The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · May 2021
A clinical practice guideline using percentage of predicted forced vital capacity improves resource allocation for rib fracture patients.
Predicting rib fracture patients that will require higher-level care is a challenge during patient triage. Percentage of predicted forced vital capacity (FVC%) incorporates patient-specific factors to customize the measurements to each patient. A single institution transitioned from a clinical practice guideline (CPG) using absolute forced vital capacity (FVC) to one using FVC% to improve triage of rib fracture patients. This study compares the outcomes of patients before and after the CPG change. ⋯ Therapeutic/Care Management. Trauma, Rib, Triage, level IV.
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J Trauma Acute Care Surg · May 2021
Observational StudyMultisystem outcomes and predictors of mortality in critically ill patients with COVID-19: Demographics and disease acuity matter more than comorbidities or treatment modalities.
We sought to describe characteristics, multisystem outcomes, and predictors of mortality of the critically ill COVID-19 patients in the largest hospital in Massachusetts. ⋯ Prognostic, level III.
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J Trauma Acute Care Surg · Apr 2021
Meta AnalysisEfficacy and feasibility of amniotic membrane for the treatment of burn wounds: A meta-analysis.
Burns cause a huge economic burden to society, and the wounds can be very difficult to manage. Clinical experience suggests that amniotic membrane (AM) is an economical and effective biological dressing for burns. However, few systematic reviews or meta-analyses have been published on such use. We aimed to evaluate the role of AM dressings in burn wounds. ⋯ Systematic Review/Meta-analysis, level III.
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J Trauma Acute Care Surg · Apr 2021
Observational StudyEvaluation of the Berlin polytrauma definition: A Dutch nationwide observational study.
The Berlin polytrauma definition (BPD) was established to identify multiple injury patients with a high risk of mortality. The definition includes injuries with an Abbreviated Injury Scale score of ≥3 in ≥2 body regions (2AIS ≥3) combined with the presence of ≥1 physiological risk factors (PRFs). The PRFs are based on age, Glasgow Coma Scale, hypotension, acidosis, and coagulopathy at specific cutoff values. This study evaluates and compares the BPD with two other multiple injury definitions used to identify patients with high resource utilization and mortality risk, using data from the Dutch National Trauma Register (DNTR). ⋯ Epidemiological study, level III.
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J Trauma Acute Care Surg · Apr 2021
Observational Study"Safer at home": The effect of the COVID-19 lockdown on epidemiology, resource utilization, and outcomes at a large urban trauma center.
The COVID-19 pandemic has affected the entire global health care system. In California, because of a high burden of cases, a lockdown order was announced on March 19, 2020. This study investigated the impact of the lockdown on the epidemiology and outcomes of trauma admissions at the largest trauma center in Los Angeles. ⋯ Epidemiological study, level III; Retrospective observational, level III.