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Trauma Registry

Anna E Sharrock, Kyle N Remick, Mark J Midwinter, Rory F Rickard
BACKGROUND: Haemorrhage is the leading cause of death on the battlefield. Seventy percent of injuries are due to explosive mechanisms. Anecdotally, these patients have had poorer outcomes when compared to those with penetrating mechanisms of injury (MOI). We wished to test the hypothesis that outcomes following vascular reconstruction were worse in blast-injured than non blast-injured patients. METHODS: Retrospective cohort study. British and American combat casualties with arterial injuries sustained in Iraq or Afghanistan (2003-2014) were identified from the UK Joint Theatre Trauma Registry (JTTR)...
September 1, 2018: Injury
Mohammed Ali Alvi, Joseph R Kapurch, David V Ivanov, Panagiotis Kerezoudis, Mohamad Bydon, Brett A Freedman
OBJECTIVE: To determine if operating on "major" vertebral fractures leads to premature abortion of surgery and/or other acute cardiopulmonary complications. DESIGN: Retrospective review CLINICAL SETTING:: Level 1 trauma center PATIENTS/PARTICIPANTS AND INTERVENTION:: We retrospectively queried our institutional Trauma Registry for all cases presenting with concomitant rib fractures and surgically managed vertebral fractures. MAIN OUTCOME MEASUREMENTS: The main outcomes included the surgical outcome (aborted vs successfully performed), total and ICU length of stay (LOS), adverse discharge, mortality and functional outcomes...
August 23, 2018: Journal of Orthopaedic Trauma
Mary Ann Spott, Cynthia R Kurkowski, Dallas R Burelison, Zsolt Stockinger
There is a widely prevailing belief that electronic health records and data registries are the same, or that registries can be replaced by electronic health records given the advances in technology. While information systems have revolutionized documentation of medical care, distinctions continue to exist. This article will clear the confusion between the two systems, using the Joint Trauma System's (JTS) Department of Defense (DoD) Trauma Registry (DoDTR), the approved enterprise wide trauma registry for the military, as an example...
September 1, 2018: Military Medicine
Gina M Berg, Maggie Searight, Ryan Sorell, Felecia A Lee, Ashley M Hervey, Paul Harrison
Trauma centers are legally bound by Emergency Medical Treatment and Active Labor Act to provide equal treatment to trauma patients, regardless of payer source. However, evidence has suggested that disparities in trauma care exist. This study investigated the relationships between payer source and procedures (total, diagnostic, and surgical) and the number of medical consults in an adult trauma population. This is a 10-year retrospective trauma registry study at a Level I trauma facility. Payer source of adult trauma patients was identified, demographics and variables associated with trauma outcomes were abstracted, and multivariate logistic regression tests were used to determine statistical differences in the number of procedures and medical consults...
August 1, 2018: American Surgeon
Neal Bhutiani, Keith R Miller, Matthew V Benns, Nicholas A Nash, Glen A Franklin, Jason W Smith, Brian G Harbrecht, Matthew C Bozeman
To date, no studies have examined the relationship between geographic and socioeconomic factors and the frequency of pedestrians sustaining traumatic injuries from a motor vehicle. The objective of this study was to analyze the impact of location on the frequency of pedestrian injury by motor vehicle. The University of Louisville Trauma Registry was queried for patients who had been struck by a motor vehicle from 2010 to 2015. Demographic and injury information as well as outcome measures were evaluated to identify those impacting risk of pedestrian versus motor vehicle accidents...
August 1, 2018: American Surgeon
Hannah E Woriax, Mark E Hamill, Carol M Gilbert, Christopher M Reed, Emily R Faulks, Katie M Love, Daniel I Lollar, Michael S Nussbaum, Bryan R Collier
We investigated the patterns of injury associated with major midface trauma. Our hypothesis is that midface injuries are associated with a decrease in certain traumatic brain injuries as well as major torso injuries. The registry of our Level I trauma center was queried for all adult patients treated over 25 years from 1989 to 2013. Patients with midface fractures were identified based on the ICD-9 code. Associated injuries were defined based both on individual ICD-9 codes as well as the Barell Injury Matrix...
August 1, 2018: American Surgeon
Stephen Klepner, Adrian Ong, Anthony Martin, Tom Wasser, Alison L Muller, Adam Sigal, Forrest B Fernandez
The American College of Surgeons Committee on Trauma defines undertriage (UT) as any major trauma patient (injury severity score ≥ 16) not undergoing treatment at the highest level of trauma team activation. This methodology does not account for many important factors that may impact outcome. We performed a retrospective review of the Pennsylvania State Trauma Registry to determine the impact of treatment interventions on mortality. Patients were stratified by triage category as follows: UT, appropriate triage, and overtriage...
August 1, 2018: American Surgeon
Ashley W Gerrish, Mark E Hamill, Katie M Love, Daniel I Lollar, Tonja M Locklear, Nitasha Dhiman, Michael S Nussbaum, Bryan R Collier
Geriatric trauma patients with low-level falls often have multiple comorbidities and limited physiologic reserve. Our aim was to investigate postdischarge mortality in this population. We hypothesized that five-year mortality would be higher relative to other blunt mechanisms. The registry of our Level 1 trauma center was queried for patients evaluated between July 2008 and December 2012. Adult patients identified were matched with mortality data from 2008 to 2013 from the National Death Index. Low-level falls were identified by E Codes; other types of blunt trauma were based on registry classification...
August 1, 2018: American Surgeon
Ian Roberts, Antonio Belli, Amy Brenner, Rizwana Chaudhri, Bukola Fawole, Tim Harris, Rashid Jooma, Abda Mahmood, Temitayo Shokunbi, Haleema Shakur
Background: Worldwide, traumatic brain injury (TBI) kills or hospitalises over 10 million people each year. Early intracranial bleeding is common after TBI, increasing the risk of death and disability. Tranexamic acid reduces blood loss in surgery and death due to bleeding in trauma patients with extra-cranial injury. Early administration of tranexamic acid in TBI patients might limit intracranial bleeding, reducing death and disability. The CRASH-3 trial aims to provide reliable evidence on the effect of tranexamic acid on death and disability in TBI patients...
2018: Wellcome Open Research
Esa M Färkkilä, Zachary S Peacock, R John Tannyhill, Laurie Petrovick, Alice Gervasini, George C Velmahos, Leonard B Kaban
PURPOSE: Patients with mandibular fractures are known to be at risk of concomitant cervical spine injuries (CSIs). The purpose of this study was to determine the incidence of and risk factors for CSIs in these patients. PATIENTS AND METHODS: We conducted a retrospective cohort study of adult trauma patients with mandibular fractures from June 1, 2007, through June 30, 2017. Patients were identified through the Massachusetts General Hospital trauma registry and were included as study patients if they had a mandibular fracture and computed tomography or magnetic resonance imaging of the cervical spine...
August 7, 2018: Journal of Oral and Maxillofacial Surgery
Yusuke Katayama, Tetsuhisa Kitamura, Tomoya Hirose, Takeyuki Kiguchi, Tasuku Matsuyama, Junya Sado, Kosuke Kiyohara, Junichi Izawa, Jotaro Tachino, Takeshi Ebihara, Kazuhisa Yoshiya, Yuko Nakagawa, Takeshi Shimazu
According to guidelines from the Eastern Association for the Surgery of Trauma, computed tomography (CT) with intravenous contrast is strongly recommended to diagnose clinically significant blunt traumatic aortic injury (BTAI). However, it remains unclear whether the timing of CT scanning is associated with the prognosis of BTAI patients.We extracted data on emergency patients who suffered a BTAI in the chest and/or the abdomen from 2004 to 2015 from the Japanese Trauma Data Bank, a nationwide trauma registry...
August 2018: Medicine (Baltimore)
Jörn Zwingmann, Rolf Lefering, Dirk Maier, Lisa Hohloch, Helge Eberbach, Mirjam Neumann, Peter C Strohm, Norbert P Südkamp, Thorsten Hammer
Injuries in the pelvic region in children and adolescents are very rare and often associated with a high energy trauma. Aim of this prospective multicenter study was, by analyzing the data from the TraumaRegister Deutsche Gesellschaft für Unfallchirurgie (TR-DGU), to evaluate any correlation between the severity of pelvic fractures and resulting mortality in different age groups.These study findings are based on a large pool of data retrieved from the prospectively-setup pelvic trauma registry established by the German Trauma Society (DGU) and the German Section of the Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) International in 1991...
August 2018: Medicine (Baltimore)
Scott D Steenburg, Tracy Spitzer, Amy Rhodes
PURPOSE: To describe our institutional experience with post-mortem computed tomography (PMCT) and its impact on decedent injury severity score (ISS) and to assess the adequacy of emergently placed support medical devices. METHODS: Over a 5-year period, patients who died at or soon after arrival and have physical exam findings inconsistent with death were candidates for inclusion. Whole body CT was performed without contrast with support medical devices left in place...
August 29, 2018: Emergency Radiology
Michael M Schlüssel, David J Keene, Susan Wagland, Joseph Alsousou, Sarah E Lamb, Keith Willett, Susan J Dutton
BACKGROUND: There has been a recent steep growth in platelet-rich plasma (PRP) use for musculoskeletal conditions, but findings from high quality clinical trial data are lacking in the literature. Here, we describe the statistical analysis plan (SAP) for the Platelet-rich plasma in Achilles Tendon Healing 2 (PATH-2) trial. METHODS: PATH-2 is a pragmatic, parallel-group, multi-centre, double-blinded, randomised, placebo-controlled, superiority trial. The study aims to evaluate the clinical efficacy of PRP in acute Achilles tendon rupture in terms of muscle-tendon function...
August 29, 2018: Trials
Marian Urban, Karen Booth, Stephan Schueler, Ivan Netuka, Guy MacGowan
The study objective is to quantify the impact of donor and recipient variables on heart transplant survival in recipients with a significant proportion of implanted continuous-flow left ventricular assist devices (LVADs). This is a prospective cohort study of International Society for Heart and Lung Transplantation (ISHLT) Registry that includes all primary heart-alone transplants in adult recipients (January 2005 and June 2013, N = 15 532, 27% LVADs). Donor and recipient characteristics were assessed for association with death or graft failure within 90 days and between 90 days and 5 years after transplantation...
August 25, 2018: Clinical Transplantation
Nolan Mann, Kellen Welch, Andrew Martin, Michael Subichin, Katherine Wietecha, Lauren E Birmingham, Tiffany D Marchand, Richard L George
BACKGROUND: Falls are a common cause of hospitalization, morbidity, and mortality among the elderly in the United States. Evidence-based imaging recommendations for evaluation of delayed intracranial hemorrhage (DICH) are not generally agreed upon. The purpose of this project was to evaluate the incidence of DICH detected by head computer tomography (CT) among an elderly population on pre-injury anticoagulant or antiplatelet (ACAP) therapy. METHODS: Data from a Level 1 Trauma Center trauma registry was used to assess the incidence of DICH in an elderly population of patients (≥65 years) who sustained a minor fall while on pre-injury ACAP medications...
August 24, 2018: BMC Emergency Medicine
Heidi Lehtola, Antti Palomäki, Pirjo Mustonen, Päivi Hartikainen, Tuomas Kiviniemi, Henri Sallinen, Ilpo Nuotio, Antti Ylitalo, K E Juhani Airaksinen, Juha Hartikainen
Background: Intracranial hemorrhage is the most devastating complication in patients with atrial fibrillation (AF) receiving oral anticoagulation (OAC). It can be either spontaneous or caused by head trauma. We sought to address the prevalence, clinical characteristics, and prognosis of traumatic and spontaneous intracranial hemorrhages in AF patients on OAC. Methods: Multicenter FibStroke registry of 5,629 patients identified 592 intracranial hemorrhages during warfarin treatment between 2003 and 2012...
August 2018: Neurology. Clinical Practice
Natasha Singh, Richard D Robinson, Therese M Duane, Jessica J Kirby, Cassie Lyell, Stefan Buca, Rajesh Gandhi, Shaynna M Mann, Nestor R Zenarosa, Hao Wang
OBJECTIVE: Trauma Quality Improvement Program participation among all trauma centers has shown to improve patient outcomes. We aim to identify trauma quality events occurring during the Emergency Department (ED) phase of care. METHODS: This is a single-center observational study using consecutively registered data in local trauma registry (Jan 1, 2016-Jun 30, 2017). Four ED crowding scores as determined by four different crowding estimation tools were assigned to each enrolled patient upon arrival to the ED...
June 18, 2018: American Journal of Emergency Medicine
C Waydhas, R Lefering, C Hoefer
BACKGROUND: The trauma registry of the German Trauma Society (TraumaRegister DGU®) is not only a tool for quality management but also for research purposes. OBJECTIVE: Evaluation of the impact of the TraumaRegister DGU® on scientific output and patient treatment. MATERIAL AND METHODS: Analysis of publications from the TraumaRegister DGU® with respect to numbers, impact factors, journals, citations and presentations. RESULTS AND CONCLUSION: The number and impact factors of publications from the TraumaRegister DGU® rose steeply during the last 10 years and in the last 3 years consisted of 25 publications per year...
August 22, 2018: Der Unfallchirurg
Ashimiyu B Durojaiye, Nicolette M McGeorge, Lisa L Puett, Dylan Stewart, James C Fackler, Peter L T Hoonakker, Harold P Lehmann, Ayse P Gurses
BACKGROUND:  Inhospital pediatric trauma care typically spans multiple locations, which influences the use of resources, that could be improved by gaining a better understanding of the inhospital flow of patients and identifying opportunities for improvement. OBJECTIVES:  To describe a process mining approach for mapping the inhospital flow of pediatric trauma patients, to identify and characterize the major patient pathways and care transitions, and to identify opportunities for patient flow and triage improvement...
July 2018: Applied Clinical Informatics
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