The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Apr 2020
Meta AnalysisThe impact of frailty on posttraumatic outcomes in older trauma patients: A systematic review and meta-analysis.
Frailty is a risk factor for mortality among the elderly. However, evidence from longitudinal studies linking trauma and frailty is fragmented, and a comprehensive analysis of the relationship between frailty and adverse outcomes is lacking. Therefore, we conducted a systematic review and meta-analysis to examine whether frailty is predictive of posttraumatic results including mortality, adverse discharge, complications, and readmission in trauma patients. ⋯ Systematic review and meta-analysis, level IV.
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J Trauma Acute Care Surg · Apr 2020
Evaluation of measurement properties of health-related quality of life instruments for burns: A systematic review.
Health-related quality of life (HRQL) is a key outcome in the evaluation of burn treatment. Health-related quality of life instruments with robust measurement properties are required to provide high-quality evidence to improve patient care. The aim of this review was to critically appraise the measurement properties of HRQL instruments used in burns. ⋯ Systematic review, level III.
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J Trauma Acute Care Surg · Feb 2020
Comparative StudyAbdominal aortic and junctional tourniquet versus zone III resuscitative endovascular balloon occlusion of the aorta in a swine junctional hemorrhage model.
Junctional hemorrhage is a leading contributor to battlefield mortality. The Abdominal Aortic and Junctional Tourniquet (AAJT) and infrarenal (zone III) resuscitative endovascular balloon occlusion of the aorta (REBOA) are emerging strategies for controlling junctional hemorrhage, with AAJT currently available in select forward deployed settings and increasing interest in applying REBOA in the military prehospital environment. This study compared the hemostatic, hemodynamic, and metabolic effects of these devices used for junctional hemorrhage control. ⋯ The AAJT and REBOA produced similar hemostatic, resuscitative, and metabolic effects in this model of severe shock with junctional hemorrhage. Both interventions may have utility in future military medical operations.
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J Trauma Acute Care Surg · Feb 2020
Randomized Controlled Trial Multicenter StudyA multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL).
The efficacy of surgical stabilization of rib fracture (SSRF) in patients without flail chest has not been studied specifically. We hypothesized that SSRF improves outcomes among patients with displaced rib fractures in the absence of flail chest. ⋯ Therapeutic, level II.
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J Trauma Acute Care Surg · Feb 2020
Multicenter Study Comparative Study Observational StudyA comparison between the TEG 6s and TEG 5000 analyzers to assess coagulation in trauma patients.
Trauma-induced coagulopathy is a major driver of mortality following severe injury. Viscoelastic goal-directed resuscitation can reduce mortality after injury. The TEG 5000 system is widely used for viscoelastic testing. However, the TEG 6s system incorporates newer technology, with encouraging results in cardiovascular interventions. The purpose of this study was to validate the TEG 6s system for use in trauma patients. ⋯ Diagnostic test, level II.