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"Trauma" AND ("Injury Severity" OR "ISS")

Abdulla Jawed, Awaiz Ahmed, Mark Rees Williams
AIM OF THE STUDY: To determine if the intraoperative use of cell salvage (CS) led to a decrease in allogeneic blood transfusion by comparing with a control group that did not receive CS. We also looked at the effects of injury severity and surgical approach. METHODS: This was a retrospective study at a major trauma center. One hundred and nineteen patients underwent open reduction and internal fixation of pelvic and acetabular fractures with (59 patients) or without intra-operative blood cell salvage (60 patients)...
August 15, 2018: International Orthopaedics
Terje Nordgarden, Peter Odland, Anne Berit Guttormsen, Kristina Stølen Ugelvik
BACKGROUND: Studies show increased mortality among severely injured patients not met by trauma team. Proper triage is important to ensure that all severely injured patients receive vital trauma care. In 2017 a new national trauma plan was implemented in Norway, which recommended the use of a modified version of "Guidelines for Field Triage of Injured Patients" to identify severely injured patients. METHODS: A retrospective study of 30,444 patients admitted to Haukeland University Hospital in 2013, with ICD-10 injury codes upon discharge...
August 14, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Thomas R McCarty, Thomas J Abramo, Robert T Maxson, Gregory Albert, Mallikarjuna R Rettiganti, Marie E Saylors, Jonathan W Orsborn, Amanda I Hollingsworth
OBJECTIVE: Hypothermia is an independent risk factor for mortality in adult trauma patients. Two small studies have shown similar results in pediatric trauma patients. Temperature is not included in any pediatric trauma assessment scores. This study sought to compare mortality and various descriptive outcomes between pediatric hypothermic and normothermic trauma patients. METHODS: Data were obtained from the National Trauma Database from 2009 to 2012. Patients meeting inclusion criteria were stratified by presence of isolated head injury, head injury with multiple trauma, and absence of head injury...
August 13, 2018: Pediatric Emergency Care
Thomas A Boyle, Kittu A Rao, Davis B Horkan, Marguerite L Bandeian, Juan E Sola, Charles A Karcutskie, Casey Allen, Eduardo A Perez, Edward B Lineen, Anthony R Hogan, Holly L Neville
BACKGROUND: Unintentional injury is the leading cause of death in children and adolescents. Injuries occurring during boating and recreational water sports are poorly described in the literature. Herein, we compare injuries from water sports to those resulting from motor vehicle collisions, which are better described in existing literature. METHODS: A retrospective review of 1935 consecutive pediatric trauma patients, as defined by age < 18 years, admitted to a single level-1 pediatric trauma center between January 2000 and August 2013 was performed...
August 13, 2018: Pediatric Surgery International
Jo-Annie Letendre, Robert Goggs
Trauma is common in dogs and causes significant morbidity and mortality, but it remains a challenge to assess prognosis in these patients. This study aimed to investigate the use of plasma cell-free DNA (cfDNA) and nucleosome concentrations as prognostic biomarkers in canine trauma. Using a prospective, observational case-control study design, 49 dogs with trauma were consecutively enrolled from 07/2015 to 10/2017 and followed to hospital discharge. Dogs with animal trauma triage (ATT) scores ≥3 at presentation were eligible for enrollment...
2018: Frontiers in Veterinary Science
Robert Goggs, Jo-Annie Letendre
Trauma is common in dogs and causes significant morbidity and mortality, but it remains challenging to predict the prognosis of dogs with traumatic injuries. This study aimed to quantify plasma high-mobility group box-1 (HMGB-1) and cytokine concentrations in dogs with moderate-to-severe trauma, and to evaluate the association between these biomarkers and the injury severity and survival to discharge. Using a prospective, observational case-control study design, 49 dogs with an animal trauma triage (ATT) score ≥3 were consecutively enrolled from 07/2015 to 10/2017 and followed to hospital discharge...
2018: Frontiers in Veterinary Science
Charlotte Hammonds, Philippa C Jackson, Patrick Foster, Jonathan D Wiper
In an ageing population, increasing numbers of patients over the age of 70 are sustaining severe trauma. These patients require careful multidisciplinary team (MDT) management with careful consideration of existing co-morbidities, as such their treatment should be individually tailored. We present the case of a patient believed to be the oldest documented patient treated in a trauma setting with free flap and circular frame fixation to an open tibial fracture. A 95-year-old male presented to the Level 1 Major Trauma Centre (MTC) with multiple injuries after a pedestrian vs car incident...
2018: European Journal of Plastic Surgery
Eleanor Curtis, Kathleen Romanowski, Soman Sen, Ashley Hill, Christine Cocanour
BACKGROUND: Although many frailty scales exist, a single scale has not been agreed upon to define frailty. Herein, we determined whether the Canadian Study on Health and Aging Clinical Frailty Scale (CSHA CFS) can predict the risk of elderly patients for hospital mortality and discharge to skilled nursing facilities (SNFs) following traumatic injury. METHODS: Charts from trauma patients aged ≥65 y admitted from December 1, 2011 to December 31, 2013 were retrospectively examined...
October 2018: Journal of Surgical Research
Ole-Petter Vinjevoll, Oddvar Uleberg, Elaine Cole
BACKGROUND: Sensitive decision making tools should assist prehospital personnel in the triage of injured patients, identifying those who require immediate lifesaving interventions and safely reducing unnecessary under- and overtriage. In 2014 a new trauma team activation (TTA) tool was implemented in Central Norway. The overall objective of this study was to evaluate the ability of the new TTA tool to identify severe injury. METHODS: This was a multi-center observational cohort study with retrospective data analysis...
August 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Samantha Alda Rodrigues, J Guey, T C H Plummer, A Pullen, B Shaw, D C Kieser
INTRODUCTION: The influence of rib impact on thoracic gunshot trauma remains unclear, despite its high occurrence. This study therefore investigates the effect of rib impact on a bullet's terminal properties and injury severity. METHODS: Two bullets were used: 5.56×45 mm (full charge and reduced charge) and 7.62×51 mm (full charge). For each bullet, three impact groups were tested: (1) plain 10% ballistic gelatin (control) conditioned at 4°C, (2) intercostal impact, and (3) rib impact, the latter two tested with samples of porcine thoracic walls embedded in gelatin...
August 8, 2018: Journal of the Royal Army Medical Corps
Lindsay A Gil, Anai N Kothari, Sarah A Brownlee, Hieu Ton-That, Purvi P Patel, Richard P Gonzalez, Fred A Luchette, Michael J Anstadt
BACKGROUND: Health care spending is driven by a very small percentage of Americans, many of whom are patients with prolonged durations of stay. The objective of this study was to characterize superusers in the trauma population. METHODS: The National Trauma Data Bank for 2008-2012 was queried. Superusers were defined as those with a duration of stay in the top 0.06% of the population and were compared with the remainder of the population to determine differences in demographic characteristics, comorbidities, prehospital factors, and outcomes...
August 7, 2018: Surgery
Laura W Lewallen, Amy L McIntosh, S Andrew Sems
The purpose of this study was to determine whether pelvic fracture pattern is associated with transfusion requirements or concomitant injuries in pediatric patients. This was a single-institution, retrospective review from 1970 to 2000. Pelvic ring injuries were classified using the Orthopaedic Trauma Association system. Injury Severity Scores were assigned. Ninety patients were included in this study. There were 27 A-type (30.0%), 51 B-type (56.7%), and 12 C-type (13.3%) injuries. Mean Injury Severity Scores were 8...
August 9, 2018: Orthopedics
Steven Liu, Quinn Fujii, Farris Serio, Andrew McCague
Objective: To determine if there exists an upper limit for amount of blood transfused in trauma patients before it reaches a point of futility. Methods: A prospective cohort study was conducted on 131 patients who received massive blood transfusion (MBT), defined as 10 U or higher of PRBCs received in the initial 24 hours. Data collected from a Level II trauma center registry were used to analyze reports of adult patients from July 2014 to 2017. Cohorts were divided by amount of blood received - 0 to 9 U, 10-19 U, 20 to 29 U, 30-39 U, 40 U or higher - odds ratio for mortality and p-values for mean Injury Severity Score and overall hospital length of stay were calculated for each group...
July 2018: Bulletin of Emergency and Trauma
Jan Oliver Voss, Nadine Thieme, Christian Doll, Stefan Hartwig, Nicolai Adolphs, Max Heiland, Jan-Dirk Raguse
Penetrating foreign bodies of different origins in the head and neck are rare and potentially dangerous injuries, which might pose problems for their detection, primary care, and final treatment. Depending on the severity of the underlying trauma, some injuries present a higher risk for the presence of foreign bodies. Minor wounds, including common lacerations, are likely to be contaminated with loose gravel debris or dental fragments, and need to be distinguished from severe wounds caused by impalement, shootings, stabbings, and explosions...
September 2018: Craniomaxillofacial Trauma & Reconstruction
Emily S Herfel, Joshua H Hill, Michael Lieber
OBJECTIVE: Trauma is the leading cause of non-obstetrical causes of death in pregnant patients. The use of radiographic imaging for evaluation in the trauma bay is a controversial topic. However, in some cases the benefits of using radiographic imaging to ensure maternal survival outweigh the risks of radiation exposure to the fetus. This study explores whether sparing fetal exposure to radiation by minimizing use of ionizing radiographic imaging to the mother will put the mother at risk for a delayed diagnosis of injury...
June 28, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Theodore G Karrison, L Philip Schumm, Masha Kocherginsky, Ronald Thisted, Douglas R Dirschl, Selwyn Rogers
BACKGROUND: The purpose of this study was to evaluate the effects of ambulance driving distance and transport time on mortality among trauma incidents occurring in the City of Chicago, a large metropolitan area. METHODS: We studied individuals >16 years old who suffered a Level I or II injury and were taken to a Level I trauma center. The outcome was in-hospital mortality, including those dead on arrival but excluding those deemed dead on scene. Driving distance was calculated from the scene of injury to the trauma center where the patient was taken...
August 6, 2018: Journal of Trauma and Acute Care Surgery
Charlie A Sewalt, Eveline J A Wiegers, Esmee Venema, Fiona E Lecky, Stephanie C E Schuit, Dennis Den Hartog, Hester F Lingsma
BACKGROUND: The volume-outcome relationship in severely injured patients remains under debate and this has consequences for the designation of trauma centers. OBJECTIVES: The aim of this study was to evaluate the relationship between hospital or surgeon volume and health outcomes in severely injured patients. METHODS: Six electronic databases were searched from 1980 up to January 30 2018 to identify studies that describe the relationship between hospital or surgeon volume and health outcomes in severely injured patients (preferably Injury Severity Score (ISS) above 15)...
August 6, 2018: Journal of Trauma and Acute Care Surgery
Jacob Folse, Charles E Hill, Matthew L Graves, George V Russell, Josie Hydrick, LaRita C Jones, William H Replogle, Patrick F Bergin, Clay A Spitler
OBJECTIVES: To evaluate all patients who received gentamicin for open fracture treatment and determine the incidence of, and risk factors for, kidney injury in this population. DESIGN: Retrospective, Case Control SETTING:: Single institution; Level 1 trauma center PATIENTS/PARTICIPANTS:: A retrospective chart review identified patients who received gentamicin for open fracture antibiotic treatment from January 2008-December 2012. Overall, 371 patients met inclusion criteria and were categorized into 2 groups using RIFLE criteria: normal kidney function (74...
July 30, 2018: Journal of Orthopaedic Trauma
Matthew Swann, Miles Batty, Gene Hu, Thomas Mitchell, Hayden Box, Adam Starr
OBJECTIVE: To evaluate the prevalence and severity of sleep disturbance experienced by patients who have sustained a traumatic orthopaedic injury, how sleep disturbance affects the patient's perceived health quality and identify factors associated with sleep disturbance. DESIGN: Cross-Sectional Cohort study. SETTING: Urban Level-I trauma center. PATIENTS/PARTICIPANTS: 335 non-consecutive patients who presented to clinic at various stages of treatment for their traumatic orthopaedic injuries...
July 30, 2018: Journal of Orthopaedic Trauma
Tuesday F Fisher, Nicholas A Kusnezov, Julia A Bader, James A Blair
Current literature is deficient in its description of acute complications following major traumatic upper extremity amputations (UEAs). This study sought to identify acute complications following major UEAs by the 2009-2012 National Trauma Databank to extract demographics, comorbidities, concomitant injuries, and surgical characteristics for major traumatic UEA patients. Multivariate analyses identified significant predictors of mortality and major systemic complications. Major traumatic upper extremity amputations were identified in 1190 patients...
2018: Journal of Surgical Orthopaedic Advances
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