROUND: Cranial and oral-maxillofacial injuries accounted for 33% of military visits to in-theater (Level III) military treatment facilities for battle injuries during Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Even after years of conflict, the size and scope of oral-maxillofacial injuries in military armed conflict is still not fully understood. This study reports U.S. Department of Defense (DoD) rates of oral-maxillofacial injuries that can be used for further surveillance and research...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#16
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28288727/helmet-wearing-in-kenya-prevalence-knowledge-attitude-practice-and-implications
#17
A M Bachani, Y W Hung, S Mogere, D Akunga, J Nyamari, A A Hyder
OBJECTIVES: In light of the increasing prevalence of motorcycles on Kenyan roads, there is a need to address the safety of individuals using this mode of transport. Helmet use has been proven to be effective in preventing head injuries and fatalities in the event of a crash. This study aims to understand the prevalence of helmet use as well as knowledge, attitudes, and practices in two districts in Kenya over a 5-year period (2010-2014). STUDY DESIGN: Observational studies on helmet use at randomly selected locations throughout each district were done every quarter to estimate the prevalence of helmet use...
March 2017: Public Health
https://www.readbyqxmd.com/read/28286623/effective-management-of-bone-fractures-with-the-illuminoss%C3%A2-photodynamic-bone-stabilization-system-initial-clinical-experience-from-the-european-union-registry
#18
Thomas Gausepohl, Dietmar Pennig, Steffen Heck, Sascha Gick, Paul A Vegt, Jon E Block
The IlluminOss(®) system (IS) uses a light-curable polymer contained within an inflatable balloon catheter, forming a patient customized intramedullary implant. A registry was established in Germany and The Netherlands to prospectively collect technical and clinical outcomes in patients treated with IS for fractures of the phalange, metacarpal, radius, ulna, distal radius, fibula, clavicle and/or olecranon. Humeral, femoral, tibial and pelvic fractures were included under compassionate use. Procedural success included successful placement of the device at the target fracture site and achievement of fracture stabilization...
February 20, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28282004/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#19
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28274471/the-nexus-criteria-are-insufficient-to-exclude-cervical-spine-fractures-in-older-blunt-trauma-patients
#20
Gabriel Paykin, Gerard O'Reilly, Helen M Ackland, Biswadev Mitra
BACKGROUND AND OBJECTIVE: The National Emergency X-Radiography Utilization Study (NEXUS) criteria are used to assess the need for imaging to evaluate cervical spine integrity after injury. The aim of this study was to assess the sensitivity of the NEXUS criteria in older blunt trauma patients. METHODS: Patients aged 65 years or older presenting between 1st July 2010 and 30th June 2014 and diagnosed with cervical spine fractures were identified from the institutional trauma registry...
February 22, 2017: Injury
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