The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyThe epidemiology of noncompressible torso hemorrhage in the wars in Iraq and Afghanistan.
Noncompressible torso hemorrhage (NCTH) is the leading cause of potentially survivable trauma in the battlefield and has recently been defined using anatomic and physiologic criteria. The objective of this study was to characterize the frequency and mortality in combat of NCTH using a contemporary definition. ⋯ Epidemiologic/prognostic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyRelationship of creatine kinase elevation and acute kidney injury in pediatric trauma patients.
Rhabdomyolysis following trauma has been associated with renal impairment. Nevertheless, the literature is scant in risk assessment of acute kidney injury (AKI) and survival in children experiencing posttraumatic rhabdomyolysis. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyPediatric trauma patients are more likely to be discharged from the emergency department after arrival by helicopter emergency medical services.
Despite faster transport times, concern about the safety of medical helicopters has led to scrutiny in the national media. Few criteria exist for the use of helicopter emergency medical services (HEMS). This study evaluated if pediatric trauma patients transported by HEMS from the injury scene were more likely to be discharged from the emergency department and more likely to be less severely injured based on Injury Severity Score (ISS) compared with adult patients. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyEstimated additional hospital length of stay caused by 40 individual complications in injured patients: an observational study of 204,388 patients.
Complications are common in the care of trauma patients and increase hospital length of stay (LoS). Because many factors influence LoS and because patients may experience more than a single complication, it is difficult to estimate the effect of individual complications on LoS. We describe here a mathematically principled approach to estimating the additional LoS caused by complications and provide estimates for additional LoS caused by 40 common complications. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Mar 2013
Comparative StudyHMGB1 activity inhibition alleviating liver injury in heatstroke.
Heatstroke is generally considered as a sepsis-like syndrome induced by hyperthermia leading to multiorgan dysfunction. High-mobility group box 1 (HMGB1) has recently been identified as a mediator of systemic inflammation leading to multiorgan dysfunction in sepsis and nonsepsis. Elevation of plasma HMGB1 in heatstroke has been suggested in experimental models and clinical patients. By far, whether HMGB1 could be a potential therapeutic target in heatstroke is unknown. The objectives of this study are to use HMGB1 monoclonal antibody to specifically inhibit the activity of extracellular HMGB1 and to observe the possible protection of liver injury in a rat heatstroke model. ⋯ HMGB1 could be a potentially effective treatment target in heatstroke. The pathogenic mechanism of heatstoke is complicated, which needs comprehensive prevention and treatment.