J Trauma
-
Review Comparative Study
Endovascular repair compared with operative repair of traumatic rupture of the thoracic aorta: a nonsystematic review and a plea for trauma-specific reporting guidelines.
Thoracic endovascular aortic repair (TEVAR) has become the preferred intervention for managing traumatic thoracic aortic injury. The literature suggests that TEVAR is associated with reduced mortality and paraplegia compared with open repair (OR). The lack of guidelines for reporting results and the paucity of patient follow-up make interpretation of the literature difficult. ⋯ The lack of reporting guidelines coupled with a paucity of follow-up data weakens any recommendation regarding the optimal choice of intervention. To address these deficiencies, we recommend reporting guidelines specific to the trauma population that will allow better risk adjustment and improve the quality of the evidence base.
-
Randomized Controlled Trial
Effect of Shenmai injection, a traditional Chinese medicine, on pulmonary dysfunction after tourniquet-induced limb ischemia-reperfusion.
Tourniquet has been considered as a recognized cause of lower limb ischemia-reperfusion injury in the orthopedic field. This study investigates pulmonary function after tourniquet deflation and the protective effect of Shenmai injection (SMI), a traditional Chinese medicine. ⋯ Pulmonary gas exchange is impaired after lower limb ischemia-reperfusion induced by clinical tourniquet application. Pretreatment with SMI, a traditional Chinese medicine, attenuates lipid peroxidation and systemic inflammatory response and mitigates pulmonary dysfunction.
-
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.
-
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.
-
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.