J Trauma
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The TRISS system is an important, widely used method for predicting survival in trauma patients. One significant shortcoming of TRISS is its inability to include intubated patients in survival analysis because a respiratory rate and a verbal response are not obtainable. This report describes one approach to this problem. ⋯ Thus, our model has predictive performance comparable with TRISS. More importantly, it is applicable to intubated patients who are not pharmacologically paralyzed. Further investigation with larger data bases is necessary.
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A retropharyngeal abscess resulted from perforation of the posterior pharyngeal wall by an anterior marginal osteophyte at the time of hyperextension injury of the cervical spine. The abscess communicated with the epidural space via the disrupted intervertebral disk, leading to the delayed onset of upper airway obstruction and tetraparesis.
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Case Reports
Successful use of autologous fibrin gel in traumatic bronchopleural fistula: case report.
Bronchopleural fistula has been successfully treated by bronchoscopic application of fibrin glue. We report the use of intrathoracic fibrin gel pleurodesis in traumatic bronchopleural fistula.
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Computed tomographic (CT) evaluation of seven posterior shoulder dislocations in five patients is reported. Computed tomography provided better visualization of the trough fracture in the humeral head than did conventional x-ray films or tomography. ⋯ The two cases of bilateral dislocation and one case of unilateral dislocation were caused by seizures. The two other cases of unilateral dislocation were caused by trauma.
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The relationship between alcohol use and injury severity was investigated in trauma patients admitted to a tertiary referral hospital during a 23-month period. Admission blood alcohol levels (BALs) were obtained on 427 trauma patients, who were stratified into three groups: those with no measurable blood alcohol, those within the legal limit of 100 mg/dL, and those over the legal limit or intoxicated. The no-alcohol group had significantly lower injury severity than the other two groups (p less than 0.001). ⋯ No significant differences were found when admission GCS values were compared with GCS determinations made 24 hours following admission by separate observers. To correct for any potential bias as a tertiary referral center, repeat analysis with exclusion of transferred patients was done with essentially no change in results. Our data revealed a highly significant relationship between alcohol use, degree of injury, and resource consumption.