J Trauma
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This study aims to determine whether severity-adjusted outcomes including mortality are adversely impacted by readmission to a surgical intensive care unit (SICU) during the same hospital stay. ⋯ Readmission to the SICU significantly increases the risk of death beyond that predicted by the APACHE II or SAPS scores alone. Higher APACHE II and SAPS scores upon discharge from the SICU and longer SICU LOS are associated with an increased incidence of readmission to the SICU on the same hospital stay. These results may be used to optimize the timing of SICU discharge and reduce the chance of readmission to intensive care.
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Injury to the spinal accessory nerve causes paralysis of the trapezius muscle, which is a painful and disabling condition. Many injuries are iatrogenic. Diagnosis is often made after a long delay, suggesting that current clinical signs are inadequate. ⋯ We propose that the resisted active external rotation test should be regarded as the key clinical sign for accessory nerve palsy.
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Review Meta Analysis Comparative Study
Does colostomy prevent infection in open blunt pelvic fractures? A systematic review.
Open pelvic fracture is a rare injury. Our aim in this study is to systematically review the literature to define when diverting colostomy is indicated to protect the patient from infection in open blunt pelvic fractures. ⋯ The role of colostomy in open blunt pelvic fractures is unresolved and randomized multicenter trials are needed.
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Comparative Study
Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: is it ready for primetime?
Although the reported sensitivity of computed tomographic angiography (CTA) for the diagnosis of blunt cervical vascular injury (BCVI) has been inadequate, we hypothesized that advances in computed tomographic technology have improved the diagnostic sensitivity of CTA at least to that of invasive catheter angiography (CA). ⋯ CTA, using a 16-channel detector, can be used to accurately screen at-risk patients for BCVI.
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Popular emergency room wisdom touts higher temperatures, snowfall, weekends, and evenings as variables that increase trauma admissions. This study analyzed the possible correlation between trauma admissions and specific weather variables, and between trauma admissions and time of day or season. ⋯ Weather and seasonal variations affect admissions at a Level I trauma center. Data from this study could be useful for determining staffing requirements and resource allocation.