J Trauma
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Meta Analysis
Nonoperative management of adult blunt splenic injury with and without splenic artery embolotherapy: a meta-analysis.
Observation and splenic artery embolotherapy (SAE) are nonoperative management (NOM) modalities for adult blunt splenic injury; however, they are quite different, inconsistently applied, and controversial. This meta-analysis compares the known outcomes data for observational management versus SAE by splenic injury grade cohort. ⋯ This meta-analysis synthesizes NOM outcomes data by modality and splenic injury grade. The failure rate of observational management increases with splenic injury grade, whereas the failure rate of SAE does not change significantly. SAE is associated with significantly higher splenic salvage rates in splenic injury grade 4 and 5 injuries.
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Meta Analysis
Recovery after injury: an individual patient data meta-analysis of general health status using the EQ-5D.
General information of health-related quality of life pathways to recovery after injury are largely absent from the literature. This article describes a study which: (1) collated and synthesized individual patient data of injured persons from an earlier systematic review and (2) produced general predictions of health-related quality of life for different injury groups for up to 1 year postinjury. ⋯ This study has produced recovery patterns for 27 injury groups using most of the worldwide individual-level data. For many injury categories, recovery is incomplete and takes much longer than estimated. This study infers that the burden of injury is likely being underestimated.
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The proportion of high school sports-related injuries requiring surgery, which pose monetary and time loss burdens, has significantly increased during the last decade. The objective was to investigate the epidemiology of high school athletic injuries requiring surgery. ⋯ Rates and patterns of injuries requiring surgery differ by sport, type of exposure, and gender. Future studies should identify sport-specific risk factors to drive effective interventions to decrease the incidence and severity of such injuries.
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The acute respiratory distress syndrome (ARDS) is a proinflammatory condition that often complicates trauma and critical illness. Animal studies have shown that both gender and sex hormones play an important role in inflammatory regulation. Human data are scant regarding the role of gender and sex hormones in developing ARDS. Our objective was to describe gender and hormonal differences in patients who develop ARDS in a large cohort of critically injured adults. ⋯ Women are more likely than men to develop ARDS after critical injury. Despite the increased incidence in ARDS, the mortality in patients with ARDS does not differ according to gender. The inflammatory properties of sex hormones may contribute to ARDS, but they do not fully explain observed gender differences.
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Comparative Study
Comparison of hospital mortality rates after burn injury in New York State: a risk-adjusted population-based observational study.
Severity-adjusted mortality is an unequivocal measure of burn care success. Hospitals can be compared on this metric using administrative data because information required for calculating statistically adjusted risk of mortality is routinely collected on hospital admission. ⋯ Administrative hospital discharge data are extensive and comparably enough collected to allow comparison of the performance of burn centers. Risk-adjusted models show that patients have statistically indistinguishable risk-adjusted odds of mortality regardless of which hospital in New York State cared for them.