The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2015
Multicenter StudyUnderstanding traumatic shock: out-of-hospital hypotension with and without other physiologic compromise.
Among trauma patients with out-of-hospital hypotension, we evaluated the predictive value of systolic blood pressure (SBP) with and without other physiologic compromise for identifying trauma patients requiring early critical resources. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Feb 2015
Hospital-acquired pneumonia is an independent predictor of poor global outcome in severe traumatic brain injury up to 5 years after discharge.
Long-term outcomes following traumatic brain injury (TBI) correlate with initial head injury severity and other acute factors. Hospital-acquired pneumonia (HAP) is a common complication in TBI. Limited information exists regarding the significance of infectious complications on long-term outcomes after TBI. We sought to characterize risks associated with HAP on outcomes 5 years after TBI. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Feb 2015
Systolic blood pressure criteria in the National Trauma Triage Protocol for geriatric trauma: 110 is the new 90.
Undertriage is a concern in geriatric patients. The National Trauma Triage Protocol (NTTP) recognized that systolic blood pressure (SBP) less than 110 mm Hg may represent shock in those older than 65 years. The objective was to evaluate the impact of substituting an SBP of less than 110 mm Hg for the current SBP of less than 90 mm Hg criterion within the NTTP on triage performance and mortality. ⋯ Diagnostic study, level IV.
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J Trauma Acute Care Surg · Feb 2015
Damage-control resuscitation increases successful nonoperative management rates and survival after severe blunt liver injury.
Nonoperative multidisciplinary management for severe (American Association for the Surgery of Trauma Grades IV and V) liver injury has been used for two decades. We have previously shown that Damage Control Resuscitation (DCR) using low-volume, balanced resuscitation improves survival of severely injured trauma patients; however, little attention has been paid to organ-specific outcomes. We wanted to determine if implementation of DCR has improved survival and successful nonoperative management after severe blunt liver injury. ⋯ Therapeutic/care management, level III.
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J Trauma Acute Care Surg · Feb 2015
Posterior component separation and transversus abdominis muscle release for complex incisional hernia repair in patients with a history of an open abdomen.
The best reconstructive approach for large fascial defects precipitated from a previous open abdomen has not been elucidated to date. We use a posterior component separation with transversus abdominis muscle release (TAR) in this scenario. ⋯ Therapeutic study, level V.