The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jun 2012
Comparative StudyDoes hemopericardium after chest trauma mandate sternotomy?
Recently, three patients with hemopericardium after severe chest trauma were successfully managed nonoperatively at our institution. This prompted the question whether these were rare or common events. Therefore, we reviewed our experience with similar injuries to test the hypothesis that trauma-induced hemopericardium mandates sternotomy. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Jun 2012
Comparative StudyAdmission rapid thrombelastography predicts development of pulmonary embolism in trauma patients.
Injury leads to dramatic disturbances in coagulation with increased risk of bleeding followed by a hypercoagulable state. A comprehensive assessment of these coagulation abnormalities can be measured and described by thrombelastography. The purpose of this study was to identify whether admission rapid-thrombelastography (r-TEG) could identify patients at risk of developing pulmonary embolism (PE) during their hospital stay. ⋯ Prognostic study, level III.
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This study explored the relationships between health-related quality of life and postacute factors such as patients' perceived access to information and support, perceptions of illness and ability to provide self-care after traumatic injury. ⋯ Prognostic study, level III.
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J Trauma Acute Care Surg · Jun 2012
Comparative StudyAre the frail destined to fail? Frailty index as predictor of surgical morbidity and mortality in the elderly.
America's aging population has led to an increase in the number of elderly patients necessitating emergency general surgery. Previous studies have demonstrated that increased frailty is a predictor of outcomes in medicine and surgical patients. We hypothesized that use of a modification of the Canadian Study of Health and Aging Frailty Index would be a predictor of morbidity and mortality in patients older than 60 years undergoing emergency general surgery. ⋯ Prognostic study, level II.
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J Trauma Acute Care Surg · Jun 2012
Comparative StudyThe mortality benefit of direct trauma center transport in a regional trauma system: a population-based analysis.
By ensuring timely access to trauma center (TC) care, well-organized trauma systems have the potential to significantly reduce injury-related mortality. However, undertriage continues to be a significant problem in many regional trauma systems. Taking a novel, population-based approach, we estimated the potential detrimental impact of undertriage to a non-TC (NTC) within a regional system. ⋯ Therapeutic study, level IV.