Journal of trauma management & outcomes
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J Trauma Manag Outcomes · Jan 2009
Hospital mortality among major trauma victims admitted on weekends and evenings: a cohort study.
Patient care may be inconsistent during off hours. We sought to determine whether victims of major trauma admitted to hospital on evenings, nights, and weekends suffer increased mortality rates. All victims of major trauma admitted to all four major acute care hospitals in the Calgary Health Region between April 1, 2002 and March 31, 2006 were included. Clinical and outcome information was obtained from regional databases. Weekends were defined as anytime Saturday or Sunday, evenings as 18:00-22:59, and nights as 23:00-07:59. ⋯ In our region, the time of admission during the day or day of the week does not influence the risk for adverse outcome and may reflect our highly developed multi-hospital acute care and trauma system.
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J Trauma Manag Outcomes · Jul 2008
Outcomes of Ilizarov ring fixation in recalcitrant infected tibial non-unions - a prospective study.
Infected non-union of long bones is a problem in the developing countries. Persistent infection, deformity, shortening, bone loss, joint stiffness and disability complicate the non-union. Secondary procedures are often required for correction of bone defects and deformity. Ilizarov method addresses all the above problems simultaneously and offers a panacea for infected non-unions. The stability of the fixation and provision for bone transport allows bridging of bone defects, limb lengthening, early weight bearing ambulation and joint mobilisation. ⋯ Treatment of infected non-unions of Tibia with Ilizarov ring fixation is effective but for optimal results the treatment needs to be individualised by the treating surgeon with due consideration of the socio-economic factors.
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J Trauma Manag Outcomes · Jan 2008
Red blood cell transfusion within the first 24 hours of admission is associated with increased mortality in the pediatric trauma population: a retrospective cohort study.
Allogeneic red blood cell transfusion is associated with increased morbidity and mortality in adult trauma patients. Although studies have suggested that the adoption of a more restrictive transfusion strategy may be safely applied to critically ill adult and all-cause critically ill pediatric patients, recent developments in our understanding of the negative consequences of red blood cell transfusion have focused almost entirely on adult populations, while the applicability of these findings to the pediatric population remains poorly defined. The object of this study was to evaluate the effect of red blood cell transfusion within the first 24 hours following admission on mortality in pediatric trauma patients treated at our institution. ⋯ Red blood cell transfusion within the first 24 hours following admission is associated with an increase in mortality in pediatric trauma patients. The potential contribution of red blood cell transfusion as an independent predictor of hospital mortality could not be assessed from our single-institution trauma registry. A review of state-wide or national trauma databases may be necessary to obtain adequate statistical confidence.
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J Trauma Manag Outcomes · Jan 2008
'Damage control orthopaedics' in patients with delayed referral to a tertiary care center: experience from a place where Composite Trauma Centers do not exist.
Management of orthopaedic injuries in polytrauma cases continues to challenge the orthopaedic traumatologist. Mass disasters compound this challenge further due to delayed referral. Recently there has been increasing evidence showing that damage control surgery has advantages that are absent in the early total care modality. We studied the damage control modality in the management of polytrauma cases with orthopaedic injuries who had been referred to our hospital after more than 24 hours of sustaining their injuries in an earthquake. This study was conducted on 51 cases after reviewing their records and complete management one year after the trauma. ⋯ In situations of delayed referral in areas where composite trauma centers do not exist the damage control modality provides an acceptable method of treatment in the management of polytrauma cases.
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J Trauma Manag Outcomes · Jan 2008
A new approach and first steps to strengthen trauma management and road safety in North Vietnam.
In Vietnam, the number of road traffic accidents increased dramatically which is a major threat for the national health system. Reliable data on the magnitude of traffic accidents as well as the current management of victims is missing. Our multistep international cooperation project aims to (1) identify local needs and knowledge related to trauma management, to (2) assess basic behavioural patterns and attitudes of road users in order to (3) establish a school-based educational programme and trauma courses for doctors. ⋯ Knowledge on behaviour and attitudes of road users in Vietnam as well as on local infrastructure and effective networks is essential to establish sustainable and effective countermeasures. Our approach might serve as guideline for future small scale projects as it proved to be feasible, cost-effective but provided scientific base for immediate on spot activities.