The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Jun 2020
Comparative StudyComparison of American Association for the Surgery of Trauma grading scale with modified Hinchey classification in acute colonic diverticulitis: A pilot study.
The American Association for the Surgery of Trauma (AAST) developed a severity scale for surgical conditions, including diverticulitis. The Hinchey classification requires operative intervention yet remains the established scoring system for acute diverticulitis. This is a pilot study to compare the AAST grading scale for acute colonic diverticulitis with the traditional Hinchey classification. We hypothesize that the AAST classification scale is equivalent to the Hinchey in predicting outcomes. ⋯ Prognostic and epidemiological study, level III.
-
J Trauma Acute Care Surg · Jun 2020
Comparative StudyA comparison of adolescent penetrating trauma patients managed at pediatric versus adult trauma centers in a mature trauma system.
While there is little debate that pediatric trauma centers (PTC) are uniquely equipped to manage pediatric trauma patients, the extent to which adolescents benefit from treatment there remains controversial. We sought to elucidate differences in management approach and outcome between PTC and adult trauma centers (ATC) for the adolescent penetrating trauma population. We hypothesized that improved mortality would be observed at ATC for this subset of patients. ⋯ Therapeutic, Level IV.
-
J Trauma Acute Care Surg · Jun 2020
Observational StudyVasopressor selection during critical care management of brain dead organ donors and the effects on kidney graft function.
Delayed graft function (DGF), the need for dialysis in the first week following kidney transplant, affects approximately one quarter of deceased-donor kidney transplant recipients. Donor demographics, donor serum creatinine, and graft cold ischemia time are associated with DGF. However, there is no consensus on the optimal management of hemodynamic instability in organ donors after brain death (DBDs). Our objective was to determine the relationship between vasopressor selection during donor management and the development of DGF. ⋯ Prognostic study, Level III.
-
J Trauma Acute Care Surg · Jun 2020
Early and prehospital trauma deaths: Who might benefit from advanced resuscitative care?
Recent civilian and military data from the United States and the United Kingdom suggest that further reductions in mortality will require prehospital or preoperating room hemorrhage control and blood product resuscitation. The aims of this study were to examine the potential preventability of prehospital and early in-hospital fatalities, and to consider the geographical location of such incidents, to contextualize how the use of advanced resuscitative techniques could be operationalized. ⋯ Epidemiological, level III.