The journal of trauma and acute care surgery
-
J Trauma Acute Care Surg · Dec 2017
Multicenter StudyVenous thromboembolism after major venous injuries: Competing priorities.
Venous thromboembolism (VTE) after major vascular injury (MVI) is particularly challenging because the competing risk of thrombosis and embolization after direct vessel injury must be balanced with risk of bleeding after surgical repair. We hypothesized that venous injuries, repair type, and intraoperative anticoagulation would influence VTE formation after MVI. ⋯ Therapeutic/care management, level IV.
-
J Trauma Acute Care Surg · Dec 2017
Multicenter Study Clinical TrialContemporary management of subclavian and axillary artery injuries-A Western Trauma Association multicenter review.
Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. ⋯ Prognostic/epidemiologic, level IV.
-
J Trauma Acute Care Surg · Dec 2017
Multicenter Study Observational StudyInjuries sustained during contact with law enforcement: An analysis from US trauma centers.
Injuries sustained by civilians from interaction with police are a polarizing contemporary sociopolitical issue. Few comprehensive studies have been published using national hospital-based data. The aim of this study was to examine the epidemiology of these injuries to better understand this mechanism of injury. ⋯ Prognostic/epidemiologic study, level III.
-
J Trauma Acute Care Surg · Dec 2017
Multicenter StudyQuantifying and exploring the recent national increase in surgical stabilization of rib fractures.
Surgical stabilization of rib fractures (SSRF) has become pivotal in the management of severe chest injuries. Recent literature supports improved outcomes and mortality in severe fracture and flail chest patients who undergo SSRF compared with nonoperative management (NOM). A 2014 National Trauma Data Bank review provided a point prevalence of 0.7% SSRF in flail patients. We hypothesize that this prevalence is increasing and that temporal, regional, and American College of Surgeons (ACS) trauma designation vary in SSRF utilization. ⋯ Epidemiological study, level III.
-
J Trauma Acute Care Surg · Dec 2017
Multicenter StudyOutcome differences in adolescent blunt severe polytrauma patients managed at pediatric versus adult trauma centers.
Previous research suggests adolescent trauma patients can be managed equally effectively at pediatric and adult trauma centers. We sought to determine whether this association would be upheld for adolescent severe polytrauma patients. We hypothesized that no difference in adjusted outcomes would be observed between pediatric trauma centers (PTCs) and adult trauma centers (ATCs) for this population. ⋯ Epidemiologic study, level III.