J Trauma
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Comparative Study
Combat musculoskeletal wounds in a US Army Brigade Combat Team during operation Iraqi Freedom.
A prospective, longitudinal analysis of musculoskeletal combat injuries sustained by a large combat-deployed maneuver unit has not previously been performed. ⋯ A large burden of complex orthopedic injuries has resulted from the combat experience in Operation Iraqi Freedom. This is because of increased enemy reliance on explosive devices, the use of individual and vehicular body armor, and improved survivability of combat-injured soldiers.
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Comparative Study
Validation of the "HAMP" mapping algorithm: a tool for long-term trauma research studies in the conversion of AIS 2005 to AIS 98.
There are significant changes in the abbreviated injury scale (AIS) 2005 system, which make it impractical to compare patients coded in AIS version 98 with patients coded in AIS version 2005. ⋯ The HAMP algorithm successfully converted injuries coded in AIS 2005 to AIS 98. This algorithm will be useful when comparing trauma patient clinical data across populations coded in different versions, especially for longitudinal studies.
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Comparative Study
Long-term evaluation of a trauma center-based juvenile driving intervention program.
Motor vehicle-related trauma remains the leading cause of adolescent injury and death in the United States. We previously reported results from the Drive Alive (DA) program-a comprehensive juvenile prevention program that highlights risky driving behavior and consequences-and demonstrated a reduction in recidivism 6 months after its completion. We further evaluated the results of the original and subsequent participants on a long-term basis. ⋯ Consistent with our prior results, this interactive intervention for juvenile driving offenders resulted in a statistically significant reduction in driving-related offenses for the 6-month periods after its completion. This effect is lost in the long term. The role of booster interventions at 6 months and beyond, as adjuncts to initial interventional prevention initiatives, needs to be explored to aid sustained positive effects in this population of drivers.
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Understanding the epidemiology of death after battlefield injury is vital to combat casualty care performance improvement. The current analysis was undertaken to develop a comprehensive perspective of deaths that occurred after casualties reached a medical treatment facility. ⋯ Hemorrhage is a major mechanism of death in PS combat injuries, underscoring the necessity for initiatives to mitigate bleeding, particularly in the prehospital environment.
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Comparative Study
Early VATS for blunt chest trauma: a management technique underutilized by acute care surgeons.
Retained hemothorax and/or empyema is a commonly recognized complication of penetrating chest injuries that may be treated by early video-assisted thoracoscopy (VATS). However, the use of VATS in blunt chest trauma is less well defined. Our acute care surgeon (ACS) group aggressively treats complications of penetrating chest trauma with VATS, and our results suggested that the early use of VATS by ACS should be expanded. ⋯ Early VATS can decrease hospital LOS and thoracotomy rate in patient suffering blunt thoracic injuries. ACS can perform this procedure safely and effectively.