J Trauma
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In acute care surgery, predicting mortality is important to determine appropriate patient transfer to a regional emergency general surgery (EGS) center. We hypothesized that distance to a referral center and severity of illness (SOI) would be predictors of death. ⋯ Age, SOI, and distance from a regional referral center explain much of the variation in mortality and can be used for triage to regional EGS centers.
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The purpose of this study was to determine the incidence and identify clinical predictors for the need for tracheostomy after cervical spinal cord injury (CSCI). ⋯ After CSCI, a fifth of patients will require tracheostomy. Intubation on scene or ED, complete CSCI at C1-C4 or C5-C7 levels, ISS≥16, facial fracture, and thoracic trauma were independently associated with the need for tracheostomy.
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Chest trauma frequently occurs in severely injured patients and is often associated with hemorrhagic shock. Immune dysfunction contributes to the adverse outcome of multiple injuries. The aims of this study were to establish a combined model of lung contusion and hemorrhage and to evaluate the cardiopulmonary and immunologic response. ⋯ Although physiologic readouts were selectively altered in response to the single or double hits, the combination did not uniformly augment the changes in inflammation. Our results suggest that the leading insult regarding the immunologic response is lung contusion, supporting the concept that lung contusion represents an important prognostic factor in multiple injuries.