The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2017
Performance of International Classification of Diseases-based injury severity measures used to predict in-hospital mortality and intensive care admission among traumatic brain-injured patients.
The International Classification of Diseases (ICD) is the main classification system used for population-based traumatic brain injury (TBI) surveillance activities but does not contain direct information on injury severity. International Classification of Diseases-based injury severity measures can be empirically derived or mapped to the Abbreviated Injury Scale, but no single approach has been formally recommended for TBI. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Feb 2017
Comparative StudyBig children or little adults? A statewide analysis of adolescent isolated severe traumatic brain injury outcomes at pediatric versus adult trauma centers.
The appropriate managing center for adolescent trauma patients is debated. We sought to determine whether outcome differences existed for adolescent severe traumatic brain injury (sTBI) patients treated at pediatric versus adult trauma centers. We hypothesized that no difference in mortality, functional status at discharge (FSD), or overall complication rate would be observed between center types. ⋯ Epidemiologic study, level III; therapeutic study, level IV.
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J Trauma Acute Care Surg · Feb 2017
Early percutaneous dilational tracheostomy does not lead to an increased risk of surgical site infection following anterior spinal surgery.
Most patients with cervical spinal cord injuries require tracheostomy. The optimal timing is still a matter of debate. Previous studies showed that patients receiving early tracheostomy had fewer ventilator days and decreased rates of pneumonia and were mobilized earlier. Because of the proximity of the anterior approach to the tracheostoma, there is concern about an increased risk of surgical site infection (SSI) related to tracheostomy. ⋯ Therapeutic study, level V.
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J Trauma Acute Care Surg · Feb 2017
External validation of the Air Medical Prehospital Triage score for identifying trauma patients likely to benefit from scene helicopter transport.
The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different data set is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study registry. ⋯ Epidemiologic/prognostic study, level III; therapeutic/care management study, level IV.