The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2016
Preinjury physical frailty and cognitive impairment among geriatric trauma patients determine postinjury functional recovery and survival.
Injury is an external stressor that often initiates a cycle of decline in many older adults. The influence of physical frailty and cognitive decline on 6-month and 1-year outcomes after injury is unreported. We hypothesized that physical frailty and cognitive impairment would be predictive of 6-month and 1-year postinjury function and overall mortality. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Feb 2016
Multicenter StudyMulticenter external validation of the Geriatric Trauma Outcome Score: A study by the Prognostic Assessment of Life and Limitations After Trauma in the Elderly (PALLIATE) consortium.
A prognostic tool for geriatric mortality after injury called the Geriatric Trauma Outcome Score (GTOS), where GTOS = [age] + [ISS × 2.5] + [22 if transfused any PRBCs by 24 hours after admission], was previously developed based on 13 years of data from geriatric trauma patients admitted to Parkland Hospital. We sought to validate this model. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Feb 2016
Prehospital airway technique does not influence incidence of ventilator-associated pneumonia in trauma patients.
The relationship between the prehospital airway device used and later development of ventilator-associated pneumonia (VAP) is unknown. We sought to determine if the prehospital airway device choice is associated with an increased risk of VAP in risk-adjusted critically injured patients. ⋯ Therapeutic study, level IV; epidemiologic study, level III.
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J Trauma Acute Care Surg · Feb 2016
Comparative StudyIsolated blunt severe traumatic brain injury in Bern, Switzerland, and the United States: A matched cohort study.
The ideal prehospital management of patients with severe traumatic brain injury (TBI) including the impact of endotracheal intubation (ETI) and physicians on scene is unclear. Prehospital management differs substantially in Switzerland and the United States: in Switzerland, there is usually a physician on scene who may provide ETI and other advanced life support procedures, whereas in the United States, prehospital management (including ETI) is performed by paramedics. ⋯ Therapeutic study, level IV.