J Trauma
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The "golden hour" of trauma care is irrelevant in rural areas. We studied the effect of distance and remoteness on major trauma patients transferred by the Royal Flying Doctor Service from rural and remote Western Australia. ⋯ There is an excess of a fourfold increase in the risk of major trauma death in patients transferred to Perth from remote and very remote Western Australia. Remoteness, as measured by the ARIA, is more important than distance, in the risk of death.
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Comparative Study
The effect of operative timing on functional outcome after isolated spinal trauma.
To evaluate the effect of operative timing on functional outcome in patients suffering spinal trauma, we conducted a retrospective analysis of the National Trauma Data Bank. By treating time to operation as a categorical variable and limiting our analysis to isolated spinal trauma, we hypothesized that time to operation would not be a predictor of functional outcome. ⋯ In patients with isolated spinal trauma, time until spinal operation does not seem to be an important predictor of functional outcome at the time of hospital discharge. Operative timing, at the discretion of the surgeon, needs to consider the risks and benefits associated with delayed versus emergent operation.
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The purpose of this study was to identify which age-related groups of hemodynamically stable blunt trauma patients will present a positive cost-to-benefit ratio, in regard to the screening of incidental findings on Focused Assessment with Sonography for Trauma (FAST). ⋯ A systematic examination of the liver and biliary tree and both kidneys of specific age groups during FAST screening of hemodynamically stable blunt trauma patients may disclose a potentially unknown pathology with a positive cost-to-benefit ratio.
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Comparative Study
Variations in bone mineral density of proximal femora of elderly people with hip fractures: a case-control analysis.
Bone mass as represented by bone mineral density (BMD) is the most important factor determining bone strength. Elderly people with and without hip fractures were compared with the BMD of the proximal femora. The correlation between hip fractures in elderly patients and osteoporosis was investigated. ⋯ The severity of osteoporosis may affect the risk of hip fractures in elderly people. The risk of intertrochanteric fractures may be determined simply by BMD, but the risk of femoral neck fractures may be determined by multiple factors. Intertrochanteric fractures may start at the greater trochanter due to its low BMD.