Articles: trauma.
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Multicenter Study
Suicide attempts presenting to trauma centers: trends across age groups using the National Trauma Data Bank.
This study sought to examine the epidemiology and mortality of violent suicide attempts presenting to trauma centers and to describe differences in male and female suicide attempters presenting to trauma centers by decade of age. ⋯ This study highlights the importance of examining the epidemiology of suicide attempts across sex and age. There are significant differences in rate of attempts, lethality of mechanism, and in-hospital mortality. Future studies should continue to investigate violent suicide attempts to design and implement effective treatment strategies targeted toward specific populations.
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Multicenter Study
Prevalence of Chest Injury With the Presence of NEXUS Chest Criteria: Data to Inform Shared Decisionmaking About Imaging Use.
The NEXUS chest decision instrument identifies a very-low-risk population of patients with blunt trauma for whom chest imaging can be avoided. However, it requires that all 7 National Emergency X-Ray Utilization Study (NEXUS) chest criteria be absent. To inform patient and physician shared decisionmaking about imaging, we describe the test characteristics of individual criteria of the NEXUS chest decision instrument and provide the prevalence of injuries when 1, 2, or 3 of the 7 criteria are present. ⋯ Patients with isolated NEXUS chest criteria have low rates of major clinical injury. The risk of major clinical injury for patients with 2 or 3 factors range from 1.7% to 16.6%, depending on the combination of criteria. Criteria-specific risks could be used to inform shared decisionmaking about the need for imaging by patients and their physicians.
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Scand J Trauma Resus · Jul 2016
Multicenter StudyAssociation between trauma and socioeconomic deprivation: a registry-based, Scotland-wide retrospective cohort study of 9,238 patients.
Trauma remains a leading cause of morbidity and mortality in the UK and throughout the world. Socioeconomic deprivation has been linked with many types of ill-health and previous studies have shown an association with injury in other parts of the world. The aim of this study was to investigate the association between socioeconomic deprivation and trauma incidence and case-fatality in Scotland. ⋯ In Scotland, populations living in socioeconomically deprived areas have a higher incidence of trauma, especially penetrating trauma, requiring hospital attendance. Case fatality is associated with more severe trauma and penetrating trauma, but not socioeconomic deprivation.
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Journal of neurosurgery · Jun 2016
Multicenter StudyAlcohol and mortality after moderate to severe traumatic brain injury: a meta-analysis of observational studies.
OBJECT Experimental studies have shown numerous neuroprotective properties of alcohol ("ethanol") after TBI, but clinical studies have provided conflicting results. The authors aimed to assess the relationship between positive blood alcohol concentration (BAC) on hospital admission and mortality after moderate to severe traumatic brain injury (TBI). METHODS The authors searched 8 databases for observational studies reported between January 1, 1990, and October 7, 2013, and investigated the effect of BAC on mortality after moderate to severe TBI. ⋯ CONCLUSIONS Positive BAC was significantly associated with lower mortality rates in moderate to severe TBI. Whether this observation is due to selection bias or neuroprotective effects of alcohol remains unknown. Future prospective studies adjusting for TBI heterogeneity is advocated to establish the potential favorable effects of alcohol on outcome after TBI.
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Arch Orthop Trauma Surg · Jun 2016
Multicenter Study Comparative StudyAre people following hip and knee arthroplasty at greater risk of experiencing a fall and fracture? Data from the Osteoarthritis Initiative.
Falls are a major challenge for older people and are a significant source of mortality and morbidity. There has been uncertainty as to whether people with total hip (THA) or knee (TKA) arthroplasty have a greater risk of falls and associated fractures. This analysis was to explore this question with a large community dataset. ⋯ There appears a lower chance of experiencing a fracture for people following THA compared to those who have not.