The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Nov 2017
Multicenter StudyMulti-institutional analysis of neutrophil-to-lymphocyte ratio (NLR) in patients with severe hemorrhage: A new mortality predictor value.
The neutrophil/lymphocyte ratio (NLR) has been associated as a predictor for increased mortality in critically ill patients. We sought to determine the relationship between NLR and outcomes in adult trauma patients with severe hemorrhage requiring the initiation of massive transfusion protocol (MTP). We hypothesized that the NLR would be a prognostic indicator of mortality in this population. ⋯ Prognostic study, level III.
-
J Trauma Acute Care Surg · Oct 2017
Randomized Controlled Trial Multicenter StudyValidation of a clinical trial composite endpoint for patients with necrotizing soft tissue infections.
Our objective was to develop and validate a composite endpoint for patients with necrotizing soft tissue infections that incorporates: local tissue injury, systemic organ dysfunction, and mortality. ⋯ Prognostic/Epidemiological, level III; Therapeutic, level IV.
-
J Trauma Acute Care Surg · Sep 2017
Multicenter StudyMortality after emergent trauma laparotomy: A multicenter, retrospective study.
Two decades ago, hypotensive trauma patients requiring emergent laparotomy had a 40% mortality. In the interim, multiple interventions to decrease hemorrhage-related mortality have been implemented but few have any documented evidence of change in outcomes for patients requiring emergent laparotomy. The purpose of this study was to determine current mortality rates for patients undergoing emergent trauma laparotomy. ⋯ Overall mortality rate of a trauma laparotomy is substantial (21%) with hemorrhage accounting for 60% of the deaths. The mortality rate for hypotensive patients (46%) appears unchanged over the last two decades and is even more concerning, with almost half of patients presenting with an SBP of 90 mm Hg or less dying.
-
J Trauma Acute Care Surg · Aug 2017
Multicenter Study Comparative StudyFocused assessment with sonography for trauma in children after blunt abdominal trauma: A multi-institutional analysis.
The utility of focused assessment with sonography for trauma (FAST) in children is poorly defined with considerable practice variation. Our purpose was to investigate the role of FAST for intra-abdominal injury (IAI) and IAI requiring acute intervention (IAI-I) in children after blunt abdominal trauma (BAT). ⋯ Prognostic and epidemiologic study, level II; diagnostic tests or criteria study, level II; therapeutic/care management study, level III.
-
J Trauma Acute Care Surg · Jul 2017
Multicenter Study Comparative StudyMulticenter retrospective study of noncompressible torso hemorrhage: Anatomic locations of bleeding and comparison of endovascular versus open approach.
Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. ⋯ Therapeutic, level V.