World journal of surgery
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World journal of surgery · Jan 2009
Prognostic factors in critically ill patients suffering from secondary peritonitis: a retrospective, observational, survival time analysis.
Acute mortality of unselected critically ill patients has improved during the last 15 years. Whether these benefits also affect survival of critically ill patients with secondary peritonitis is unclear as is the relevance of specific prognostic factors, such as source control. ⋯ Four-month prognosis of critically ill, surgical patients with secondary peritonitis is poor and mostly determined by the ability to obtain source control. Outcome has improved since 2002, and after successful surgical and intensive care therapy long-term survival seems to be good.
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World journal of surgery · Jan 2009
Rib fracture repair: indications, technical issues, and future directions.
Rib fracture repair has been performed at selected centers around the world for more than 50 years; however, the operative indications have not been established and are considered controversial. The outcome of a strictly nonoperative approach may not be optimal. ⋯ Nonetheless, several effective repair systems have been developed. Future directions for progress on this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized trials.
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A number of recent studies have demonstrated disparity between racial groups in both outcome and processes of trauma care. These were not controlled for the presence of shock. ⋯ We found no mortality differences based on race for GSW. Hispanics have a higher mortality rate for MVC. For both injury types, Blacks and Hispanics had shorter hospital stays and a greater likelihood of transfer to post-acute care when compared to white patients. Hypotension on admission has a much more significant impact on outcome than race and ethnicity.