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https://www.readbyqxmd.com/read/30121154/race-is-a-predictor-of-withdrawal-of-life-support-in-patients-with-intracerebral-hemorrhage
#1
Stuart M Fraser, Glenda L Torres, Chunyan Cai, H Alex Choi, Anjail Sharrief, Tiffany R Chang
INTRODUCTION: Medical and socioeconomic factors may impact decisions to change the goals of care for patients with intracerebral hemorrhage (ICH) to comfort measures only. METHODS: We reviewed prospectively collected data on patients with ICH, including baseline patient demographics, Glasgow Coma Scale (GCS), National Institute of Health Stroke Scale (NIHSS), and ICH score. We conducted multivariable logistic regression analysis to identify predictors of change to comfort measures only status...
August 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/30119686/functional-outcomes-in-adults-with-tuberculous-meningitis-admitted-to-the-icu-a-multicenter-cohort-study
#2
Marie Cantier, Adeline Morisot, Emmanuel Guérot, Bruno Megarbane, Keyvan Razazi, Damien Contou, Eric Mariotte, Emmanuel Canet, Etienne De Montmollin, Vincent Dubée, Eric Boulet, Stéphane Gaudry, Guillaume Voiriot, Julien Mayaux, Frédéric Pène, Mathilde Neuville, Bruno Mourvillier, Stéphane Ruckly, Lila Bouadma, Michel Wolff, Jean-François Timsit, Romain Sonneville
BACKGROUND: Tuberculous meningitis (TBM) is a devastating infection in tuberculosis endemic areas with limited access to intensive care. Functional outcomes of severe adult TBM patients admitted to the ICU in nonendemic areas are not known. METHODS: We conducted a retrospective multicenter cohort study (2004-2016) of consecutive TBM patients admitted to 12 ICUs in the Paris area, France. Clinical, biological, and brain magnetic resonance imaging (MRI) findings at admission associated with a poor functional outcome (i...
August 17, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/30119074/risk-factors-on-hospital-arrival-for-acute-respiratory-distress-syndrome-following-pediatric-trauma
#3
Elizabeth Y Killien, Brianna Mills, R Scott Watson, Monica S Vavilala, Frederick P Rivara
OBJECTIVES: To determine risk factors identifiable at hospital arrival associated with acute respiratory distress syndrome development among critically injured children. DESIGN: Retrospective cohort study. SETTING: Level I or II adult or pediatric trauma centers contributing to the National Trauma Data Bank from 2007 to 2016. PATIENTS: Patients less than 18 years admitted to an ICU with traumatic injury. INTERVENTIONS: None...
August 16, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/30119071/intracranial-pressure-trajectories-a-novel-approach-to-informing-severe-traumatic-brain-injury-phenotypes
#4
Ruchira M Jha, Jonathan Elmer, Benjamin E Zusman, Shashvat Desai, Ava M Puccio, David O Okonkwo, Seo Young Park, Lori A Shutter, Jessica S Wallisch, Yvette P Conley, Patrick M Kochanek
OBJECTIVES: Intracranial pressure in traumatic brain injury is dynamic and influenced by factors like injury patterns, treatments, and genetics. Existing studies use time invariant summary intracranial pressure measures thus potentially losing critical information about temporal trends. We identified longitudinal intracranial pressure trajectories in severe traumatic brain injury and evaluated whether they predicted outcome. We further interrogated the model to explore whether ABCC8 polymorphisms (a known cerebraledema regulator) differed across trajectory groups...
August 16, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/30118369/correlation-between-the-revised-trauma-score-and-injury-severity-score-implications-for-prehospital-trauma-triage
#5
Samuel M Galvagno, Michael Massey, Pierre Bouzat, Roumen Vesselinov, Matthew J Levy, Michael G Millin, Deborah M Stein, Thomas M Scalea, Jon Mark Hirshon
STUDY OBJECTIVE: Prehospital triage of the seriously injured patient is fraught with challenges and trauma scoring systems in current triage guidelines warrant further investigation. The primary objective of this study was to assess the correlation of the physiologically based Revised Trauma Score (RTS) and MGAP score (mechanism of injury, Glasgow coma scale, age, blood pressure) with the anatomically based Injury Severity Score (ISS). The secondary objectives for this study were to compare the accuracy of the MGAP score and the RTS for the prediction of in-hospital mortality for trauma patients...
August 17, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/30116903/frequency-and-characteristics-of-traumatic-brain-injury-in-restrained-drivers-involved-in-road-traffic-accidents
#6
Joji Inamasu, Msasato Nakaya, Dai Kujirai, Keita Mayanagi, Masashi Nakatsukasa
BACKGROUND: While seatbelt is an important device protecting drivers from traumatic brain injury (TBI), it has rarely been reported how often and in what circumstances restrained drivers sustain TBI after road traffic accident (RTA). Whole-body computed tomography (WBCT) for blunt trauma patients may provide a unique opportunity to investigate the frequency and characteristics of TBI sustained by restrained drivers. METHODS: A single-center, retrospective observational study was conducted using prospectively acquired data...
August 17, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/30112403/a-meta-analysis-of-the-influencing-factors-for-tracheostomy-after-cervical-spinal-cord-injury
#7
Yan Wang, Zhiliang Guo, Dehong Fan, Haijiang Lu, Dong Xie, Dahai Zhang, Yongtian Jiang, Pei Li, Haijun Teng
Background: Traumatic cervical spinal cord injury (CSCI) is a common disease that has high complication, disability, and mortality rates and a poor prognosis. Tracheostomy is an important supportive therapy for patients with CSCI. However, a consensus on the predictive factors for tracheostomy after CSCI has not been reached. Objective: This meta-analysis study assessed the influencing factors for tracheostomy after CSCI. Methods: We searched for relevant studies on the influencing factors for tracheostomy after CSCI...
2018: BioMed Research International
https://www.readbyqxmd.com/read/30107855/undertriage-of-major-trauma-patients-at-a-university-hospital-a-retrospective-cohort-study
#8
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
https://www.readbyqxmd.com/read/30106987/post-hospital-mortality-in-children-aged-2-12-years-in-tanzania-a-prospective-cohort-study
#9
Duncan K Hau, Neema Chami, Aynsley Duncan, Luke R Smart, Adolfine Hokororo, Neema M Kayange, Robert N Peck
BACKGROUND: Sub-Saharan Africa has the highest rates of child mortality worldwide. Little is known about post-hospital outcomes after an index hospitalization for older children. We determined 12-month post-hospital mortality rate and identified factors associated with higher mortality. METHODS: In this prospective cohort study, we enrolled children 2-12 years of age admitted to the pediatric wards of two public hospitals in northwestern Tanzania. Participants or proxies were contacted at 3, 6 and 12 months post-hospitalization...
2018: PloS One
https://www.readbyqxmd.com/read/30106865/predictors-of-severe-clinical-course-in-children-with-carbon-monoxide-poisoning
#10
Leman Akcan Yildiz, Ayse Gultekingil, Selman Kesici, Benan Bayrakci, Ozlem Teksam
OBJECTIVE: Carbon monoxide (CO) is a gas, which is produced by incomplete combustion of hydrocarbon-containing substances, and causes significant tissue and organ damage in the common event of CO poisoning. This study aims to evaluate the demographic, clinical, and laboratory characteristics of patients diagnosed with CO poisoning in the emergency department and to determine the factors associated with severe course in the acute phase of poisoning. METHODS: A total of 331 patients diagnosed with CO poisoning in Hacettepe University Children's Hospital, Pediatric Emergency Unit, between January 2004 and March 2014 were included in the study...
August 13, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/30105495/analysis-of-water-sports-injuries-admitted-to-a-pediatric-trauma-center-a-13-year-experience
#11
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
https://www.readbyqxmd.com/read/30104314/validation-of-the-ich-score-in-patients-with-spontaneous-intracerebral-haemorrhage-admitted-to-the-intensive-care-unit-in-southern-spain
#12
Sonia Rodríguez-Fernández, Encarnación Castillo-Lorente, Francisco Guerrero-Lopez, David Rodríguez-Rubio, Eduardo Aguilar-Alonso, Jesús Lafuente-Baraza, Francisco Javier Gómez-Jiménez, Juan Mora-Ordóñez, Ricardo Rivera-López, María Dolores Arias-Verdú, Guillermo Quesada-García, Miguel Ángel Arráez-Sánchez, Ricardo Rivera-Fernández
OBJECTIVE: Validation of the intracerebral haemorrhage (ICH) score in patients with a diagnosis of spontaneous ICH admitted to the intensive care unit (ICU). METHODS: A multicentre cohort study was conducted in all consecutive patients with ICH admitted to the ICUs of three hospitals with a neurosurgery department between 2009 and 2012 in Andalusia, Spain. Data collected included ICH, Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores...
August 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/30098813/direct-oral-anticoagulants-do-not-worsen-traumatic-brain-injury-after-low-level-falls-in-the-elderly
#13
Madelyn Batey, Jason Hecht, Cherise Callahan, Wendy Wahl
BACKGROUND: Falls are now the leading cause of trauma and represent the most common type of trauma in the elderly. The use of anticoagulants is increasing in older patients, but there are little data on outcomes after traumatic brain injury while anticoagulated with direct oral anticoagulants compared with warfarin. We hypothesized that anticoagulated patients would have a greater mortality and complications than nonanticoagulated patients, and patients on direct oral anticoagulants would have more fatal outcomes after low-level falls because of lack of reversal agents...
August 8, 2018: Surgery
https://www.readbyqxmd.com/read/30095347/the-identification-of-a-subgroup-of-children-with-traumatic-subarachnoid-hemorrhage-at-low-risk-of-neuroworsening
#14
Cecilia L Dalle Ore, Robert C Rennert, Alexander J Schupper, Brandon C Gabel, David Gonda, Bradley Peterson, Lawrence F Marshall, Michael Levy, Hal S Meltzer
OBJECTIVE Pediatric traumatic subarachnoid hemorrhage (tSAH) often results in intensive care unit (ICU) admission, the performance of additional diagnostic studies, and ICU-level therapeutic interventions to identify and prevent episodes of neuroworsening. METHODS Data prospectively collected in an institutionally specific trauma registry between 2006 and 2015 were supplemented with a retrospective chart review of children admitted with isolated traumatic subarachnoid hemorrhage (tSAH) and an admission Glasgow Coma Scale (GCS) score of 13-15...
August 10, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/30094049/prediction-of-acute-kidney-injury-with-a-machine-learning-algorithm-using-electronic-health-record-data
#15
Hamid Mohamadlou, Anna Lynn-Palevsky, Christopher Barton, Uli Chettipally, Lisa Shieh, Jacob Calvert, Nicholas R Saber, Ritankar Das
Background: A major problem in treating acute kidney injury (AKI) is that clinical criteria for recognition are markers of established kidney damage or impaired function; treatment before such damage manifests is desirable. Clinicians could intervene during what may be a crucial stage for preventing permanent kidney injury if patients with incipient AKI and those at high risk of developing AKI could be identified. Objective: In this study, we evaluate a machine learning algorithm for early detection and prediction of AKI...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/30093878/primary-cct-imaging-based-clinico-neurological-assessment-calling-for-addition-of-telestroke-video-consultation-in-patients-with-intracerebral-hemorrhage
#16
Andrea Wagner, Karl-Michael Schebesch, Florian Zeman, Stefan Isenmann, Andreas Steinbrecher, Thomas Kapapa, Dobri Baldaranov, Roland Backhaus, Felix Schlachetzki
Background and Purpose: Intracerebral hemorrhage (ICH) requires rapid decision making to decrease morbidity and mortality although time frame and optimal therapy are still ill defined. Ideally, specialized neurologists, neurosurgeons, and (neuro-) radiologists who know the patient's clinical status and their cerebral computed tomography imaging (cCT) make a joint decision on the clinical management. However, in telestroke networks, a shift toward cCT imaging criteria used for decision making can be observed for practical reasons...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/30093276/superusers-drivers-of-health-care-resource-utilization-in-the-national-trauma-population
#17
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
https://www.readbyqxmd.com/read/30088439/are-hypernatremia-and-coagulopathy-useful-clinical-biomarkers-in-dogs-with-head-trauma-a-retrospective-study
#18
Franziska Riese, Sonja Steinmetz, Karl Rohn, Andrea Tipold
This study was performed to evaluate clinical biomarkers as prognostic values in dogs with traumatic brain injury (TBI) based on findings in human patients. Sodium-levels of 158 dogs with TBI and 169 patients with trauma without involvement of the head (EHT) were examined. TBI-patients with hypernatremia had a slightly higher risk to die (22.03 %) than dogs with normal sodium levels (19.76 %). However there was no significant correlation between sodium levels and outcome in TBI-patients (p= 0.6357). Dogs with sodium levels higher than 160 mmol/L were non-survivors...
August 8, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/30084818/predictors-of-acute-complications-following-traumatic-upper-extremity-amputation
#19
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...
December 0: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/30080783/independent-predictors-of-survival-after-traumatic-atlanto-occipital-dissociation
#20
Morgan Schellenberg, Kenji Inaba, Vincent Cheng, James M Bardes, Patrick Heindel, Kazuhide Matsushima, Elizabeth Benjamin, Demetrios Demetriades
BACKGROUND: Atlanto-occipital dissociation (AOD) occurs when the skull base is forcibly separated from the vertebral column. Existing literature on AOD is sparse and risk factors for mortality are unknown. This study determined independent predictors of survival after AOD. METHODS: Patients who sustained AOD were identified from the National Trauma Data Bank (2007-2014). Those arriving without signs of life or with missing mortality data were excluded. Study groups were defined as patients who survived to hospital discharge versus patients who died in hospital...
August 2018: Journal of Trauma and Acute Care Surgery
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