J Trauma
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Multicenter Study Comparative Study
Effect of the modified Glasgow Coma Scale score criteria for mild traumatic brain injury on mortality prediction: comparing classic and modified Glasgow Coma Scale score model scores of 13.
The Glasgow Coma Scale (GCS) classifies traumatic brain injuries (TBIs) as mild (14-15), moderate (9-13), or severe (3-8). The Advanced Trauma Life Support modified this classification so that a GCS score of 13 is categorized as mild TBI. We investigated the effect of this modification on mortality prediction, comparing patients with a GCS score of 13 classified as moderate TBI (classic model) to patients with GCS score of 13 classified as mild TBI (modified model). ⋯ The lack of overlap between receiver operating characteristic curves of both models reveals a statistically significant difference in their ability to predict mortality. The classic model demonstrated better goodness of fit than the modified model. A GCS score of 13 classified as moderate TBI in a multivariate logistic regression model performed better than a GCS score of 13 classified as mild.
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Meta Analysis
Efficacy and safety of intensive insulin therapy for critically ill neurologic patients: a meta-analysis.
Whether intensive insulin therapy (IIT) may improve clinical outcomes for patients admitted to intensive care units, especially critically ill neurologic patients, is still debated. In the present study, we performed a meta-analysis of literature comparing the efficacy and safety of IIT and conventional insulin therapy (CIT) for critically ill neurologic patients in terms of mortality, infection rate, neurologic outcome, and hypoglycemia. ⋯ As compared with CIT, IIT may not benefit critically ill neurologic patients in terms of mortality, infection rate, or neurologic outcome and in fact may be associated with increased hypoglycemic complications. Therefore, IIT cannot be recommended over conventional control for critical neurologic disease, but further study is warranted.
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Randomized Controlled Trial Comparative Study
On the road with injury prevention--an analysis of the efficacy of a mobile injury prevention exhibit.
To assess the effectiveness of a mobile injury prevention vehicle (mobile safety street [MSS]) with a hands-on curriculum on instruction and retention of safety knowledge compared with traditional classroom safety curriculum among grade 5 elementary school children. ⋯ Community-based injury prevention programs are essential to reducing preventable injury and deaths from trauma. This study demonstrates that a hands-on program is more effective than traditional methods for providing safety knowledge.
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Comparative Study
Goods for Guns--the use of a gun buyback as an injury prevention/community education tool.
US children aged between 5 years and 14 years have a rate of gun-related homicide 17 times higher and a rate of gun-related suicide and unintentional firearm injury 10 times higher than other developed countries. Gun buyback programs have been criticized as ineffective interventions in decreasing violence. The Injury Free Coalition for Kids-Worcester (IFCK-W) Goods for Guns buyback is a multipronged approach to address these concerns and to reduce the number of firearms in the community. ⋯ IFCK-W Goods for Guns is a relatively inexpensive injury prevention model program that removes unwanted firearms from homes, raises community awareness about gun safety, and provides high-risk individuals with trigger locks and educational counseling.