The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jan 2015
Review Meta AnalysisImpact of prehospital transfer strategies in major trauma and head injury: systematic review, meta-analysis, and recommendations for study design.
It is unclear whether trauma patients should be transferred initially to a trauma center or local hospital. ⋯ Systematic review, level IV.
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J Trauma Acute Care Surg · Oct 2014
Review Meta AnalysisWhole-body computed tomographic scanning leads to better survival as opposed to selective scanning in trauma patients: a systematic review and meta-analysis.
Traumatic injury in the United States is the Number 1 cause of mortality for patients 1 year to 44 years of age. Studies suggest that early identification of major injury leads to better outcomes for patients. Imaging, such as computed tomography (CT), is routinely used to help determine the presence of major underlying injuries. We review the literature to determine whether whole-body CT (WBCT), a protocol including a noncontrast scan of the brain and neck and a contrast-enhanced scan of the chest, abdomen, and pelvis, detects more clinically significant injuries as opposed to selective scanning as determined by mortality rates. ⋯ Systematic review and meta-analysis, level III.
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J Trauma Acute Care Surg · Mar 2014
Review Meta AnalysisPredictors of mortality in geriatric trauma patients: a systematic review and meta-analysis.
The rate of mortality and factors predicting worst outcomes in the geriatric population presenting with trauma are not well established. This study aimed to examine mortality rates in severe and extremely severe injured individuals 65 years or older and to identify the predictors of mortality based on available evidence in the literature. ⋯ Systematic review and meta-analysis, level IV.
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J Trauma Acute Care Surg · Jan 2014
Review Meta AnalysisAssociation between static and dynamic thenar near-infrared spectroscopy and mortality in patients with sepsis: a systematic review and meta-analysis.
Oxygen delivery and consumption disturbances are frequently seen with critically illness, potentially leading to pathologic changes in tissue oxygenation (StO2). Near-infrared spectroscopy (NIRS) is a potentially useful method to monitor StO2, but the role of NIRS in prognostication of septic patients is uncertain. The aim of this study was to systematically review the literature and evaluate static and dynamic NIRS in patients with sepsis. ⋯ Systematic review/meta-analysis, level III.
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J Trauma Acute Care Surg · Oct 2013
Review Meta AnalysisEarly application of airway pressure release ventilation may reduce mortality in high-risk trauma patients: a systematic review of observational trauma ARDS literature.
Adult respiratory distress syndrome is often refractory to treatment and develops after entering the health care system. This suggests an opportunity to prevent this syndrome before it develops. The objective of this study was to demonstrate that early application of airway pressure release ventilation in high-risk trauma patients reduces hospital mortality as compared with similarly injured patients on conventional ventilation. ⋯ Systematic review, level IV.