The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Oct 2014
Comparative StudyComparison of postinjury multiple-organ failure scoring systems: Denver versus Sequential Organ Failure Assessment.
The Denver and Sequential Organ Failure Assessment (SOFA) scores have been used widely to describe the epidemiology of postinjury multiple-organ failure; however, differences in these scores make it difficult to compare incidence, duration, and mortality of multiple-organ failure. The study aim was to compare the performance of the Denver and SOFA scores with respect to the outcomes of mortality, intensive care unit length of stay (ICU LOS), and ventilator days. ⋯ Diagnostic study, level II.
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J Trauma Acute Care Surg · Oct 2014
ReviewManagement of adult patients with buttock and perineal burns: The Ross Tilley Burn Centre experience.
Perineal and buttock burns are challenging wounds to heal for several reasons because of the contamination risk and shear stress that is always present. Because of the nature of the wound bed, pathogens can have ready access to create systemic infections and complications. Prolonged healing times also delay the recovery for patients and add to their discomfort and psychological stress from the injury. The ideal treatment approach is not well defined, and the aims of this study were to conduct a literature review of current treatment suggestions and to look at our own patient population to determine how our center treated these challenging patients. ⋯ Epidemiologic study, level IV. Therapeutic study, level V.
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J Trauma Acute Care Surg · Oct 2014
Prehospital hypertension is predictive of traumatic brain injury and is associated with higher mortality.
The purpose of the current study was to investigate the effect of early adrenergic hyperactivity as manifested by prehospital (emergency medical service [EMS]) hypertension on outcomes of traumatic brain injury (TBI) patients and to develop a prognostic model of the presence of TBI based on EMS and admission (emergency department [ED]) hypertension. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Oct 2014
Review Meta AnalysisWhole-body computed tomographic scanning leads to better survival as opposed to selective scanning in trauma patients: a systematic review and meta-analysis.
Traumatic injury in the United States is the Number 1 cause of mortality for patients 1 year to 44 years of age. Studies suggest that early identification of major injury leads to better outcomes for patients. Imaging, such as computed tomography (CT), is routinely used to help determine the presence of major underlying injuries. We review the literature to determine whether whole-body CT (WBCT), a protocol including a noncontrast scan of the brain and neck and a contrast-enhanced scan of the chest, abdomen, and pelvis, detects more clinically significant injuries as opposed to selective scanning as determined by mortality rates. ⋯ Systematic review and meta-analysis, level III.
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Computed tomography (CT) scan is the criterion standard to rule out cervical spine (c-spine) injury after blunt trauma. Many algorithms still include other tools to exclude ligamentous injuries that often lead to unnecessary prolonged collar use. The purpose of this study was to determine the accuracy of CT to rule out any clinically significant c-spine injury that would require intervention. ⋯ Prognostic study, level II; diagnostic study, level II.