J Trauma
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Comparative Study
Pelvic fractures in pediatric and adult trauma patients: are they different injuries?
Many aspects of pediatric trauma are considerably different from adult trauma. Very few studies have performed comprehensive comparisons between pediatric and adult pelvic fractures. The purpose of this study was to compare the incidence of pelvic fracture, the epidemiologic characteristics, type of associated abdominal injuries, and outcomes between pediatric (age 16 years) patients. ⋯ Pediatric trauma patients are significantly less likely than adults to suffer pelvic fractures, although the age group is not a significant risk factor for the severity of pelvic fracture. The incidence of associated abdominal injuries is high and similar in the two age groups. Motor vehicle crash, fall from a height, and pelvis AIS score >/= 4 were significant predictors of associated abdominal injuries in the adult but not the pediatric patients. The need for blood transfusion is similar in both groups irrespective of Injury Severity Score and pelvis AIS score. The mortality resulting from exsanguination related to pelvic fractures is very low, especially in pediatric patients.
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Comparative Study
Comparative analysis of hemostatic agents in a swine model of lethal groin injury.
Techniques for better hemorrhage control after injury could change outcome. A large-animal model of lethal, uncontrolled hemorrhage was developed to test whether the use of various hemostatic agents would decrease bleeding and improve early survival. ⋯ Of the hemostatic agents tested, QuikClot improved survival and decreased bleeding in a swine model of lethal vascular and soft tissue injury.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Prevention of venous thromboembolism in the rehabilitation phase after spinal cord injury: prophylaxis with low-dose heparin or enoxaparin.
This prospective, multicenter study compared low-dose unfractionated heparin (UFH) with enoxaparin for prophylaxis against venous thromboembolism (VTE) during the rehabilitation phase after spinal cord injury. ⋯ In this nonrandomized comparison, enoxaparin appeared more effective than heparin in the prevention of thromboembolic complications during rehabilitation after spinal cord injury. Both interventions were safe in this population.
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Comparative Study
The association between occupant restraint systems and risk of injury in frontal motor vehicle collisions.
An evaluation of seat belt use and airbag deployment, either alone or in combination, on risk of injury to specific body regions has yet to be completed. ⋯ Airbag deployment does not appear to significantly reduce the risk of injury either alone or in combination with seat belts. Airbag deployment without associated seat belt use may increase the risk of lower extremity injury.
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The pattern and severity of crash injury depends on a complex interaction of biomechanical factors such as deceleration velocity at impact (delta-V), seat-belt and airbag use, and type of impact. Human body characteristics such as height and weight may play an important role. We hypothesized that body mass index (BMI) will influence crash injury patterns. ⋯ Although no difference in ISS was identified between the lean and obese cohorts, there was an increase in mortality with the obese cohort. The severity of lower extremity injuries increased with increasing BMI. The overweight cohort was associated with lower ISS and abdominal mAIS score compared with the lean cohort. This protection may be attributable to an increase in insulating tissue, or a "cushion effect," without a significant increase in mass and momentum.