The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2015
Multicenter StudyIntracranial pressure monitoring and inpatient mortality in severe traumatic brain injury: A propensity score-matched analysis.
Although intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI) is recommended by the Brain Trauma Foundation, the benefits remain controversial. We sought to determine the impact of ICP monitor placement on inpatient mortality within a regional trauma system after correcting for selection bias through propensity score matching. ⋯ Therapeutic/care management study, level III.
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J Trauma Acute Care Surg · Mar 2015
Multicenter Study Observational StudyProspective derivation of a clinical decision rule for thoracolumbar spine evaluation after blunt trauma: An American Association for the Surgery of Trauma Multi-Institutional Trials Group Study.
Unlike the cervical spine (C-spine), where National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian C-spine Rules can be used, evidence-based thoracolumbar spine (TL-spine) clearance guidelines do not exist. The aim of this study was to develop a clinical decision rule for evaluating the TL-spine after injury. ⋯ Diagnostic test, level III.
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J Trauma Acute Care Surg · Mar 2015
Multicenter Study Comparative Study Observational StudyA comparison of prehospital lactate and systolic blood pressure for predicting the need for resuscitative care in trauma transported by ground.
Reliance on prehospital trauma triage guidelines misses patients with serious injury. Lactate is a biomarker capable of identifying high-risk trauma patients. Our objective was to compare prehospital point-of-care lactate (P-LAC) with systolic blood pressure (SBP) for predicting the need for resuscitative care (RC) in trauma patients transported by ground emergency medical services. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Mar 2015
Multicenter StudyEvolving beyond the vicious triad: Differential mediation of traumatic coagulopathy by injury, shock, and resuscitation.
A subset of trauma patients with critical injury present with coagulopathy, portending markedly worse outcomes. Clinical practice is evolving to treat the classical risk factors of hypothermia, hemodilution, and acidosis; however, coagulopathy persists even in the absence of these factors. We sought to determine the relative importance of injury- and shock-specific factors compared with resuscitation-associated factors in coagulopathy after trauma. ⋯ Prognostic and epidemiologic study, level II.
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J Trauma Acute Care Surg · Feb 2015
Multicenter StudyUnderstanding traumatic shock: out-of-hospital hypotension with and without other physiologic compromise.
Among trauma patients with out-of-hospital hypotension, we evaluated the predictive value of systolic blood pressure (SBP) with and without other physiologic compromise for identifying trauma patients requiring early critical resources. ⋯ Prognostic study, level II.