The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2014
Comparative StudySuccessful placement of intracranial pressure monitors by trauma surgeons.
The Brain Trauma Foundation guidelines advocate for the use of intracranial pressure (ICP) monitoring following traumatic brain injury (TBI) in patients with a Glasgow Coma Scale (GCS) score of 8 or less and an abnormal computed tomographic scan finding. The absence of 24-hour in-house neurosurgery coverage can negatively impact timely monitor placement. We reviewed the safety profile of ICP monitor placement by trauma surgeons trained and credentialed in their insertion by neurosurgeons. ⋯ Therapeutic/care management study, level IV.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyFrontal sinus volume predicts incidence of brain contusion in patients with head trauma.
The function of the paranasal sinuses is a topic of debate. One hypothesis suggested has been that sinuses act as a "crumple zone," serving to protect the contents of the head from impact. In this study, we examine the interactions of the frontal sinus and the brain in the setting of head trauma. Our formal hypothesis is that frontal sinus volume is less in head trauma patients with contusion than in head trauma patients without contusion. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyTissue oxygenation monitoring using resonance Raman spectroscopy during hemorrhage.
The ability to monitor the patient of hemorrhage noninvasively remains a challenge. We examined the ability of resonance Raman spectroscopy to monitor tissue hemoglobin oxygenation (RRS-StO2) during hemorrhage and compared its performance with conventional invasive mixed venous (SmvO2) and central venous (ScvO2) hemoglobin oxygen saturation as well as with near-infrared spectroscopy tissue hemoglobin oxygenation (NIRS-StO2). ⋯ RRS-StO2 seems to have significantly better ability to track central oxygenation measures during hemorrhage as well as to predict shock based on elevated lactate levels when compared with NIRS-StO2.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyInternationally comparable diagnosis-specific survival probabilities for calculation of the ICD-10-based Injury Severity Score.
The International Statistical Classification of Diseases, 10th Revision (ICD-10)-based Injury Severity Score (ICISS) performs well but requires diagnosis-specific survival probabilities (DSPs), which are empirically derived, for its calculation. The objective was to examine if DSPs based on data pooled from several countries could increase accuracy, precision, utility, and international comparability of DSPs and ICISS. ⋯ Prognostic and epidemiological study, level III.
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J Trauma Acute Care Surg · Feb 2014
Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality.
Unstable pelvic fracture is predominantly caused by high-energy blunt trauma and is associated with a high risk of mortality. The epidemiology in the United States is largely unknown. The purpose of this study was to examine the epidemiology of unstable pelvic fracture based on patient and hospital demographics in the United States during the last decade. ⋯ Epidemiologic study, level III.