Archives of surgery (Chicago, Ill. : 1960)
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Multicenter Study
Factors associated with survival following blunt chest trauma in older patients: results from a large regional trauma cooperative.
We hypothesized that patient factors, injury patterns, and therapeutic interventions influence outcomes among older patients incurring traumatic chest injuries. ⋯ In a large regional trauma cooperative, increasing age and Injury Severity Score were independent predictors of survival among older patients incurring traumatic RFs. Admission to high-volume trauma centers, preexisting congestive heart failure, and intubation added to mortality. Therapies associated with improved survival were patient-controlled analgesia and tracheostomy. Further regional cooperation should allow development of standard care practices for these challenging patients.
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Multicenter Study
Management of the most severely injured spleen: a multicenter study of the Research Consortium of New England Centers for Trauma (ReCONECT).
To determine the rate and predictors of failure of nonoperative management (NOM) in grade IV and V blunt splenic injuries (BSI). ⋯ Nearly two-thirds of patients with grade IV or V BSI require surgery. A grade V BSI and brain injury predict failure of NOM. This data must be taken into account when generalizations are made about the overall high success rates of NOM, which do not represent severe BSI.