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Trauma mortality

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https://www.readbyqxmd.com/read/28343030/diagnostic-and-therapeutic-role-of-endoscopic-retrograde-pancreatography-in-the-management-of-traumatic-pancreatic-duct-injury-patients-single-center-experience-for-34-years
#1
Seongyup Kim, Jae Woo Kim, Pil Young Jung, Hye Youn Kwon, Hongjin Shim, Ji Young Jang, Keum Seok Bae
BACKGROUND: Traumatic pancreatic injuries are rare and present diagnostic and therapeutic difficulties. We evaluated the usefulness of endoscopic retrograde pancreatography and transpapillary pancreatic stent in the diagnosis and treatment of pancreatic trauma patients. METHODS: We reviewed medical records of 83 pancreas trauma patients who underwent endoscopic retrograde pancreatography for the suspicion of pancreas duct injury between January 1983 and December 2016...
March 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28343028/epidemiology-of-penetrating-injuries-in-the-united-kingdom-a-systematic-review
#2
REVIEW
G Whittaker, J Norton, J Densley, D Bew
INTRODUCTION: Penetrating injuries account for a significant number of deaths in the United Kingdom (UK) annually. Numerous articles have examined the epidemiology of penetrating trauma in various areas of the UK. This article aimed to systematically review the current literature and evaluate the incidence and mortality of penetrating injury according to region in the UK. METHODS: A systematic literature search was performed using MEDLINE(®) (1946 to June 2016), EMBASE(®) (1974 to June 2016), and PsycINFO(®) (1806 to June 2016) databases...
March 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28342925/epidemiology-and-characteristics-of-neurosurgical-conditions-at-mbarara-regional-referral-hospital
#3
Jihad Abdelgadir, Emily R Smith, Maria Punchak, Joao Ricardo Vissoci, Catherine Staton, Alex Muhindo, David Kitya, Lawrence P Park, Michael M Haglund
BACKGROUND: The unmet surgical need, specifically neurosurgical need, in Uganda is significant, yet only two public hospitals currently perform neurosurgery in the country. This study examines the epidemiology and outcomes of neurosurgical conditions presenting to one of 12 regional referral hospitals in Uganda, in an effort to understand the neurosurgical needs of this population. METHODS: The study was conducted at Mbarara Regional Referral Hospital (MRRH), in southwestern Uganda...
March 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#4
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339159/differences-in-survival-outcome-for-severely-injured-paediatric-trauma-by-type-of-trauma-centre
#5
Rebecca J Mitchell, Kate Curtis, Luke Testa, Andrew Ja Holland, Soundappan Sv Soundappan, Sarah Adams
AIM: Whether treatment at paediatric trauma centres (PTCs) provides a survival advantage for injured children over treatment at adult trauma centres (ATCs) remains inconclusive. This study examines the association between trauma centre type and in-hospital mortality for severely injured paediatric trauma patients in New South Wales, Australia. METHODS: A retrospective examination of paediatric patient characteristics (aged ≤15 years), treatment and injury outcome was conducted using data from the New South Wales Trauma Registry for 2009-2014...
March 24, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28338600/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-a-aast-multi-institutional-study
#6
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk for severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational multi-center study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (SBP<90 or HR>120 and base deficit > 5, and the ability to review pelvic imaging...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338598/characterization-of-distinct-coagulopathic-phenotypes-in-injury-pathway-specific-drivers-and-implications-for-individualized-treatment
#7
S Ariane Christie, Lucy Z Kornblith, Benjamin M Howard, Amanda S Conroy, Ryan C Kunitake, Mary F Nelson, Carolyn M Hendrickson, Carolyn S Calfee, Rachael A Callcut, Mitchell Jay Cohen
BACKGROUND: International normalized ratio (INR) and partial thromboplastin time (PTT) are used interchangeably to diagnose acute traumatic coagulopathy (ATC) but reflect disparate activation pathways. In this study we identified injury/patient characteristics and coagulation factors that drive contact pathway, tissue factor pathway (TF), and common pathway dysfunction by examining injured patients with discordant coagulopathies. We hypothesized that patients with INR/PTT discordance reflect differing phenotypes representing contact vs...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338595/3-0-nacl-adenosine-lidocaine-mg-2-alm-bolus-and-4-hours-drip-infusion-reduces-non-compressible-hemorrhage-by-60-in-a-rat-model
#8
Hayley L Letson, Geoffrey P Dobson
BACKGROUND: Noncompressible torso hemorrhage is the leading cause of potentially survivable trauma in far-forward combat environments. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg (ALM) bolus and 0.9% NaCl/ALM 'drip' on survivability and cardiac/gut/kidney function in a rat model of hepatic hemorrhage and shock. METHODS: Male Sprague-Dawley rats (428±4 g) were anesthetized and randomly assigned to one of five groups (n=16): 1) Sham, 2) No Treatment, 3) Saline controls, 4) ALM therapy and 5) Hextend®...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338552/is-the-future-of-coronary-arterial-revascularization-a-hybrid-approach-the-canadian-experience-across-three-centers
#9
Vincenzo Giambruno, Ahmad Hafiz, Stephanie A Fox, Hugues Jeanmart, Richard C Cook, Feras H Khaliel, Patrick Teefy, Kumar Sridhar, Shahar Lavi, Rodrigo Bagur, Varinder K Randhawa, Ivan Iglesias, Philip M Jones, Christopher C Harle, Daniel Bainbridge, Michael W A Chu, Bob B Kiaii
OBJECTIVE: Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. METHODS: From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28337922/acquired-pulmonary-artery-pseudoaneurysms-a-pictorial-review
#10
Benedicte Guillaume, Anne Vendrell, Xavier Stefanovic, Frederic Thony, Gilbert R Ferretti
Pulmonary artery pseudoaneurysms (PAPs) are uncommon but potentially lethal. They may be incidentally discovered on imaging, or following massive hemoptysis if they rupture, with high risk of mortality. The most frequent causes of PAP are trauma and infectious disease. Vasculitis, in particular Behçet's disease, neoplasm, congenital disease and pulmonary hypertension are rarer causes of PAP. A PAP can be suspected from chest X-Ray and contrast CT, but requires confirmation by CT angiography. Arteriography is no longer performed for diagnostic purposes, but can be useful to prepare endovascular occlusion of the PAP...
March 24, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28336445/mortality-associated-characteristics-of-traumatic-brain-injury-patients-at-the-university-teaching-hospital-of-kigali-rwanda
#11
Elizabeth Krebs, Charles J Gerardo, Lawrence P Park, Joao Ricardo Nickenig Vissoci, Jean Claude Byiringiro, Fidele Byiringiro, Stephen Rulisa, Nathan Thielman, Catherine Staton
OBJECTIVE: Traumatic Brain Injury (TBI) is a leading cause of death and disability. TBI patients in low and middle- income countries have worse outcomes than those in high-income countries. We aimed to evaluate important clinical indicators associated with mortality for TBI patients at the University Teaching Hospital of Kigali (UTHK) Kigali, Rwanda. METHODS: Prospective consecutive sampling of TBI patients presenting to UTHK Accident and Emergency Department were screened for inclusion criteria: reported head trauma, alteration in consciousness, headache, or visible head trauma...
March 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28336419/scarf-related-injuries-at-a-major-trauma-center-in-northern-india
#12
Pritish Singh, Ashok Kumar, Vishal Shekhawat
PURPOSE: Scarf is a long loose piece of cloth worn around the neck and shoulder. Despite cultural association of this apparel, it is part of numerous injury episodes of varying enormity. Entanglement of loose scarf in spoke wheels of bike, tricycle, belt driven machines like sugarcane juice machine, thresher, grinding machines, etc is observed both in social and industrial milieu. This study aims to investigate the scarf-related injuries at a major trauma center in northern India. METHODS: From June 2013 to May 2015, a hospital-based prospective observational study was done in patients who presented to a level 1 trauma center in northern India with the mode of injury involving scarf around the neck...
March 9, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28336026/viscoelastic-studies-effective-tools-for-trauma-and-surgical-resuscitation-efforts
#13
Dagoberto Salinas
Trauma-induced coagulopathy (TIC) is an abrupt disruption of all hemostatic components of coagulation resulting from severe tissue injury and hypoperfusion. The effective management of TIC has remained elusive to clinicians using traditional laboratory methods, challenging efforts to improve outcomes related to uncontrolled bleeding. Recent initiatives have aimed to reduce TIC-associated morbidity and mortality, further invoking trauma experts to explore innovative modalities in the field of viscoelastic studies, such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM)...
April 2017: AORN Journal
https://www.readbyqxmd.com/read/28335673/modifiable-risk-factors-for-delirium-in-critically-ill-trauma-patients
#14
Marc-Alexandre Duceppe, David R Williamson, Audrée Elliott, Mélissa Para, Marie-Christine Poirier, Marie-Soleil Delisle, Dan Deckelbaum, Tarek Razek, Monique Desjardins, Jean-Claude Bertrand, Francis Bernard, Philippe Rico, Lisa Burry, Anne Julie Frenette, Marc Perreault
OBJECTIVE: Intensive care unit (ICU)-acquired delirium has been associated with increased morbidity and mortality. Prevention strategies including modification of delirium risk factors are emphasized by practice guidelines. No study has specifically evaluated modifiable delirium risk factors in trauma ICU patients. Our goal was to evaluate modifiable risk factors for delirium among trauma patients admitted to the ICU. DESIGN: Prospective observational study. SETTING: Two level 1 trauma ICU centers...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28332220/perspectives-on-risk-assessment-of-risk-profiles-and-outcomes-among-women-planning-community-birth-in-the-united-states
#15
Marit L Bovbjerg, Melissa Cheyney, Jennifer Brown, Kim J Cox, Lawrence Leeman
BACKGROUND: There is little agreement on who is a good candidate for community (home or birth center) birth in the United States. METHODS: Data on n=47 394 midwife-attended, planned community births come from the Midwives Alliance of North America Statistics Project. Logistic regression quantified the independent contribution of 10 risk factors to maternal and neonatal outcomes. Risk factors included: primiparity, advanced maternal age, obesity, gestational diabetes, preeclampsia, postterm pregnancy, twins, breech presentation, history of cesarean and vaginal birth, and history of cesarean without history of vaginal birth...
March 22, 2017: Birth
https://www.readbyqxmd.com/read/28331951/failure-to-rescue-the-elderly-a-superior-quality-metric-for-trauma-centers
#16
G Barmparas, E J Ley, M J Martin, A Ko, M Harada, D Weigmann, K R Catchpole, B L Gewertz
BACKGROUND: Trauma centers require reliable metrics to better compare the quality of care delivered. We compared mortality after a reported complication, termed failure to rescue (FTR), and FTR in the elderly (age >65 years) (FTRE) to determine which is a superior metric to assess quality of care delivered by trauma centers. METHODS: This was a retrospective review of the National Trauma Databank (NTDB) research data sets 2010 and 2011. Patients ≥16 years admitted to centers reporting ≥80% of AIS and/or ≥ 20% of comorbidities with > 200 subjects in the NTDB were selected...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28331300/dementia-and-delirium-the-outcomes-in-elderly-hip-fracture-patients
#17
Christina A Mosk, Marnix Mus, Jos Pam Vroemen, Tjeerd van der Ploeg, Dagmar I Vos, Leon Hgj Elmans, Lijckle van der Laan
BACKGROUND: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium. METHODS: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28328728/crew-resource-management-in-the-trauma-room-a-prospective-3-year-cohort-study
#18
Marck H T M Haerkens, Matthijs Kox, Pieter M Noe, Johannes G Van Der Hoeven, Peter Pickkers
OBJECTIVE: Human factors account for the majority of adverse events. Human factors awareness training entitled Crew Resource Management (CRM) is associated with improved safety and reduced complications and mortality in critically ill patients. We determined the effects of CRM implementation in the trauma room of an Emergency Department (ED). PATIENTS AND METHODS: A prospective 3-year cohort study was carried out in a level 1 ED, admitting more than 12 000 patients annually (>1500 trauma related)...
March 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28328674/the-value-of-the-injury-severity-score-in-pediatric-trauma-time-for-a-new-definition-of-severe-injury
#19
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS>15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and AIS to predict mortality and define optimal thresholds of severe injury in pediatric trauma. METHODS: Patients from the Pennsylvania trauma registry 2000-2013 were included...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328672/pediatric-trauma-under-triage-in-ohio
#20
Juan P Gurria, Lynn Haas, Md Monir Hossain, Mohammad Alfrad Nobel Bhuiyan, Misty Troutt, Suzanne Moody, Richard A Falcone
BACKGROUND: Appropriate and timely triage is an essential component of a trauma system. In the state of Ohio there are 6 verified pediatric trauma centers (PTC) across 8 state regions. The purpose of this study was to better understand the pediatric under-triage rates in the state. METHODS: We utilized the Ohio Trauma Registry from 2007 - 2012, consisting of 14,045 records of children < 16 years admitted to a hospital for greater than 48 hours or who sustained a traumatic death...
March 20, 2017: Journal of Trauma and Acute Care Surgery
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