The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2014
Time and cost analysis of gallbladder surgery under the acute care surgery model.
The acute care surgery (ACS) model has been shown to improve work flow efficiency and to reduce hospital stay. We hypothesized that, in patients with gallbladder (GB) disease who were admitted through our emergency department (ED) and then underwent surgery, the ACS model shortened the time to surgery, decreased the length of hospital stay, and reduced hospital costs. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Mar 2014
Should adhesive small bowel obstruction be managed laparoscopically? A National Surgical Quality Improvement Program propensity score analysis.
Celiotomy is the most common approach for refractory small bowel obstruction (SBO). Small reviews suggest that a laparoscopic approach is associated with shorter stay and less morbidity. Given the limitations of previous studies, we sought to evaluate outcomes of laparoscopic (L) compared with open (O) adhesiolysis for SBO, using the National Surgical Quality Improvement Program data set. ⋯ Therapeutic study, level IV.
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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
Clinical TrialNovel prehospital monitor with injury acuity alarm to identify trauma patients who require lifesaving intervention.
A miniature wireless vital signs monitor (MWVSM, www.athena.gtx.com) has been designed according to US Special Operations Command specifications for field monitoring of combat casualties. It incorporates an injury acuity algorithm termed the Murphy Factor (MF), which is calculated from whatever vital signs are available at the moment and changes in the last 30 seconds. We tested the hypothesis that MF can identify civilian trauma patients during prehospital transport who will require a lifesaving intervention (LSI) upon hospital admission. ⋯ Prospective observational, level II.