The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · May 2014
Multicenter Study Comparative StudyVenovenous extracorporeal life support improves survival in adult trauma patients with acute hypoxemic respiratory failure: a multicenter retrospective cohort study.
Venovenous extracorporeal life support (VV ECLS) has been reported in adult trauma patients with severe respiratory failure; however, ECLS is not available in many trauma centers, few trauma surgeons have experience initiating ECLS and managing ECLS patients, and there is currently little evidence supporting its use in severely injured patients. This study seeks to determine if VV ECLS improves survival in such patients. ⋯ Therapeutic study, level III.
-
J Trauma Acute Care Surg · May 2014
Multicenter StudyDerivation and validation of a quality indicator for 30-day unplanned hospital readmission to evaluate trauma care.
Unplanned readmissions represent 20% of all admissions and cost $12 billion annually in the United States. Despite the burden of injuries for the health care system, no quality indicator (QI) based on readmissions is available to evaluate trauma care. The objective of this study was to derive and internally validate a QI for a 30-day unplanned hospital readmission to evaluate trauma care. ⋯ Prognostic study, level III.
-
J Trauma Acute Care Surg · May 2014
Multicenter StudyBenchmarking trauma centers on mortality alone does not reflect quality of care: implications for pay-for-performance.
Trauma centers are currently benchmarked on mortality outcomes alone. However, pay-for-performance measures may financially penalize centers based on complications. Our objective was to determine whether the results would be similar to the current standard method of mortality-based benchmarking if trauma centers were profiled on complications. ⋯ Prognostic/epidemiologic study, level III.
-
J Trauma Acute Care Surg · Apr 2014
Multicenter StudyDeveloping best practices to study trauma outcomes in large databases: an evidence-based approach to determine the best mortality risk adjustment model.
The National Trauma Data Bank (NTDB) is an invaluable resource to study trauma outcomes. Recent evidence suggests the existence of great variability in covariate handling and inclusion in multivariable analyses using NTDB, leading to differences in the quality of published studies and potentially in benchmarking trauma centers. Our objectives were to identify the best possible mortality risk adjustment model (RAM) and to define the minimum number of covariates required to adequately predict trauma mortality in the NTDB. ⋯ Prognostic study, level III.
-
J Trauma Acute Care Surg · Apr 2014
Multicenter StudyBlood component transfusion increases the risk of death in children with traumatic brain injury.
Blood transfusion has been associated with worse outcomes in adult trauma patients with traumatic brain injury (TBI). However, the effects in injured children have not been evaluated. We hypothesize that blood transfusion is also associated with worse outcomes in children with TBI. ⋯ Epidemiologic study, level III. Therapeutic study, level IV.