The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyPosttraumatic stress disorder following traumatic injury at 6 months: associations with alcohol use and depression.
Posttraumatic stress disorder (PTSD) is progressively recognized as a psychological morbidity in injured patients. Participants in a longitudinal study were identified as PTSD positive or PTSD negative at 6 months following injury. Risky alcohol use, depression, demographic, and injury-related variables were explored. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyThe conjoint effect of reduced crystalloid administration and decreased damage-control laparotomy use in the development of abdominal compartment syndrome.
Anticipation of abdominal compartment syndrome (ACS) is a factor for performing damage-control laparotomy (DCL). Recent years have seen changes in resuscitation patterns and a decline in the use of DCL. We hypothesized that reductions in both crystalloid resuscitation and the use of DCL is associated with a reduced rate of ACS in trauma patients. ⋯ Epidemiologic/therapeutic study, level IV.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyThe Mayo Clinic experience with Morel-Lavallée lesions: establishment of a practice management guideline.
Although uncommon, Morel-Lavallée lesions (also called closed degloving injuries) are associated with considerable morbidity in trauma patients. There is lack of consensus regarding proper management of these lesions. Management options include nonoperative therapies, along with percutaneous and operative techniques. We sought to define the factors associated with failure of percutaneous aspiration to better identify patients requiring immediate operative management. ⋯ Therapeutic/care management study, level III.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyComputer versus paper system for recognition and management of sepsis in surgical intensive care.
A system to provide surveillance, diagnosis, and protocolized management of surgical intensive care unit (SICU) sepsis was undertaken as a performance improvement project. A system for sepsis management was implemented for SICU patients using paper followed by a computerized system. The hypothesis was that the computerized system would be associated with improved process and outcomes. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Feb 2014
Comparative StudyFibrinogen and platelet contributions to clot formation: implications for trauma resuscitation and thromboprophylaxis.
Thromboelastography (TEG) is used to diagnose perturbations in clot formation and lysis that are characteristic of acute traumatic coagulopathy. With novel functional fibrinogen (FF) TEG, fibrin- and platelet-based contributions to clot formation can be elucidated to tailor resuscitation and thromboprophylaxis. We sought to describe the longitudinal contributions of fibrinogen and platelets to clot strength after injury, hypothesizing that low levels of FF and a low contribution of fibrinogen to clot strength on admission would be associated with coagulopathy, increased transfusion requirements, and worse outcomes. ⋯ Prognostic study, level III.