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Latest & greatest articles for trauma
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Trauma recidivism at an emergency department of a Swedish medical center 27747558 2018 11 13 2197-1714 3 1 2016 Dec Injury epidemiology Inj Epidemiol Trauma recidivism at an emergency department of a Swedish medical center. 22 To inform targeted prevention, we studied patterns of trauma recidivism and whether a first injury predicts the risk for a recurrent injury. In a population-based study of 98,502 adult injury events 1999-2012, at the emergency department of Umeå University Hospital (...) , Sweden, we compared non-recidivists with recidivists in terms of patients' sex, age, type of injury and severity of the injury. Thirty-six percent of all patients suffered recurrent injuries, which were associated with a higher proportion of inpatient care and more hospital days. Young men and elderly women were at the highest risk for trauma recidivism. At 20 to 24 years, men had a 2.4 (CI 95 % 2.3-2.5) higher risk than women, a 90 years old woman had almost a 10-fold higher risk for another
Glasgow Coma Scale Motor Component ("Patient Does Not Follow Commands") Performs Similarly to Total Glasgow Coma Scale in Predicting Severe Injury in Trauma Patients 27436703 2016 07 24 2016 11 29 1097-6760 68 6 2016 Dec Annals of emergency medicine Ann Emerg Med Glasgow Coma Scale Motor Component ("Patient Does Not Follow Commands") Performs Similarly to Total Glasgow Coma Scale in Predicting Severe Injury in Trauma Patients. 744-750.e3 S0196-0644(16)30295-5 10.1016/j.annemergmed.2016.06.017 (...) Trauma victims are frequently triaged to a trauma center according to the patient's calculated Glasgow Coma Scale (GCS) score despite its known inconsistencies. The substitution of a simpler binary assessment of GCS-motor (GCS-m) score less than 6 (ie, "patient does not follow commands") would simplify field triage. We compare total GCS score to this binary assessment for predicting trauma outcomes. This retrospective analysis of a statewide trauma registry includes records from 393,877 patients from
Thrombelastography-Based Dosing of Enoxaparin for Thromboprophylaxis in Trauma and Surgical Patients: A Randomized Clinical Trial 27487253 2016 08 03 2017 02 03 2168-6262 151 10 2016 Oct 19 JAMA surgery JAMA Surg Thrombelastography-Based Dosing of Enoxaparin for Thromboprophylaxis in Trauma and Surgical Patients: A Randomized Clinical Trial. e162069 10.1001/jamasurg.2016.2069 Prophylactic enoxaparin is used to prevent venous thromboembolism (VTE) in surgical and trauma patients. However, VTE (...) remains an important source of morbidity and mortality, potentially exacerbated by antithrombin III or anti-Factor Xa deficiencies and missed enoxaparin doses. Recent data suggest that a difference in reaction time (time to initial fibrin formation) greater than 1 minute between heparinase and standard thrombelastogram (TEG) is associated with a decreased risk of VTE. To evaluate the effectiveness of TEG-adjusted prophylactic enoxaparin dosing among trauma and surgical patients
Barriers Against Implementing Blunt Abdominal Trauma Guidelines in a Hospital: A Qualitative Study 27757191 2018 11 13 2008-5842 8 8 2016 Aug Electronic physician Electron Physician Barriers Against Implementing Blunt Abdominal Trauma Guidelines in a Hospital: A Qualitative Study. 2793-2801 Clinical practice guidelines are structured recommendations that help physicians and patients to make proper decisions when dealing with a specific clinical condition. Because blunt abdominal trauma causes (...) a various range of mild, single-system, and multisystem injuries, early detection will help to reduce mortality and resulting disability. Emergency treatment should be initiated based on CPGs. This study aimed to determine the variables affecting implementing blunt abdominal trauma CPGs in an Iranian hospital. This study was conducted as a qualitative and phenomenology study in the Family Hospital in Tehran (Iran) in 2015. The research population included eight experts and key people in the area
The onset of rheumatoid arthritis following trauma 27843373 2018 11 13 1179-156X 8 2016 Open access rheumatology : research and reviews Open Access Rheumatol The onset of rheumatoid arthritis following trauma. 77-80 Rheumatoid arthritis (RA) is known to have many predisposing factors. We studied individuals whose RA was initiated by physical injuries. Sixty patients (43 females), previously well, developed RA following trauma. No other known environmental or familial influences were present (...) . Fourteen sustained a fracture; of the 46 who did not, 36 sustained multiple injuries that in part involved the axial skeleton. Subsequent unremitting daily pain, stiffness, limited motion, pain on motion, and/or swelling in the injured areas were mandatory for inclusion. Nine months after injuries (span: 2 weeks-36 months), more obvious signs of inflammation (IM) appeared in multiple other joints that were previously not affected by the original trauma. In those with laboratory tests done prior
Effectiveness of cadaverâ€based educational seminar for trauma surgery: skills retention after halfâ€year followâ€up 29123837 2018 11 13 2052-8817 4 1 2017 01 Acute medicine & surgery Acute Med Surg Effectiveness of cadaver-based educational seminar for trauma surgery: skills retention after half-year follow-up. 57-67 10.1002/ams2.230 In Japan, trauma surgery training remains insufficient, and on-the-job training has become increasingly difficult because of the decreasing number of severe (...) trauma patients and the development of non-operative management. Therefore, we assessed whether a 1-day cadaver-based seminar is effective for trauma surgery training. Data were collected from 11 seminars carried out from January 2013 to March 2014, including a 10-point self-assessment of confidence levels (SACL) for 21 surgical skills and an evaluation of the contents before, just after, and a half-year after the seminar. Statistical analysis was undertaken using the paired t -test at P < 0.0167
A survival prediction logistic regression models for blunt trauma victims in Japan 29123836 2018 11 13 2052-8817 4 1 2017 01 Acute medicine & surgery Acute Med Surg A survival prediction logistic regression models for blunt trauma victims in Japan. 52-56 10.1002/ams2.228 This research aimed to propose a logistic regression model for Japanese blunt trauma victims. We tested whether the logistic regression model previously created from data registered in the Japan Trauma Data Bank between 2005 (...) and 2008 is still valid for the data from the same data bank between 2009 and 2013. Additionally, we analyzed whether the model would be highly accurate even when its coefficients were rounded off to two decimal places. The model was proved to be highly accurate (94.56%) in the recent data (2009-2013). We also showed that the model remains valid without respiratory rate data and the simplified model would maintain high accuracy. We propose the equation of survival prediction of blunt trauma victims
Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial. 27382455 2016 07 06 2016 07 06 2017 02 20 8 5 2016 May Electronic physician Electron Physician Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial. 2432-5 10.19082/2432 Cervical spine trauma occurs mostly among young males due to falls and car accidents. The CT scan (...) technology is replacing radiography in many medical clinics as it is very capable in detecting subtle cervical spine injuries. However, the use of CT scan for routine screening in patients with cervical spine trauma remains controversial due to its radiation risks and relatively high cost. The focus of this research was on using morphine in patients with cervical spine trauma. The objective was to determine the ability of morphine to reduce the number of patients in need of CT scans. This double-blinded
Cardiac Troponin I is Increased in Patients with Polytrauma and Chest or Head Trauma. Results of A Retrospective Case-Control Study J Med Biochem 2016; 35 (3) DOI: 10.1515/jomb-2016-0010 UDK 577.1 : 61 ISSN 1452-8258 J Med Biochem 35: 275–281, 2016 Original paper Originalni nau~ni rad CARDIAC TROPONIN I IS INCREASED IN PATIENTS WITH POLYTRAUMA AND CHEST OR HEAD TRAUMA. RESULTS OF A RETROSPECTIVE CASE-CONTROL STUDY SR^ANI TROPONIN I JE POVI[EN KOD PACIJENATA SA POLITRAUMOM I TRAUMAMA GRUDI ILI (...) number of patients admitted to the emergency department (ED) with different types of trauma. Methods: The study population consisted of all patients aged 18 years or older admitted to the local ED with all types of traumas over a 1-year period. Results of cTnI were compared with those of 125 consecutive blood donors and 25 non-cardiac chest pain ED patients. Results: The final study population consisted of 380 trau- ma patients, 10 with isolated abdominal trauma, 99 with isolated trauma of the limbs
Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. BACKGROUND: Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. We aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in patients with trauma. METHODS (...) : We undertook an international, multicentre, randomised controlled trial at four hospitals in the Netherlands and one in Switzerland. Patients aged 18 years or older with trauma with compromised vital parameters, clinical suspicion of life-threatening injuries, or severe injury were randomly assigned (1:1) by ALEA randomisation to immediate total-body CT scanning or to a standard work-up with conventional imaging supplemented with selective CT scanning. Neither doctors nor patients were masked
Outcomes of abdominal trauma patients with hemorrhagic shock requiring emergency laparotomy: efficacy of intraâ€aortic balloon occlusion 29123810 2018 11 13 2052-8817 3 4 2016 10 Acute medicine & surgery Acute Med Surg Outcomes of abdominal trauma patients with hemorrhagic shock requiring emergency laparotomy: efficacy of intra-aortic balloon occlusion. 345-350 10.1002/ams2.212 The aims of this study were to investigate outcomes of abdominal trauma in patients with hemorrhagic shock requiring (...) differences in presenting Glasgow Coma Scale, body temperature, lactate, prothrombin time - international normalized ratio, or Revised Trauma Score between the survivors ( n = 12) and non-survivors ( n = 7). The only significant differences between these two groups were observed in Injury Severity Score ( P = 0.047) and Ps ( P = 0.007). In all patients, the balloons were successfully placed in 8.1 ± 3.3 min in the thoracic aorta, and a significant increase in systolic blood pressure was observed
Sarcopenia is a predictive factor for prolonged intensive care unit stays in highâ€energy blunt trauma patients 29123807 2018 11 13 2052-8817 3 4 2016 10 Acute medicine & surgery Acute Med Surg Sarcopenia is a predictive factor for prolonged intensive care unit stays in high-energy blunt trauma patients. 326-331 10.1002/ams2.195 Sarcopenia has been increasingly reported as a prognostic factor for outcome in settings such as cirrhosis, liver transplantation, and emergent surgery. We aimed (...) to elucidate the significance of sarcopenia in severe blunt trauma patients. We retrospectively analyzed 84 patients emergently admitted to the intensive care unit at Kyushu University Hospital (Fukuoka, Japan) from May 2012 to April 2015. We assessed the amount of skeletal muscle present according to computed tomography and its relevance to ventilation-free days, patients' length of stay in the intensive care unit, and 28-day mortality. Twenty-five (29.7%) patients were defined as sarcopenic. Sixteen
Esophageal perforation associated with fracture of the upper thoracic spine from blunt trauma: a case report 28053736 2018 11 13 2058-6124 2 2016 Spinal cord series and cases Spinal Cord Ser Cases Esophageal perforation associated with fracture of the upper thoracic spine from blunt trauma: a case report. 15034 10.1038/scsandc.2015.34 We report the successful conservative management of an unusual case of esophageal perforation associated with an upper thoracic spinal fracture from blunt trauma (...) perforation healed with conservative treatment without life-threatening complications. The possibility of esophageal injury should always be considered when treating upper thoracic spinal injuries due to blunt trauma. Inoue Tetsuji T Department of Orthopaedic Surgery, Minamata City General Hospital and Medical Center , Minamata, Japan. Abe Michio M Department of Surgery, Minamata City General Hospital and Medical Center , Minamata, Japan. eng Journal Article 2016 04 07 England Spinal Cord Ser Cases