Articles: hospitals.
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Eur J Trauma Emerg Surg · Jan 2025
Quality of referrals and adherence to guidelines for adult patients with minimal to moderate head injuries in a selection of Norwegian hospitals.
This study aimed to assess adherence to the Scandinavian guidelines, the justification of referrals, and the quality of referrals of patients with mild, minimal, and moderate head injuries in a selection of Norwegian hospitals. ⋯ Adherence to the Scandinavian guidelines and the quality of referrals of patients with mild, minimal, and moderate head injuries are low. Training and using S100B is recommended to improve the justification rate and quality of patient care.
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Firearm violence in America has been declared a public health crisis. This study investigates variation in firearm injuries by county-level characteristics and intent of firearm use. ⋯ These results suggest that deaths remain a problem in all Florida county communities while hospitalizations are highly influenced by socioeconomic factors and county size. Heatmaps may inform level one trauma hospitals to implement tailored education for high risk surrounding communities.
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Understanding clinical trajectories of sepsis patients is crucial for prognostication, resource planning, and to inform digital twin models of critical illness. This study aims to identify common clinical trajectories based on dynamic assessment of cardiorespiratory support using a validated electronic health record data that covers retrospective cohort of 19,177 patients with sepsis admitted to ICUs of Mayo Clinic Hospitals over eight-year period. Patient trajectories were modeled from ICU admission up to 14 days using an unsupervised machine learning two-stage clustering method based on cardiorespiratory support in ICU and hospital discharge status. ⋯ Four distinct trajectories were identified: fast recovery (27% with a mortality rate of 3.5% and median hospital LOS of 3 (IQR, 2-15) days), slow recovery (62% with a mortality rate of 3.6% and hospital LOS of 8 (IQR, 6-13) days), fast decline (4% with a mortality rate of 99.7% and hospital LOS of 1 (IQR, 0-1) day), and delayed decline (7% with a mortality rate of 97.9% and hospital LOS of 5 (IQR, 3-8) days). Distinct trajectories remained robust and were distinguished by Charlston comorbidity index, Apache III scores, day 1 and day 3 SOFA (p < 0.001 ANOVA). These findings provide a foundation for developing prediction models and digital twin decision support tools, improving both shared decision-making and resource planning.