J Trauma
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This study aims to determine whether severity-adjusted outcomes including mortality are adversely impacted by readmission to a surgical intensive care unit (SICU) during the same hospital stay. ⋯ Readmission to the SICU significantly increases the risk of death beyond that predicted by the APACHE II or SAPS scores alone. Higher APACHE II and SAPS scores upon discharge from the SICU and longer SICU LOS are associated with an increased incidence of readmission to the SICU on the same hospital stay. These results may be used to optimize the timing of SICU discharge and reduce the chance of readmission to intensive care.
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Injury to the spinal accessory nerve causes paralysis of the trapezius muscle, which is a painful and disabling condition. Many injuries are iatrogenic. Diagnosis is often made after a long delay, suggesting that current clinical signs are inadequate. ⋯ We propose that the resisted active external rotation test should be regarded as the key clinical sign for accessory nerve palsy.
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Review Meta Analysis Comparative Study
Does colostomy prevent infection in open blunt pelvic fractures? A systematic review.
Open pelvic fracture is a rare injury. Our aim in this study is to systematically review the literature to define when diverting colostomy is indicated to protect the patient from infection in open blunt pelvic fractures. ⋯ The role of colostomy in open blunt pelvic fractures is unresolved and randomized multicenter trials are needed.
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To better identify women at risk for intimate partner violence (IPV), we developed a diagnostic protocol composed of injury location and response to a verbal questionnaire to identify women at high risk for reporting an IPV-related injury etiology. The purpose of this study was to test the external validity of the protocol when applied at two institutions that differ considerably in terms of geography and socioeconomic measures. ⋯ Despite significant geographic and socioeconomic differences between the two hospitals, the results suggest that our protocol may be applicable in disparate clinical settings.
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To examine risk factors associated with water sports-related cervical spine injuries (WSCSI). ⋯ Wave forced impacts of the head with the ocean bottom typically occurred at moderate to severe shorebreaks, and involved inexperienced, large-build males in their 40s. Spinal stenosis and degenerative spondylosis may increase the risk of cervical spine injury associated with WFI due to the increased risk of neck hyperextension and hyperflexion impacts inherent to this activity.