The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2017
Review Meta AnalysisPrehospital hypertonic fluid resuscitation for trauma patients: A systematic review and meta-analysis.
Prehospital assessment of a patient's circulation status and appropriate resuscitation with intravenous fluids plays a critical role in patients with obvious hemorrhage or systolic blood pressure below 90 mm Hg. ⋯ Systematic review and meta-analysis, level I.
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J Trauma Acute Care Surg · May 2017
Multicenter Study Observational StudyNovel oral anticoagulants and trauma: The results of a prospective American Association for the Surgery of Trauma Multi-Institutional Trial.
The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants (NOAs) on trauma outcomes is unknown. We hypothesized that patients on NOAs would have higher rates of ICH, ICH progression, and death compared with patients on traditional anticoagulant and antiplatelet agents. ⋯ Prognostic/epidemiologic study, level III.
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J Trauma Acute Care Surg · May 2017
The American College of Surgeons Needs-Based Assessment of Trauma Systems: Estimates for the State of California.
In 2015, the American College of Surgeons Committee on Trauma convened a consensus conference to develop the Needs-Based Assessment of Trauma Systems (NBATS) tool to assist in determining the number of trauma centers required for a region. We tested the performance of NBATS with respect to the optimal number of trauma centers needed by region in California. ⋯ Economic, level V.
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J Trauma Acute Care Surg · May 2017
Potential impact of Affordable Care Act-related insurance expansion on trauma care reimbursement.
Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. ⋯ Economic analysis, level II.
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J Trauma Acute Care Surg · May 2017
Comparative StudyThe occurrence of single and multiple organ dysfunction in pediatric electrical versus other thermal burns.
Multiple organ failure (MOF) is a major contributor to morbidity and mortality in burned children. While various complications induced by electrical injuries have been described, the incidence and severity of single organ failure (SOF) and MOF associated with this type of injury are unknown. The study was undertaken to compare the incidence and severity of SOF and MOF as well as other complications between electrically and thermally burned children. ⋯ Retrospective chart review, level III.