J Trauma
-
Comparative Study
Injured patients have lower mortality when treated by "full-time" trauma surgeons vs. surgeons who cover trauma "part-time".
Studies examining the effect of trauma surgeon volume on patient outcomes have had disparate results. We hypothesize that "full-time" trauma surgeons would have lower patient mortality rates than surgeons covering trauma "part-time." ⋯ Even within an established trauma program treating many injured patients, mortality is significantly lower in patients initially treated by "full-time" trauma surgeons.
-
Admission systemic inflammatory response syndrome (SIRS) score has been previously reported to be an accurate predictor of infection and outcome in trauma. However, the data were limited to the first 7 days of admission. Our objective in this follow-up study was to prospectively evaluate the utility of daily SIRS scores in the second and third week of admission as compared with the first week in prediction of nosocomial infection and outcome in high-risk trauma patients. ⋯ SIRS is predictive of nosocomial infection in trauma through postinjury day 21. Nosocomial infection should be considered as a treatable cause of SIRS in trauma patients, and early diagnostic interventions should be initiated to evaluate for potential causes.
-
Pelvic fractures can be an important source of major hemorrhage in victims of blunt trauma. However, no rapid and reliable noninvasive method exists for predicting which subjects will have major hemorrhage. The objective of this study is to use information available upon presentation to the trauma center to develop a clinical prediction rule to identify subjects with pelvic fracture who are at high risk of major hemorrhage. ⋯ Probability of major pelvic fracture related hemorrhage can be estimated from initial pelvic radiograph, pulse, and hematocrit.