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https://www.readbyqxmd.com/read/29675749/evaluation-of-severe-and-fatal-injuries-in-extreme-and-contact-sports-an-international-multicenter-analysis
#1
Christian D Weber, Klemens Horst, Anthony R Nguyen, Rolf Lefering, Hans-Christoph Pape, Frank Hildebrand
PURPOSE: The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. METHODS: We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®)...
April 19, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29538237/proximal-penetrating-extremity-injuries-an-opportunity-to-decrease-overtriage
#2
Grace E Martin, Heng He, Amy T Makley, Timothy A Pritts, Joel B Elterman, Jay A Johannigman, Michael D Goodman
BACKGROUND: Penetrating injuries to the extremity proximal to the elbow or knee are anatomic criteria for full trauma team activation by the American College of Surgeon's Committee on Trauma standards. This criterion lacks objective evidence-based support. Overtriage of trauma team activation may result in excessive costs and resource burden at trauma centers. We hypothesized that full trauma team activation for penetrating injuries to the proximal extremities by anatomic criteria alone may lead to significant overtriage...
March 12, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29419715/spine-trauma-from-personal-watercraft-usage
#3
Chester J Donnally, Gil Metser, Eric S Roth, Justin P Moo Young, Augustus J Rush, Motasem A Al Maaieh
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To identify patient characteristics and associated injuries in those sustaining a spine fracture from personal watercraft (PWC) usage. SUMMARY OF BACKGROUND DATA: There are few studies regarding PWC use and injuries, and even more scarce are studies evaluating PWC usage and spine injuries. Identifying high risk actions and individuals can help to effectively treat them, reduce mortality, and possibly avoid certain spine fractures...
February 6, 2018: Spine
https://www.readbyqxmd.com/read/29412051/prehospital-analgesia-for-pediatric-trauma-patients-in-iraq-and-afghanistan
#4
Steven G Schauer, Allyson A Arana, Jason F Naylor, Guyon J Hill, Michael D April
BACKGROUND: Previous studies have evaluated prehospital analgesia during combat operations in Iraq and Afghanistan, but were limited to the adult population. However, a significant portion of the casualties of those conflicts were children. We describe the prehospital analgesia administered to wartime pediatric trauma patients. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients (<18 years of age) admitted to United States and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016...
February 7, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29391108/application-of-a-geriatric-injury-protocol-demonstrates-high-survival-rates-for-geriatric-trauma-patients-with-high-injury-acuity
#5
Tigran Karamanukyan, Andrea Pakula, Maureen Martin, Ashwitha Francis, Ruby Skinner
Geriatric trauma has historically been associated with poor outcomes, particularly in the setting of severe polytrauma. Although geriatric trauma protocols are common, there are limited data on their impact in patients with high injury severity. In this study, we sought to investigate the impact of a geriatric injury protocol on outcomes in patients with severe trauma acuity. Ninety-eight geriatric patients (age ≥65) admitted to our trauma center with injury severity scores (ISS) ≥15 comprised the study cohort...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29371879/casualties-of-peace-an-analysis-of-casualties-admitted-to-the-intensive-care-unit-during-the-negotiation-of-the-comprehensive-colombian-process-of-peace
#6
Carlos A Ordoñez, Ramiro Manzano-Nunez, Maria Paula Naranjo, Esteban Foianini, Cecibel Cevallos, Maria Alejandra Londoño, Alvaro I Sanchez Ortiz, Alberto F García, Ernest E Moore
Background: After 52 years of war in 2012, the Colombian government began the negotiation of a process of peace, and by November 2012, a truce was agreed. We sought to analyze casualties who were admitted to the intensive care unit (ICU) before and during the period of the negotiation of the comprehensive Colombian process of peace. Methods: Retrospective study of hostile casualties admitted to the ICU at a Level I trauma center from January 2011 to December 2016...
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29283966/undertriage-in-trauma-does-an-organized-trauma-network-capture-the-major-trauma-victim-a-statewide-analysis
#7
Michael A Horst, Shreya Jammula, Brian W Gross, Alan D Cook, Eric H Bradburn, Juliet Altenburg, Danielle Von Nieda, Madison Morgan, Frederick B Rogers
BACKGROUND: Proper triage of critically injured trauma patients to accredited trauma centers (TCs) is essential for survival and patient outcomes. We sought to determine the percentage of patients meeting trauma criteria who received care at non-TCs (NTCs) within the statewide trauma system that exists in the state of Pennsylvania. We hypothesized that a substantial proportion of the trauma population would be undertriaged to NTCs with undertriage rates (UTR) decreasing with increasing severity of injury...
March 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283920/does-lactate-affect-the-association-of-early-hyperglycemia-and-multiple-organ-failure-in-severely-injured-blunt-trauma-patients
#8
Justin E Richards, Thomas M Scalea, Michael A Mazzeffi, Peter Rock, Samuel M Galvagno
BACKGROUND: Early hyperglycemia is associated with multiple organ failure (MOF) after traumatic injury; however, few studies have considered the contribution of depth of clinical shock. We hypothesize that when considered simultaneously, glucose and lactate are associated with MOF in severely injured blunt trauma patients. METHODS: We performed a retrospective investigation at a single tertiary care trauma center. Inclusion criteria were patient age ≥18 years, injury severity score (ISS) >15, blunt mechanism of injury, and an intensive care unit length of stay >48 hours...
March 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29221606/-medical-information-system-pmsi-does-not-adequately-identify-severe-trauma
#9
A Perozziello, T Gauss, A Diop, M Frank-Soltysiak, P Rufat, M Raux, S Hamada, B Riou
BACKGROUND: Resource allocation to hospitals is highly dependent on appropriate case coding. For trauma victims, the major diagnosis-coding category (DCC) is multiple trauma (DCC26), which triggers higher funding. We hypothesized that DCC26 has limited capacity for appropriate identification of severe trauma victims. METHODS: We studied Injury Severity Score (ISS), Trauma Related Injury Severity Score (TRISS) and in-hospital mortality using data recorded in three level 1 trauma centers over a 2-year period...
February 2018: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/29214322/road-traffic-accidents-in-children-the-what-how-and-why
#10
Yue Yen Lee, Eric Fang, Yanyi Weng, Sashikumar Ganapathy
INTRODUCTION: Road traffic accidents (RTAs) in Singapore involving children were evaluated, with particular focus on the epidemiology, surrounding circumstances and outcomes of these accidents. Key factors associated with worse prognosis were identified. We proposed some measures that may be implemented to reduce the frequency and severity of such accidents. METHODS: This was a retrospective study of RTAs involving children aged 0-16 years who presented to the Children's Emergency at KK Women's and Children's Hospital, Singapore, from January 2011 to June 2014...
December 7, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/29194318/non-compliance-with-acs-cot-recommended-criteria-for-full-trauma-team-activation-is-associated-with-undertriage-deaths
#11
Christopher J Tignanelli, Wayne E Vander Kolk, Judy N Mikhail, Matthew J Delano, Mark R Hemmila
BACKGROUND: The appropriate triage of acutely injured patients within a trauma system is associated with improved rates of mortality and optimal resource utilization. The American College of Surgeons Committee on Trauma (ACS-COT) put forward six minimum criteria (ACS-6) for full trauma team activation (TTA). We hypothesized that ACS-COT verified trauma center compliance with these criteria is associated with low under-triage rates and improved overall mortality. METHODS: Data from a state-wide collaborative quality initiative was utilized...
November 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29170332/35-to-pan-scan-or-not-to-pan-scan-further-analysis-of-the-tarn-database-2012-2017
#12
Paul Hunt, Fiona Lecky, Omar Bouamra
BACKGROUND: A 'whole body' or 'pan-scan' computed tomography (CT) imaging approach is now becoming the standard of care during the early management of adult patients with suspected severe blunt multitrauma. A number of studies have variously reported a mortality benefit or no benefit from a pan-scan approach compared to that of carrying out body region-focused CT and/or plain radiographs or a mixture of imaging modalities. However, unanswered questions still remain due to the significant heterogeneity in practice between institutions, and the limitations of published studies...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29127439/trauma-patients-centralization-for-the-mechanism-of-trauma-old-questions-without-answers
#13
S Magnone, A Ghirardi, M Ceresoli, L Ansaloni
INTRODUCTION: Centralization of trauma patients has become the standard of care. Unfortunately, overtriage can overcome the capability of Trauma Centres. This study aims to analyse the association of different mechanisms of injury with severe or major trauma defined as Injury Severity Score (ISS) greater than 15 and an estimation of overtriage upon our Trauma Centre. METHODS: A retrospective review of our prospective database was undertaken from March 2014 to August 2016...
November 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28969894/targeting-resuscitation-to-normalization-of-coagulating-status-hyper-and-hypocoagulability-after-severe-injury-are-both-associated-with-increased-mortality
#14
Hunter B Moore, Ernest E Moore, Ioannis N Liras, Charles Wade, Benjamin R Huebner, Clay Cothren Burlew, Fredric M Pieracci, Angela Sauaia, Bryan A Cotton
INTRODUCTION: The prevalence and impact of hypercoagulability (hypo) in severely injured patients early after injury remains unclear. We hypothesize that the predominant phenotype of postinjury coagulopathy is hypercoagulability (hyper) and it is associated with increased mortality. MATERIAL AND METHODS: Blood samples from 141 healthy volunteers assayed with thrombelastography (TEG) were used to identify thresholds of hypo and hypercoagulability (above 95th/below the 5th percentile) in four TEG indices...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28965094/how-health-service-delivery-guides-the-allocation-of-major-trauma-patients-in-the-intensive-care-units-of-the-inclusive-hub-and-spoke-trauma-system-of-the-emilia-romagna-region-italy-a-cross-sectional-study
#15
Arturo Chieregato, Annalisa Volpi, Giovanni Gordini, Chiara Ventura, Marco Barozzi, Maria Luisa Rita Caspani, Andrea Fabbri, Anna Maria Ferrari, Enrico Ferri, Aimone Giugni, Massimiliano Marino, Costanza Martino, Mario Pizzamiglio, Maurizio Ravaldini, Emanuele Russo, Laura Trabucco, Susanna Trombetti, Rossana De Palma
OBJECTIVE: To evaluate cross-sectional patient distribution and standardised 30-day mortality in the intensive care units (ICU) of an inclusive hub and spoke trauma system. SETTING: ICUs of the Integrated System for Trauma Patient Care (SIAT) of Emilia-Romagna, an Italian region with a population of approximately 4.5 million. PARTICIPANTS: 5300 patients with an Injury Severity Score (ISS) >15 were admitted to the regional ICUs and recorded in the Regional Severe Trauma Registry between 2007 and 2012...
September 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28930946/evaluating-the-traditional-day-and-night-shift-in-an-acute-care-surgery-fellowship-is-the-swing-shift-a-better-choice
#16
Paul J Chestovich, Christopher F McNicoll, Nichole K Ingalls, Deborah A Kuhls, Douglas R Fraser, Shawna L Morrissey, John J Fildes
BACKGROUND: Fellowship trainees in acute care surgery require experience in the management of complex and operative trauma cases. Trauma center staffing usually follows standard 12-hour or 24-hour shifts, with resident and fellow trainees following a similar schedule. Although trauma admissions can be generally unpredictable, we analyzed temporal trends of trauma patient arrival times to determine the best time frame to maximize trainee experience during each day. METHODS: We reviewed 10 years (2007-2016) of trauma registry data for blunt and penetrating trauma activations...
January 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28894892/using-emergency-trauma-team-activations-to-measure-trauma-activity-and-injury-severity-10-years-of-experience-using-an-australian-major-trauma-centre-registry
#17
M M Dinh, S Roncal, K Curtis, R Ivers
OBJECTIVES: To describe the outcomes of Emergency Department trauma team activations over a 10-year period with respect to injury severity and hospital length of stay. METHODS: This was a retrospective study using trauma registry data at a single Major Trauma Centre in Australia. All trauma team activations and arrivals on pre-hospital major trauma (T1) protocol recorded in the trauma registry between June 2006 and July 2016 were included. The outcome of interest was major trauma, defined as an Injury Severity Score (ISS) >12 or length of stay >3 days or requiring urgent operative intervention or admission to the Intensive Care Unit following trauma...
September 11, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28829661/multicenter-prospective-study-of-prehospital-administration-of-analgesia-in-the-u-s-combat-theater-of-afghanistan
#18
Steven G Schauer, Alejandra G Mora, Joseph K Maddry, Vikhyat S Bebarta
BACKGROUND: Published data on prehospital medical care in combat is limited, likely due to the chaotic and unpredictable nature of care under fire and difficulty in documentation There is limited data on how often analgesic agents are administered, which drug are being used, and whether there is an association with injury patterns. METHODS: This study was a prospective, multicenter, observational study to determine which analgesic agents are being used prehospital and whether there is an association with injury patterns...
November 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28780982/validation-of-the-criteria-for-early-critical-care-resource-use-in-assessing-the-effectiveness-of-field-triage
#19
Ki Ok Ahn, Sang Chul Kim, Ju Ok Park, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong
BACKGROUND: This study aimed to validate the criteria for early critical care resource (CCR) use as an outcome predictor for seriously injured patients triaged in the field by comparing the effectiveness of the criteria for early CCR use with that of criteria defined by an Injury Severity Score (ISS) >15. METHODS: We analysed data from seriously injured trauma patients who were triaged using a field triage protocol by emergency medical service providers (EMS-ST patients)...
February 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#20
Jan-Michael Van Gent, Richard Yee Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism, including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given that recent data suggesting postinjury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of postinjury DVT and PE are different...
December 2017: Journal of Trauma and Acute Care Surgery
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