The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Sep 2018
Randomized Controlled TrialDo screening and a randomized brief intervention at a Level 1 trauma center impact acute stress reactions to prevent later development of posttraumatic stress disorder?
Approximately 20% to 40% of trauma survivors experience posttraumatic stress disorder (PTSD). The American College of Surgeons Committee on Trauma reports that early screening and referral has the potential to improve outcomes and that further study of screening and intervention for PTSD would be beneficial. This prospective randomized study screened hospitalized patients for traumatic stress reactions and assessed the effect of a brief intervention in reducing later development of PTSD. ⋯ Prospective randomized controlled trial, level II.
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J Trauma Acute Care Surg · Apr 2018
Randomized Controlled TrialPost-discharge adherence with venous thromboembolism prophylaxis after orthopedic trauma: Results from a randomized controlled trial of aspirin versus low molecular weight heparin.
Orthopedic trauma patients are often treated with venous thromboembolism (VTE) chemoprophylaxis with aspirin or low molecular weight heparin (LMWH) after discharge from their index admission, but adherence patterns are not known. We hypothesized that overall adherence would be moderate and greater with aspirin compared to LMWH. ⋯ Therapeutic, level II.
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J Trauma Acute Care Surg · Jan 2018
Randomized Controlled TrialThe hyperfibrinolytic phenotype is the most lethal and resource intense presentation of fibrinolysis in massive transfusion patients.
Among bleeding patients, we hypothesized that the hyperfibrinolytic (HF) phenotype would be associated with the highest mortality, whereas shutdown (SD) patients would have the greatest complication burden. ⋯ Prognostic, level II.
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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.
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J Trauma Acute Care Surg · Sep 2017
Randomized Controlled TrialErythropoietin in patients with traumatic brain injury and extracranial injury-A post hoc analysis of the erythropoietin traumatic brain injury trial.
Erythropoietin (EPO) may reduce mortality after traumatic brain injury (TBI). Secondary brain injury is exacerbated by multiple trauma, and possibly modifiable by EPO. We hypothesized that EPO decreases mortality more in TBI patients with multiple trauma, than in patients with TBI alone. ⋯ Therapeutic study, level III.