J Trauma
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Multicenter Study Comparative Study
The New Injury Severity Score: a more accurate predictor of in-hospital mortality than the Injury Severity Score.
The purpose of this study was to determine whether the New Injury Severity Score (NISS) is a better predictor of mortality than the Injury Severity Score (ISS) in general and in subgroups according to age, penetrating trauma, and body region injured. ⋯ The NISS is a more accurate predictor of in-hospital death than the ISS and should be chosen over the ISS for case-mix control in trauma research, especially in certain subpopulations such as head/neck-injured patients.
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Comparative Study
Prospective evaluation of computed tomographic scanning for the spinal clearance of obtunded trauma patients: preliminary results.
Screening methods for detecting cervical spine injury in obtunded ventilated patients continue to evolve. This study compared the use of plain radiography to computed tomographic (CT) scanning of cervical spines in the obtunded blunt trauma patient. The accuracy of plain radiography and CT scanning in detecting clinically significant cervical spine injury in the obtunded blunt trauma patient was evaluated. ⋯ CT scanning in conjunction with plain films enhances the number of cervical spine injuries seen radiographically. Application of a protocol of plain radiographs and CT scanning may be used to clear cervical spines in the obtunded trauma patient. Ongoing evaluation of this protocol is required.
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The aging of the population in the United States has led to an increase in geriatric trauma. This study aimed to examine the characteristics and outcomes of geriatric trauma patients in New York State. ⋯ Trauma is a serious and escalating problem for the elderly, and increasing age is a significant risk factor for patient mortality.
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Firearm violence is the second leading cause of injury-related death. This study examined the use of local trauma centers as lead organizations in their communities to address firearm injury. ⋯ Trauma centers, when provided resources and support, with the model described, can function as lead organizations in partnering with the community to acquire and use community-specific data for local firearm injury prevention.
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Endovascular stent grafting (EVSG) has emerged as a new treatment for aortic disease and has recently been applied to the treatment of acute blunt aortic injury (BAI). The purpose of this study was to determine the outcome of EVSG for patients with BAI at two tertiary (Level I) trauma centers. ⋯ Repair of BAI with EVSG can be performed safely in patients with BAI. Mortality, morbidity, and especially paraplegia are reduced. Further long-term studies are required to support the routine use of EVSG technology for BAI.