The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jun 2014
Multicenter StudyIn-hospital mortality from femoral shaft fracture depends on the initial delay to fracture fixation and Injury Severity Score: a retrospective cohort study from the NTDB 2002-2006.
Optimal surgical timing for definitive treatment of femur fractures in severely injured patients remains controversial. This study was performed to examine in-hospital mortality for patients with femur fractures with regard to surgical timing, Injury Severity Score (ISS), and age. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Jun 2014
Multicenter StudyImplementation of a nationwide trauma network for the care of severely injured patients.
Regional differences in the care of severely injured patients remain problematic in industrial countries. ⋯ Epidemiologic study, level III. Therapeutic/care management study, level IV.
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J Trauma Acute Care Surg · Jun 2014
A composite index for predicting readmission following emergency general surgery.
Preventable readmission has become a national focus. It is clear that surgical patients present specific challenges to those interested in preventing readmission. Little is known about this outcome in the emergent population. We are interested in determining if there are readily available data variables to predict risk of readmission. The surgical Apgar score (SAS) is calculated from objective intraoperative variables and has been shown to be predictive of postoperative mortality in the nonemergent setting. The objectives of this study were to characterize 30-day readmissions in emergent general surgery and to determine whether certain variables were associated with readmissions. We hypothesized that the SAS correlates with the risk for readmission in emergency general surgery patients. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jun 2014
Management and outcome of patients with blunt splenic injury and preexisting liver cirrhosis.
The response of liver cirrhosis (LC) patients to abdominal trauma, including blunt splenic injury (BSI) is unfavorable. To better understand the response to BSI in LC patients, the present study reviewed a much larger group of such patients, derived from the National Trauma Data Bank. ⋯ Prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · Jun 2014
Management of lower extremity vascular injuries in pediatric trauma patients: a single Level I trauma center experience.
Traumatic vascular injuries of the lower extremity in the pediatric population are rare but can result in significant morbidity. We aimed at describing our experience with such complex injuries, with associated patterns of injury, diagnostic and therapeutic challenges, and outcomes. ⋯ Epidemiologic study, level III.