World journal of surgery
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World journal of surgery · Jul 2018
Multicenter StudyBlunt Cerebrovascular Artery Injury and Stroke in Severely Injured Patients: An International Multicenter Analysis.
Blunt cerebrovascular injury (BCVI) is considered to be a rare entity in patients with high-energy trauma and is a potentially preventable cause of secondary brain damage. If it occurs, it may be fatal or associated with poor outcomes related to devastating complications. We hypothesized that analyses of epidemiology and concomitant injuries may predict the development of BCVI and associated complications. ⋯ Our data validated cervical spine injuries as a major predictor, but the predictive value of BSF must be scrutinized. Patient age appears to play a contradictory role in BCVI risk and BCVI-associated mortality. Predicting which patients will develop BCVI remains an ongoing challenge, especially since many patients do not present with concomitant injuries of the head or spine and therefore might not be captured by standard screening criteria.
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World journal of surgery · Jul 2018
A Nomogram to Predict Prognosis in Malignant Pleural Mesothelioma.
Malignant pleural mesothelioma (MPM) is a rare malignancy with heterogeneous outcomes. This study was aimed to develop a nomogram to precisely and visually predict survival of MPM patients. ⋯ We developed a nomogram to accurately predict clinical outcomes of MPM patients based on individual characteristics. Risk stratification by the survival nomogram could optimize individual therapies and follow-up.
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World journal of surgery · Jul 2018
Observational StudyEarly Management of Retained Hemothorax in Blunt Head and Chest Trauma.
Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries. ⋯ In this study, early VATS could be performed safely in brain hemorrhage patients without indication of surgical decompression. The clinical outcomes were much better in patients receiving early intervention within 4 days after trauma.
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World journal of surgery · Jul 2018
Measuring Outcomes of Clinical Care: Victorian Emergency Laparotomy Audit Using Quality Investigator.
The Australian and New Zealand Audit of Surgical Mortality (ANZASM) National Report 2015 found that within the cohort of audited deaths, 85% were emergencies with acute life-threatening conditions, and by far, the most common procedures were laparotomy and colorectal procedures. Emergency laparotomy outcomes have shown improvement through audit and reporting in the UK. The purpose of this study was to determine the outcome of emergency laparotomy in the state of Victoria, Australia. ⋯ Administrative data accessed via a tool such as DFQI can provide useful population data to guide further evidence-based improvement strategies. The mortality for emergency laparotomy within Victorian hospitals is comparable, if not better than that seen in overseas studies. There is a need to continue routine audit of mortality rates and implement systems improvement where necessary.