The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyComplications in acute phase hospitalization of traumatic spinal cord injury: does surgical timing matter?
Optimal timing of surgery after a traumatic spinal cord injury (SCI) is one of the most controversial subjects in spine surgery. We assessed the relationship between surgical timing and the occurrence of nonneurologic postoperative complications during acute hospital stay for patients with a traumatic SCI. ⋯ Prognostic study, level III; therapeutic/care management study, level IV.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyPediatric trauma patients are more likely to be discharged from the emergency department after arrival by helicopter emergency medical services.
Despite faster transport times, concern about the safety of medical helicopters has led to scrutiny in the national media. Few criteria exist for the use of helicopter emergency medical services (HEMS). This study evaluated if pediatric trauma patients transported by HEMS from the injury scene were more likely to be discharged from the emergency department and more likely to be less severely injured based on Injury Severity Score (ISS) compared with adult patients. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyThe impact of specialist trauma service on major trauma mortality.
Trauma services throughout the world have had positive effects on trauma-related mortality. Australian trauma services are generally more consultative in nature rather than the North American model of full trauma admission service. We hypothesized that the introduction of a consultative specialist trauma service in a Level I Australian trauma center would reduce mortality of the severely injured. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyEstimated additional hospital length of stay caused by 40 individual complications in injured patients: an observational study of 204,388 patients.
Complications are common in the care of trauma patients and increase hospital length of stay (LoS). Because many factors influence LoS and because patients may experience more than a single complication, it is difficult to estimate the effect of individual complications on LoS. We describe here a mathematically principled approach to estimating the additional LoS caused by complications and provide estimates for additional LoS caused by 40 common complications. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyComparisons of lactated Ringer's and Hextend resuscitation on hemodynamics and coagulation following femur injury and severe hemorrhage in pigs.
This study compared coagulation function after resuscitation with Hextend and lactated Ringer's (LR) solution in pigs with tissue injury and hemorrhagic shock. ⋯ After traumatic hemorrhage, coagulation function was restored within 6 hours with LR resuscitation but not with Hextend. The lack of recovery after Hextend is likely caused by greater hemodilution and possible effects of starches on coagulation substrates and further documents the need to restrict the use of high-molecular-weight starch in resuscitation fluids for bleeding casualties.