The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Dec 2015
Multicenter StudyThe role of computed tomographic scan in ongoing triage of operative hepatic trauma: A Western Trauma Association multicenter retrospective study.
A subset of patients explored for abdominal injury have persistent hepatic bleeding on postoperative computed tomography (CT) and/or angiography, either not identified or not manageable at initial laparotomy. To identify patients at risk for ongoing hemorrhage and guide triage to angiography, we investigated the relationship of early postoperative CT scan with outcomes in operative hepatic trauma. ⋯ Care management/therapeutic study, level IV; epidemiologic/prognostic study, level III.
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J Trauma Acute Care Surg · Dec 2015
Multicenter Study Observational StudyRecursive partitioning identifies greater than 4 U of packed red blood cells per hour as an improved massive transfusion definition.
Massive transfusion (MT) is classically defined as greater than 10 U of packed red blood cells (PRBCs) in 24 hours. This fails to capture the most severely injured patients. Extending the previous work of Savage and Rahbar, a rolling hourly rate-based definition of MT may more accurately define critically injured patients requiring early, aggressive resuscitation. ⋯ Prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · Dec 2015
Multicenter StudyThe found down patient: A Western Trauma Association multicenter study.
Unconscious patients who present after being "found down" represent a unique triage challenge. These patients are selected for either trauma or medical evaluation based on limited information and have been shown in a single-center study to have significant occult injuries and/or missed medical diagnoses. We sought to further characterize this population in a multicenter study and to identify predictors of mistriage. ⋯ Epidemiologic study, level III.