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
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
Multicenter StudyHemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage.
Trauma hemorrhage continues to carry a high mortality rate despite changes in modern practice. Traditional approaches to the massively bleeding patient have been shown to result in persistent coagulopathy, bleeding, and poor outcomes. Hemostatic (or damage control) resuscitation developed from the discovery of acute traumatic coagulopathy and increased recognition of the negative consequences of dilutional coagulopathy. These strategies concentrate on early delivery of coagulation therapy combined with permissive hypotension. The efficacy of hemostatic resuscitation in correcting coagulopathy and restoring tissue perfusion during acute hemorrhage has not been studied. ⋯ Epidemiologic study, level III.