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https://www.readbyqxmd.com/read/28331951/failure-to-rescue-the-elderly-a-superior-quality-metric-for-trauma-centers
#1
G Barmparas, E J Ley, M J Martin, A Ko, M Harada, D Weigmann, K R Catchpole, B L Gewertz
BACKGROUND: Trauma centers require reliable metrics to better compare the quality of care delivered. We compared mortality after a reported complication, termed failure to rescue (FTR), and FTR in the elderly (age >65 years) (FTRE) to determine which is a superior metric to assess quality of care delivered by trauma centers. METHODS: This was a retrospective review of the National Trauma Databank (NTDB) research data sets 2010 and 2011. Patients ≥16 years admitted to centers reporting ≥80% of AIS and/or ≥ 20% of comorbidities with > 200 subjects in the NTDB were selected...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28272111/disability-risk-in-pediatric-motor-vehicle-crash-occupants
#2
Andrea N Doud, Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Ryan T Barnard, John K Petty, Joel D Stitzel
BACKGROUND: Mortality rates among children in motor vehicle crashes (MVCs) are typically low, however non-fatal injuries can vary in severity by imposing differing levels of short- and long-term disability. To better discriminate the severity of non-fatal MVC-injuries, a pediatric-specific disability risk (DR) metric was created. METHODS: The National Automotive Sampling System (NASS-CDS) 2000-2011 was used to define the top 95% most common Abbreviated Injury Scale (AIS) 2+ injuries among pediatric MVC occupants...
March 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28263858/predicting-mortality-and-independence-at-discharge-in-the-aging-traumatic-brain-injury-population-using-data-available-at-admission
#3
Preston R Miller, Michael C Chang, J Jason Hoth, Amy N Hildreth, Stacey Q Wolfe, Jessica L Gross, R Shayn Martin, Jeffrey E Carter, J Wayne Meredith, Ralph D'Agostino
INTRODUCTION: Aging worsens outcome in traumatic brain injury (TBI), but available studies may not provide accurate outcome predictions due to confounding associated injuries. Our goal was to develop a predictive tool using variables available at admission to predict outcome related to severity of brain injury in aging patients. METHODS: Characteristics and outcomes of blunt trauma patients with isolated TBI of ages ≥ 50 in National Trauma Data Bank (NTDB) were evaluated...
January 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28263857/organ-donation-an-unexpected-benefit-of-aggressive-resuscitation-of-trauma-patients-presenting-dead-on-arrival
#4
Abdul Q Alarhayem, Stephen M Cohn, Mark T Muir, John G Myers, James Fuqua, Brian J Eastridge
BACKGROUND: We sought to determine if aggressive resuscitation in trauma patients presenting without vital signs or "dead on arrival" (DOA) was futile. We also sought to determine if organ donation was an unexpected benefit of aggressive resuscitation. STUDY DESIGN: We conducted a review of adults presenting to our Level 1 trauma center with no signs of life (pulse = 0; systolic blood pressure = 0; and no evidence of neurologic activity, GCS = 3). Primary outcome was survival to hospital discharge or major organ donation (heart, lung, kidney, liver or pancreas were harvested)...
March 2, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28242065/the-impact-of-helmet-use-on-outcomes-after-a-motorcycle-crash
#5
Desmond Khor, Kenji Inaba, Alberto Aiolfi, Samantha Delapena, Elizabeth Benjamin, Kazuhide Matsushima, Aaron M Strumwasser, Demetrios Demetriades
BACKGROUND: Helmet use in a motorcycle collision has been shown to reduce head injury and death. Its protective effect on the cervical spine (C-spine), however, remains unclear. The objective of this study was to explore the relationship between helmet use and C-spine injuries. METHOD: Retrospective National Trauma Data Bank (NTDB) study. All motorcycle collisions between 2007 and 2014 involving either a driver or passenger were included. Data collected included demographics, vital signs, Abbreviated Injury Scale (AIS), Injury Severity Score (ISS) and specific injuries...
February 20, 2017: Injury
https://www.readbyqxmd.com/read/28222915/comparison-of-modified-kampala-trauma-score-with-trauma-mortality-prediction-model-and-trauma-injury-severity-score-a-national-trauma-data-bank-study
#6
Serhat Akay, Ahmet Mucteba Ozturk, Huriye Akay
BACKGROUND: Mortality prediction of trauma patients relies on anatomical, physiological or combined scores. The purpose of this study is to compare the diagnostic accuracy of the modified Kampala Trauma Score (M-KTS) with the Trauma Mortality Prediction Model (TMPM), and Trauma-Injury Severity Score (TRISS) using data from a large dataset from a developed registry, the National Trauma Data Bank (NTDB). METHODS: Using 2011 and 2012 data from NTDB, patient based trauma scores (M-KTS, TMPM, and TRISS) were calculated and predictive ability of M-KTS for mortality was compared with other trauma scores using receiver operating characteristics (ROC) curves...
February 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28206934/increased-age-predicts-failure-to-rescue
#7
Galinos Barmparas, Matthew J Martin, Douglas A Wiegmann, Ken R Catchpole, Bruce L Gewertz, Eric J Ley
Failure to rescue (FTR), defined as any death after the development of in-hospital complications, is an important quality measure, but the relationship with age after a traumatic injury, has not been well defined. We sought to examine whether older trauma patients are at higher risk for FTR. The National Trauma Databank (NTDB) research datasets 2007 to 2011 were queried for patients ≥16 years who had any reported complication. Those who survived (non-FTR) were compared with those who did not (FTR) using a forward logistic regression model...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28041758/emergency-medical-services-ems-versus-non-ems-transport-among-injured-children-in-the-united-states
#8
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...
March 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27992751/blunt-abdominal-trauma-from-motor-vehicle-collisions-from-2007-to-2011-renal-injury-probability-and-severity-in-children-versus-adults
#9
Michael P Kurtz, Jairam R Eswara, Joel M Vetter, Caleb P Nelson, Steven B Brandes
PURPOSE: There are sparse data directly comparing the probability of renal injury in children and adults. The kidney of the child is believed to be more susceptible to blunt injury for a variety of anatomical reasons. In a large cohort we tested the hypothesis that the pediatric kidney is more susceptible to any renal injury and to higher grade injury. MATERIALS AND METHODS: We queried the NTDB® (National Trauma Data Bank®) on all hospital admissions following motor vehicle collisions in a pediatric population (age less than 21 years) and a referent adult population (age 30 to 50 years)...
December 16, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27914588/obesity-in-pediatric-trauma
#10
Cordelie E Witt, Saman Arbabi, Avery B Nathens, Monica S Vavilala, Frederick P Rivara
BACKGROUND/PURPOSE: The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. METHODS: Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated...
November 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27895200/demographics-mechanisms-of-injury-and-concurrent-injuries-associated-with-calcaneus-fractures-a-study-of-14-516-patients-in-the-american-college-of-surgeons-national-trauma-data-bank
#11
Daniel D Bohl, Nathaniel T Ondeck, Andre M Samuel, Pablo J Diaz-Collado, Stephen J Nelson, Bryce A Basques, Michael P Leslie, Jonathan N Grauer
Background This study uses the American College of Surgeons National Trauma Data Bank (NTDB) to update the field on the demographics, injury mechanisms, and concurrent injuries among a national sample of patients admitted to the hospital department with calcaneus fractures. Methods Patients with calcaneus fractures in the NTDB during 2011-2012 were identified and assessed. Results A total of 14 516 patients with calcaneus fractures were included. The most common comorbidity was hypertension (18%), and more than 90% of fractures occurred via traffic accident (49%) or fall (43%)...
November 28, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27890336/complications-and-revision-amputation-following-trauma-related-lower-limb-loss
#12
Eric Edison Low, Elizabeth Inkellis, Saam Morshed
INTRODUCTION: Trauma-related amputations are a common cause of limb loss in the United States. Despite the military and public health impact of trauma-related amputations, distributions of various lower limb amputations and the relative frequency of complications and revision amputations have not been well described. We used the National Trauma Data Bank (NTDB) in order to investigate the epidemiology of trauma-related lower extremity amputations among civilians in U.S. trauma centers...
February 2017: Injury
https://www.readbyqxmd.com/read/27873234/eeg-monitoring-and-antiepileptic-drugs-in-children-with-severe-tbi
#13
Christopher M Ruzas, Peter E DeWitt, Kimberly S Bennett, Kevin E Chapman, Nicole Harlaar, Tellen D Bennett
BACKGROUND: Traumatic brain injury (TBI) causes substantial morbidity and mortality in US children. Post-traumatic seizures (PTS) occur in 11-42% of children with severe TBI and are associated with unfavorable outcome. Electroencephalographic (EEG) monitoring may be used to detect PTS and antiepileptic drugs (AEDs) may be used to treat PTS, but national rates of EEG and AED use are not known. The purpose of this study was to describe the frequency and timing of EEG and AED use in children hospitalized after severe TBI...
April 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27815954/development-of-a-middle-age-and-geriatric-trauma-mortality-risk-score-a-tool-to-guide-palliative-care-consultations
#14
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/27747749/race-and-rehabilitation-following-spinal-cord-injury-equality-of-access-for-american-indians-alaska-natives-compared-to-other-racial-groups
#15
Alan D Cook, Jeanette G Ward, Kristina M Chapple, Hassan Akinbiyi, Mark Garrett, Forrest O'Dell Moore
BACKGROUND: Representing 2 % of the general population, American Indians/Alaska Natives (AIs/ANs) were associated with 0.5 % (63) of the estimated 12,500 new cases of spinal cord injury (SCI) reported to the National Spinal Cord Injury Statistic Center in 2013. To date, the trend in health care disparities among AIs/ANs in the SCI community has not been examined. We sought to compare the rate of discharge to rehabilitation facilities (DRF) following traumatic SCI among adult AIs/ANs to other racial/ethnic groups for patients 15 to 64 years old...
December 2015: Injury Epidemiology
https://www.readbyqxmd.com/read/27621021/trends-in-open-vascular-surgery-for-trauma-implications-for-the-future-of-acute-care-surgery
#16
Joseph D Forrester, Thomas G Weiser, Paul Maggio, Timothy Browder, Lakshika Tennakoon, David Spain, Kristan Staudenmayer
BACKGROUND: Trauma patients with vascular injuries have historically been within a general surgeon's operative ability. Changes in training and decline in operative trauma have decreased trainees' exposure to these injuries. We sought to determine how frequently vascular procedures are performed at US trauma centers to quantify the need for general surgeons trained to manage vascular injuries. METHODS: We conducted a retrospective analysis of the National Trauma Data Base (NTDB) from 2012 compared with 2002...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27586099/functional-outcomes-of-motor-vehicle-crash-head-injuries-in-pediatric-and-adult-occupants
#17
Samantha L Schoell, Ashley A Weaver, Jennifer W Talton, Gretchen Baker, Andrea N Doud, Ryan T Barnard, Joel D Stitzel, Mark R Zonfrillo
OBJECTIVE: The objective of the study was to develop a disability-based metric for motor vehicle crash (MVC) injuries, with a focus on head injuries, and compare the functional outcomes between the pediatric and adult populations. METHODS: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank-Research Data System (NTDB-RDS) for the top 95% most frequently occurring Abbreviated Injury Scale (AIS) 3, 4, and 5 head injuries in NASS-CDS 2000-2011...
September 2016: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27577183/management-of-blunt-pancreatic-trauma-in-children-review-of-the-national-trauma-data-bank
#18
Brian R Englum, Brian C Gulack, Henry E Rice, John E Scarborough, Obinna O Adibe
PURPOSE: This study aims to examine the current management strategies and outcomes after blunt pancreatic trauma in children using a national patient registry. METHODS: Using the National Trauma Data Bank (NTDB) from 2007-2011, we identified all patients ≤18years old who suffered blunt pancreatic trauma. Patients were categorized as undergoing nonoperative pancreatic management (no abdominal operation, abdominal operation without pancreatic-specific procedure, or pancreatic drainage alone) or operative pancreatic management (pancreatic resection/repair)...
September 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27567923/prehospital-intubation-for-isolated-severe-blunt-traumatic-brain-injury-worse-outcomes-and-higher-mortality
#19
Tobias Haltmeier, Elizabeth Benjamin, Stefano Siboni, Evren Dilektasli, Kenji Inaba, Demetrios Demetriades
PURPOSE: Prehospital endotracheal intubation (ETI) for traumatic brain injury (TBI) is a controversial issue. The aim of this study was to investigate the effect of prehospital ETI in patients with TBI. METHODS: Cohort-matched study using the US National Trauma Data Bank (NTDB) 2008-2012. Patients with isolated severe blunt TBI (AIS head ≥3, AIS chest/abdomen <3) and a field GCS ≤8 were extracted from NTDB. A 1:1 matching of patients with and without prehospital ETI was performed...
August 27, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27553053/no-disparity-for-american-indians-in-surgery-for-pelvis-lower-extremity-fractures-a-cohort-study-of-the-national-trauma-data-bank-ntdb
#20
Alan Cook, Kristina Chapple, Neil Motzkin, Jeanette Ward, Forrest Moore
BACKGROUND: Racial/ethnic disparities in trauma care have been reported. The American Indian/Alaska Native (AI/AN) population faces a twofold to fourfold increase of risk for traumatic injury. We hypothesized that surgical intervention and time to surgery were associated with race/ethnicity, specifically AI/AN compared to other race/ethnicity groups with open pelvic and lower extremity fractures (OPLEFx). METHODS: Non-AI/AN racial/ethnic groups were compared to AI/ANs among adults aged 15 years and older using the National Trauma Data Bank for 2008-2012...
August 23, 2016: Journal of Racial and Ethnic Health Disparities
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