Injury
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To assess the predictors for conservative management failure and long term outcomes after isolated blunt high grade renal trauma (HGRT). ⋯ Increased HRD, laceration numbers > 3, parenchymal devascularization ≥ 25%, and presence of VCE are findings that reflect the necessity for active bleeding interventions after isolated blunt HGRT. Parenchymal devascularization ≥ 25% is an independent factor for RPV deterioration. Neither the grade of renal trauma nor the type of treatment is a predictor for such deterioration.
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Observational Study
Association between ion shift index and prognosis in severe trauma patients without isolated head injury.
This study aimed to investigate the ion shift index (ISI) as a prognostic factor of severe trauma. We hypothesized that the initial ISI measured in the emergency department (ED) is associated with discharge survival in severe non-isolated head injury (IHI) patients. ⋯ The initial ISI in the ED after trauma was associated with mortality in severe non-IHI trauma patients. In conjunction with other prognostic indicators, it could be used as an early prognostic marker, particularly if TRISS is unavailable.
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Hemorrhage is an important cause of preventable injury-related death. Many low- and middle-income country (LMIC) patients do not have timely access to safe blood. We sought to determine the degree of appropriateness of blood transfusion among patients with injuries requiring surgical intervention at presentation to a tertiary hospital in Ghana. ⋯ Our data suggest that clearer guidelines for blood transfusion among emergency surgery patients are needed in Ghana and similar LMICs to avoid inappropriate use of blood as a scarce resource.
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Randomized Controlled Trial
Retrievable inferior vena cava filter for primary prophylaxis of pulmonary embolism in at-risk trauma patients: A feasibility trial.
To determine if insertion of rIVCF for PE prophylaxis in high risk trauma patients could result in a clinically meaningful reduction (>24 h) in time that patients are left unprotected from PEs SUMMARY AND BACKGROUND DATA: Trauma patients are at high risk for the development of pulmonary embolism (PE). Early pharmacologic PE prophylaxis is ideal, however many patients are unable to receive prophylaxis due to concomitant injuries. Current guidelines are conflicting on the role of prophylactic retrievable inferior vena cava filters (rIVCF) for PE prevention in this patient population, and robust data to guide clinicians is lacking. ⋯ Level 1 Evidence randomized controlled trial.