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Trauma population mortality

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https://www.readbyqxmd.com/read/28093252/low-energy-open-ankle-fractures-in-the-elderly-outcome-and-treatment-algorithm
#1
Asanka Wijendra, Rupali Alwe, Michael Lamyman, George A Grammatopoulos, Gregoris Kambouroglou
BACKGROUND: With an aging but still active population, open ankle fractures are increasingly presenting as low energy fragility injuries, sharing many characteristics with that of hip fractures. Yet, there is little in the literature on the management and outcome of these fractures. The primary aim of this study was to describe the outcome following open, ankle fragility fracture. Our secondary aim was to identify potential factors that improved outcome. METHODS: All consecutive, low energy open ankle fractures treated at a Level I Trauma Centre over a five-year period were included...
December 10, 2016: Injury
https://www.readbyqxmd.com/read/28074471/the-probability-of-hospitalizations-for-mild-to-moderate-injuries-by-trauma-center-ownership-type
#2
Etienne E Pracht, Barbara Langland-Orban, Jessica L Ryan
OBJECTIVE: To corroborate anecdotal evidence with systematic evidence of a lower threshold for admission among for-profit hospitals. DATA SOURCES: The study used Florida emergency department and hospital discharge datasets for 2012 to 2014. The treatment variable of interest was for-profit-designated trauma center status. The dependent variable indicated whether a patient with mild-to-moderate injuries was admitted after presenting as a trauma alert and then discharged to home...
January 10, 2017: Health Services Research
https://www.readbyqxmd.com/read/28069138/disparities-in-access-to-trauma-care-in-the-united-states-a-population-based-analysis
#3
Brendan G Carr, Ariel J Bowman, Catherine S Wolff, Michael T Mullen, Daniel N Holena, Charles C Branas, Douglas J Wiebe
BACKGROUND: Injury is a major contributor to morbidity and mortality in the United States. Accordingly, expanding access to trauma care is a Healthy People priority. The extent to which disparities in access to trauma care exist in the US is unknown. Our objective was to describe geographic, demographic, and socioeconomic disparities in access to trauma care in the United States. METHODS: Cross-sectional study of the US population in 2010 using small units of geographic analysis and validated estimates of population access to a Level I or II trauma center within 60minutes via ambulance or helicopter...
January 3, 2017: Injury
https://www.readbyqxmd.com/read/28066618/tracheal-and-bronchial-stenoses-and-other-obstructive-conditions
#4
REVIEW
Claudia Schweiger, Aliza P Cohen, Michael J Rutter
Although tracheal stenosis and bronchial stenosis are relatively rare in the pediatric population, they are both associated with significant morbidity and mortality. While most cases of congenital tracheal stenosis in children present as complete tracheal rings (CTRs), other congenital tracheal obstructions are also encountered in clinical practice. In addition, acquired obstructive tracheal conditions stemming from endotracheal trauma or previous surgical interventions may occur. Many affected children also have associated cardiovascular malformations, further complicating their management...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28041607/firearm-injuries-in-a-pediatric-population-african-american-adolescents-continue-to-carry-the-heavy-burden
#5
M Bachier-Rodriguez, J Freeman, A Feliz
BACKGROUND: Firearm injuries have the highest case-fatality rate among pediatric trauma related deaths. We sought to determine whether demographics, mechanism of injury, and outcomes were age specific. METHODS: We performed a 5 year retrospective analysis of patients 0-19 years old with firearm related injuries. Children were divided into two cohorts based on age. Mann-Whitney and Pearson's X(2) were used to compare continuous and categorical variables, respectively...
November 3, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28030710/association-of-radiologic-indicators-of-frailty-with-1-year-mortality-in-older-trauma-patients-opportunistic-screening-for-sarcopenia-and-osteopenia
#6
Stephen J Kaplan, Tam N Pham, Saman Arbabi, Joel A Gross, Mamatha Damodarasamy, Itay Bentov, Lisa A Taitsman, Steven H Mitchell, May J Reed
Importance: Assessment of physical frailty in older trauma patients admitted to the intensive care unit is often not feasible using traditional frailty assessment instruments. The use of opportunistic computed tomography (CT) scans to assess sarcopenia and osteopenia as indicators of underlying frailty may provide complementary prognostic information on long-term outcomes. Objective: To determine whether sarcopenia and/or osteopenia are associated with 1-year mortality in an older trauma patient population...
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28030507/defining-multiple-organ-failure-after-major-trauma-a-comparison-of-the-denver-sequential-organ-failure-assessment-and-marshall-scoring-systems
#7
Lynn Hutchings, Peter Watkinson, J Duncan Young, Keith Willett
BACKGROUND: Postinjury multiple organ failure (MOF) remains a significant cause of morbidity and mortality. A large number of scoring systems have been proposed to define MOF, with no gold-standard. The purpose of this study was to compare three commonly used scores - the Denver PostInjury Multiple Organ Failure Score, the Sequential Organ Failure Assessment (SOFA) and the Marshall Multiple Organ Dysfunction Score - by descriptive analysis of the populations described by each score, and their predictive ability for mortality...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030506/rib-fracture-fixation-in-the-65-year-and-older-population-a-paradigm-shift-in-management-strategy-at-a-level-i-trauma-center
#8
Michael T Fitzgerald, DennisW Ashley, Hesham Abukhdeir, D Benjamin Christie
BACKGROUND: Rib fractures after chest wall trauma are a common injury, however carry a significant morbidity and mortality risk. The impact of rib fractures in the ≥ 65yo patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients ≥ 65yo receiving rib plating have decreased mortality, complication rates, and an accelerated return to normal functional states when compared to controls. METHODS: With IRB approval, a retrospective review analyzed patients ≥ 65yo with rib fractures admitted from 2009-2015 receiving rib plating(RP group)(n=23) compared to non-operative, injury-matched controls admitted from 2003-2008(NO group)(n=50)...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#9
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030497/extra-corporeal-membrane-oxygenation-ecmo-following-traumatic-injury
#10
Sarwat Ahmad, Jay Menaker, Joseph Kufera, James O'Connor, Thomas M Scalea, Deborah M Stein
BACKGROUND: The use of ECMO for acute respiratory failure following injury is controversial and poorly described. METHODS: We reviewed our single-center experience with use of ECMO from January 2006 to November 2015 at a Level 1 primary adult resource center for trauma to determine the association of in-hospital mortality with patient demographics and clinical variables. RESULTS: 46 patients were treated with ECMO. Patients requiring venoarterial ECMO (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030492/stapled-versus-handsewn-a-prospective-emergency-surgery-study-shapes-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#11
Brandon R Bruns, David S Morris, Martin Zielinski, Nathan T Mowery, Preston R Miller, Kristen Arnold, Herb A Phelan, Jason Murry, David Turay, John Fam, John S Oh, Oliver L Gunter, Toby Enniss, Joseph D Love, David Skarupa, Matthew Benns, Alisan Fathalizadeh, Pak Shan Leung, Matthew M Carrick, Brent Jewett, Joseph Sakran, Lindsay O'Meara, Anthony V Herrera, Hegang Chen, Thomas M Scalea, Jose J Diaz
BACKGROUND: Data from the trauma patient population suggests handsewn anastomoses (HS) are superior to stapled (ST). A recent retrospective study in emergency general surgery (EGS) patients had similar findings. The aim of the current study is to evaluate HS and ST anastomoses in EGS patients undergoing urgent/emergent operations. METHODS: The study was sponsored by the AAST Multi-Institutional Studies Committee. Patients undergoing urgent/emergent bowel resection for EGS pathology were prospectively enrolled from 7/22/2013-12/31/2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28017806/predicting-in-hospital-and-1-year-mortality-in-geriatric-trauma-patients-using-geriatric-trauma-outcome-score
#12
Rebecka Ahl, Herb A Phelan, Sinan Dogan, Yang Cao, Allyson C Cook, Shahin Mohseni
BACKGROUND: The Geriatric Trauma Outcome Score, GTOS (= [age] + [Injury Severity Score (ISS)x2.5] + 22 [if packed red blood cells (PRBC) transfused ≤24hrs of admission]), was developed and validated as a prognostic indicator for in-hospital mortality in elderly trauma patients. However, GTOS neither provides information regarding post-discharge outcomes, nor discriminates between patients dying with and without care restrictions. Isolating the latter, GTOS prediction performance was examined during admission and 1-year post-discharge in a mature European trauma registry...
December 22, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28011072/mortality-prediction-models-in-the-general-trauma-population-a-systematic-review
#13
REVIEW
Leonie de Munter, Suzanne Polinder, Koen W W Lansink, Maryse C Cnossen, Ewout W Steyerberg, Mariska A C de Jongh
BACKGROUND: Trauma is the leading cause of death in individuals younger than 40 years. There are many different models for predicting patient outcome following trauma. To our knowledge, no comprehensive review has been performed on prognostic models for the general trauma population. Therefore, this review aimed to describe (1) existing mortality prediction models for the general trauma population, (2) the methodological quality and (3) which variables are most relevant for the model prediction of mortality in the general trauma population...
December 15, 2016: Injury
https://www.readbyqxmd.com/read/28005711/trauma-system-regionalization-improves-mortality-in-patients-requiring-trauma-laparotomy
#14
David Schechtman, Jack C He, Brenda M Zosa, Debra Allen, Jeffrey A Claridge
INTRODUCTION: This study evaluates the impact of a regional trauma network (RTN) on patient survival, intensive care unit (ICU) length of stay, and hospital length of stay in patients who required trauma laparotomy. METHODS: Patients who required trauma laparotomy from January 2008 to December 2013 were analyzed. Patients admitted during 2008-2009 and 2011-2013 were designated as pre-RTN and RTN groups, respectively. The primary outcome was mortality. RESULTS: A total of 569 patients were analyzed, 231 patients were pre-RTN, and 338 were in the RTN group...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28003031/pyomyositis-is-not-only-a-tropical-pathology-a-case-series
#15
Laura Comegna, Paola Irma Guidone, Giovanni Prezioso, Simone Franchini, Marianna Immacolata Petrosino, Paola Di Filippo, Francesco Chiarelli, Angelika Mohn, Nadia Rossi
BACKGROUND: Pyomyositis is an acute bacterial infection of skeletal muscle that results in localized abscess formation. This infection was thought to be endemic to tropical countries, and is also known as "tropical pyomyositis". However, pyomyositis is increasingly recognized in temperate climates and is frequently associated with an immunosuppressive condition, such as human immunodeficiency virus, malignancy, and diabetes mellitus. It is also found in healthy and athletic people after strenuous or vigorous exercise or following localized and possibly unnoticed trauma...
December 21, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27999959/validation-of-trauma-scales-iss-niss-rts-and-triss-for-predicting-mortality-in-a-colombian-population
#16
Carlos Oliver Valderrama-Molina, Nelson Giraldo, Alfredo Constain, Andres Puerta, Camilo Restrepo, Alba León, Fabián Jaimes
BACKGROUND: Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting. MATERIALS AND METHODS: Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay...
December 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27994378/pediatric-trauma-big-score-predicting-mortality-in-polytraumatized-pediatric-patients
#17
Mohamed Abd El-Aziz El-Gamasy, Ahmed Abd El Basset Abo Elezz, Ahmed Sobhy Mohamed Basuni, Mohamed El Sayed Ali Abd Elrazek
BACKGROUND: Trauma is a worldwide health problem and the major cause of death and disability, particularly affecting the young population. It is important to remember that pediatric trauma care has made a significant improvement in the outcomes of these injured children. AIM OF THE WORK: This study aimed at evaluation of pediatric trauma BIG score in comparison with New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS) in Tanta University Emergency Hospital...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27993204/massive-transfusion-in-pediatric-trauma-analysis-of-the-national-trauma-databank
#18
Michelle C Shroyer, Russell L Griffin, Vincent E Mortellaro, Robert T Russell
BACKGROUND: Massive transfusion (MT) in pediatric trauma has been described in combat populations and other single institutions studies. We aim to define the incidence of MT in a large US civilian pediatric trauma population, identify predictive parameters of MT, and the mortality associated with MT. METHODS: Data from the National Trauma Databank (2010-2012), a trauma registry maintained by the American College of Surgeons, were analyzed. We included pediatric trauma patients ≤14 y that underwent MT, as defined by 40 mL/kg of blood products within the first 24 h after admission...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27979470/a-simplified-stratification-system-for-venous-thromboembolism-risk-in-severely-injured-trauma-patients
#19
Jonathan P Meizoso, Charles A Karcutskie, Juliet J Ray, Xiomara Ruiz, Enrique Ginzburg, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: The objective of this study was to re-evaluate and simplify the Greenfield risk assessment profile (RAP) for venous thromboembolism (VTE) in trauma using information readily available at the bedside. METHODS: Retrospective review of 1233 consecutive admissions to the trauma intensive care unit from August 2011-January 2015. Univariate analyses were performed to determine which RAP risk factors were significant contributors to VTE. Multivariable logistic regression was used to develop models for risk stratification...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27978846/resuscitative-endovascular-balloon-occlusion-of-the-aorta-versus-aortic-cross-clamping-among-patients-with-critical-trauma-a-nationwide-cohort-study-in-japan
#20
Toshikazu Abe, Masatoshi Uchida, Isao Nagata, Daizoh Saitoh, Nanako Tamiya
BACKGROUND: Measures of aortic occlusion (AO) for resuscitation in patients with severe torso trauma remain controversial. Our aim was to characterize the current use of resuscitative endovascular balloon occlusion of the aorta (REBOA) and resuscitative open aortic cross-clamping (ACC), and to evaluate whether REBOA should be an alternative method to resuscitative open ACC. METHODS: This study was a retrospective cohort study between 2004 and 2013 from a nationwide trauma registry in Japan...
December 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
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