Journal of the American College of Surgeons
-
Mortality after trauma has been shown to be influenced by host factors, such as age and preexisting medical conditions (PMCs). The independent predictive value of specific PMCs for in-hospital mortality after adjustment for injury severity, injury pattern, age, and presence of other PMCs has not been fully elucidated. ⋯ Specific PMCs were associated with increased mortality after trauma independent from injury severity and age. Knowledge of the identified relevant PMCs could help the medical team to be able to assess the mortality risk profile of trauma patients in a more detailed and quantifiable way.
-
Hypothermia increases the tolerable ischemia time for myocardium in hemorrhagic shock, but precise mechanisms are not clearly established. Here we studied activation of Akt cell survival pathway in a rodent model of emergency preservation and delayed resuscitation. ⋯ Profound hypothermia increases survival in a rodent model of hemorrhagic shock and prolonged low-flow state. Hypothermia preserves Akt signaling pathway in cardiomyocytes with a concurrent decrease in cardiac apoptosis.
-
The purpose of this study was to determine the effects of race, socioeconomic status, and demographic and clinical variables on the outcomes of gastrointestinal stromal tumors (GISTs). ⋯ Before 2000, African Americans were less likely to have surgery, and they demonstrated an overall increased mortality rate for GIST. Since 2000, African Americans have benefited from increased surgical resection rates, decreased perioperative mortality, and improved longterm survival. These changes have appeared to erase racial disparities in the treatment of GIST.