J Trauma
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Basic science research suggests that sex hormones affect survival after traumatic shock. This study sought to determine the independent effect of gender on mortality among trauma patients in different hormone-related age groups. ⋯ Females aged between 13 and 64 years exhibit significantly lower mortality than males after trauma-associated shock. This outcome difference is lost at the extremes of age (preadolescent children and individuals aged ≥ 65 years) where the effects of sex hormones are absent or diminished. These findings suggest that hormonal differences play a role in the gender-based outcome disparities after traumatic shock.
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This study was performed to determine the effects of orthopedic trauma on pregnancy outcomes in pregnant trauma patients. ⋯ Our findings indicate that traumatized pregnant women with orthopedic injuries are high-risk obstetrical patients and may benefit from referral to a medical center capable of handling both the primary injury and the potential preterm birth associated with the injury.
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The purpose of this article was to compare clinical and functional outcomes of surgically treated trimalleolar fractures with bimalleolar and unimalleolar ankle fractures. ⋯ Most patients after unstable ankle fractures treated surgically do well; however, some patients continue to have some pain and dysfunction at 1 year. There was a significant difference in outcomes comparing patients with unstable ankle fractures associated with and without posterior malleolus fractures. The presence of a posterior malleolus fracture may indicate higher energy of injury, and it does seem to result in worse outcomes at 1 year, but this seems to even out over time as was seen at 2-year follow-up in a smaller group of patients.
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Cardiac injury is one of the most lethal injuries. The objective of this study was to determine the real amount of risk factors for penetrating cardiac injuries. ⋯ Our data have shown the real amount of risk variables for mortality in penetrating cardiac injuries by using binary logistic model.
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Advances in care such as damage control surgery, hemostatic resuscitation, protocol-driven cerebral perfusion management, and lung-protective ventilation have promised to improve survival after major trauma. We examined injury severity, mortality, and preventability in a mature trauma system during a 12-year period to assess the overall benefits of these and other improvements. ⋯ Survival after severe trauma and survival benchmarked against predicted risk improved significantly at our center during the past 12 years despite generally increasing age and worsening injuries. Advances in trauma care have kept pace with an aging population and greater severity of injury, but overall survival has not improved.