World journal of surgery
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World journal of surgery · Aug 2014
Comparative StudyProthrombin complex concentrate versus fresh-frozen plasma for reversal of coagulopathy of trauma: is there a difference?
The development of coagulopathy of trauma is multifactorial associated with hypoperfusion and consumption of coagulation factors. Previous studies have compared the role of factor replacement versus FPP for reversal of trauma coagulopathy. The purpose of our study was to determine the time to correction of coagulopathy and blood product requirement in patients who received PCC+FFP compared with patients who received FFP alone. ⋯ PCC in conjunction with FFP rapidly corrects INR in a matched cohort of trauma patients not on warfarin therapy compared with FFP therapy alone. The use of PCC as an adjunct to FFP therapy is associated with reduction of blood product requirement and also lowers overall cost.
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World journal of surgery · Aug 2014
Comparative StudyIs the Kampala trauma score an effective predictor of mortality in low-resource settings? A comparison of multiple trauma severity scores.
In the developed world, multiple injury severity scores have been used for trauma patient evaluation and study. However, few studies have supported the effectiveness of different trauma scoring methods in the developing world. The Kampala Trauma Score (KTS) was developed for use in resource-limited settings and has been shown to be a robust predictor of death. This study evaluates the ability of KTS to predict the mortality of trauma patients compared to other trauma scoring systems. ⋯ This comparison of KTS to other trauma scores supports the adoption of KTS for injury surveillance and triage in resource-limited settings. We show that the KTS is as effective as other scoring systems for predicting patient mortality.
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World journal of surgery · Aug 2014
Extracapsular lymph node involvement is associated with colorectal liver metastases and impact outcome after hepatectomy for colorectal metastases.
Hepatic resection of metastatic colorectal cancer (CRC) has become the treatment of choice for patients after resection of the primary CRC. However, some patients do not benefit from immediate resection because of rapidly progressive disease. The aim of this study was to examine the prognostic value of extracapsular invasion (ECI) of lymph node (LN) metastasis of CRC with liver metastases following liver resection. ⋯ In patients with hepatic CRC metastases, ECI in regional LNs reflects a particularly aggressive behavior, such as a greater number of liver metastases. In CRC patients with liver metastases, ECI in regional LNs might be correlated with poor prognosis following liver resection.
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World journal of surgery · Aug 2014
Low tissue oxygen saturation is associated with requirements for transfusion in the rural trauma population.
Tissue O2 saturation (StO2) is a measure of tissue perfusion and should decrease during active hemorrhage. An initial StO2 value upon trauma center arrival measured concurrently with or prior to vitals, may predict hemorrhagic shock, requiring early blood product transfusion. Our aim was to identify the early StO2 threshold associated with a greater volume of packed red blood cell (PRBC) transfusion 24 h after injury. ⋯ An StO2 value <65% correlates with greater requirement for PRBC transfusion 24 h after injury. This suggests that StO2 can be used as an early marker of hemorrhage which may be superior to traditional vital signs in the trauma population.
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World journal of surgery · Aug 2014
Trauma system evaluation in developing countries: applicability of American College of Surgeons/Committee on Trauma (ACS/COT) basic criteria.
Trauma continues to be a major health problem worldwide, particularly in the developing world, with high mortality and morbidity. Yet most developing countries lack an organized trauma system. Furthermore, developing countries do not have in place any accreditation process for trauma centers; thus, no accepted standard assessment tools exist to evaluate their trauma services. ⋯ The ACS/COT basic criteria can be used as assessment tools to evaluate trauma care in developing countries. Further studies are needed in other developing countries to validate the applicability of these criteria.