The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Mar 2021
Multicenter StudyOutcome after surgical stabilization of rib fractures versus nonoperative treatment in patients with multiple rib fractures and moderate to severe traumatic brain injury (CWIS-TBI).
Outcomes after surgical stabilization of rib fractures (SSRF) have not been studied in patients with multiple rib fractures and traumatic brain injury (TBI). We hypothesized that SSRF, as compared with nonoperative management, is associated with favorable outcomes in patients with TBI. ⋯ Therapeutic, level IV.
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J Trauma Acute Care Surg · Feb 2021
Multicenter StudyIncreasing BMI is associated with higher mortality, worsening outcomes and highly specific injury patterns following trauma: A multi-institutional analysis of 191,274 patients.
As the prevalence of obesity has increased, trauma centers are faced with managing this expanding demographics' unique care requirements. Research on the effects of body mass index (BMI) in trauma patients remains conflicting. This study aims to evaluate the impact of BMI on patterns of injury and patient outcomes following trauma. ⋯ Epidemiological, Level III.
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J Trauma Acute Care Surg · Feb 2021
Hybrid emergency room shows maximum effect on trauma resuscitation when used in patients with higher severity.
The hybrid emergency room (ER) system is a novel trauma workflow that uses angio-computed tomography equipment in a trauma resuscitation room. Although the hybrid ER system decreases time to start surgery and endovascular treatments and improves mortality, the optimal target benefitting from this system remained unclear. We aimed to identify a subset of trauma patients likely to receive the greatest benefits from the hybrid ER. ⋯ Therapeutic/care management, level IV.
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J Trauma Acute Care Surg · Jan 2021
Hard signs gone soft: A critical evaluation of presenting signs of extremity vascular injury.
Despite advances in management of extremity vascular injuries, "hard signs" remain the primary criterion to determine need for imaging and urgency of exploration. We propose that hard signs are outdated and that hemorrhagic and ischemic signs of vascular injury may be of greater clinical utility. ⋯ Diagnostic, level III.