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Trauma population mortality

Ashley Gionfriddo, Mika L Nonoyama, Peter C Laussen, Peter N Cox, Megan Clarke, Alejandro A Floh
OBJECTIVES: To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. DESIGN: Retrospective cohort study...
March 15, 2018: Pediatric Critical Care Medicine
Konstantinos S Mylonas, Diamantis I Tsilimigras, Pavlos Texakalidis, Pouya Hemmati, Dimitrios Schizas, Konstantinos P Economopoulos
Literature discussing cardiac injuries in children is limited. Systematic search of PubMed identified 21 studies enrolling 1,062 pediatric patients who experienced cardiac trauma in the United States during the period 1961 to 2012. The predominant type of injury was blunt cardiac contusion affecting 59.7% (n = 634/1,062) of the study population. Motor vehicle crashes (53.5%, n = 391/731) were the leading cause of blunt cardiac trauma, while gunshot wounds (50%, n = 150/300) accounted for most penetrating injuries...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Nitin Agarwal, Georgios A Zenonos, Prateek Agarwal, Frank J Walch, Eileen Roach, Sandra J Stokes, Robert M Friedlander, Peter C Gerszten
BACKGROUND: Pharmacological prophylaxis for venous thromboembolism (VTE) in the neurosurgical population is still a matter of debate, as the risk-to-benefit ratio is not well defined. OBJECTIVE: To further evaluate the risk-to-benefit ratio of VTE prophylaxis (VTEP) for all neurosurgical procedures. METHODS: A prospective evaluation was performed after the initiation of a VTEP protocol for 11 436 patients undergoing neurosurgical procedures over 24 mo...
March 9, 2018: Neurosurgery
Mathieu Boutonnet, Paer Abback, Frédéric Le Saché, Anatole Harrois, Arnaud Follin, Nicolas Imbert, Andrew P Cap, Julie Trichereau, Sylvain Ausset
BACKGROUND: Tranexamic acid (TXA) use in severe trauma remains controversial notably because of concerns of the applicability of the CRASH-2 study findings in mature trauma systems. The aim of our study was to evaluate the outcomes of TXA administration in severely injured trauma patients managed in a mature trauma care system. METHODS: We performed a retrospective study of data prospectively collected in the TraumaBase registry (a regional registry collecting the prehospital and hospital data of trauma patients admitted in 6 Level One Trauma Centers in Paris Area, France)...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Shaylan K Govind, Neil H Merritt
BACKGROUND: The objective of our study was to identify the most common mechanisms of injury leading to death in our pediatric population. METHODS: A retrospective cohort of fatally injured children 0-17 years old treated at our trauma center during 2000-2015. RESULTS: The mortality rate in our population was 8% (n = 103). Fifty-five percent were male. The majority (76%) of fatal injuries were blunt. Overall, motor vehicle collisions (MVCs) were the most common mechanism of injury (61%), followed by assault/abuse (9%)...
March 6, 2018: American Journal of Surgery
Anthony Kopatsis, Christine Wagner, Helen Costello, Nicholas Morin, Katherine Elizabeth Kopatsis, Mario Gomez
We sought to determine patterns of injury in our Latino trauma community targeting alcohol (EtOH) intoxication as an influential variable. With the information gained in our culturally specific and culturally sensitive trauma community, we can use the information to fine-tune our trauma preventive medicine programs. Trauma injuries are the third largest contributor to racial disparities in the United States. Alcohol is involved in approximately half of all trauma admissions to trauma centers around the country...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Sharon Wacht, Kristin Salottolo, Amy Atnip, Michelle Hooks, Mary Bailie, Matthew Carrick
Head strikes can be fatal for patients taking blood thinners (anticoagulants or antiplatelets). Our trauma center instituted the "head strike protocol" to provide uniform and expedited care for adult trauma patients taking preinjury anticoagulants and antiplatelet medications with suspected head injury. The purpose of this article is to describe the development and implementation of the head strike protocol and compare time metrics and outcomes before and after implementing the protocol. Per the head strike protocol, patients with suspected traumatic intracranial hemorrhage (tICH) were screened for anticoagulants or antiplatelet medications by emergency medical service personnel/at first contact, activated as a Level II trauma and received a computed tomographic scan of the head within 30 min of arrival, and started reversal of blood products within 30 min of tICH confirmation...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
P T Maclure, S Gluck, A Pearce, M E Finnis
This study was performed to estimate the effect of the retrieval process on mortality for patients admitted to a mixed adult intensive care unit (ICU) compared with propensity-matched, non-retrieved controls. Patients retrieved to the Royal Adelaide Hospital (RAH) ICU between 2011 and 2015 were propensity-score matched for age, gender, Aboriginal and Torres Strait Islander status, Acute Physiology and Chronic Health Evaluation (APACHE) III score and diagnostic group with non-retrieved ICU patients to estimate the average treatment effect of retrieval on hospital mortality...
March 2018: Anaesthesia and Intensive Care
Julia E Napier, Michael S Lund, Douglas L Armstrong, Denise McAloose
The Amur leopard ( Panthera pardus orientalis) is one of the most critically endangered leopards on the International Union for the Conservation of Nature red list. The primary objective of this retrospective study was to identify common and significant causes of morbidity and mortality in the North American Amur leopard zoo population. This information provides insights that contribute to their improved care, health, and medical management and, ultimately, affects the sustainability of this leopard subspecies in the wild...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma (CRTT) is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries are the most common mechanisms of trauma to the chest. Imaging plays a key role in the battlefield management of CRTT casualties. This work discusses the imaging manifestations of thoracic injuries from blunt trauma and blast injury, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries were the most common mechanisms of trauma. Imaging plays a key role in the management of combat-related thoracic trauma casualties. This review discusses the imaging manifestations of thoracic injuries from penetrating trauma, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
Stephen C Gale, JoAnn Peters, Jason S Murry, Jessica S Crystal, Viktor Y Dombrovskiy
Background: Late middle age (LMA), is a watershed between youth and old age, with unique physical and social changes and declines in vitality, but a desire to remain active despite increasing comorbidity. While post-injury outcomes in the elderly are well studied, little is known regarding LMA patients. We analyzed the injured LMA population admitted to a rural, regional Level 1 Trauma Center relative to outcomes for both younger and older patients. Materials and methods: Our registry was queried retrospectively for patients admitted 7/2008- 12/2015; they were divided into three cohorts: 18-54, 55-65, and >65 years...
March 2018: Annals of Medicine and Surgery
Craig S McConnel, Ashleigh A McNeil, Joleen C Hadrich, Jason E Lombard, Jane Heller, Franklyn B Garry
Background: There is an increasing push for dairy production to be scientifically grounded and ethically responsible in the oversight of animal health and well-being. Addressing underlying challenges affecting the quality and length of productive life necessitates novel assessment and accountability metrics. Human medical epidemiologists developed the Disability-Adjusted Life Year metric as a summary measure of health addressing the complementary nature of disease and death. The goal of this project was to develop and implement a dairy Disease-Adjusted Lactation (DALact) summary measure of health, as a comparison against cumulative disease frequency...
2018: Irish Veterinary Journal
Krista L Haines, Tiffany Zens, Megan Beems, Ryan Rauh, Hee Soo Jung, Suresh Agarwal
BACKGROUND: Health-care disparities based on socioeconomic status have been well documented in the trauma literature; however, there is a paucity of data on how these factors affect outcomes in patients experiencing severe thoracic trauma. This study aims to identify the effect of insurance status and race on patient mortality and disposition after thoracic trauma. METHODS: The National Trauma Data Bank was queried from 2007 to 2012 for patients with sternal fractures, rib fractures, and flailed chest...
April 2018: Journal of Surgical Research
Navpreet K Dhillon, Joshua Tseng, Galinos Barmparas, Megan Y Harada, Ara Ko, Eric J T Smith, Gretchen M Thomsen, Eric J Ley
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in the United States, especially in the elderly, who have the highest rates of TBI-related hospitalizations and deaths among all age groups. Sepsis is one of many risk factors that is associated with higher mortality and longer length of hospital stay in this population partially due to the immunosuppressive effects of TBI. The significance of early indicators of infection, such as a positive blood, sputum, or urine culture, is not well described...
April 2018: Journal of Surgical Research
Chien-En Tang, Hang-Tsung Liu, Pao-Jen Kuo, Yi-Chun Chen, Shiun-Yuan Hsu, Chih-Che Lin, Ching-Hua Hsieh
The Osteoporosis Self-assessment Tool for Asians (OSTA) is a validated index based on age and weight to predict the risk of osteoporosis in women. This cross-sectional study was designed to evaluate the impact of sexual dimorphism on the trauma patterns and the clinical outcomes of patients with high-risk OSTA scores. Trauma data of patients with high-risk OSTA scores between 1 January 2009 and 31 December 2015 were retrieved from the trauma registry system of a level I trauma center. A total of 2248 patients including 1585 women and 663 men were included in this study...
February 27, 2018: International Journal of Environmental Research and Public Health
Sean Shaohua Chen, Nichole Bosson, Marianne Gausche-Hill, Deidre D Gorospe, Richard E Tadeo
OBJECTIVE: Explore trends in trauma incidence and mortality rates in Los Angeles County. DESIGN: Data for patients treated at Los Angeles County trauma centers from 2000 to 2011 were analyzed for this study. Age-adjusted incidence and mortality rates were calculated by gender, race, injury type, injury severity, and mechanism of injury. Trends were assessed using linear regression to determine the annual percentage change (APC). RESULTS: There were 223 773 patients included...
February 28, 2018: Journal of Public Health Management and Practice: JPHMP
Anna Clebone
PURPOSE OF REVIEW: Trauma is the most common cause of pediatric mortality. Much of the research that led to life-saving interventions in adults, however, has not been replicated in the pediatric population. Children have important physiologic and anatomic differences from adults, which impact hemostasis and transfusion. Hemorrhage is a leading cause of death in trauma, and children have important differences in their coagulation profiles. Transfusion strategies, including the massive transfusion protocol and use of antifibrinolytics, are still controversial...
April 2018: Current Opinion in Anaesthesiology
Stephanie A Mason, Avery B Nathens, James P Byrne, Christina Diong, Robert A Fowler, Paul J Karanicolas, Rahim Moineddin, Marc G Jeschke
OBJECTIVE: To estimate long-term mortality following major burn injury compared with matched controls. SUMMARY BACKGROUND DATA: The effect of sustaining a major burn injury on long-term life expectancy is poorly understood. METHODS: Using health administrative data, all adults who survived to discharge after major burn injury between 2003 and 2013 were matched to between 1 and 5 uninjured controls on age, sex, and the extent of both physical and psychological comorbidity...
February 27, 2018: Annals of Surgery
Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis K Exadaktylos, Frank Neff
OBJECTIVE: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population...
2018: PloS One
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