J Trauma
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The purpose of this study was to examine the success rate of nonoperative management of blunt splenic injury in an institution using splenic embolization. ⋯ Splenic embolization is a valuable adjunct to splenic salvage in our experience, allowing for the increased use of nonoperative management and higher salvage rates for American Association for the Surgery of Trauma splenic injury grades when compared with prior studies. Main coil embolization has a similar salvage rate when compared with other angiographic techniques. An arteriovenous fistula as a CT finding was predictive of a 40% nonoperative failure rate.
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Recombinant factor VII (rFVII) is an attractive agent to control refractory, coagulopathic bleeding in patients following major surgery. The purpose of this review is to evaluate the published experiences of rFVII in adult, nonhemophilic, surgical and trauma patients. ⋯ Recombinant factor VII is an effective therapeutic agent for achieving hemostasis in nonhemophilic surgical patients. Published clinical experiences, however, are limited to small case series and case reports.
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This follow-up study of consecutive traffic accident victims aimed to characterize the variation in recuperation time, to estimate the incidence of delayed recovery, and to identify predictors of nonrecovery 1 and 6 months after the accident. This study included 318 of 811 consecutive patients. Whiplash type neck injuries (48%) were the most common, followed by other minor injuries (38%). ⋯ With control for mutual confounding variables in a multivariate model, injury severity, working status, and education were associated, respectively, with 4.5-fold, 3.2-fold and 2.3-fold gradients in odds of recovery not reported at 1 month. At 6 months, only working status (odds ratio [OR], 3.2) and education (OR, 2.3) were associated with the risk of reporting nonrecovery. The authors concluded that social factors are important predictors of outcome 1 and 6 months after minor traffic accidents.