J Trauma
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Comparative Study
Effect of a voluntary trauma system on preventable death and inappropriate care in a rural state.
This study compares the preventable death rate and the nature and degree of inappropriate care in a rural state before and after implementation of a voluntary trauma system. ⋯ Implementation of a voluntary trauma system has positive effects on PDR and inappropriate care. The degree and nature of inappropriate care remain a concern. Mandated and funded system policies may further influence care positively.
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Blunt thoracic aortic injury (BAI) is a rare and highly lethal injury. We sought to identify occupant and collision characteristics associated with motor vehicle collision (MVC)-related BAI. ⋯ The risk factors for BAI identified in this study support generally accepted etiologic mechanisms for this injury.
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The purpose of this study was to assess the ability of the International Classification of Diseases-based Injury Severity Score (ICISS) to detect preventable deaths, and to compare the performance of trauma care facilities. ⋯ The degree of agreement in the preventability of trauma death derived from the ICISS with a professional judgment on preventability was similar to that derived from the Trauma and Injury Severity Score. The W-scores of EMCs correlated well with their preventable death rates, with marginal statistical significance. This study has demonstrated that the ICISS is useful in detecting preventable deaths and in comparing the performance of trauma care facilities.
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American Association for the Surgery of Trauma (AAST) Organ Injury Scale (OIS) grades IV and V complex hepatic injuries are highly lethal. Our objectives were to review experience and identify predictors of outcome and to evaluate the role of angioembolization in decreasing mortality. ⋯ Improvements in mortality can be achieved with an appropriate operative approach. Angioembolization as an adjunct procedure decreases mortality in AAST-OIS grades IV and V hepatic injuries.