J Trauma
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Comparative Study
Effectiveness of helicopter versus ground ambulance services for interfacility transport.
Helicopters provide rapid interfacility transport, but the effect on patients is largely unknown. ⋯ The patients transported by helicopter did not have improved outcomes compared with patients transported by ground. These data argue against a large advantage of helicopters for interfacility transport. A randomized trial is needed to address these issues conclusively.
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Randomized Controlled Trial Comparative Study Clinical Trial
Kapandji pinning or closed reduction for extra-articular distal radius fractures.
In a randomized prospective trial, closed reduction and plaster application was compared with Kapandji pinning. Closed reduction and plaster cast application was performed in 50 patients, Kapandji pinning in 48 patients. ⋯ In terms of maintenance of reduction and functional outcome at 1-year follow-up, no statistically significant differences were found between the two groups. We conclude, therefore, that both techniques can be applied to extra-articular fractures of the distal radius according to the characteristics of the forearm and the surgeon's or the patient's need.
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Comparative Study
Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death.
Elderly patients suffer higher mortality rates after trauma than younger patients. This increased mortality is attributable to age, preexisting disease, and complications as well as injury severity. ⋯ Elderly trauma patients more frequently suffer late mortality than younger patients because of the combination of injury and increased preexisting disease and complications after injury. Aggressive treatment of the elderly trauma patient is warranted; however, in the face of significant preexisting disease or complications, survival is less likely. Predictive models of survival can be developed, taking into account preexisting disease and complications as well as admission parameters such as age, ISS, and RTS, and specific risk of mortality quantitated.
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Comparative Study
The ICD-9-based illness severity score: a new model that outperforms both DRG and APR-DRG as predictors of survival and resource utilization.
This project is designed to develop and validate a predictive model that is a useful benchmarking and quality of care assessment tool based on International Classification of Diseases, Ninth Revision (ICD-9), diagnoses and procedures. This model, the ICD-9-Based Illness Severity Score (ICISS), was developed from the Agency for Health Care Policy Research's Health Care Utilization Project database and is used to predict hospital survival, hospital length of stay, and hospital charges of injured patients admitted to University of North Carolina Hospitals. The study also compared the outcome predictions of ICISS with those of the long-established diagnosis-related groups (DRG) and the 3M product APR-DRG systems. ⋯ This study demonstrates that an ICD-9-based predictive model (ICISS) can markedly outperform both DRG and APR-DRG as a predictor of survival, hospital length of stay, and hospital charges.
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Randomized Controlled Trial Comparative Study Clinical Trial
The role of presacral drainage in the management of penetrating rectal injuries.
To compare in a randomized, prospective manner infectious complication rates associated with presacral drainage versus no drainage in the presence of penetrating rectal injury. ⋯ We conclude that presacral drainage for penetrating rectal injuries has no effect on infectious complications associated with the rectal injuries.