The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Jun 2019
Right hospital, right patients: Penetrating injury patients treated at high-volume penetrating trauma centers have lower mortality.
The recognition of the relationship between volume and outcomes led to the regionalization of trauma care. The relationship between trauma mechanism-subtype and outcomes has yet to be explored. We hypothesized that trauma centers with a high volume of penetrating trauma patients might be associated with a higher survival rate for penetrating trauma patients. ⋯ Prognostic/Epidemiology Study, Level-III; Therapeutic/Care Management, Level IV.
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J Trauma Acute Care Surg · Jun 2019
Fall downs should not fall out: Blunt cerebrovascular injury in geriatric patients after low-energy trauma is common.
There are limited data examining the impact of screening for blunt cerebrovascular injury (BCVI) in the geriatric population sustaining falls. We hypothesize that BCVI screening in this cohort would rarely identify injuries that would change management. ⋯ Therapeutic/care management, level IV.
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J Trauma Acute Care Surg · Jun 2019
Should they stay or should they go? Who benefits from interfacility transfer to a higher-level trauma center following initial presentation at a lower-level trauma center.
Interfacility transfer of patients from Level III/IV to Level I/II (tertiary) trauma centers has been associated with improved outcomes. However, little data are available classifying the specific subsets of patients that derive maximal benefit from transfer to a tertiary trauma center. Drawbacks to transfer include increased secondary overtriage. Here, we ask which injury patterns are associated with improved survival following interfacility transfer. ⋯ Therapeutic/Care Management, Level IV.
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J Trauma Acute Care Surg · May 2019
Multicenter Study Clinical TrialIndocyanine green dye angiography as an adjunct to assess indeterminate burn wounds: A prospective, multicentered, triple-blinded study.
Clinical assessment of indeterminate burn wounds has been reported to yield poor accuracy, even when performed by burn experts. Indocyanine green (ICG) dye angiography has been found to be highly accurate in assessing burn depth, but there is still limited evidence of its use in indeterminate burn wounds. This study aims to compare the accuracy of ICG angiography to that of clinical assessment in assessing indeterminate burn wounds. ⋯ Indocyanine green angiography yields a significantly higher accuracy than clinical assessment in indeterminate burn wounds. This intervention can, thus, be a useful tool to aid clinical judgment.
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J Trauma Acute Care Surg · May 2019
Meta Analysis Comparative StudyComparison of the efficacy of a bougie and stylet in patients with endotracheal intubation: A meta-analysis of randomized controlled trials.
Endotracheal intubation (ETI) is a procedure widely performed for several clinical indications. In typical ETI, an endotracheal tube is placed into a patient's trachea with the help of a malleable metal rod covered with a clear plastic sheath (called a stylet). However, another intubation aid, a bougie (also named a gum elastic bougie or endotracheal tube introducer), was also introduced in the clinical setting to improve the efficacy of conventional ETI. ⋯ Systematic review and meta-analysis, level II.