The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Oct 2013
Gender impacts mortality after traumatic brain injury in teenagers.
Gender may influence outcomes following traumatic brain injury (TBI) although the mechanism is unknown. Animal TBI studies suggest that gender differences in endogenous hormone production may be the source. Limited retrospective clinical studies on gender present varied conclusions. Pediatric patients represent a unique population as pubescent children experience up-regulation of endogenous hormones that varies dramatically by gender. Younger children do not have these hormonal differences. The aim of this study was to compare pubescent and prepubescent females with males after isolated TBI to identify independent predictors of mortality. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Oct 2013
The swinging pendulum: a national perspective of nonoperative management in severe blunt liver injury.
Despite a shift toward nonoperative management (NOM) of blunt liver trauma, severe injuries continue to require operative management. Our objective was to examine current trends of NOM for severe blunt liver injury from a national perspective. ⋯ Therapeutic study, level IV; prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · Oct 2013
Who needs an orthopedic trauma surgeon? An analysis of US national injury patterns.
Many hospitals in the United States are seeking to obtain and maintain trauma credentialing. Assessment of trauma center success has traditionally focused on mortality without directed measure of surgical subspecialization. However, survival alone may not be a sufficient marker of success with modern health care. The purpose of this study was to determine the number of trauma patients nationally who would benefit from subspecialized care by an orthopedic traumatologist. ⋯ Economic/decision analysis, level IV.
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J Trauma Acute Care Surg · Oct 2013
Let technology do the work: Improving prediction of massive transfusion with the aid of a smartphone application.
The use of massive transfusion protocols (MTPs) is now common in civilian trauma settings, and early activation of MTP has been shown to increase survival of MTP recipients. Numerous MTP prediction tools have been developed; however, they are often cumbersome to use efficiently or have traded predictive power for ease of use. We hypothesized that a highly accurate predictor of massive transfusion could be created and incorporated into a smartphone application that would provide an additional tool for clinicians to use in directing the resuscitation of critically injured patients. ⋯ Prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · Oct 2013
The impact of liver cirrhosis on outcomes in trauma patients: a prospective study.
The adverse effects of liver cirrhosis on outcomes following trauma has been established in retrospective series. In this study, however, we set out to evaluate prospectively the in-hospital outcome measures in this subgroup of trauma patients. ⋯ Prognostic study, level III.