The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Sep 2018
Multicenter Study Comparative StudyAn AAST-MITC analysis of pancreatic trauma: Staple or sew? Resect or drain?
Pancreatic trauma results in high morbidity and mortality, in part caused by the delay in diagnosis and subsequent organ dysfunction. Optimal operative management strategies remain unclear. We therefore sought to determine CT accuracy in diagnosing pancreatic injury and the morbidity and mortality associated with varying operative strategies. ⋯ Epidemiologic/Diagnostic study, level III.
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J Trauma Acute Care Surg · Aug 2018
Multicenter Study Observational StudyIndependent predictors of survival after traumatic atlanto-occipital dissociation.
Atlanto-occipital dissociation (AOD) occurs when the skull base is forcibly separated from the vertebral column. Existing literature on AOD is sparse and risk factors for mortality are unknown. This study determined independent predictors of survival after AOD. ⋯ Progonostic/Epidemiological, level III; Therapeutic, level IV.
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J Trauma Acute Care Surg · Jul 2018
Multicenter Study Comparative StudyDeconstructing dogma: Nonoperative management of small bowel obstruction in the virgin abdomen.
Management of small bowel obstruction (SBO) has become more conservative, especially in those patients with previous abdominal surgery (PAS). However, surgical dogma continues to recommend operative exploration for SBO with no PAS. With the increased use of computed tomography imaging resulting in more SBO diagnoses, it is important to reevaluate the role of mandatory operative exploration. Gastrografin (GG) administration decreases the need for operative exploration and may be an option for SBO without PAS. We hypothesized that the use of GG for SBO without PAS will be equally effective in reducing the operative exploration rate compared with that for SBO with PAS. ⋯ Therapeutic, level IV.
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J Trauma Acute Care Surg · Jul 2018
Multicenter Study Clinical TrialEAST Multicenter Trial on targeted temperature management for hanging-induced cardiac arrest.
We sought to determine the outcome of suicidal hanging and the impact of targeted temperature management (TTM) on hanging-induced cardiac arrest (CA) through an Eastern Association for the Surgery of Trauma (EAST) multicenter retrospective study. ⋯ Therapeutic study, level IV; prognostic study, level III.
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J Trauma Acute Care Surg · Jul 2018
Multicenter Study Observational StudyOccupational exposure during emergency department thoracotomy: A prospective, multi-institution study.
Occupational exposure is an important consideration during emergency department thoracotomy (EDT). While human immunodeficiency virus/hepatitis prevalence in trauma patients (0-16.8%) and occupational exposure rates during operative trauma procedures (1.9-18.0%) have been reported, exposure risk during EDT is unknown. We hypothesized that occupational exposure risk during EDT would be greater than other operative trauma procedures. ⋯ Therapeutic/care management study, level III.