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https://www.readbyqxmd.com/read/28107241/polytrauma-patients-with-associated-spine-fractures-an-assessment-of-surgical-intervention-on-patient-outcome
#1
Steven R Niedermeier, Safdar N Khan
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To examine perioperative characteristics among polytraumatized patients with operative, unstable spine fractures with and without concomitant operative long bone injuries. SUMMARY OF BACKGROUND DATA: Treatment of polytrauma patients has delicate and time-sensitive protocols to ensure successful recovery. The literature defines standards for vertebral injury and surgical intervention...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#2
Michelle M Corrado, Junxin Shi, Krista K Wheeler, Jin Peng, Brian Kenney, Sarah Johnson, Huiyun Xiang
OBJECTIVES: This study aimed to assess the proportions of injured children transported to trauma centers by different transportation modes and evaluate the effect of transportation mode on inter-facility transfer rates using the US national trauma registry. METHODS: We analyzed data from the 2007-2012 National Trauma Data Bank (NTDB) to study trends of EMS versus non-EMS transport. Multivariable logistic regression was used to evaluate the association between transport mode and inter-facility transfer...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040501/10-year-trend-in-crystalloid-resuscitation-reduced-volume-and-lower-mortality
#3
Megan Y Harada, Ara Ko, Galinos Barmparas, Eric J T Smith, Bansuri K Patel, Navpreet K Dhillon, Gretchen M Thomsen, Eric J Ley
BACKGROUND: Liberal emergency department (ED) resuscitation after trauma may lead to uncontrolled hemorrhage, reduced organ perfusion, and compartment syndrome. Recent guidelines reduced the standard starting point for crystalloid resuscitation from 2 L to 1 L and emphasized "balanced" resuscitation. The purpose of this study was to characterize how an urban, Level 1 trauma center has responded to changes in crystalloid resuscitation practices over time and to describe associated patient outcomes...
December 28, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/28030491/severe-injuries-associated-with-skiing-and-snowboarding-a-national-trauma-data-bank-study
#4
Amory de Roulet, Kenji Inaba, Aaron Strumwasser, Konstantinos Chouliaras, Demetrios Demetriades
BACKGROUND: Injuries following skiing and snowboarding accidents lead to an estimated 7,000 hospital admissions annually and present a significant burden to the health care system. The epidemiology, injury patterns, hospital resource utilization, and outcomes associated with these severe injuries need further characterization. METHODS: The National Trauma Data Bank was queried for the period 2007-2014 for admissions with injury severity score (ISS) >15 and ICD-9 codes 885...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#5
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28017330/mortality-following-helicopter-versus-ground-transport-of-injured-children
#6
Stephanie F Polites, Martin D Zielinski, Aodhnait S Fahy, Amy E Wagie, Christopher R Moir, Donald H Jenkins, Scott P Zietlow, Elizabeth B Habermann
INTRODUCTION: Injured children may be transported to trauma centers by helicopter air ambulance (HAA); however, a benefit in outcomes to this expensive resource has not been consistently shown in the literature and there is concern that HAA is over-utilized. A study that adequately controls for selection biases in transport mode is needed to determine which injured children benefit from HAA. The purpose of this study was to determine if HAA impacts mortality differently in minimally and severely injured children and if there are predictors of over-triage of HAA in children that can be identified...
December 19, 2016: Injury
https://www.readbyqxmd.com/read/27821894/trauma-registry-of-the-pan-american-trauma-society-one-year-of-experience-in-two-hospitals-in-southwest-colombia
#7
Carlos A Ordoñez, Mónica Morales, Johanna Carolina Rojas-Mirquez, Francisco Javier Bonilla-Escobar, Marisol Badiel, Fernando Miñán Arana, Adolfo González, Luis Fernando Pino, Amadeus Uribe-Gómez, Mario Alain Herrera, Maria Isabel Gutiérrez-Martínez, Juan Carlos Puyana, Michael Abutanos, Rao R Ivatury
BACKGROUND: Trauma information systems are needed to improve decision making and to identify potential areas of intervention. OBJECTIVE: To describe the first year of experience with a trauma registry in two referral centers in southwest Colombia. METHODS: The study was performed in two referral centers in Cali. Patients with traumatic injuries seen between January 1 and December 31, 2012, were included. The collected information included demographics, mechanism of trauma, injury severity score (ISS), and mortality...
September 30, 2016: Colombia Médica: CM
https://www.readbyqxmd.com/read/27809989/management-of-polytrauma-patients-in-the-uk-is-there-a-weekend-effect
#8
Vasileios Giannoudis, Michalis Panteli, Peter V Giannoudis
BACKGROUND/PURPOSE: It has been suggested that hospital admission during weekends poses a risk for adverse outcomes and increased patient mortality, the so-called 'weekend effect'. We undertook an evaluation of the impact of weekend admissions to the management of polytraumatised patients, in a Level I Major Trauma Centre (MTC) in the UK. MATERIALS AND METHODS: A retrospective review of prospectively documented data of polytrauma patients (injury severity score (ISS)>15), admitted between April 2013 and August 2015 was performed...
November 2016: Injury
https://www.readbyqxmd.com/read/27809859/variation-in-type-and-frequency-of-diagnostic-imaging-during-trauma-care-across-multiple-time-points-by-patient-insurance-type
#9
Nathaniel Bell, Laura Repáraz, William R Fry, R Stephen Smith, Alejandro Luis
BACKGROUND: Research has shown that uninsured patients receive fewer radiographic studies during trauma care, but less is known as to whether differences in care are present among other insurance groups or across different time points during hospitalization. Our objective was to examine the number of radiographic studies administered to a cohort of trauma patients over the entire hospital stay as well as during the first 24-hours of care. METHODS: Patient data were obtained from an American College of Surgeons (ACS) verified Level I Trauma Center between January 1, 2011 and December 31, 2012...
November 3, 2016: BMC Medical Imaging
https://www.readbyqxmd.com/read/27806488/in-hospital-outcome-based-on-the-mode-of-ems-transportation-in-a-high-income-rapidly-developing-middle-eastern-country
#10
Hassan Al-Thani, Ayman El-Menyar, Yugan Pillay, Monira Mollazehi, Ahammed Mekkodathil, Rafael Consunji
BACKGROUND: Helicopter emergency medical services (HEMS) are considered as a standard component of advanced pre-hospital emergency care system. We assessed the clinical presentation and outcomes of trauma patients transported by HEMS versus ground emergency medical services (GEMS). METHODS: A retrospective analysis of prospectively collected trauma registry data at a level I trauma center was conducted for patients transported by GEMS and HEMS between 2011 and 2013...
July 6, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27789565/is-there-a-weekend-effect-in-major-trauma
#11
David Metcalfe, Daniel C Perry, Omar Bouamra, Ali Salim, Fiona E Lecky, Maralyn Woodford, Antoinette Edwards, Matthew L Costa
BACKGROUND: Many previous studies have shown that patients admitted to hospital at weekends have worse outcomes than those on other days. It has been proposed that parity of clinical services throughout the week could mitigate the 'weekend effect'. This study aimed to determine whether or not a weekend effect is observed within an all-hours consultant-led major trauma service. METHODS: We undertook an observational cohort study using data submitted by all 22 major trauma centres (MTCs) in England to the Trauma Audit & Research Network...
December 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27717564/prospective-validation-of-the-shock-index-pediatric-adjusted-sipa-in-blunt-liver-and-spleen-trauma-an-atomac-study
#12
Maria E Linnaus, David M Notrica, Crystal S Langlais, Shawn D St Peter, Charles M Leys, Daniel J Ostlie, R Todd Maxson, Todd Ponsky, David W Tuggle, James W Eubanks, Amina Bhatia, Adam C Alder, Cynthia Greenwell, Nilda M Garcia, Karla A Lawson, Prasenjeet Motghare, Robert W Letton
BACKGROUND: Age-adjusted pediatric shock index (SIPA) does not require knowledge of age-adjusted blood pressure norms, yet correlates with mortality, serious injury, and need for transfusion in trauma. No prospective studies support its validity. METHODS: A multicenter prospective observational study of patients 4-16years presenting April 2013-January 2016 with blunt liver and/or spleen injury (BLSI). SIPA (maximum heart rate/minimum systolic blood pressure) thresholds of >1...
September 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27712903/end-tidal-co2-on-admission-is-associated-with-hemorrhagic-shock-and-predicts-the-need-for-massive-transfusion-as-defined-by-the-critical-administration-threshold-a-pilot-study
#13
Melvin E Stone, Stanley Kalata, Anna Liveris, Zachary Adorno, Shira Yellin, Edward Chao, Srinivas H Reddy, Michael Jones, Carlos Vargas, Sheldon Teperman
BACKGROUND: Critical administration threshold (≥3 units of packed red blood cells/h or CAT+) has been proposed as a new definition for massive transfusion (MT) that includes volume and rate of blood transfusion. CAT+ has been shown to eliminate survivor bias and be a better predictor of mortality than the traditional MT (>10 units/24h). End-tidal CO2 (ET CO2) negatively correlates with lactate and is an early predictor of shock in trauma patients. We conducted a pilot study to test the hypothesis that low ET CO2 on admission predicts CAT+...
January 2017: Injury
https://www.readbyqxmd.com/read/27682469/predictors-of-mortality-in-pediatric-urban-firearm-injuries
#14
Kelly A Feldman, Jun Tashiro, Casey J Allen, Eduardo A Perez, Holly L Neville, Carl I Schulman, Juan E Sola
BACKGROUND: Although firearms account for less than 5 % of all pediatric injuries, they have the highest associated case fatality rate. METHODS: The registry at a Level-1 trauma center was used to identify firearm injuries (<18 years of age) from 1991 to 2011. Descriptive statistics and risk-adjusted multivariate analyses (MVA) were performed. RESULTS: Overall, 1085 patients were identified. Immediate operations were performed in 33 % (n = 358) of patients with most having abdominal surgery (n = 214)...
September 28, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27629235/ten-year-maturation-period-in-a-level-i-trauma-center-a-cohort-comparison-study
#15
A M K Harmsen, G F Giannakopoulos, M Terra, E S M de Lange de Klerk, F W Bloemers
PURPOSE: Many changes have been made to improve trauma care. Improved trauma team response and usage of a hybrid resuscitation room are examples of how this trauma center has developed. The aim was to assess how the outcome of the trauma population was influenced by the maturation. METHODS: A cohort comparison, between June 2004-July 2005 and 2014, was performed. All adult trauma patients with an Injury Severity Score (ISS) >15 were included. Variables collected were: patient demographics, mechanism of trauma, total prehospital time, pre- and inhospital trauma scores, vital signs, blood values and interventions, and physician staffed helicopter emergency medical services (P-HEMS) involvement and outcome...
September 15, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27586097/prehospital-transportation-decisions-for-patients-sustaining-major-trauma-in-road-traffic-crashes-in-sweden
#16
Stefan Candefjord, Ruben Buendia, Eva-Corina Caragounis, Bengt Arne Sjöqvist, Helen Fagerlind
OBJECTIVE: The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes (RTCs) who could benefit from direct transportation to a trauma center (TC). METHODS: Currently, there is no national classification of TC in Sweden. In this study, 7 university hospitals (UHs) in Sweden were selected to represent a TC level I or level II. These UHs have similar capabilities as the definition for level I and level II TC in the United States...
September 2016: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27582383/direct-oral-anticoagulants-compared-with-warfarin-in-patients-with-severe-blunt-trauma
#17
James M Feeney, Matthew Neulander, Monica DiFiori, Lilla Kis, David S Shapiro, Vijay Jayaraman, William T Marshall, Stephanie C Montgomery
METHODS: We queried our Trauma Quality Improvement Program registry for patients who presented between 6/1/2011 and 9/1/2015 with severe (injury severity score (ISS)>15) blunt traumatic injury during anticoagulant use. Patients were then grouped into those prescribed warfarin and patients prescribed any of the available novel Direct Oral Anticoagulants (DOAC) medications. We excluded severe (AIS≧4) head injuries. RESULTS: There were no differences between DOAC and warfarin groups in terms of age, gender mean ISS, median hospital or intensive care unit lengths of stay, complication proportions, numbers of complications per patient, or the proportion of patients requiring transfusion...
January 2017: Injury
https://www.readbyqxmd.com/read/27565074/mobile-health-technology-transforms-injury-severity-scoring-in-south-africa
#18
Richard Trafford Spence, Eiman Zargaran, S Morad Hameed, Pradeep Navsaria, Andrew Nicol
BACKGROUND: The burden of data collection associated with injury severity scoring has limited its application in areas of the world with the highest incidence of trauma. MATERIAL AND METHODS: Since January 2014, electronic records (electronic Trauma Health Records [eTHRs]) replaced all handwritten records at the Groote Schuur Hospital Trauma Unit in South Africa. Data fields required for Glasgow Coma Scale, Revised Trauma Score, Kampala Trauma Score, Injury Severity Score (ISS), and Trauma Score-Injury Severity Score calculations are now prospectively collected...
August 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27561336/evaluation-of-a-trauma-team-activation-protocol-revision-a-prospective-cohort-study
#19
Trond Dehli, Svein Arne Monsen, Knut Fredriksen, Kristian Bartnes
BACKGROUND: Correct triage based on prehospital information contributes to a better outcome for potentially seriously injured patients. In 2011 we changed the trauma team activation (TTA) criteria in our center in order to improve the high over- and undertriage properties of the protocol. Five criteria that were unable to predict severe injury were removed. In the present study, we evaluated the protocol revision by comparing over- and undertriage in the former and present set of criteria...
August 25, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27540549/thorax-trauma-severity-score-is-it-reliable-for-patient-s-evaluation-in-a-secondary-level-hospital
#20
Isidro Martínez Casas, María Auxiliadora Amador Marchante, Mihai Paduraru, Ana Isabel Fabregues Olea, Andreu Nolasco, Juan Carlos Medina
OBJECTIVE: To determine the predictive and diagnostic value of thorax trauma severity score (TTSS) in a population of thoracic trauma patients admitted to a secondary level trauma center. METHODS: A Retrospective analysis of patients admitted over a period of two years with IDC-9 codes related to thoracic trauma was undertaken. The association of TTSS with complications and mortality was evaluated. We also determined the predictive value of TTSS using receiver operating characteristic curve (ROC)...
July 2016: Bulletin of Emergency and Trauma
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