The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2014
Multicenter StudyTemporal trends of postinjury multiple-organ failure: still resource intensive, morbid, and lethal.
While the incidence of postinjury multiple-organ failure (MOF) has declined during the past decade, temporal trends of its morbidity, mortality, presentation patterns, and health care resources use have been inconsistent. The purpose of this study was to describe the evolving epidemiology of postinjury MOF from 2003 to 2010 in multiple trauma centers sharing standard treatment protocols. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2014
Review Meta AnalysisPredictors of mortality in geriatric trauma patients: a systematic review and meta-analysis.
The rate of mortality and factors predicting worst outcomes in the geriatric population presenting with trauma are not well established. This study aimed to examine mortality rates in severe and extremely severe injured individuals 65 years or older and to identify the predictors of mortality based on available evidence in the literature. ⋯ Systematic review and meta-analysis, level IV.
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J Trauma Acute Care Surg · Mar 2014
Are all deaths recorded equally? The impact of hospice care on risk-adjusted mortality.
Hospice care provides dignity and comfort at the end of life. While patients transferred to hospice die, they are often not recorded as in-hospital deaths in trauma registries or in some administrative discharge data. Mortality rates for the purpose of database research, performance improvement, or public reporting may therefore be artificially low. The current study sought to determine the impact of discharges to hospice on risk-adjusted mortality for trauma deaths reported to the Trauma Quality Improvement Program. ⋯ Given the large variation in the proportion of deaths recorded as discharged to a hospice rather than as in-hospital deaths, there is the potential for significant distortion of actual performance. Failure to consider this potential may misguide efforts directing performance improvement, research, and national reporting. Discharges to a hospice should be included with in-hospital deaths when reporting risk-adjusted mortality.
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J Trauma Acute Care Surg · Mar 2014
Multicenter StudyFrom 9-1-1 call to death: evaluating traumatic deaths in seven regions for early recognition of high-risk patients.
This study aimed to characterize initial clinical presentations of patients served by emergency medical services (EMS) who die following injury, with particular attention to patients with occult ("talk-and-die") presentations. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2014
Incidence of knee dislocation and concomitant vascular injury requiring surgery: a nationwide study.
Acute knee (tibiofemoral joint) dislocation is a serious knee injury, although population-based numbers and incidence rates of knee dislocation with or without concomitant vascular injury are unknown. ⋯ Nationwide epidemiologic study, level I.