J Trauma
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This study was performed to determine the agreement between and within surgeons concerning the influence on treatment plan of routine versus selective multidetector-row computed tomography (MDCT) findings in blunt trauma patients. ⋯ All surgeons agreed that the traumatic injuries additionally found by routine MDCT, frequently resulted in a change of treatment plan. There was a moderate-to-excellent agreement between and within surgeons that these additional findings resulted in a change of treatment plan.
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Because relevant changes in the epidemiology of the traumatic spinal cord injury (SCI) has been reported, we sought to examine the demographics, injury characteristics, and clinical outcomes of patients with spine trauma who have been treated in our spine trauma center. ⋯ Our results indicate that significant differences in the characteristics of acute spine trauma but not demographics have occurred overtime in our institution. Also, there were significant differences between our database and the NTR regarding age distribution. Our reduced in-hospital mortality rates in comparison with the provincial data reinforce the recommendations for early management of SCI patients in a spine trauma center.
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Male and female nervous systems respond differently to traumatic brain injury (TBI) and in vivo research relates this difference to neuroprotection from female sex hormones. Attempts to replicate female sex hormone-related neuroprotection in clinical studies have been unsuccessful. The objective of this study was to determine whether gender or menopausal status affects mortality in patients with moderate to severe TBI. ⋯ Female gender is independently associated with reduced mortality and decreased complications after TBI. As peri- and postmenopausal women demonstrated improved survival, and premenopausal women did not, estrogen unlikely confers neuroprotection in women after TBI. Future TBI treatment may benefit with further research focused on why peri- and postmenopausal women show decreased mortality after TBI.
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Multicenter Study
Relative bradycardia in hypotensive trauma patients: a reappraisal.
The inability to mount tachycardia (T) after trauma-related hypotension is labeled relative bradycardia (RB). The objective of this study was to examine RB incidence and prognosis in a large cohort of patients. ⋯ RB was common in hypotensive adult trauma patients; overall, it was associated with increased mortality. Patients older than 55 years and with a higher Glasgow coma scale score demonstrated decreased mortality with RB. When RB was further divided, a HR between 60 and 90 demonstrated a significant lower mortality compared with a HR <60 and to T.