The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2017
Combat surgical workload in Operation Iraqi Freedom and Operation Enduring Freedom: The definitive analysis.
Relatively few publications exist on surgical workload in the deployed military setting. This study analyzes US military combat surgical workload in Iraq and Afghanistan to gain a more thorough understanding of surgical training gaps and personnel requirements. ⋯ Epidemiologic study, level III; Care management, level III.
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J Trauma Acute Care Surg · Jul 2017
Risk factors and costs associated with nationwide nonelective readmission after trauma.
Most prior studies of readmission after trauma have been limited to single institutions, whereas multi-institutional studies have been limited to single states and an inability to distinguish between elective and nonelective readmissions. The purpose of this study was to identify the risk factors and costs associated with nonelective readmission after trauma across the United States. ⋯ Care management/epidimeological, level IV.
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J Trauma Acute Care Surg · Jul 2017
Kaolin-based hemostatic dressing improves hemorrhage control from a penetrating inferior vena cava injury in coagulopathic swine.
Retrohepatic inferior vena cava (RIVC) injuries are often lethal due to challenges in obtaining hemorrhage control. We hypothesized that packing with a new kaolin-based hemostatic dressing (Control+; Z-Medica, Wallingford, CT) would improve hemorrhage control from a penetrating RIVC injury compared with packing with standard laparotomy sponges alone. ⋯ This is basic science research based on a large animal model, level V.
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J Trauma Acute Care Surg · Jul 2017
Comparative StudyUnfractionated heparin versus low-molecular-weight heparin for venous thromboembolism prophylaxis in trauma.
Venous thromboembolism (VTE) is a common complication in trauma patients. Pharmacologic prophylaxis is utilized in trauma patients to reduce their risk of a VTE event. The Eastern Association for the Surgery of Trauma guidelines recommend use of low-molecular-weight heparin (LMWH) as the preferred agent in these patients. However, there is literature suggesting that unfractionated heparin (UFH) is an acceptable, and less costly, alternative VTE prophylaxis agent with equivalent efficacy in trauma patients. We examined data from the Michigan Trauma Quality Improvement Program to perform a comparative effectiveness study of UFH versus LMWH on outcomes for trauma patients. ⋯ Therapeutic, level III.
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J Trauma Acute Care Surg · Jul 2017
Multicenter Study Observational StudyMulticenter observational prehospital resuscitation on helicopter study.
Earlier use of in-hospital plasma, platelets, and red blood cells (RBCs) has improved survival in trauma patients with severe hemorrhage. Retrospective studies have associated improved early survival with prehospital blood product transfusion (PHT). We hypothesized that PHT of plasma and/or RBCs would result in improved survival after injury in patients transported by helicopter. ⋯ Level II.