J Trauma
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Comparative Study
POSSUM predicts hospital mortality and long-term survival in patients with hip fractures.
Each year, some 18,000 Dutch residents, most of them elderly, suffer a hip fracture. These patients constitute a major, and increasing, healthcare problem with high mortality. In an ageing population, not only the incidence of hip fractures will increase but also comorbidity. Comorbidity is a major cause of high mortality. The physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM) system predicts mortality and morbidity in surgical patients using physiologic and operative factors. ⋯ This study has shown that the orthopedic POSSUM is an excellent predictor of inhospital mortality and long-term survival in patients suffering from hip fractures. It is a reasonable predictor of severe postoperative complications. The orthopedic POSSUM is a useful risk stratification and audit tool.
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Comparative Study
External validation of a prognostic model for early mortality after traumatic brain injury.
Traumatic brain injury (TBI) is a major cause of lost disability-adjusted life years, and a valid model allowing prediction of outcome would be welcome. For a clinical prediction model to be valid, generalization to other populations must be possible. The aim of this study was to externally validate a model for in-hospital mortality in patients with TBI, which was recently development at the University of Southern California (USC). ⋯ The findings question the external validity of the USC model, suggesting that it should not be implemented as a tool for short-term mortality prediction in our TBI population.
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Comparative Study
Prehospital serum lactate as a predictor of outcomes in trauma patients: a retrospective observational study.
Lactate is associated with morbidity and mortality; however, the value of prehospital lactate (pLA) is unknown. Our objective was to determine whether pLA improves identification of mortality and morbidity independent of vital signs. ⋯ The pLA measurements improve prediction of mortality, surgery, and MODS. Lactate may improve the identification of patients who require monitoring, resources, and resuscitation.