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https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#1
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
December 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27888344/impact-of-urgent-resuscitative-surgery-for-life-threatening-torso-trauma
#2
Hisashi Matsumoto, Yoshiaki Hara, Takanori Yagi, Nobuyuki Saito, Kazuki Mashiko, Hiroaki Iida, Tomokazu Motomura, Fumihiko Nakayama, Kazuhiro Okada, Hiroshi Yasumatsu, Taigo Sakamoto, Takao Seo, Yusuke Konda, You Hattori, Hiroyuki Yokota
PURPOSE: This study investigated the advantages of performing urgent resuscitative surgery (URS) in the emergency department (ED); namely, our URS policy, to avoid a delay in hemorrhage control for patients with severe torso trauma and unstable vital signs. METHODS: We divided 264 eligible cases into a URS group (n = 97) and a non-URS group (n = 167) to compare, retrospectively, the observed survival rate with the predicted survival using the Trauma and Injury Severity Score (TRISS)...
November 25, 2016: Surgery Today
https://www.readbyqxmd.com/read/27815954/development-of-a-middle-age-and-geriatric-trauma-mortality-risk-score-a-tool-to-guide-palliative-care-consultations
#3
Sanjit R Konda, Rachel Seymour, Arthur Manoli, Jordan Gales, Madhav A Karunakar
INTRODUCTION: This study aimed to develop a tool to quantify risk of inpatient mortality among geriatric and middleaged trauma patients. This study sought to demonstrate the ability of the novel risk score in the early identification of high risk trauma patients for resource-sparing interventions, including referral to palliative medicine. MATERIALS AND METHODS: This retrospective cohort study utilized data from a single level 1 trauma center. Regression analysis was used to create a novel risk of inpatient mortality score...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27686345/long-term-outcomes-in-patients-with-septic-shock-transfused-at-a-lower-versus-a-higher-haemoglobin-threshold-the-triss-randomised-multicentre-clinical-trial
#4
Sofie L Rygård, Lars B Holst, Jørn Wetterslev, Per Winkel, Pär I Johansson, Jan Wernerman, Anne B Guttormsen, Sari Karlsson, Anders Perner
PURPOSE: We assessed the predefined long-term outcomes in patients randomised in the Transfusion Requirements in Septic Shock (TRISS) trial. METHODS: In 32 Scandinavian ICUs, we randomised 1005 patients with septic shock and haemoglobin of 9 g/dl or less to receive single units of leuko-reduced red cells when haemoglobin level was 7 g/dl or less (lower threshold) or 9 g/dl or less (higher threshold) during ICU stay. We assessed mortality rates 1 year after randomisation and again in all patients at time of longest follow-up in the intention-to-treat population (n = 998) and health-related quality of life (HRQoL) 1 year after randomisation in the Danish patients only (n = 777)...
September 30, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27667119/validation-of-international-trauma-scoring-systems-in-urban-trauma-centres-in-india
#5
Nobhojit Roy, Martin Gerdin, Eric Schneider, Deepa K Kizhakke Veetil, Monty Khajanchi, Vineet Kumar, Makhal Lal Saha, Satish Dharap, Amit Gupta, Göran Tomson, Johan von Schreeb
INTRODUCTION: In the Lower-Middle Income Country setting, we validate trauma severity scoring systems, namely Injury Severity Score (ISS), New Injury Severity Scale (NISS) score, the Kampala Trauma Score (KTS), Revised Trauma Score (RTS) score and the TRauma Injury Severity Score (TRISS) using Indian trauma patients. PATIENTS AND METHODS: From 1 September 2013 to 28 February 2015, we conducted a prospective multi-centre observational cohort study of trauma patients in four Indian university hospitals, in three megacities, Kolkata, Mumbai and Delhi...
September 20, 2016: Injury
https://www.readbyqxmd.com/read/27658944/the-impact-of-measurement-of-respiratory-quotient-by-indirect-calorimetry-on-the-achievement-of-nitrogen-balance-in-patients-with-severe-traumatic-brain-injury
#6
J Maxwell, C Gwardschaladse, G Lombardo, P Petrone, A Policastro, D Karev, K Prabhakaran, A Betancourt, C P Marini
BACKGROUND: This study evaluated the impact of IC on the optimization of nutritional support and the achievement of +NB in patients with TBI. MATERIALS AND METHODS: 27 patients (GCS ≤ 8), treated with a 5-day multimodality monitoring and goal-directed therapy protocol, received enteral nutrition on day 1 followed by IC on days 3 and 5 and assessment of NB on day 7. In the first cohort (n = 11), no adjustment in kcal was made. In the second cohort (n = 16), nutrition was targeted to an RQ of 0...
September 22, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27550497/reduced-mortality-by-physician-staffed-hems-dispatch-for-adult-blunt-trauma-patients-in-korea
#7
Kyoungwon Jung, Yo Huh, John Cj Lee, Younghwan Kim, Jonghwan Moon, Seok Hwa Youn, Jiyoung Kim, Tea Youn Kim, Juryang Kim, Hyoju Kim
The aim of this study was to investigate the efficiency of domestic physician-staffed helicopter emergency medical service (HEMS) for the transport of patients with severe trauma to a hospital. The study included patients with blunt trauma who were transported to our hospital by physician-staffed HEMS (Group P; n = 100) or nonphysician-staffed HEMS (Group NP; n = 80). Basic patient characteristics, transport time, treatment procedures, and medical treatment outcomes assessed using the Trauma and Injury Severity Score (TRISS) were compared between groups...
October 2016: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27388437/association-between-trauma-and-socioeconomic-deprivation-a-registry-based-scotland-wide-retrospective-cohort-study-of-9-238-patients
#8
Alasdair R Corfield, Danny F MacKay, Jill P Pell
BACKGROUND: Trauma remains a leading cause of morbidity and mortality in the UK and throughout the world. Socioeconomic deprivation has been linked with many types of ill-health and previous studies have shown an association with injury in other parts of the world. The aim of this study was to investigate the association between socioeconomic deprivation and trauma incidence and case-fatality in Scotland. METHODS: The study included nine thousand two hundred and thirty eight patients attending Emergency Departments following trauma across Scotland in 2011-12...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27375316/factors-affecting-morbidity-in-solid-organ-injuries
#9
Serdar Baygeldi, Oktay Karakose, Kazım Caglar Özcelik, Hüseyin Pülat, Sedat Damar, Hüseyin Eken, İsmail Zihni, Alpaslan Fedai Çalta, Bilsel Baç
Background and Aim. The aim of this study was to investigate the effects of demographic characteristics, biochemical parameters, amount of blood transfusion, and trauma scores on morbidity in patients with solid organ injury following trauma. Material and Method. One hundred nine patients with solid organ injury due to abdominal trauma during January 2005 and October 2015 were examined retrospectively in the General Surgery Department of Dicle University Medical Faculty. Patients' age, gender, trauma interval time, vital status (heart rate, arterial tension, and respiratory rate), hematocrit (HCT) value, serum area aminotransferase (ALT) and aspartate aminotransferase (AST) values, presence of free abdominal fluid in USG, trauma mechanism, extra-abdominal system injuries, injured solid organs and their number, degree of injury in abdominal CT, number of blood transfusions, duration of hospital stay, time of operation (for those undergoing operation), trauma scores (ISS, RTS, Glasgow coma scale, and TRISS), and causes of morbidity and mortality were examined...
2016: Disease Markers
https://www.readbyqxmd.com/read/27343135/survival-prediction-algorithms-miss-significant-opportunities-for-improvement-if-used-for-case-selection-in-trauma-quality-improvement-programs
#10
Catherine Heim, Elaine Cole, Anita West, Nigel Tai, Karim Brohi
BACKGROUND: Quality improvement (QI) programs have shown to reduce preventable mortality in trauma care. Detailed review of all trauma deaths is a time and resource consuming process and calculated probability of survival (Ps) has been proposed as audit filter. Review is limited on deaths that were 'expected to survive'. However no Ps-based algorithm has been validated and no study has examined elements of preventability associated with deaths classified as 'expected'. The objective of this study was to examine whether trauma performance review can be streamlined using existing mortality prediction tools without missing important areas for improvement...
September 2016: Injury
https://www.readbyqxmd.com/read/27290449/validation-of-the-probability-of-survival-using-the-triss-methodology-in-the-spanish-trauma-icu-registry-retrauci
#11
M Chico-Fernández, M Sánchez-Casado, F Alberdi-Odriozola, F Guerrero-López, M D Mayor-García, J Egea-Guerrero, J F Fernández-Ortega, A Bueno-González, J González-Robledo, L Servià-Goixart, J Roldán-Ramírez, Má Ballesteros-Sanz, E Tejerina-Álvarez, J A Llompart-Pou
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27274519/acute-physiology-and-chronic-health-evaluation-apache-iii-score-compared-to-trauma-injury-severity-score-triss-in-predicting-mortality-of-trauma-patients
#12
Parvin Darbandsar Mazandarani, Kamran Heydari, Hamidreza Hatamabadi, Parvin Kashani, Yasin Jamali Danesh
INTRODUCTION: More than 50 scoring systems have been published for classification of trauma patients in the field, emergency room, and intensive care settings, so far. The present study aimed to compare the ability of trauma injury severity score (TRISS) and acute physiology and chronic health evaluation (APACHE) III in predicting mortality of intensive care unit (ICU) admitted trauma patients. METHODS: This prospective cross-sectional study included ICU admitted multiple trauma patients of Imam Hossein and Hafte-Tir Hospitals, Tehran, Iran, during 2011 and 2012...
2016: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/27255740/predictors-of-mortality-in-pediatric-trauma-experiences-of-a-level-1-trauma-center-and-an-assessment-of-the-international-classification-injury-severity-score-iciss
#13
Casey J Allen, Amy E Wagenaar, Davis B Horkan, Daniel J Baldor, William M Hannay, Jun Tashiro, Nicholas Namias, Juan E Sola
OBJECTIVES: Injury severity scoring tools allow systematic comparison of outcomes in trauma research and quality improvement by indexing an expected mortality risk for certain injuries. This study investigated the predictive value of the empirically derived ICD9-derived Injury Severity Score (ICISS) compared to expert consensus-derived scoring systems for trauma mortality in a pediatric population. METHODS: 1935 consecutive trauma patients aged <18 years from 1/2000 to 12/2012 were reviewed...
July 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27172523/probability-of-survival-scores-in-different-trauma-registries-a-systematic-review
#14
REVIEW
Bogdan Stoica, Sorin Paun, Ioan Tanase, Ionut Negoi, Alexandru Chiotoroiu, Mircea Beuran
INTRODUCTION: A mixed score to predict the probability of survival has a key role in the modern trauma systems. The aim of the current studies is to summarize the current knowledge about estimation of survival in major trauma patients, in different trauma registries. METHOD: Systematic review of the literature using electronic search in the PubMed/Medline, Web of Science Core Collection and EBSCO databases. We have used as a MeSH or truncated words a combination of trauma "probability of survival" and "mixed scores"...
March 2016: Chirurgia
https://www.readbyqxmd.com/read/27164973/comparison-of-risk-adjusted-survival-in-two-scandinavian-level-i-trauma-centres
#15
Poya Ghorbani, Kjetil Gorseth Ringdal, Morten Hestnes, Nils Oddvar Skaga, Torsten Eken, Anders Ekbom, Lovisa Strömmer
BACKGROUND: Assessment of trauma-system performance is important for improving the care of injured patients. The aim of the study was to compare risk-adjusted survival in two Scandinavian Level-I trauma centres. METHODS: This was an observational, retrospective study of prospectively-collected trauma registry data for patients >14 years from Karolinska University Hospital - Solna (KUH), Sweden, and Oslo University Hospital - Ullevål (OUH), Norway, from 2009-2011...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27135075/venous-glucose-serum-lactate-and-base-deficit-as-biochemical-predictors-of-mortality-in-patients-with-polytrauma
#16
Sameh Saad, Naglaa Mohamed, Amr Moghazy, Gouda Ellabban, Soliman El-Kamash
BACKGROUND: The trauma and injury severity score (TRISS) and Acute Physiology and Chronic Health Evaluation IV (APACHE IV) are accurate but complex. This study aimed to compare venous glucose, levels of serum lactate, and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients versus (TRISS) and (APACHE IV). METHODS: This was a comparative cross-sectional study of 282 patients with polytrauma presented to the Emergency Department (ED)...
January 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27124822/early-predictors-of-mortality-in-geriatric-patients-with-trauma
#17
Matthew S Wilson, Sanjit R Konda, Rachel B Seymour, Madhav A Karunakar
OBJECTIVE: To identify variables that predict mortality in geriatric patients with trauma. DESIGN: Retrospective review. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: A total of 147 geriatric patients with trauma (age ≥65) with a predicted probability of survival of 10%-75% based on the Trauma Score-Injury Severity Score (TRISS). MAIN OUTCOME MEASUREMENTS: Patients were divided into 2 cohorts: survivors and nonsurvivors...
September 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27089878/scoring-severity-in-trauma-comparison-of-prehospital-scoring-systems-in-trauma-icu-patients
#18
J A Llompart-Pou, M Chico-Fernández, M Sánchez-Casado, R Salaberria-Udabe, C Carbayo-Górriz, F Guerrero-López, J González-Robledo, M Á Ballesteros-Sanz, R Herrán-Monge, L Servià-Goixart, R León-López, E Val-Jordán
PURPOSE: We evaluated the predictive ability of mechanism, Glasgow coma scale, age and arterial pressure (MGAP), Glasgow coma scale, age and systolic blood pressure (GAP), and triage-revised trauma Score (T-RTS) scores in patients from the Spanish trauma ICU registry using the trauma and injury severity score (TRISS) as a reference standard. METHODS: Patients admitted for traumatic disease in the participating ICU were included. Quantitative data were reported as median [interquartile range (IQR), categorical data as number (percentage)]...
April 18, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27080709/obese-motorcycle-riders-have-a-different-injury-pattern-and-longer-hospital-length-of-stay-than-the-normal-weight-patients
#19
Hang-Tsung Liu, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Shiun-Yuan Hsu, Hsiao-Yun Hsieh, Ching-Hua Hsieh
BACKGROUND: The adverse effects of obesity on the physical health have been extensively studied in the general population, but not in motorcycle riders (includes both drivers and pillions). The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients who were hospitalized for the treatment of trauma following motorcycle accidents in a level I trauma center...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27068001/mortality-prediction-using-triss-methodology-in-the-spanish-icu-trauma-registry-retrauci
#20
M Chico-Fernández, J A Llompart-Pou, M Sánchez-Casado, F Alberdi-Odriozola, F Guerrero-López, M D Mayor-García, J J Egea-Guerrero, J F Fernández-Ortega, A Bueno-González, J González-Robledo, L Servià-Goixart, J Roldán-Ramírez, M Á Ballesteros-Sanz, E Tejerina-Alvarez, F I Pino-Sánchez, J Homar-Ramírez
OBJECTIVES: To validate Trauma and Injury Severity Score (TRISS) methodology as an auditing tool in the Spanish ICU Trauma Registry (RETRAUCI). DESIGN: A prospective, multicenter registry evaluation was carried out. SETTING: Thirteen Spanish Intensive Care Units (ICUs). PATIENTS: Individuals with traumatic disease and available data admitted to the participating ICUs. INTERVENTIONS: Predicted mortality using TRISS methodology was compared with that observed in the pilot phase of the RETRAUCI from November 2012 to January 2015...
October 2016: Medicina Intensiva
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