The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2019
Multicenter StudyThe why and how our trauma patients die: A prospective Multicenter Western Trauma Association study.
Historically, hemorrhage has been attributed as the leading cause (40%) of early death. However, a rigorous, real-time classification of the cause of death (COD) has not been performed. This study sought to prospectively adjudicate and classify COD to determine the epidemiology of trauma mortality. ⋯ Epidemiologic, level II.
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J Trauma Acute Care Surg · May 2019
Pediatric blunt renal trauma practice management guidelines: Collaboration between the Eastern Association for the Surgery of Trauma and the Pediatric Trauma Society.
Injury to the kidney from either blunt or penetrating trauma is the most common urinary tract injury. Children are at higher risk of renal injury from blunt trauma than adults, but no pediatric renal trauma guidelines have been established. The authors reviewed the literature to guide clinicians in the appropriate methods of management of pediatric renal trauma. ⋯ Guidelines study, level III.
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J Trauma Acute Care Surg · May 2019
Chest computed tomography imaging utility for radiographically occult rib fractures in elderly fall-injured patients.
Previous studies demonstrate an association between rib fractures and morbidity and mortality in trauma. This relationship in low-mechanism injuries, such as ground-level fall, is less clearly defined. Furthermore, computed tomography (CT) has increased sensitivity for rib fractures compared with chest x-ray (CXR); its utility in elderly fall patients is unknown. We sought to determine whether CT-diagnosed rib fractures in elderly fall patients with a normal CXR were associated with increased in-hospital resource utilization or mortality. ⋯ Diagnostic, level III.
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J Trauma Acute Care Surg · May 2019
Association between age and acute respiratory distress syndrome development and mortality following trauma.
Improved understanding of the relationship between patient age and acute respiratory distress syndrome (ARDS) development and mortality following traumatic injury may help facilitate generation of new hypotheses about ARDS pathophysiology and the role of novel treatments to improve outcomes across the age spectrum. ⋯ Prognostic/epidemiological study, level III.
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J Trauma Acute Care Surg · May 2019
Pediatric emergency department readiness among US trauma hospitals.
Pediatric readiness among US emergency departments is not universal. Trauma hospitals adhere to standards that may support day-to-day readiness for children. ⋯ Care management, level III.