The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2015
Improved survival in UK combat casualties from Iraq and Afghanistan: 2003-2012.
The United Kingdom was at war in Iraq and Afghanistan for more than a decade. Despite assertions regarding advances in military trauma care during these wars, thus far, no studies have examined survival in UK troops during this sustained period of combat. The aims of this study were to examine temporal changes of injury patterns defined by body region and survival in a population of UK Military casualties between 2003 and 2012 in Iraq and Afghanistan. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · May 2015
Multicenter StudyTrends in pediatric spleen management: Do hospital type and ownership still matter?
Nonoperative management of traumatic blunt splenic injury is preferred over splenectomy because of improved outcomes and reduced complications. However, variability in treatment is previously reported with respect to hospital profit types and ownership. ⋯ Epidemiologic and prognostic study, level III.
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J Trauma Acute Care Surg · May 2015
Multicenter StudyDoes unit designation matter? A dedicated trauma intensive care unit is associated with lower postinjury complication rates and death after major complication.
Recent data suggest that specialty intensive care units (ICUs) have outcomes better than those of mixed ICUs. The cause for this apparent discrepancy has not been well established. We hypothesized that trauma patients admitted to a dedicated trauma ICU (TICU) would have a lower complication rate as well as death after complication (failure to rescue [FTR]). ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · May 2015
Multicenter StudyImpact of specific postoperative complications on the outcomes of emergency general surgery patients.
The relative contribution of specific postoperative complications on mortality after emergency operations has not been previously described. Identifying specific contributors to postoperative mortality following acute care surgery will allow for significant improvement in the care of these patients. ⋯ Prognostic and epidemiologic study, level III.
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J Trauma Acute Care Surg · May 2015
ReviewThe role of REBOA in the control of exsanguinating torso hemorrhage.
The management of patients with exsanguinating torso hemorrhage is challenging. Emergency surgery, with the occasional use of resuscitative thoracotomy for patient in extremis, is the current standard. ⋯ We submit that broad and liberal application of this technique is premature given the current data and in light of historical experience. We propose an algorithm for the management of patients with exsanguinating torso hemorrhage, as well as a set of research questions that we feel can help clarify the role of REBOA in modern trauma care in a variety of trauma settings.