J Trauma
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Comparative Study
In-hospital mortality and surgical utilization in severely polytraumatized patients with and without spinal injury.
Patients who sustain major trauma experience multisystem injuries including those affecting the spine. We hypothesize that recovery after spinal injuries differs from those affecting other systems. The purpose of our study was to compare in-hospital mortality and surgical resource utilization in severely polytraumatized patient with and without spinal injury. ⋯ In this study, we conclude that the presence of a spinal injury in the setting of severe polytrauma (ISS>15) is associated with a prolonged course of ventilatory support, ICU, and in-hospital LOS. Trauma hospitals treating patients with spinal fracture should be aware of differences in the use of health services for this patient population.
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The purpose of this study was to assess the feasibility and accuracy of computer-assisted surgery (CAS) for screw placement in different pelvic regions using intraoperative three-dimensional (3D) imaging and to evaluate the influence of surgeons' experience with such a system on procedure time, radiation time, radiation dose, and misplacement rate. ⋯ The 3D fluoroscopic navigated procedure in pelvic surgery seems to be a useful tool for all surgeons and especially for less experienced ones. Furthermore, the intraoperative reconstruction of multiplanar 3D images allows a secure control of implant positioning.
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Utah state trauma audit filters assess expeditious care at referring emergency departments for severely injured patients to avoid delays in transfer. We evaluated two state performance measures related to pediatric trauma care before arrival at the Level I trauma center. ⋯ There was substantial nonadherence with trauma performance measures for triage in <2 hours among pediatric trauma patients with ISS >15. Because of low rates of poor outcome, we are unable to determine whether adherence with state triage goals lessens morbidity or mortality.
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Epidural hematoma (EDH) is a major traumatic brain injury and a potentially life-threatening condition, with the mortality rate in the young age group varying across studies. The aim of this analysis was to investigate the magnitude of traumatic EDH in young patients aged 0 year to 24 years in Queensland, Australia. ⋯ The results indicate that the Injury Severity Score adjusted in-hospital mortality rates for young patients with EDH were 4.8%. Given the limited information on morbidity resulting from EDH, further analysis to examine modifiable factors for better management and to evaluate survivor's long-term health outcomes via a longitudinal follow-up study is warranted.
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A helmet mandatory for people younger than 16 years was implemented in most Austrian provinces in the winter season 2009/2010. The objective of this study was to evaluate the impact of a ski helmet mandatory on age-dependent helmet use. ⋯ A helmet mandatory for people aged 15 years or less may increase helmet use in involved age groups when helmet use is relatively low. However, public discussions and preventive helmet campaigns based on sound theories of health behavior change may also induce increases in helmet use in skiers aged older than 15 years without helmet mandatory.