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"Trauma Centre" OR "Trauma Center"

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https://www.readbyqxmd.com/read/30342762/opioid-dependency-is-independently-associated-with-inferior-clinical-outcomes-after-trauma
#1
Walter Robert Hsiang, Catherine McGeoch, Sarah Lee, William Cheung, Robert Becher, Kimberly A Davis, Kevin Schuster
INTRODUCTION: Increased use of opioids has led to higher rates of overdose and hospital admissions. Studies in trauma populations have focused on outcomes associated with acute intoxications rather than addiction. We hypothesize that clinical outcomes after injury would be inferior for opioid-dependent patients compared to opioid-naïve patients. METHODS: We identified all opioid-dependent adult patients admitted to an academic level I trauma center in 2016 with an Injury Severity Score (ISS) ≥ 5...
October 15, 2018: Injury
https://www.readbyqxmd.com/read/30342249/epidemiological-investigation-and-successful-management-of-burkholderia-cepacia-outbreak-in-neuro-trauma-intensive-care-unit
#2
Neha Rastogi, Surbhi Khurana, Balaji Veeraraghavan, Francis Yesurajan Inbanathan, Suresh Kumar Rajamani Sekar, Deepak Gupta, Keshav Goel, Ashish Bindra, Navdeep Sokhal, Ashutosh Panda, Rajesh Malhotra, Purva Mathur
OBJECTIVE: This study describes a detailed epidemiological and molecular characterization of an outbreak of Burkholderia cepacia at a neuro-trauma intensive care unit of a level-1 trauma centre. It emphasizes stringent infection control interventions taken to successfully curb this outbreak. METHODS: Clinical and microbiological data was reviewed for the patients, who had more than one blood culture that grew B. cepacia. Bacterial identification and antimicrobial susceptibility was done using automated VITEK II systems...
October 17, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/30342182/prospective-analysis-of-pediatric-ocular-chemical-burns-laundry-detergent-pods
#3
Mark P Breazzano, H Russell Day, Sarah Tanaka, Uyen Tran
PURPOSE: To present data on chemical ocular burns in children seen at a single tertiary care facility resulting from accidental eye exposure to the contents of laundry detergent pods. METHODS: All emergent pediatric ophthalmology consultations specific for chemical ocular burns at a level I trauma center were included as part of a prospective quality improvement investigation over a 13-month period. Age, causative agent, and examination findings at presentation and final follow-up were recorded and analyzed...
October 17, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/30341469/psychological-prophylaxis-an-integrated-psychological-services-program-in-trauma-care
#4
Nina C Silander, David J Chesire, Kamela S Scott
The primary medical goals of acute care are restoration of physical health and return to physical function. However, in response to traumatic events and injuries, psychological factors are critical to one's overall recovery. Both pre-morbid psychiatric comorbidities and post-injury psychological compromise affect physical and psychological recovery in inpatient trauma populations. The Psychological Services Program (PSP), a model trauma/acute care program, addresses these critical factors in a Level 1 Trauma Center...
October 19, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/30341125/readmission-and-mortality-in-patients-treated-by-interprofessional-student-teams-at-a-training-ward-compared-with-patients-receiving-usual-care-a-retrospective-cohort-study
#5
Karin Hallin, Max Gordon, Olof Sköldenberg, Peter Henriksson, Anna Kiessling
OBJECTIVE: This study aimed to compare the rate of patient readmissions and mortality between care provided at an orthopaedic interprofessional training ward (IPTW) and usual care. DESIGN: Retrospective cohort study. SETTING: Orthopaedic wards at a level II trauma centre at a Swedish university teaching hospital between 2006 and 2011. PARTICIPANTS: Two cohorts were identified: (1) a control cohort that had not received care at the IPTW, and (2) patients who had been treated for at least 1 day at the IPTW...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30340991/optimal-ct-protocol-for-the-diagnosis-of-active-bleeding-in-abdominal-trauma-patients
#6
Se Jong Kim, Su Joa Ahn, Seung Joon Choi, Dae Hong Park, Hyung Sik Kim, Jeong Ho Kim
OBJECTIVES: The aim of this study is to compare the radiologic diagnostic performance of arterial phase, portal phase and combined phase computed tomography (CT) for traumatic abdominal injury. In addition, this study is attempted to decrease lifetime attributable risks (LARs) of cancer due to radiation exposure by using optimal CT protocol. MATERIALS AND METHODS: A total of 114 consecutive patients with a traumatic abdominal injury and an abdominal hematoma on CT were enrolled at a single tertiary regional trauma center between January 2016 and March 2017...
October 12, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30340313/significance-of-blood-transfusion-units-in-determining-the-probability-of-mortality-among-elderly-trauma-patients-based-on-the-geriatric-trauma-outcome-scoring-system-a-cross-sectional-analysis-based-on-trauma-registered-data
#7
Shao-Chun Wu, Cheng-Shyuan Rau, Pao-Jen Kuo, Hang-Tsung Liu, Shiun-Yuan Hsu, Ching-Hua Hsieh
Background : For elderly trauma patients, a prognostic tool called the Geriatric Trauma Outcome Score (GTOS), where GTOS = (age) + (ISS × 2.5) + (22 if any packed red blood cells (pRBCs) were transfused within 24 h after admission), was developed for predicting mortality. In such calculation, a score of 22 was added in the calculation of GTOS regardless of the transfused units of blood. This study aimed to assess the effect of transfused blood units on the mortality outcomes of the elderly trauma patients who received blood transfusion (BT)...
October 18, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/30336936/the-risk-of-delayed-intracranial-hemorrhage-with-direct-acting-oral-anticoagulants-after-trauma-a-two-center-study
#8
Galinos Barmparas, Leslie Kobayashi, Navpreet K Dhillon, Kavita A Patel, Eric J Ley, Raul Coimbra, Daniel R Margulies
BACKGROUND: The aim of this study was to characterize the risk of a delayed intracranial hemorrhage (ICH) in trauma patients on direct-acting oral anticoagulants (DOACs). METHODS: Patients on DOACs admitted to two Level I Trauma Centers between 2014 and 2017 were reviewed. Only patients with a negative admission CT brain were included. The primary outcome was a delayed ICH. RESULTS: Overall, 249 patients were included. The median age was 81 years with 82% undergoing a repeat CT...
October 14, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/30335690/pediatric-major-vascular-injuries-a-16-year-institutional-experience-from-a-combined-adult-and-pediatric-trauma-center
#9
Lindsey L Perea, Joshua P Hazelton, Nicole Fox, John P Gaughan, John Porter, Anna Goldenberg
OBJECTIVES: Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center. METHODS: A retrospective review (January 2000 to May 2016) was conducted of all pediatric (<18 years old) trauma patients who presented with a vascular injury...
October 17, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30335686/risk-factors-for-compartment-syndrome-in-pediatric-trauma-patients
#10
Jennifer A Sees, Gretchen J Cutler, Henry W Ortega
OBJECTIVE: This study aimed to identify risk factors for compartment syndrome (CS) in pediatric trauma populations. METHODS: We included patients younger than 19 years treated at trauma centers contributing to the National Trauma Data Bank between 2009 and 2012. Multivariable logistic regression was used to examine the association between risk factors and the development of CS. The final model adjusted for age, sex, race, number of comorbidities, Glascow Coma Scale, Injury Severity Score, mechanism of injury, and fracture of the lower limb...
October 17, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30334895/pediatric-lawn-mower-injuries-we-need-to-change-course-to-make-a-difference-commentary-on-an-article-by-amanda-nicole-fletcher-md-mscr-et-al-pediatric-lawn-mower-injuries-presenting-at-a-level-i-trauma-center-1995-to-2015-a-danger-to-our-youngest-children
#11
https://www.readbyqxmd.com/read/30334881/pediatric-lawn-mower-injuries-presenting-at-a-level-i-trauma-center-1995-to-2015-a-danger-to-our-youngest-children
#12
Amanda Nicole Fletcher, Richard M Schwend, Mitchell Solano, Christopher Wester, Dale E Jarka
BACKGROUND: Unintentional injuries are the leading cause of morbidity and mortality among children 0 to 18 years of age in the U.S. An estimated 9,400 to 17,000 pediatric lawn-mower injuries occur each year. The aims of this study were to better define the epidemiology of lawn-mower injuries and to identify predictors of severe lawn-mower injuries to optimize public education and injury prevention. METHODS: All patients 0 to 18 years of age who presented to Children's Mercy Hospital (CMH), Kansas City, Missouri, during the period of 1995 to 2015 after sustaining a lawn-mower injury were identified using International Classification of Diseases, 9th Revision (ICD-9) codes...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/30334232/inpatient-complications-predict-tracheostomy-better-than-admission-variables-after-traumatic-brain-injury
#13
Ryne Jenkins, Nicholas A Morris, Bryce Haac, Richard Van Besien, Deborah M Stein, Wan-Tsu Chang, Gary Schwartzbauer, Gunjan Parikh, Neeraj Badjatia
BACKGROUND: Data regarding who will require tracheostomy are lacking which may limit investigations into therapeutic effects of early tracheostomy. METHODS: We performed an observational study of adult traumatic brain injury (TBI) patients requiring intensive care unit (ICU) admission for ≥ 72 h and mechanical ventilation for ≥ 24 h between January 2014 and December 2014 at a level 1 trauma center. Patients who had life-sustaining measures withdrawn were excluded...
October 17, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/30334071/the-role-of-coagulopathy-on-clinical-outcome-following-traumatic-brain-injury-in-children-analysis-of-66-consecutive-cases-in-a-single-center-institution
#14
Guilherme Gozzoli Podolsky-Gondim, Luciano Lopes Furlanetti, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero, Ricardo Santos de Oliveira
INTRODUCTION: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far. OBJECTIVES: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children...
October 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30333079/management-of-atrophic-mandibular-fractures-an-italian-multicentric-retrospective-study
#15
Giovanni Gerbino, Stefan Cocis, Fabio Roccia, Giorgio Novelli, Gabriele Canzi, Davide Sozzi
PURPOSE: The aim of this multicentric study was to retrospectively evaluate the surgical outcome of atrophic mandible fractures treated with open reduction and rigid fixation (ORIF), using load-bearing plates. MATERIALS AND METHODS: 55 patients from three trauma centers were retrieved for the study. Inclusion criteria were: edentulous patients with mandibular body fractures; mandibular body thickness <20 mm. Collected data included: cause of fracture; degree of atrophy (according to Luhr's classification); characteristics of the fracture; adequacy of reduction; postoperative complications...
September 25, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/30327841/emergency-bleeding-control-interventions-after-immediate-total-body-ct-scans-in-trauma-patients
#16
Kaij Treskes, Teun P Saltzherr, Michael J R Edwards, Benn J A Beuker, D Den Hartog, Joachim Hohmann, Jan S Luitse, Ludo F M Beenen, Markus W Hollmann, Marcel G W Dijkgraaf, J Carel Goslings
BACKGROUND: Immediate total-body CT (iTBCT) is often used for screening of potential severely injured patients. Patients requiring emergency bleeding control interventions benefit from fast and optimal trauma screening. The aim of this study was to assess whether an initial trauma assessment with iTBCT is associated with lower mortality in patients requiring emergency bleeding control interventions. METHODS: In the REACT-2 trial, patients who sustained major trauma were randomized for iTBCT or for conventional imaging and selective CT scanning (standard workup; STWU) in five trauma centers...
October 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/30327495/analysis-of-risk-factors-for-hyponatremia-in-patients-with-acute-spinal-cord-injury-a-retrospective-single-institution-study-in-japan
#17
Hiroyuki Ohbe, Tomoaki Koakutsu, Shigeki Kushimoto
STUDY DESIGN: Retrospective single-institution observational study. OBJECTIVE: Spinal cord injury (SCI) is associated with a high prevalence of hyponatremia, which can cause various clinical symptoms and increase mortality. We aimed to analyze the risk factors for hyponatremia in patients with acute SCI. SETTING: Trauma Center, Tohoku University Hospital, Japan METHODS: We reviewed the medical records of patients with SCI admitted between January 2008 and November 2016...
October 16, 2018: Spinal Cord
https://www.readbyqxmd.com/read/30325989/association-of-system-level-factors-with-secondary-overtriage-in-trauma-patients
#18
Priti P Parikh, Pratik Parikh, Logan Mamer, Mary C McCarthy, Joseph V Sakran
Importance: Studies show that secondary overtriage (SO) contributes significantly to the economic burden of injured patients; thus, the association of SO with use of the trauma system has been examined. However, the association of the underlying trauma system design with such overtriage has yet to be evaluated. Objectives: To evaluate whether the distribution of trauma centers in a statewide trauma system is associated with SO and to identify clinical and demographic factors that may lead to SO...
September 19, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/30324583/the-nature-of-trauma-pain-and-its-association-with-catastrophizing-and-sleep
#19
Michelle C Accardi-Ravid, Joshua R Dyer, Sam R Sharar, Shelley Wiechman, Mark P Jensen, Hunter G Hoffman, David R Patterson
BACKGROUND: Nearly 2.8 million people are hospitalized in the USA annually for traumatic injuries, which include orthopedic and internal organ injuries. Early post-injury pain is predictive of poor outcomes, including inability to eventually return to work, and long-term psychological distress. The goal of the present study was to improve our scientific understanding of trauma-related pain by examining (1) the nature and frequency of inpatient trauma pain and (2) the associations between inpatient trauma pain, education, opioid analgesic equivalent use, pain catastrophizing, and sleep quality...
October 15, 2018: International Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/30324241/the-need-for-red-blood-cell-transfusions-in-the-emergency-department-as-a-risk-factor-for-failure-of-non-operative-management-of-splenic-trauma-a-multicenter-prospective-study
#20
Paola Fugazzola, Lucia Morganti, Federico Coccolini, Stefano Magnone, Giulia Montori, Marco Ceresoli, Matteo Tomasoni, Dario Piazzalunga, Stefano Maccatrozzo, Niccolò Allievi, Savino Occhionorelli, Luca Ansaloni
INTRODUCTION: The majority of patients with splenic trauma undergo non-operative management (NOM); around 15% of these cases fail NOM and require surgery. The aim of the current study is to assess whether the hemodynamic status of the patient represents a risk factor for failure of NOM (fNOM) and if this may be considered a relevant factor in the decision-making process, especially in Centers where AE (angioembolization), intensive monitoring and 24-h-operating room are not available...
October 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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