The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jul 2012
Predicting outcomes after traumatic brain injury: the development and validation of prognostic models based on admission characteristics.
Early estimation of prognosis for the patient with traumatic brain injury is an important factor in making treatment decisions, resource allocation, classify patients, or communicating with family. We aimed to develop and validate practical prognostic models for mortality at 30 days and for 6 months unfavorable outcome after moderate and severe traumatic brain injury. ⋯ Our validated prognostic models have good performance and are generalizable to be used to predict outcome of new patients. We recommend the use of prognostic models to complement clinical decision making.
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J Trauma Acute Care Surg · Jul 2012
Validation of the pulse rate over pressure evaluation index as a detector of early occult hemorrhage: a prospective observational study.
The aim of this study was to validate a calculation of pulse rate (PR) divided by pulse pressure (pulse rate over pressure evaluation [ROPE] index) as a method of predicting early hemorrhagic compensation in healthy patients donating blood. The ROPE index calculations were compared with shock index (PR divided by systolic blood pressure) calculations for the same donors. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jul 2012
Who is in danger? Impingement and penetration of the anterior cortex of the distal femur during intramedullary nailing of proximal femur fractures: preoperatively measurable risk factors.
Intramedullary nail (IMN) perforation through the cortex of the distal femur is a risk of intramedullary stabilization of proximal femur fractures. This study was performed to identify information that is available before operation that can pick out patients at risk for this complication. ⋯ Prognostic study, level III; therapeutic study, level IV.
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J Trauma Acute Care Surg · Jul 2012
Patterns of pediatric injury in South Africa: an analysis of hospital data between 1997 and 2006.
Pediatric injuries are associated with significant morbidity and mortality, especially in low- and middle-income countries. Despite the magnitude of this burden, there is lack of data to characterize the etiology and risk factors associated with childhood injuries, especially in low- and middle-income countries. The aim of this article is to describe the demographics, mechanisms, and severity of injuries during a 10-year time period using hospital-based data in Cape Town, South Africa. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jul 2012
The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest.
The clinical utility of determining cardiac motion on ultrasound has been reported for patients presenting in pulseless medical cardiac arrest. However, the relationship between ultrasound-documented cardiac activity and the probability of surviving pulseless electrical activity has not been examined in populations with trauma. We hypothesized that cardiac activity on ultrasound predicts survival for patients presenting in pulseless traumatic arrest. ⋯ Survival in pulseless traumatic arrest is very low, but survival for patients with no cardiac motion on ultrasound is also exceedingly rare. Cardiac ultrasound had a negative predictive value approaching 100% for survival to hospital admission. For patients with prolonged prehospital cardiopulmonary resuscitation, ultrasound evaluation of cardiac motion in pulseless patients with trauma may be a rapid way to help determine which patients have no chance of survival in the setting of lethal injuries, so that futile resuscitations can be stopped.