The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jun 2013
The value of traditional vital signs, shock index, and age-based markers in predicting trauma mortality.
Systolic blood pressure (SBP), heart rate (HR), and respiratory rate are poor predictors of trauma outcome. We postulate that HR/SBP (shock index [SI]) and novel new markers SI × age (SIA), SBP / age (BPAI), maximum HR (220 - age) - HR (minpulse [MP]), and HR / maximum HR (pulse max index [PMI]) are better predictors of 48-hour mortality compared with traditional vital signs. ⋯ Prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · Jun 2013
Multicenter StudyOccult abusive injuries in infants with apparently isolated skull fractures.
There is currently no consensus about which screening studies should be undertaken to identify abusive injuries in infants with apparently isolated skull fractures. Our objective was to determine rates of screening, rates of injury identification, and rates of reporting to child protective services among infants who underwent subspecialty evaluation for abuse after presenting with an apparently isolated skull fracture. ⋯ Epidemiological study, level IV.
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J Trauma Acute Care Surg · Jun 2013
Clinical TrialImproving outcomes at Level I trauma centers: an early evaluation of the Trauma Survivors Network.
The Trauma Survivors Network (TSN), a program developed to help patients and families manage the psychosocial impact of their injuries, combines information access, self-management training, peer support, and online social networking. The purpose of this study was to evaluate the effectiveness of the TSN in improving patient reported outcomes among orthopedic trauma patients at a Level I trauma center. ⋯ Therapeutic study, level IV.
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J Trauma Acute Care Surg · Jun 2013
Clinical TrialAmino acid infusion fails to stimulate skeletal muscle protein synthesis up to 1 year after injury in children with severe burns.
Burn injury results in increased skeletal muscle protein turnover, where the magnitude of protein breakdown outweighs synthesis, resulting in muscle wasting. The effect of increased amino acid (AA) provision on skeletal muscle fractional synthesis rate (FSR) in severely burned patients during their convalescence after discharge from hospital is not known. Subsequently, the purpose of this study was to determine skeletal muscle FSR in response to AA infusion in severely burned pediatric patients at discharge from hospital and at 6 and 12 months after injury. ⋯ Prognostic study, level II.