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https://www.readbyqxmd.com/read/28530775/a-surgical-approach-to-iatrogenic-vascular-injuries-in-pediatric-cases
#1
Yüksel Beşir, Orhan Gökalp, Börteçin Eygi, Banu Bahriye Lafcı, Gamze Gökalp, Levent Yılık, Hasan İner, Ali Gürbüz
BACKGROUND: Surgical intervention is mandatory in many children who present with vascular trauma or in complicated cases after medical interventions. In this study, surgical interventions applied after vascular injuries in children were analyzed. METHODS: Between January 2002 and December 2012, 17 patients (aged under 18) who were admitted to the emergency room with vascular injuries were retrospectively analyzed. The data was collected through hospital records...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530771/macrophage-migration-inhibitory-factor-levels-correlate-with-an-infection-in-trauma-patients
#2
Young Duck Cho, Sung Hyuk Choi, Jung Youn Kim, Sung Jun Park, Young Hoon Yoon, Han Jin Cho, Ji Won Yeom
BACKGROUND: The role of migration inhibitory factor (MIF) is best understood in septic shock and septic disease; however, the role of MIF in a secondary infection after trauma has not yet been completely studied. This study aimed to evaluate the role of MIF in trauma patients. METHODS: The patients in the study population were divided into two groups according to the results of their MIF levels. The initial MIF levels, trauma mechanism, revised trauma score, survival rate, length of stay (LOS) in the intensive care unit (ICU), level of leukocytes, and level of C-reactive protein (CRP) were compared between the groups...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28528969/limitation-of-life-sustaining-treatment-in-severe-trauma-in-the-elderly-after-admission-to-an-intensive-care-unit
#3
Y Peñasco, A González-Castro, J C Rodríguez Borregán, M Ortiz-Lasa, R Jáuregui Solórzano, M J Sánchez Arguiano, P Escudero Acha
OBJECTIVE: To analyze the factors associated to limitation of life-sustaining treatment (LLST) measures in elderly patients admitted to an intensive care unit (ICU) due to trauma. DESIGN: A retrospective, descriptive, observational study was carried out. SETTING: ICU. PATIENTS: A total of 149 patients aged 65 years or older admitted to the ICU due to trauma. Hospital mortality, the decision to limit life-sustaining treatment and the factors associated to these measures were analyzed...
May 18, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28525509/analgesic-choice-in-management-of-rib-fractures-paravertebral-block-or-epidural-analgesia
#4
Mahdi Malekpour, Ammar Hashmi, James Dove, Denise Torres, Jeffrey Wild
BACKGROUND: Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). METHODS: Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28521903/motorcycle-related-hospitalizations-of-the-elderly
#5
Ching-Hua Hsieh, Hang-Tsung Liu, Shiun-Yuan Hsu, Hsiao-Yun Hsieh, Yi-Chun Chen
BACKGROUND: To investigate the injury pattern, mechanisms, severity, and mortality of the elderly hospitalized for treatment of trauma following motorcycle accidents. METHODS: Motorcycle-related hospitalization of 994 elderly and 5078 adult patients from the 16,548 hospitalized patients registered in the Trauma Registry System between January 1, 2009 and December 31, 2013. RESULTS: The motorcycle-related elderly trauma patients had higher injury severity, less favorable outcomes, higher proportion of patients admitted to the intensive care unit (ICU), prolonged hospital and ICU stays and higher mortality than those adult motorcycle riders...
April 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28521902/differences-between-the-sexes-in-motorcycle-related-injuries-and-fatalities-at-a-taiwanese-level-i-trauma-center
#6
Ching-Hua Hsieh, Shiun-Yuan Hsu, Hsiao-Yun Hsieh, Yi-Chun Chen
BACKGROUND: Female patients present with unique physiological and behavioral characteristics compared to male patients. The aim of this study was to investigate and compare the injury patterns, injury characteristics, and mortality of male and female patients hospitalized for treatment of motorcycle accident-related trauma in a level I trauma center. METHODS: Retrospective analysis of motorcycle-related injuries from the Trauma Registry System was performed to identify and compare 4028 male and 2919 female patients hospitalized for treatment between January 1, 2009 and December 31, 2013...
April 2017: Biomedical Journal
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#7
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28498856/patterns-of-intravenous-fluid-resuscitation-use-in-adult-intensive-care-patients-between-2007-and-2014-an-international-cross-sectional-study
#8
Naomi E Hammond, Colman Taylor, Simon Finfer, Flavia R Machado, YouZhong An, Laurent Billot, Frank Bloos, Fernando Bozza, Alexandre Biasi Cavalcanti, Maryam Correa, Bin Du, Peter B Hjortrup, Yang Li, Lauralyn McIntryre, Manoj Saxena, Frédérique Schortgen, Nicola R Watts, John Myburgh
BACKGROUND: In 2007, the Saline versus Albumin Fluid Evaluation-Translation of Research Into Practice Study (SAFE-TRIPS) reported that 0.9% sodium chloride (saline) and hydroxyethyl starch (HES) were the most commonly used resuscitation fluids in intensive care unit (ICU) patients. Evidence has emerged since 2007 that these fluids are associated with adverse patient-centred outcomes. Based on the published evidence since 2007, we sought to determine the current type of fluid resuscitation used in clinical practice and the predictors of fluid choice and determine whether these have changed between 2007 and 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28495240/risk-factors-for-pulmonary-complication-following-operative-fixation-of-spine-fractures
#9
Douglas S Weinberg, Brian Z Hedges, Jonathan E Belding, Timothy A Moore, Heather A Vallier
BACKGROUND CONTEXT: Previous studies have suggested pulmonary complications are common among patients undergoing fixation for traumatic spine fractures. This leads to prolonged hospital stay, worse functional outcomes, and increased economic burden. However, only limited prognostic information exists regarding which patients are at greatest risk for pulmonary complications. PURPOSE: To identify factors predictive of perioperative pulmonary complications in patients undergoing fixation of spine fractures...
May 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28495204/intracranial-pressure-monitoring-in-severe-traumatic-brain-injuries-a-closer-look-at-level-1-trauma-centers-in-the-united-states
#10
Piccinini Alice, Lewis Meghan, Benjamin Elizabeth, Aiolfi Alberto, Inaba Kenji, Demetriades Demetrios
INTRODUCTION: The Brain Trauma Foundation (BTF) recently updated recommendations for intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI). The effect of ICP monitoring on outcomes is controversial, and compliance with BTF guidelines is variable. The purpose of this study was to assess both compliance and outcomes at level I trauma centers. MATERIALS AND METHODS: The American College of Surgeons Trauma Quality Improvement Program database was queried for all patients admitted to level I trauma centers with isolated blunt severe TBI (AIS>3, GCS<9) who met criteria for ICP monitoring...
April 20, 2017: Injury
https://www.readbyqxmd.com/read/28495203/treatment-of-air-leak-in-polytrauma-patients-with-blunt-chest-injury
#11
Gabriel Halat, Lukas L Negrin, Konstantina Chrysou, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
INTRODUCTION: Precise diagnostics and an adequate therapeutic approach are mandatory in the treatment of air leak in polytrauma patients with blunt chest trauma. The aim of this study was to evaluate the incidence, characteristics, and management of air leak following this injury pattern. PATIENTS AND METHODS: Data from 110 polytrauma patients was collected retrospectively. Fifty-four patients received initial treatment by chest tube placement for pneumothorax. These patients were classified into two groups, one with severe air leak and one with minor air leak...
May 1, 2017: Injury
https://www.readbyqxmd.com/read/28493754/discrepancy-in-caregiving-expectations-predicts-problematic-alcohol-use-among-caregivers-of-trauma-injury-patients-six-months-after-icu-admission
#12
Nathan T Kearns, Heidemarie Blumenthal, Evan E Rainey, Monica M Bennett, Mark B Powers, Michael L Foreman, Ann Marie Warren
This prospective study examined the influence of caregiving variables on the development of problematic alcohol use among family members of patients admitted to an urban Level I trauma center. Data were collected from 124 caregivers 48 hrs after initial hospitalization of their family member. The final sample included 81 participants (24.6% male; Mage = 47.8) who completed their follow-up assessment at 6 months. Hierarchical linear and logistic regression analyses assessed increases in consumption and odds of a positive screen for problematic alcohol use in association with caregiver burden, actual time spent in the caregiving role, and caregiving differential (i...
May 11, 2017: Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors
https://www.readbyqxmd.com/read/28493038/perioperative-implications-of-thoracic-decortications-a-retrospective-cohort-study
#13
Jay Gorman, Duane Funk, Sadeesh Srinathan, John Embil, Linda Girling, Stephen Kowalski
PURPOSE: An increasing number of thoracic decortications have been performed in Manitoba, from five in 2007 to 45 in 2014. The primary objective of this study was to define the epidemiology of decortications in Manitoba. The secondary objective was to compare patients who underwent decortication due to primary infectious vs non-infectious etiology with respect to their perioperative outcomes. METHODS: Data for this cohort study were extracted from consecutive charts of all adult patients who underwent a decortication in Manitoba from 2007-2014 inclusive...
May 10, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28492407/the-spleen-not-taken-differences-in-management-and-outcomes-of-blunt-splenic-injuries-in-teenagers-cared-for-by-adult-and-pediatric-trauma-teams-in-a-single-institution
#14
Sean O'Connor, Andrea N Doud, Leah M Sieren, Preston R Miller, Kristen A Zeller
BACKGROUND: Non-operative management (NOM) of blunt splenic injury, initially touted for the care of pediatric patients, has become the standard of care for stable trauma patients of all ages. In our institution, trauma patients <16 years old are managed by the pediatric surgery service and patients ≥16 years are managed by the adult trauma service. Angioembolization is routinely employed for adults with blunt splenic injury but rarely used for pediatric patients. A retrospective chart review was performed to determine if more liberal use of angioembolization increases the success rate of NOM of blunt splenic injury in adolescents...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28490566/a-retrospective-cohort-study-of-the-utility-of-the-modified-early-warning-score-for-interfacility-transfer-of-patients-with-traumatic-injury
#15
Kristin Salottolo, Matthew Carrick, Jacob Johnson, Mark Gamber, David Bar-Or
OBJECTIVE: The modified early warning score (MEWS) is a 'track and trigger' score using routine physiological vital signs. The objective is to determine if the pretransfer MEWS can be used for predicting outcomes in trauma patients requiring interfacility transfer to higher levels of care. DESIGN, SETTING AND PARTICIPANTS: Retrospective study of consecutively transferred trauma patients into a level-II trauma centre from 2013 to 2014. INTERVENTIONS: None...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28489471/effect-of-the-2011-revisions-to-the-field-triage-guidelines-on-under-and-over-triage-rates-for-pediatric-trauma-patients
#16
E Brooke Lerner, Jeremy T Cushman, Amy L Drendel, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: In 2011, revised Field Triage Guidelines were released jointly by the Centers for Disease Control and Prevention (CDC) and the American College of Surgeons - Committee on Trauma (ACS-COT). It is unknown how the modifications will affect the number of injured children identified by EMS providers as needing transport to a trauma center. OBJECTIVE: To determine the change in under- and over-triage rates when the 2011 Field Triage Guidelines are compared to the 2006 and 1999 versions...
May 10, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28486891/assessing-contemporary-intensive-care-unit-outcome-development-and-validation-of-the-australian-and-new-zealand-risk-of-death-admission-model
#17
E Paul, M Bailey, J Kasza, D V Pilcher
The Australian and New Zealand Risk of Death (ANZROD) model currently used for benchmarking intensive care units (ICUs) in Australia and New Zealand utilises physiological data collected up to 24 hours after ICU admission to estimate the risk of hospital mortality. This study aimed to develop the Australian and New Zealand Risk of Death admission (ANZROD<sub>0</sub>) model to predict hospital mortality using data available at presentation to ICU and compare its performance with the ANZROD in Australian and New Zealand hospitals...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#18
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28485313/clinical-characteristics-and-current-interventions-in-shock-patients-in-chinese-emergency-departments-a-multicenter-prospective-cohort-study
#19
Shu-Bin Guo, Yun-Xia Chen, Xue-Zhong Yu
BACKGROUND: Shock is a life-threatening condition in emergency departments (EDs) and is associated with a high mortality; however, its clinical characteristics and current interventions in China are seldom reported. This study investigated the clinical characteristics and current interventions of shock patients in Chinese EDs. METHODS: This multicenter prospective cohort study was conducted in the EDs of 33 academic hospitals in 16 Chinese provinces. Adult shock patients were enrolled from December 2013 to April 2014...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28484782/necrotizing-fasciitis-treatment-concepts-and-clinical-results
#20
M Leiblein, I Marzi, A L Sander, J H Barker, F Ebert, J Frank
BACKGROUND: Necrotizing fasciitis is a life-threatening soft tissue infection characterized by a rapid spreading infection of the subcutaneous tissue and in particular the fascia. The management of infected tissues requires a rapid diagnosis, immediate aggressive surgical management and an extended debridement. In some cases early amputations of the affected tissues and maximum intensive care treatment, in case of sepsis, are required. Due to a rising number of cases we aimed to evaluate our patients in a retrospective review...
May 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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