J Trauma
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This study aimed to assess the effects of local and state anti-crime initiatives on the number of gunshot wound admissions to a level 1 trauma center. ⋯ Gunshot wound admissions attributable to assault at a level 1 trauma center decreased during a period when several local and state initiatives focused on decreasing violent crime were enacted. The causes likely were multifunctional, and included increasing the number of police officers as well as the enactment of new laws.
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There has been a significant proliferation of medical helicopters and medical helicopter operations in the United States over the last decade. The purpose of this study was to determine whether the proliferation of medical helicopter operations in the United States was associated with a subsequent increase in the number of accidents ⋯ There was a steady and marked increase in the number of medical helicopter accidents in the United States during the 10-year period (1993-2002). These findings are worrisome in light of recent research that has indicated use of medical helicopters may be excessive and nonbeneficial for most patients.
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Firearm violence is the second leading cause of injury-related death. This study examined the use of local trauma centers as lead organizations in their communities to address firearm injury. ⋯ Trauma centers, when provided resources and support, with the model described, can function as lead organizations in partnering with the community to acquire and use community-specific data for local firearm injury prevention.
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Comparative Study
Differences in mortality predictions between Injury Severity Score triplets: a significant flaw.
This study investigated the validity of similar Injury Severity Scores (ISS) generated by different Abbreviated Injury Scale triplets. ⋯ The mortality rates are significantly different between pairs of triplets that generate the same ISS total. Caution must be used in the interpretation of outcomes from ISS values generated by different triplets.
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Hypothermia is associated with an increased risk of bleeding and is a significant contributing factor to the morbidity and mortality of trauma and complicated surgical procedures. A core temperature of 33 degrees C is associated with a significantly increased risk of death after trauma compared with 37 degrees C. Hypothermia-associated bleeding has been hypothesized to result from dysregulation of enzymatic function, reduced platelet activity, and/or altered fibrinolysis. ⋯ Our results suggest that bleeding observed at mildly reduced temperatures (33 degrees - 37 degrees C) results primarily from a platelet adhesion defect, and not reduced enzyme activity or platelet activation. However, at temperatures below 33 degrees C, both reduced platelet function and enzyme activity likely contribute to the coagulopathy.