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Trauma population mortality

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https://www.readbyqxmd.com/read/28644586/medical-record-weight-mrw-a-new-reliable-predictor-of-hospital-stay-morbidity-and-mortality-in-the-hip-fracture-population
#1
P Calpin, K Taheny, J F Baker, J Green, J P McCabe
We sought to compare the weight of patient's medical records (MRW) to that of standardised surgical risk scoring systems in predicting postoperative hospital stay, morbidity, and mortality in patients with hip fracture. Patients admitted for surgical treatment of a newly diagnosed hip fracture over a 3-month period were enrolled. Patients with documented morbidity or mortality had significantly heavier medical records. The MRW was equivalent to the age-adjusted Charlson co-morbidity index and better than the American Society of Anaesthesiologists physical status score (ASA), the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM,) and Portsmouth-POSSUM score (P-POSSUM) in correlation with length of hospital admission, p = ...
December 12, 2016: Irish Medical Journal
https://www.readbyqxmd.com/read/28641304/hyperemesis-gravidarum-a-review-of-recent-literature
#2
Viktoriya London, Stephanie Grube, David M Sherer, Ovadia Abulafia
BACKGROUND: In the United States, hyperemesis gravidarum is the most common cause of hospitalization during the first half of pregnancy and is second only to preterm labor for hospitalizations in pregnancy overall. In approximately 0.3-3% of pregnancies, hyperemesis gravidarum is prevalent and this percentage varies on account of different diagnostic criteria and ethnic variation in study populations. Despite extensive research in this field, the mechanism of the disease is largely unknown...
June 23, 2017: Pharmacology
https://www.readbyqxmd.com/read/28637569/assessing-field-triage-decisions-and-the-international-classification-injury-severity-score-iciss-at-predicting-outcomes-of-trauma-patients
#3
Casey J Allen, Daniel J Baldor, Carl I Schulman, Louis R Pizano, Alan S Livingstone, Nicholas Namias
Florida considers the International Classification Injury Severity Score (ICISS) from hospital discharges within a geographic region in the apportionment of trauma centers (TCs). Patients with an ICISS <0.85 are considered to require triage to a TC, yet many are triaged to an emergency department (ED). We assess outcomes of those with an ICISS <0.85 by the actual triage decision of emergency medical services (EMS). From October 2011 to October 2013, 39,021 consecutive admissions with injury ICD-9 codes were analyzed...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637556/pretrauma-functional-independence-measure-score-predicts-survival-in-geriatric-trauma
#4
Brian Fletcher, Eric Bradburn, Christopher Baker, Bryan Collier, Mark Hamill, Katherine Shaver
The Functional Independence Measure (FIM) is used by rehabilitation professionals to access disability. The FIM score combines both motor and cognitive parameters to assess a patient's level of required assistance in performing activities of daily living (ADL). The geriatric trauma patient is becoming an increasingly important cohort for trauma services. FIM has been shown to predict discharge outcomes and those at high risk for falls. We hypothesized pretrauma FIM scores may predict survival in the geriatric trauma population...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637554/the-g60-trauma-center-a-future-consideration
#5
Marko Bukur, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, Fahim Habib
With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637551/outcomes-of-geriatric-trauma-patients-on-preinjury-anticoagulation-a-multicenter-study
#6
Darwin Ang, Stan Kurek, Mark McKenney, Scott Norwood, Brian Kimbrell, Erik Barquist, Huazhi Liu, Annette O'Dell, Michele Ziglar, James Hurst
Outpatient anticoagulation in the geriatric trauma patient is a challenging clinical problem. The aim of this study is to determine clinical outcomes associated with class of preinjury anticoagulants (PA) used by this population. This is a multicenter retrospective cohort study among four Level II trauma centers. A total of 1642 patients were evaluated; 684 patients were on anticoagulation and 958 patients were not. Patients on PA were compared with those who were not. Drug classes were divided into thromboxane A2 inhibitors, vitamin K factor-dependent inhibitors, antithrombin III activation, platelet P2Y12 inhibitors, and thrombin inhibitors...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28624037/trauma-care-in-a-multiethnic-population-effects-of-being-undocumented
#7
Jonathan M Wyrick, Brittany A Kalosza, George N Coritsidis, Raymond Tse, George Agriantonis
BACKGROUND: Epidemiologic studies have shown that undocumented immigrants (UIs) display characteristics of having a low socioeconomic status and are primarily of ethnic minorities. These social determinants of health are known to be associated with diminished health care access and poor clinical outcomes. We therefore investigated the impact of documentation status on the clinical outcomes of patients with traumatic injuries. MATERIALS AND METHODS: We conducted a retrospective review of the trauma registry at our safety net institution for all adult patients who were admitted from 2010 to 2014...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28624030/emergency-department-length-of-stay-in-critical-nonoperative-trauma
#8
Anaar Siletz, Kexin Jin, Marilyn Cohen, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
BACKGROUND: Prolonged emergency department (ED) stays correlate with negative outcomes in critically ill nontrauma patients. This study sought to determine the effect of ED length of stay (LOS) on trauma patients. MATERIALS AND METHODS: Two hundred forty-one trauma patients requiring direct intensive care unit (ICU) admission were identified. Patients requiring immediate operative intervention were excluded. Odds ratios (ORs) of outcomes for patients transferred to ICU in ≤90 min were compared with patients transferred in >90 min, adjusting for Injury Severity Score (ISS)...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28614442/skin-and-soft-tissue-infections-in-the-intensive-care-unit-a-retrospective-study-in-a-tertiary-care-center
#9
Luís Filipe Malheiro, Rita Magano, Alcina Ferreira, António Sarmento, Lurdes Santos
Objective: To identify factors that may influence outcomes in patients with severe skin and soft tissue infections in the intensive care unit. Methods: A retrospective observational study was conducted in a cohort of 1,123 critically ill patients admitted to an intensive care unit with a primary or secondary diagnosis of severe skin and soft tissues infection between January 2006 and December 2014. Results: Thirty patients were included, 20 (66...
June 12, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28610778/a-comparison-between-non-powder-gun-and-powder-gun-injuries-in-a-young-pediatric-population
#10
Jennifer J Freeman, Marielena Bachier-Rodriguez, Jessica Staszak, Alexander Feliz
INTRODUCTION: Non-powder guns (NPG) are viewed as toys for children by the general public. Literature on firearm injuries in the pediatric population is increasing, however there are still large gaps in the published literature regarding NPG. We intended to identify and compare the epidemiology, circumstances of injury and outcomes of children with NPG versus powder-gun injuries (GSW). PATIENTS AND METHODS: We performed a 6-year retrospective analysis of children 0-14 years old treated for NPG and GSW injuries at our level one pediatric trauma center...
May 29, 2017: Injury
https://www.readbyqxmd.com/read/28601311/the-prevalence-of-psychiatric-diagnoses-and-associated-mortality-in-hospitalized-us-trauma-patients
#11
Laura L Townsend, Micaela M Esquivel, Tarsicio Uribe-Leitz, Thomas G Weiser, Paul M Maggio, David A Spain, Lakshika Tennakoon, Kristan Staudenmayer
BACKGROUND: We hypothesized that psychiatric diagnoses would be common in hospitalized trauma patients in the United States and when present, would be associated with worse outcomes. MATERIALS AND METHODS: The Nationwide Inpatient Sample (NIS, 2012) was used to determine national estimates for the number of patients admitted with an injury. Psychiatric diagnoses were identified using diagnosis codes according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601210/tranexamic-acid-use-in-prehospital-uncontrolled-hemorrhage
#12
REVIEW
Benjamin R Huebner, Warren C Dorlac, Chris Cribari
The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-blinded, placebo-controlled study incorporating >20,000 patients, numerous limitations and weaknesses have been described. As a result, additional studies have followed, delineating the potential risks and benefits of TXA administration...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28600579/road-crashes-in-older-persons-and-the-use-of-comorbidity-polypharmacy-score-in-an-asian-population
#13
Mui Teng Chua, Keshav Bhandari, Victor Yk Ong, Win Sen Kuan
INTRODUCTION: Age-related physiological changes predispose older road users to higher mortality from traffic crashes. We aimed to describe the injury epidemiology of these patients, and explore the association between the comorbidity polypharmacy score (CPS) and outcomes. MATERIALS AND METHODS: This retrospective study utilised data from the Trauma Registry in the National University Hospital, Singapore, between January 2011 and December 2014. Patients involved in traffic crashes aged 45 years and above with injury severity scores (ISS) of 9 and higher were included...
May 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28598905/military-use-of-txa-in-combat-trauma-does-it-matter
#14
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...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28598904/deaths-and-high-risk-trauma-patients-missed-by-standard-trauma-data-sources
#15
Craig D Newgard, Rochelle Fu, E Brooke Lerner, Mohamud Daya, Dagan Wright, Jonathan Jui, N Clay Mann, Eileen Bulger, Jerris Hedges, Lynn Wittwer, David Lehrfeld, Thomas Rea
BACKGROUND: Trauma registries are used to evaluate and improve trauma care, yet potentially miss certain trauma deaths and high-risk patients. We estimated the number of missed deaths and high-risk trauma patients using commonly-available sources of trauma data, and bias in quality metrics for field trauma triage. METHODS: This was a pre-planned secondary analysis of a population-based prospective cohort of injured patients transported by 44 EMS agencies to 28 hospitals in 7 Northwest counties from 1/1/2011 to 12/31/2011 and followed through hospitalization...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#16
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28584040/perinatal-and-maternal-morbidity-and-mortality-after-attempted-operative-vaginal-delivery-at-midpelvic-station
#17
Giulia M Muraca, Yasser Sabr, Sarka Lisonkova, Amanda Skoll, Rollin Brant, Geoffrey W Cundiff, K S Joseph
BACKGROUND: Increased use of operative vaginal delivery (i.e., forceps or vacuum application), of which 20% occurs at midpelvic station, has been advocated to reduce the rate of cesarean delivery. We aimed to quantify severe perinatal and maternal morbidity and mortality associated with attempted midpelvic operative vaginal delivery. METHODS: We studied all term singleton deliveries in Canada between 2003 and 2013, by attempted midpelvic operative vaginal or cesarean delivery with labour (with and without prolonged second stage)...
June 5, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28583456/outcomes-following-exploratory-burr-holes-for-traumatic-brain-injury-in-a-resource-poor-setting
#18
Jessica Eaton, Asma Bilal Hanif, Gift Mulima, Chifundo Kajombo, Anthony Charles
BACKGROUND: TBI is a leading cause of death and disability worldwide. The incidence of TBI in LMICs is disproportionately high, with an associated increased risk of mortality from TBI relative to high-income countries. While CT is the diagnostic method of choice, this is often unavailable in LMICs. Exploratory burr holes may provide a suitable choice for diagnosis and treatment of TBI. METHODS: We performed a retrospective review of prospectively collected data at KCH, a tertiary care center in Lilongwe, Malawi...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28580386/hospitalizations-for-osteoporosis-related-fractures-economic-costs-and-clinical-outcomes
#19
Derek Weycker, Xiaoyan Li, Rich Barron, Rebecca Bornheimer, David Chandler
BACKGROUND: Osteoporotic fractures frequently require inpatient care, and are associated with elevated risks of morbidity, mortality, and re-hospitalization. A comprehensive evaluation of healthcare costs, resource utilization, and outcomes associated with osteoporosis (OP)-related fractures treated in US hospitals was undertaken. METHODS: A retrospective analysis using the Premier Perspective Database (2010 - 2013) was conducted. Study population comprised patients aged ≥ 50 years hospitalized with a principal diagnosis of a closed or pathologic fracture commonly associated with OP; the first qualifying hospitalization was designated the "index admission"...
December 2016: Bone Reports
https://www.readbyqxmd.com/read/28557846/adolescent-motor-vehicle-crash-prevention-through-a-trauma-centered-based-intervention-program
#20
Cathline Layba, Lance Griffin, Daniel Jupiter, Charles Mathers, William Mileski
Traumatic injuries account for millions of emergency room visits and hospital admissions annually. Motor vehicle crashes (MVC) remain a leading cause of mortality between the ages of one to 44. With the popularity of smart devices, drivers are ever more distracted on the road. Programs that educate drivers on safe actions and to raise awareness of the perils of drunk and distracted driving exist, but there is little data that demonstrates a reduction in motor vehicle injury rates. We sought to determine if the implementation of such a program in our community would impact the rates of MVCs...
May 25, 2017: Journal of Trauma and Acute Care Surgery
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