The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2019
Multicenter StudyThe why and how our trauma patients die: A prospective Multicenter Western Trauma Association study.
Historically, hemorrhage has been attributed as the leading cause (40%) of early death. However, a rigorous, real-time classification of the cause of death (COD) has not been performed. This study sought to prospectively adjudicate and classify COD to determine the epidemiology of trauma mortality. ⋯ Epidemiologic, level II.
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J Trauma Acute Care Surg · May 2019
Multicenter Study Clinical TrialIndocyanine green dye angiography as an adjunct to assess indeterminate burn wounds: A prospective, multicentered, triple-blinded study.
Clinical assessment of indeterminate burn wounds has been reported to yield poor accuracy, even when performed by burn experts. Indocyanine green (ICG) dye angiography has been found to be highly accurate in assessing burn depth, but there is still limited evidence of its use in indeterminate burn wounds. This study aims to compare the accuracy of ICG angiography to that of clinical assessment in assessing indeterminate burn wounds. ⋯ Indocyanine green angiography yields a significantly higher accuracy than clinical assessment in indeterminate burn wounds. This intervention can, thus, be a useful tool to aid clinical judgment.
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J Trauma Acute Care Surg · Mar 2019
Randomized Controlled Trial Multicenter StudyThe impact of hypothermia on outcomes in massively transfused patients.
Hypothermia is associated with poor outcomes after injury. The relationship between hypothermia during contemporary large volume resuscitation and blood product consumption is unknown. We evaluated this association, and the predictive value of hypothermia on mortality. ⋯ Prognostic, level III.
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J Trauma Acute Care Surg · Jan 2019
Multicenter Study Clinical TrialClearing the cervical spine in patients with distracting injuries: An AAST multi-institutional trial.
Single institution studies have shown that clinical examination of the cervical spine (c-spine) is sensitive for clearance of the c-spine in blunt trauma patients with distracting injuries. Despite an unclear definition, most trauma centers still adhere to the notion that distracting injuries adversely affect the sensitivity of c-spine clinical examination. A prospective AAST multi-institutional trial was performed to assess the sensitivity of clinical examination screening of the c-spine in awake and alert blunt trauma patients with distracting injuries. ⋯ Therapeutic/care management, level IV.
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J Trauma Acute Care Surg · Oct 2018
Randomized Controlled Trial Multicenter Study Comparative Study Pragmatic Clinical TrialA comparison of resuscitation intensity and critical administration threshold in predicting early mortality among bleeding patients: A multicenter validation in 680 major transfusion patients.
To address deficiencies associated with the classic definition of massive transfusion (MT), critical administration threshold (CAT) and resuscitation intensity (RI) were developed to better quantify the overall severity of illness and predict the need for transfusions and early mortality. We sought to evaluate these as more appropriate replacements for MT in defining mortality risk in patients undergoing major transfusions. ⋯ Prognostic, level III.