The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jan 2014
Comparative StudyA comparison of the Injury Severity Score and the Trauma Mortality Prediction Model.
Performance benchmarking requires accurate measurement of injury severity. Despite its shortcomings, the Injury Severity Score (ISS) remains the industry standard 40 years after its creation. A new severity measure, the Trauma Mortality Prediction Model (TMPM), uses either the Abbreviated Injury Scale (AIS) or DRG International Classification of Diseases-9th Rev. (ICD-9) lexicons and may better quantify injury severity compared with ISS. We compared the performance of TMPM with ISS and other measures of injury severity in a single cohort of patients. ⋯ Disagnostic study, level I; prognostic study, level II.
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J Trauma Acute Care Surg · Jan 2014
Assessment of coagulopathy, endothelial injury, and inflammation after traumatic brain injury and hemorrhage in a porcine model.
Traumatic brain injury (TBI) and hemorrhagic shock (HS) can be associated with coagulopathy and inflammation, but the mechanisms are poorly understood. We hypothesized that a combination of TBI and HS would disturb coagulation, damage the endothelium, and activate inflammatory and complement systems. ⋯ The combination of TBI and shock results in an immediate activation of coagulation and complement systems with subsequent endothelial shedding, protein C activation, and inflammation.
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J Trauma Acute Care Surg · Jan 2014
Predicting hospital discharge disposition in geriatric trauma patients: is frailty the answer?
The frailty index (FI) has been shown to predict outcomes in geriatric patients. However, FI has never been applied as a prognostic measure after trauma. The aim of our study was to identify hospital admission factors predicting discharge disposition in geriatric trauma patients. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jan 2014
The prevalence and impact of prescription controlled substance use among injured patients at a Level I trauma center.
There has been increasing attention focused on the epidemic of prescription drug use in the United States, but little is known about its effects in trauma. The purpose of this study was to define the prevalence of prescription controlled substance use among trauma patients and determine its effects on outcome. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Jan 2014
Children are safer in states with strict firearm laws: a National Inpatient Sample study.
Firearm control laws vary across the United States and remain state specific. The aim of this study was to determine the relationship between variation in states' firearm control laws and the risk of firearm-related injuries in pediatric population. We hypothesized that strict firearm control laws impact the incidence of pediatric firearm injury. ⋯ Prognostic study, level III.