J Trauma
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Multicenter Study Comparative Study
Impact of the version of the abbreviated injury scale on injury severity characterization and quality assessment of trauma care.
The Abbreviated Injury Scale (AIS) was updated in 2008 (AIS 2008). We aimed to investigate the impact of AIS 2008 on the characterization of injury severity and quality assessment of trauma care. ⋯ The use of different AIS versions influenced the selection of major trauma patients and affected the quality assessment of the trauma care. Researchers should be aware of these findings when selecting the version of the AIS.
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Randomized Controlled Trial Comparative Study
Brief violence interventions with community case management services are effective for high-risk trauma patients.
Currently there are few data that brief violence intervention (BVI) and community case management services (CCMS) are effective for trauma patients admitted for interpersonal violence in terms of recidivism, service utilization, or alcohol abuse. The objective of this study is to assess outcomes for a cohort of young trauma patients in a prospective, randomized trial comparing BVI with BVI + CCMS. ⋯ In-hospital BVI with community wraparound case management interventions can improve hospital and community service utilization both short- and long-term for high-risk injured patients. Longer follow-up is needed to show sustained reduction.
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Hemorrhagic shock is a leading cause of death in both civilian and battlefield trauma. Currently available medical monitors provide measures of standard vital signs that are insensitive and nonspecific. More important, hypotension and other signs and symptoms of shock can appear when it may be too late to apply effective life-saving interventions. The resulting challenge is that early diagnosis is difficult because hemorrhagic shock is first recognized by late-responding vital signs and symptoms. The purpose of these experiments was to test the hypothesis that state-of-the-art machine-learning techniques, when integrated with novel non-invasive monitoring technologies, could detect early indicators of blood volume loss and impending circulatory failure in conscious, healthy humans who experience reduced central blood volume. ⋯ Machine modeling can accurately identify reduced central blood volume and predict impending hemodynamic decompensation (shock onset) in individuals. Such a capability can provide decision support for earlier intervention.
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Multicenter Study Comparative Study
Outcomes of trauma victims with cardiac arrest who survive to intensive care unit admission.
The prognosis for patients with return of spontaneous circulation after trauma-related cardiac arrest (TRCA) is unclear. Our purpose was to (1) determine outcomes for patients with TRCA resuscitated and admitted to the intensive care unit (ICU), (2) identify ICU-based predictors of in-hospital death in this population, and (3) compare outcomes of patients resuscitated from TRCA and atraumatic cardiac arrest (ATCA). ⋯ Despite lower survival than ATCAs, a significant percentage of TRCAs surviving to ICU admission were discharged alive. This suggests aggressive support of this population is not necessarily futile. Investigation into whether optimization of postresuscitation factors would improve outcome for these patients may be warranted.