World journal of surgery
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World journal of surgery · Apr 2012
Modification of the Trauma and Injury Severity Score (TRISS) method provides better survival prediction in Asian blunt trauma victims.
The objective of the present study was to identify logistic regression models with better survival prediction than the Trauma and Injury Severity Score (TRISS) method in assessing blunt trauma (BT) victims in Japan and Thailand. An additional aim was to demonstrate the feasibility of probability of survival (Ps) estimation without respiratory rate (RR) on admission, which is often missing or unreliable in Asian countries. ⋯ For better prediction of Ps, the actual number of the AY should be used as an explanatory variable instead of the coded value (used by the TRISS method). The logistic regression model using the ISS, AY, and coded values of SBP, GCS, and RR estimates the best prediction. Information about RR seems to be unimportant for survival prediction in BT victims in Asian countries.
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World journal of surgery · Apr 2012
Clinicopathological profile, airway management, and outcome in huge multinodular goiters: an institutional experience from an endemic goiter region.
Huge goiters are common in iodine-deficient endemic regions. They are of concern to the surgeons because of the anticipated risk of difficult dissection and increased chances of surgical complications. Similarly, they are of concern to the anesthesiologists because of anticipated intubation-related difficulties and post-thyroidectomy tracheomalacia. In the present study we aimed to present our experience of managing goiters based on their gross weight, highlighting their clinicopathological profile, perioperative airway-related difficulties, and management of surgical morbidity. ⋯ Long-standing huge goiters are common in iodine-deficient endemic areas. The majority of patients have symptomatic or clinicoradiological evidence of airway involvement. The incidence of RSE, airway deformity, intubation difficulty, and tracheomalacia is high with huge goiters. The surgery is technically demanding with greater associated chances of injury to native structures. Malignancy influences the presentation and outcome in smaller goiters. In centers with experienced endocrine surgeons and dedicated anesthetists, huge goiters can be successfully managed with minimal short-term and long-term morbidity.