Archives of surgery (Chicago, Ill. : 1960)
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To determine if a change in trauma designation from level II (L2) to level I (L1) in the same institution reduces mortality. ⋯ The significant reduction in mortality of trauma patients with severe or specific injuries after the change to a higher trauma level designation may justify direct triage of these patients to L1 facilities, when available.
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Increased risk of adrenal insufficiency following etomidate exposure in critically injured patients.
Timely diagnosis and treatment of adrenal insufficiency (AI) dramatically reduces mortality in trauma patients. We sought to identify risk factors and populations with a high risk of developing AI. ⋯ Exposure to etomidate is a modifiable risk factor for the development of AI in this sample of critically injured patients. The use of etomidate for procedural sedation and rapid-sequence intubation in this patient population should be reevaluated.
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To determine the attributable costs associated with surgical site infection (SSI) following breast surgery. ⋯ Surgical site infection after breast cancer surgical procedures was more common than expected for clean surgery and more common than SSI after non-cancer-related breast surgical procedures. Knowledge of the attributable costs of SSI in this patient population can be used to justify infection control interventions to reduce the risk of infection.