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Injury mortality

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https://www.readbyqxmd.com/read/28930962/attenuation-of-hemorrhage-associated-lung-injury-by-adjuvant-treatment-with-c23-an-oligopeptide-derived-from-cold-inducible-rna-binding-protein
#1
Fangming Zhang, Weng-Lang Yang, Max Brenner, Ping Wang
BACKGROUND: Hemorrhagic shock (HS) is an important cause of mortality. HS is associated with an elevated incidence of acute lung injury and acute respiratory distress syndrome, significantly contributing to HS morbidity and mortality. Cold-inducible RNA-binding protein (CIRP) is released into the circulation during HS and can cause lung injury. C23 is a CIRP-derived oligopeptide that binds with high affinity to the CIRP receptor and inhibits CIRP-induced phagocyte secretion of TNF-α...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#2
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930957/clot-dynamics-and-mortality-the-ma-r-ratio
#3
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing thromboelastography (TEG) to identify those at risk of subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930956/implications-of-the-trauma-quality-improvement-project-inclusion-of-nonsurvivable-injuries-in-performance-benchmarking
#4
Jiselle Bock Heaney, Rebecca Schroll, Jennifer Turney, Lance Stuke, Alan B Marr, Patrick Greiffenstein, Rosemarie Robledo, Amanda Theriot, Juan Duchesne, John Hunt
BACKGROUND: The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a Level I high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with nonsurvivable injuries. METHODS: Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013 to 2014 with length of stay (LOS) less than 1 day to determine survivability of the injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930954/acute-procedural-interventions-after-pediatric-blunt-abdominal-trauma-a-prospective-multicenter-evaluation
#5
Chase A Arbra, Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Eunice Y Huang, Kate B Savoie, Matthew T Santore, KuoJen Tsao, Tiffany G Ostovar-Kermani, Richard A Falcone, M Sidney Dassinger, John Recicar, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David P Mooney, Chinwendu Onwubiko, Jeffrey S Upperman, Christian J Streck
BACKGROUND: Pediatric intra-abdominal injuries (IAI) from blunt abdominal trauma (BAT) rarely require emergent intervention. For those children undergoing procedural intervention, our aim was to understand the timing and indications for operation and angiographic embolization. METHODS: We prospectively enrolled children younger than 16 years after BAT at 14 Level I Pediatric Trauma Centers over a 1-year period. Patients with IAI who received an intervention (IAI-I) were compared with those who did not receive an intervention using descriptive statistics and univariate analysis; p less than 0...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930952/military-use-of-tranexamic-acid-in-combat-trauma-does-it-matter
#6
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930947/the-mortality-ascent-hourly-risk-of-death-for-hemodynamically-unstable-trauma-patients-at-level-ii-versus-level-i-trauma-centers
#7
Juan P Herrera-Escobar, Arturo J Rios-Diaz, Cheryl Zogg, Lindsey L Wolf, Alyssa Harlow, Eric B Schneider, Zara Cooper, Carlos A Ordonez, Ali Salim, Adil H Haider
BACKGROUND: Severely injured trauma patients have higher in-hospital mortality at Level II versus Level I Trauma Centers (TCs). In order to better understand these differences, we sought to determine if there were any time-periods during which hemodynamically unstable trauma patients are at higher risk of death at Level II versus Level I TCs within the first 24 hours post-admission. STUDY DESIGN: Trauma patients aged 18-64 years, with Injury Severity Score ≥15, SBP <90 mmHg at admission, and treated at Level II or Level I TCs, were identified using the 2007-2012 National Trauma Data Bank...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930911/an-enrichment-strategy-yields-seven-novel-single-nucleotide-polymorphisms-associated-with-mortality-and-altered-th17-responses-following-blunt-trauma
#8
Lukas Schimunek, Rami A Namas, Jinling Yin, Dongmei Liu, Derek Barclay, Fayten El-Dehaibi, Andrew Abboud, Haley Lindberg, Ruben Zamora, R Billiar Timothy, Yoram Vodovotz
Trauma is the leading cause of death worldwide for individuals under the age of 55. Interpatient genomic differences, in the form of candidate single nucleotide polymorphisms (SNPs), have been associated previously with adverse outcomes after trauma. However, the utility of these SNPs to predict outcomes based on a meaningful endpoint such as survival is as yet undefined. We hypothesized that specific SNP haplotypes could segregate trauma survivors from non-survivors. Genomic DNA samples were obtained from 453 blunt trauma patients, for whom complete daily clinical and biomarker data were available for 397...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28930046/canadian-benchmarks-for-acute-injury-care
#9
Lynne Moore, David Evans, Natalie L Yanchar, Jaimini Thakore, Henry Thomas Stelfox, Sayed Morad Hameed, Richard Simons, John Kortbeek, Julien Clément, François Lauzier, Alexis F Turgeon
BACKGROUND: Acute care injury outcomes vary substantially across Canadian provinces and trauma centres. Our aim was to develop Canadian benchmarks to monitor mortality and hospital length of stay (LOS) for injury admissions. METHODS: Benchmarks were derived using data from the Canadian National Trauma Registry on patients with major trauma admitted to any level I or II trauma centre in Canada and from the following patient subgroups: isolated traumatic brain injury (TBI), isolated thoracoabdominal injury, multisystem blunt injury, age 65 years or older...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#10
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929560/minocycline-and-matrix-metalloproteinase-inhibition-in-acute-intracerebral-hemorrhage-a-pilot-study
#11
J J Chang, M Kim-Tenser, B A Emanuel, G M Jones, K Chapple, A Alikhani, N Sanossian, W J Mack, G Tsivgoulis, A V Alexandrov, T Pourmotabbed
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a devastating cerebrovascular disorder with high morbidity and mortality. Minocycline is a matrix metalloproteinase-9 (MMP-9) inhibitor that may attenuate secondary mechanisms of injury in ICH. The feasibility and safety of minocycline in ICH patients were evaluated in a pilot, double-blinded, placebo-controlled randomized clinical trial. METHODS: Patients with acute onset (<12 h from symptom onset) ICH and small initial hematoma volume (<30 ml) were randomized to high-dose (10 mg/kg) intravenous minocycline or placebo...
September 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28928970/the-role-of-hyperuricemia-on-vascular-endothelium-dysfunction
#12
Haitao Zhen, Fen Gui
Hyperuricemia appears to be associated with an increased risk for cardiovascular disease and associated mortality. Population epidemiological data support a causal link between hyperuricemia and cardiovascular disease. Endothelium injury could be one of the potential mechanisms in hyperuricemia-induced cardiovascular disease. However, the specific role of uric acid (UA) in the impairment of vascular relaxation and its signal transduction pathway has not been examined. The authors investigated the role of UA on vascular relaxation, nitric oxide (NO) production and expression of proinflammatory cytokines...
October 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28928925/the-fortuitous-repair-of-a-common-bile-duct-injury-following-placement-of-a-percutaneous-transhepatic-cholangiogram-catheter
#13
Branum G Griswold, Jared A White
Common bile duct injuries are associated with a high rate of morbidity and mortality and are discussed frequently in the literature. These injuries may be difficult to diagnose intraoperatively and are often challenging to repair, necessitating referral to hepatobiliary surgery specialists at academic institutions. This case report highlights the management of a completely disrupted common bile duct identified post-operatively using a percutaneous transhepatic cholangiography (PTC) catheter to bridge the gap between the proximal and distal ductal injury prior to operative repair...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28928799/effects-of-n-acetylcysteine-treatment-in-acute-respiratory-distress-syndrome-a-meta-analysis
#14
Ying Zhang, Shaoxue Ding, Caifeng Li, Yifeng Wang, Zhe Chen, Zhiqiang Wang
Acute respiratory distress syndrome (ARDS) is a serious complication of acute lung injury. Severe systemic inflammation is the main cause of multiple organ dysfunction and high mortality. Removal of reactive oxygen species by anti-oxidants has been applied in clinical practice. N-acetylcysteine (NAC) is the most commonly used anti-oxidant. However, the benefit of anti-oxidant therapy was not consistently demonstrated by previous studies. In the present study, a meta-analysis was performed to evaluate the effects of NAC for adult patients with ARDS...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28928592/the-journey-of-harmless-bullet-the-perioperative-care-of-penetrating-cardiac-injury
#15
Ahmad Abou-Leila, Gennadiy Voronov
Traumatic injuries to the heart contribute significantly to trauma are associated with high mortality. Cardiac gunshot wounds (GSW) are considered more lethal compared to other injuries and present several unique challenges to the anesthesia management and perioperative care. We are reporting a rare case of a trauma victim who survived a GSW to the heart. We will discuss the perioperative care of penetrating cardiac injuries, the role of the anesthesia team in resuscitation, safe anesthesia induction, cardiopulmonary bypass management, and the essential role of intraoperative transesophageal echocardiogram imaging...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928429/nrf2-ho-1-mediates-the-neuroprotective-effect-of-mangiferin-on-early-brain-injury-after-subarachnoid-hemorrhage-by-attenuating-mitochondria-related-apoptosis-and-neuroinflammation
#16
Zefeng Wang, Songxue Guo, Junxing Wang, Yuanyuan Shen, Jianmin Zhang, Qun Wu
Early brain injury (EBI) is involved in the process of cerebral tissue damage caused by subarachnoid hemorrhage (SAH), and multiple mechanisms, such as apoptosis and inflammation, participate in its development. Mangiferin (MF), a natural C-glucoside xanthone, has been reported to exert beneficial effects against several types of organ injury by influencing various biological progresses. The current study aimed to investigate the potential of MF to protect against EBI following SAH via histological and biological assessments...
September 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28928275/development-of-diagnostic-criteria-and-a-prognostic-score-for-hepatitis-b-virus-related-acute-on-chronic-liver-failure
#17
Tianzhou Wu, Jiang Li, Li Shao, Jiaojiao Xin, Longyan Jiang, Qian Zhou, Dongyan Shi, Jing Jiang, Suwan Sun, Linfeng Jin, Ping Ye, Lingling Yang, Yinyun Lu, Tan Li, Jianrong Huang, Xiaowei Xu, Jiajia Chen, Shaorui Hao, Yuemei Chen, Shaojie Xin, Zhiliang Gao, Zhongping Duan, Tao Han, Yuming Wang, Jianhe Gan, Tingting Feng, Chen Pan, Yongping Chen, Hai Li, Yan Huang, Qing Xie, Shumei Lin, Lanjuan Li, Jun Li
OBJECTIVE: The definition of acute-on-chronic liver failure (ACLF) based on cirrhosis, irrespective of aetiology, remains controversial. This study aimed to clarify the clinicopathological characteristics of patients with hepatitis B virus-related ACLF (HBV-ACLF) in a prospective study and develop new diagnostic criteria and a prognostic score for such patients. DESIGN: The clinical data from 1322 hospitalised patients with acute decompensation of cirrhosis or severe liver injury due to chronic hepatitis B (CHB) at 13 liver centres in China were used to develop new diagnostic and prognostic criteria...
September 19, 2017: Gut
https://www.readbyqxmd.com/read/28927951/definitive-airway-management-after-pre-hospital-supraglottic-airway-insertion-outcomes-and-a-management-algorithm-for-trauma-patients
#18
Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski, Scott P Zietlow, Brian D Kim, David S Morris
BACKGROUND: Prehospital airway management increasingly involves supraglottic airway insertion and a paucity of data evaluates outcomes in trauma populations. We aim to describe definitive airway management in traumatically injured patients who necessitated prehospital supraglottic airway insertion. METHODS: We performed a single institution retrospective review of multisystem injured patients (≥15years) that received prehospital supraglottic airway insertion during 2009 to 2016...
September 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28927912/steinmann-pins-for-c1-lateral-mass-screw-placement-during-atlantoaxial-stabilization
#19
Joshua E Meyers, Kunal Vakharia, Joseph M Kowalski, Vassilios G Dimopoulos, John Pollina
OBJECTIVE: The authors describe a modified technique for placement of the C1 lateral mass screw using a Steinmann pin as a guide. This technique minimizes dissection and provides atlantoaxial stabilization during arthrodesis. METHODS: In our technique, a non-threaded 1.6mm spade-tip Steinmann pin is placed into the lateral mass of C1 to serve as a guide over which a powered drill is used for screw insertion. Perioperative data were collected for consecutive patients who underwent a C1-2 arthrodesis that involved the modified technique between March 2010 and July 2016...
September 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28927832/impact-of-weekend-admission-on-mortality-and-other-outcomes-among-patients-with-burn-injury-a-nationwide-analysis
#20
Heather Peluso, Marwan S Abougergi, Julie Caffrey
OBJECTIVE: To study the relationship between day of admission and important outcomes among patients with burn injuries. METHODS: The 2014 National Inpatient Sample database was used. Inclusion criterion was a principal diagnosis of burn injury. Exclusion criteria were age <18years, superficial burn, and non-urgent admission. The primary outcome was in-hospital mortality. Secondary outcomes were morbidity (septic shock and prolonged mechanical ventilation), treatment metrics (time to surgery and parenteral or enteral nutrition (P/E-nutrition)) and resource utilization (length of stay (LOS) and total hospitalization charges and costs)...
September 16, 2017: Burns: Journal of the International Society for Burn Injuries
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