J Trauma
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Multicenter Study
Blunt traumatic thoracic aortic injuries: early or delayed repair--results of an American Association for the Surgery of Trauma prospective study.
The traditional approach to stable blunt thoracic aortic injuries (TAI) is immediate repair, with delayed repair reserved for patients with major associated injuries. In recent years, there has been a trend toward delayed repair, even in low-risk patients. This study evaluates the current practices in the surgical community regarding the timing of aortic repair and its effects on outcomes. ⋯ Delayed repair of stable blunt TAI is associated with improved survival, irrespective of the presence or not of major associated injuries. However, delayed repair is associated with a longer length of ICU stay and in the group of patients with no major associated injuries a significantly higher complication rate.
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Multicenter Study Comparative Study
Warm fresh whole blood is independently associated with improved survival for patients with combat-related traumatic injuries.
Increased understanding of the pathophysiology of the acute coagulopathy of trauma has lead many to question the current transfusion approach to hemorrhagic shock. We hypothesized that warm fresh whole blood (WFWB) transfusion would be associated with improved survival in patients with trauma compared with those transfused only stored component therapy (CT). ⋯ In patients with trauma with hemorrhagic shock, resuscitation strategies that include WFWB may improve 30-day survival, and may be a result of less anticoagulants and additives with WFWB use in this population.
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Multicenter Study
Outcome after injury: memories, health-related quality of life, anxiety, and symptoms of depression after intensive care.
To examine the relationship between delusional memories from the Intensive Care Unit (ICU) stay, health related quality of life (HRQoL), anxiety, and symptoms of depression in patients with physical trauma, 6 months to 18 months after their ICU stay. ⋯ Our results highlight the importance of treating the delusional memories experienced by ICU patients with a trauma diagnosis as a postinjury factor with a potential to create anxiety and symptoms of depression and which may affect HRQoL after discharge.
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Multicenter Study
Incidence of deep venous thrombosis after temporary joint spanning external fixation for complex lower extremity injuries.
The purpose of this study was to determine the incidence of deep venous thrombosis (DVT) in a prospective protocol of early spanning external fixation with the concurrent use of low-molecular weight heparin (LMWH) in patients with high-energy lower extremity trauma. ⋯ The incidence of DVT in patients treated with a protocol of early joint spanning external fixation and LMWH administration does not exceed historical controls. The early restoration of limb length, alignment, and stability allows early mobilization, which may contribute to the prevention of DVT.