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Trauma mortality

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https://www.readbyqxmd.com/read/29915778/pediatric-trauma-care-in-low-resource-settings-challenges-opportunities-and-solutions
#1
REVIEW
Andrew W Kiragu, Stephen J Dunlop, Njoki Mwarumba, Sanusi Gidado, Adesope Adesina, Michael Mwachiro, Daniel A Gbadero, Tina M Slusher
Trauma constitutes a significant cause of death and disability globally. The vast majority -about 95%, of the 5.8 million deaths each year, occur in low-and-middle-income countries (LMICs) 3-6. This includes almost 1 million children. The resource-adapted introduction of trauma care protocols, regionalized care and the growth specialized centers for trauma care within each LMIC are key to improved outcomes and the lowering of trauma-related morbidity and mortality globally. Resource limitations in LMICs make it necessary to develop injury prevention strategies and optimize the use of locally available resources when injury prevention measures fail...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29914833/favorable-impact-of-thoracic-endovascular-aortic-repair-on-survival-of-patients-with-acute-uncomplicated-type-b-aortic-dissection
#2
James C Iannuzzi, Sahael M Stapleton, Yanik J Bababekov, David Chang, Robert T Lancaster, Mark F Conrad, Richard P Cambria, Virendra I Patel
BACKGROUND: In uncomplicated type B aortic dissection (UTBAD), the "gold standard" has been nonoperative treatment with medical therapy, although this has been questioned by studies demonstrating improved outcomes in those treated with thoracic endovascular aortic repair (TEVAR). This study assessed long-term survival after acute UTBAD comparing medical therapy, open repair, and TEVAR. METHODS: The California Office of Statewide Hospital Planning Development database was analyzed from 2000 to 2010 for adult patients with acute UTBAD...
June 15, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29914530/early-fibrinogen-concentrate-therapy-for-major-haemorrhage-in-trauma-e-fit-1-results-from-a-uk-multi-centre-randomised-double-blind-placebo-controlled-pilot-trial
#3
Nicola Curry, Claire Foley, Henna Wong, Ana Mora, Elinor Curnow, Agne Zarankaite, Renate Hodge, Valerie Hopkins, Alison Deary, James Ray, Phil Moss, Matthew J Reed, Suzanne Kellett, Ross Davenport, Simon Stanworth
BACKGROUND: There is increasing interest in the timely administration of concentrated sources of fibrinogen to patients with major traumatic bleeding. Following evaluation of early cryoprecipitate in the CRYOSTAT 1 trial, we explored the use of fibrinogen concentrate, which may have advantages of more rapid administration in acute haemorrhage. The aims of this pragmatic study were to assess the feasibility of fibrinogen concentrate administration within 45 minutes of hospital admission and to quantify efficacy in maintaining fibrinogen levels ≥ 2 g/L during active haemorrhage...
June 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29914487/blunt-liver-trauma-a-descriptive-analysis-from-a-level-i-trauma-center
#4
Ibrahim Afifi, Sheraz Abayazeed, Ayman El-Menyar, Husham Abdelrahman, Ruben Peralta, Hassan Al-Thani
BACKGROUND: We aimed to review liver injury experience in a level 1 trauma center; namely clinical presentation, grading, management approach and clinical outcomes. METHODS: It is a retrospective analysis to include all blunt liver injury patients who were admitted at the Level 1 trauma center over a 3-year period. Data were compared and analyzed based on the liver injury grades and management approaches. RESULTS: Blunt liver injury accounted for 38% of the total blunt abdominal trauma cases with a mean age of 31 ± 13 years...
June 19, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29909925/the-pelvic-fracture-indicator-of-injury-severity-or-lethal-fracture
#5
Jonas Holtenius, Peyman Bakhshayesh, Anders Enocson
BACKGROUND: Presence of pelvic fractures in trauma patients has previously been related to high mortality. However, there are controversies on whether pelvic fractures are the underlying cause of death or if it is rather an indicator of injury severity. We aimed to assess whether the presence of pelvic fracture increased mortality among a cohort of trauma patients or if it was simply an indicator of severe injury. MATERIAL AND METHODS: Karolinska University Hospital is the largest trauma centre in Sweden...
June 12, 2018: Injury
https://www.readbyqxmd.com/read/29909749/a-comparison-of-maternal-and-neonatal-outcomes-with-forceps-delivery-versus-cesarean-delivery
#6
Xiaohua Liu, Mark B Landon, Weiwei Cheng, Yan Chen
OBJECTIVE: To compare maternal and neonatal outcomes by forceps vaginal delivery versus cesarean delivery during the second stage of labor. METHODS: We conducted a retrospective cohort study in a large tertiary maternity center in Shanghai, China through 2007-2016. A total of 7046 women carrying a singleton term nonanomalous fetus with vertex presentation who underwent forceps vaginal delivery, or cesarean delivery from a low station in the second stage of labor were included...
June 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29909669/mind-the-gap-11-years-of-train-related-injuries-at-the-royal-london-hospital-major-trauma-centre
#7
J Virdee, G Pafitanis, R Alamouti, K Brohi, H Patel
Introduction This study presents an extensive retrospective database of patients with polytrauma following train-related injuries and highlights the key lessons learnt in this rare clinical presentation. Materials and methods We retrospectively collected data from 127 patients who presented to Royal London Hospital after sustaining train related trauma. We analysed demographics, accident report data, aetiologies and clinical management interventions. All data were screened and injuries were mapped to various anatomical regions...
June 18, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29908849/cephalic-region-war-injuries-in-children-experience-in-french-nato-hospital-in-kabul-afghanistan
#8
Hussam El Chehab, Emilie Agard, Corinne Dot
BACKGROUNDS: The NATO KAIA Hospital (Kabul International Airport), under French command, provided medical support for NATO forces in the Kabul region from 2009 to 2014. Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma. METHODS: A retrospective study was conducted and commenced with the hospital opening (July 2009) to March 2012 on all children (<15years) with war trauma...
June 9, 2018: Injury
https://www.readbyqxmd.com/read/29907231/socioeconomics-affecting-quality-outcomes-in-asian-trauma-patients-within-the-united-states
#9
Krista L Haines, Suresh Agarwal, Hee Soo Jung
INTRODUCTION: Asian-Americans and Pacific Islanders are often considered as a uniform group when examining race in health outcomes. However, the generally favorable economic outcomes in this group belie significant socioeconomic variance between its heterogeneous subgroups. This study evaluates the impact of socioeconomic status on the health outcomes of Asian trauma patients. METHODS: From 2012 to 2015, 52,704 Asians who presented to trauma centers were registered with the National Trauma Data Bank with known disposition...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907229/effects-of-medicaid-expansion-on-disparities-in-trauma-care-and-outcomes-in-young-adults
#10
Manzilat Akande, Peter C Minneci, Katherine J Deans, Henry Xiang, Deena J Chisolm, Jennifer N Cooper
BACKGROUND: Racial/ethnic and socioeconomic disparities in trauma care and outcomes among young adults are well documented. As the Patient Protection and Affordable Care Act Medicaid expansion has increased insurance coverage among young adults, we aimed to investigate its impact on disparities in insurance coverage and outcomes among hospitalized young adult trauma patients. MATERIALS AND METHODS: We used the healthcare cost and utilization project state inpatient databases to examine changes in insurance coverage and risk-adjusted outcomes from before (2012-2013) to after (2014) Medicaid expansion among young adults (age 19-44) hospitalized for injury across 11 Medicaid expansion states...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907210/nonoperative-management-of-penetrating-abdominal-solid-organ-injuries-in-children
#11
Reid Sakamoto, Kazuhide Matsushima, Amory de Roulet, Kristine Beetham, Aaron Strumwasser, Damon Clark, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Nonoperative management (NOM) of penetrating solid organ injuries (SOI) has not been well described in the pediatric population. The objective of this study was to characterize the epidemiology, injury patterns, and factors associated with trial and failure of NOM. METHODS: This is a retrospective cohort analysis of the National Trauma Data Bank for the period of 2007-2014. The study population included patients ≤18 y with penetrating injury to the liver, spleen, or kidney...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29906381/points-pearls-management-of-multiply-injured-pediatric-trauma-patients-in-the-emergency-department
#12
Andria Tatem, Rupa Kapoor, Bryan Wilson
Management of the child with multiple traumatic injuries can be challenging, and important injuries may not be readily recognized. Early recognition of serious injuries, initiation of appropriate diagnostic studies, and rapid stabilization of injuries are key to decreasing morbidity and mortality in the multiply injured pediatric trauma patient. The differential diagnosis for these patients is wide, and treatment is targeted to the specific injuries. In this issue, a systematic approach to the multiply injured pediatric patient will be reviewed, with specific attention to commonly missed injuries and those injuries that may cause significant morbidity or mortality...
June 1, 2018: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/29905916/epidemiological-trends-of-traumatic-brain-and-spinal-cord-injury-in-puerto-rico-from-november-10th-2006-through-may-24th-2011
#13
Ricardo H Brau, Yaritza Acevedo-Salas, Katya Giovannetti
OBJECTIVE: According to the Centers for Disease Control and Prevention (CDC), injury to the central nervous system (CNS) continues to be a leading cause of injury-related morbidity and mortality in the US today. METHODS: A prospective cohort study was performed to determine the incidence of all traumatic CNS injuries. Descriptive variables were presented as frequencies and percentages. Quantitative variables were expressed as means and averages (plus/minus standard deviation); bivariate cross-tabulation and multiple regression analyses were employed to identify risk factors and compare epidemiological patterns of injury related variables...
June 2018: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/29905897/patterns-of-injury-and-outcomes-in-the-elderly-patient-with-rib-fractures-a-multicenter-observational-study
#14
Mark G Van Vledder, Vicky Kwakernaak, Tjebbe Hagenaars, Esther M M Van Lieshout, Michiel H J Verhofstad
BACKGROUND: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures. METHODS: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region. Data regarding demographics, mechanism of injury, pulmonary and cardiovascular history, pattern of extra-thoracic and intrathoracic injuries, ICU admission, length of stay, and morbidity and mortality following admission were collected...
June 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29905625/use-of-the-sttgma-tool-to-risk-stratify-1-year-functional-outcomes-and-mortality-in-geriatric-trauma-patients
#15
Sanjit R Konda, Ariana Lott, Hesham Saleh, Jordan Gales, Kenneth A Egol
OBJECTIVES: Determine if a novel inpatient mortality risk assessment tool designed to be calculated in the emergency department (ED) setting can risk stratify patient reported functional outcomes and mortality at one year. DESIGN: Prospective cohort SETTING:: Academic level one trauma center PATIENTS:: 685 patients >55 years old who were orthopaedic surgery consults or trauma surgery consults in the ED between 10/1/2014 and 9/30/2015. INTERVENTION: Calculation of validated trauma triage score (STTGMA) using each patient's demographics, injury severity, and functional status MAIN OUTCOME MEASUREMENTS:: mortality, EQ-5D questionnaire, and percent return to baseline function since their hospitalization at one-year post hospitalization...
June 4, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29905549/recent-principles-of-antimicrobial-treatment-in-polytrauma-induced-sepsis-and-septic-shock-review
#16
B Kanashvili, Kh Saganelidze, L Ratiani
20% of trauma deaths occur late after the injury. It is usually the result of sepsis, multi-system organ failure, or other complications. In Polytrauma induced sepsis and septic shock patients, antibacterial management is crucial. The knowledge of recent aspects of treatment is decreasing the costs and the resistance of pathogens, morbidity and mortality. Different models of treatment are suggested by authors, basically they are depended on: the patients age, there health condition, the factors of immunodeficiency, at the location of infection and others...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29904601/incidence-and-risk-factors-for-complications-after-definitive-skeletal-fixation-of-lower-extremity-in-multiple-injury-patients-a-retrospective-chart-review
#17
Thananit Sangkomkamhang, Wilaiphorn Thinkhamrop, Bandit Thinkhamrop, Wongsa Laohasiriwong
Background : The management of multiple injuries is complex. Type and timing of treatment for lower extremity fractures is a controversial subject. Although many studies have demonstrated the safety and effectiveness of early treatment, others have suggested that early definitive stabilization may cause complications, especially with chest and head injuries. The aim of this study was to determine the complications and effects of timing of fixation, and investigate risk factors for complications in multiple injuries patients with lower extremity fractures...
2018: F1000Research
https://www.readbyqxmd.com/read/29903672/evaluation-of-tranexamic-acid-in-trauma-patients-a-retrospective-quantitative-analysis
#18
Michelle Ng, Jerrold Perrott, Sarah Burgess
INTRODUCTION: Tranexamic acid (TXA) has been shown to decrease mortality in adult trauma patients with or at significant risk of hemorrhage when administered within 3 h of injury. The use and appropriateness of TXA in adult trauma patients presenting to Royal Columbian Hospital (RCH) was investigated. METHODS: This retrospective chart review utilized the British Columbia Trauma Registry to identify 100 consecutive trauma patients that presented to the emergency department at RCH between April 2012 to June 2015 and met the following indications for TXA: systolic blood pressure <90 mm Hg and/or heart rate >110 bpm and presentation within 8 h of injury...
June 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29903600/revisiting-extracorporeal-membrane-oxygenation-for-ards-in-burns-a-case-series-and-review-of-the-literature
#19
Craig R Ainsworth, Jeffrey Dellavolpe, Kevin K Chung, Leopoldo C Cancio, Phillip Mason
INTRODUCTION: Recent reports on the use of extracorporeal membrane oxygenation (ECMO) in critically ill burn patients with Acute Respiratory Distress Syndrome (ARDS) recommended against the use of ECMO. The authors cited the high mortality rates associated with the use of ECMO in these patients with no appreciable benefit. Accumulating evidence from referral centers suggests improved survival in patients with ARDS receiving ECMO. We report our recent experience treating patients with severe ARDS with ECMO in a burn intensive care unit...
June 11, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29903577/increased-reduction-in-exsanguination-rates-leaves-brain-injury-as-the-only-major-cause-of-death-in-blunt-trauma
#20
D Jochems, L P H Leenen, F Hietbrink, R M Houwert, K J P van Wessem
INTRODUCTION: Central nervous system (CNS) related injuries and exsanguination have been the most common causes of death in trauma for decades. Despite improvements in haemorrhage control in recent years exsanguination is still a major cause of death. We conducted a prospective database study to investigate the current incidence of haemorrhage related mortality. MATERIALS AND METHODS: A prospective database study of all trauma patients admitted to an urban major trauma centre between January 2007 and December 2016 was conducted...
May 23, 2018: Injury
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