The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Feb 2018
Multicenter Study Observational StudyThrombelastography early amplitudes in bleeding and coagulopathic trauma patients: Results from a multicenter study.
Early amplitudes in the viscoelastic hemostatic assays, thrombelastography (TEG) and rotation thromboelastometry (ROTEM), provide fast results, which is critical in the resuscitation of bleeding patients. This study investigated associations between TEG early amplitudes and standard TEG variables in a large multicenter cohort of moderately to severely injured trauma patients admitted at three North European Level I Trauma Centers. ⋯ Prognostic study, level III.
-
J Trauma Acute Care Surg · Feb 2018
Multicenter StudyNoncompliance with American College of Surgeons Committee on Trauma recommended criteria for full trauma team activation is associated with undertriage deaths.
The appropriate triage of acutely injured patients within a trauma system is associated with improved rates of mortality and optimal resource utilization. The American College of Surgeons Committee on Trauma (ACS-COT) put forward six minimum criteria (ACS-6) for full trauma team activation (TTA). We hypothesized that ACS-COT-verified trauma center compliance with these criteria is associated with low undertriage rates and improved overall mortality. ⋯ Care management, level III.
-
J Trauma Acute Care Surg · Feb 2018
Multicenter Study Comparative StudyVariability in management of blunt liver trauma and contribution of level of American College of Surgeons Committee on Trauma verification status on mortality.
Patients who sustain blunt liver trauma and are treated at an American College of Surgeons Committee on Trauma-verified Level I trauma center have an overall lower risk of mortality compared with patients admitted to a level II trauma center. However, elements contributing to these differences are unknown. We hypothesize that practice variation exists between trauma centers in management of blunt liver injury. Our objective is to identify practice variations and their effect on clinical outcomes. ⋯ Care management, level IV.
-
J Trauma Acute Care Surg · Feb 2018
Multicenter Study Observational StudyThe American Association for the Surgery of Trauma Severity Grade is valid and generalizable in adhesive small bowel obstruction.
The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate the AAST ASBO grading system using the Eastern Association for the Surgery of Trauma multi-institutional small bowel obstruction prospective observational study. ⋯ Prognostic, level III.
-
J Trauma Acute Care Surg · Jan 2018
Multicenter StudyA multicenter evaluation of the optimal timing of surgical stabilization of rib fractures.
The optimal timing of surgical stabilization of rib fractures (SSRF) remains debated. We hypothesized that (1) demographic, radiologic, and clinical variables are associated with time to surgery and (2) shorter time to SSRF improves acute outcomes. ⋯ Therapy, level III.