Injury
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Falls from standing (FFS) have become the most common mechanism of injury at many trauma centers. Liberal imaging of low energy trauma has questionable value. We hypothesize that torso trauma intervention is rare in the FFS population, and physical examination sufficiently screens for torso injuries needing intervention. ⋯ Torso injuries in FFS are rare. Of our study population, 13 abdominal injuries underwent intervention, and 11 chest injuries underwent intervention. Screening patients by physical examination and vital signs is sufficient and safely allows for the use of selective abdominal and chest CT.
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Multicenter Study
Priorities for trauma quality improvement and registry use in Australia and New Zealand.
The Australia New Zealand Trauma Registry enables the collection and analysis of standardised data about trauma patients and their care for quality improvement, injury prevention and benchmarking. Little is known, however, about the needs of providers and clinicians in relation to these data, or their views on trauma quality improvement priorities. As clinical experts, trauma clinicians should have input to these as ultimately their practice may be influenced by report findings. This paper presents the perspectives of multidisciplinary trauma care professionals in Australia and New Zealand about the use of the Australia New Zealand Trauma Registry data and trauma quality improvement priorities. ⋯ Trauma registry data are under-utilised and their use to drive clinical improvement and system/process improvement is fundamental to trauma quality improvement in Australia and New Zealand.
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Multicenter Study
Epidemiological state, predictive model for mortality, and optimal management strategy for pancreatic injury: A multicentre nationwide cohort study.
Data for establishing the optimal management modalities for pancreatic injury are lacking. Herein, we aimed to describe the epidemiology, identify mortality predictors, and determine the optimal management strategy for pancreatic injury. ⋯ AAST grade, Revised Trauma Scale score on arrival, age, and coexistence of severe abdominal injury aside from pancreatic injury were prognostic factors of mortality after pancreatic injury. Confounder-adjusted analysis did not show that operative management was superior to non-operative management for survival. Non-operative management may be a reasonable strategy for select pancreatic injury patients, especially in institutions where expertise in interventional endoscopy is available.
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Multicenter Study
Risk of severe acute kidney injury in multiple trauma patients: Risk estimation based on a national trauma dataset.
The development of acute kidney injury (AKI) in trauma patients has been associated with almost three fold increase in overall mortality. However, there is a paucity of information of early recognition of risk factors of severe AKI in trauma patients examining the patient's demography, injury characteristics and comorbidities. The purpose of the study was early identification of risk factors of severe AKI. ⋯ Current analysis showed certain patients demography, injury characteristics, along with comorbidities are associated with risk of severe AKI.
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This study is intended to assess the current optimal management of traumatic renal injuries (TRIs), with a focus on high-grade and penetrating injuries. ⋯ Even in high-grade injuries and penetrating trauma, the majority of patients with TRI can be managed non-operatively or with the assistance of endourological or endovascular techniques, with good outcomes. Risk factors for nephrectomy include the presence of high-grade injuries, penetrating trauma and metabolic acidosis on presentation.