The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2015
Utility of three-dimensional computed tomography for the surgical management of rib fractures.
Surgical stabilization of flail chest is increasingly recognized as a valid approach to improve pulmonary mechanics in selected trauma patients. The use of two-dimensional (2D) computed tomography (CT) has become almost universal in the assessment of blunt chest trauma and multiple rib fractures. We hypothesized that three-dimensional (3D) CT adds valuable information to the preoperative plan for fixation of rib fractures. ⋯ Diagnostic study, level II.
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J Trauma Acute Care Surg · Mar 2015
Tourniquet use at the Boston Marathon bombing: Lost in translation.
The Boston Marathon bombing was the first major, modern US terrorist event with multiple, severe lower extremity injuries. First responders, including trained professionals and civilian bystanders, rushed to aid the injured. The purpose of this review was to determine how severely bleeding extremity injuries were treated in the prehospital setting in the aftermath of the Boston Marathon bombing. ⋯ Epidemiologic study, level V.
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J Trauma Acute Care Surg · Mar 2015
Changes in gene expression following trauma are related to the age of transfused packed red blood cells.
Transfusion of packed red blood cells (PRBCs) is associated with an increased incidence of nosocomial infections and an increased risk of death. The duration of storage before transfusion may influence these outcomes. Here, we explore the association between the age of transfused PRBCs and specific patterns of inflammatory gene expression in severely injured trauma patients. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2015
Preinjury warfarin, but not antiplatelet medications, increases mortality in elderly traumatic brain injury patients.
Previous studies of traumatic brain injury (TBI) outcomes in elderly patients on oral antithrombotic (OAT) therapies have yielded conflicting results. Our objective was to examine the effect of premorbid OAT medications on outcomes among elderly TBI patients with intracranial hemorrhage. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2015
Load index model: An advanced tool to support decision making during mass-casualty incidents.
In mass-casualty events, accessing information concerning hospital congestion levels is crucial to improving patient distribution and optimizing care. The study aimed to develop a decision support tool for distributing casualties to hospitals in an emergency scenario involving multiple casualties. ⋯ The proposed model improved capacity to ensure evacuation of patients to less congested medical facilities in emergency situations, thereby enhancing lifesaving medical services. The model supported decision-making processes in both simulation exercises and an actual emergency situation.