J Trauma
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Comparative Study
Comparison of the costs of acute treatment for gunshot and stab wounds: further evidence of the need for firearms control.
Gun control is proposed primarily to decrease the incidence of injury and death from gunshot wounds (GSWs). We hypothesize that decreasing the number of GSWs will also produce significant economic savings, even if personal violence were to continue at the same rate, maintaining the same overall incidence of penetrating trauma. We analyzed charges and reimbursements for the treatment for all patients with GSWs (n = 1116) and stab wounds (SWs) (n = 1529) admitted to a level I trauma center from 1986 through 1992. ⋯ Thus, if all patients with GSWs instead suffered SWs, there would be an annual savings of $1,290,000 overall and of $981,000 of public funds from this institution alone. Treatment costs for GSWs are higher than those for SWs and are rising more rapidly, with an increasing amount of public funds going to meet these costs. Considerable savings to society would accrue from any effort that decreased firearm injuries, even if the same level of violence persisted using other weapons.
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Comparative Study
An evaluation of expert human and automated Abbreviated Injury Scale and ICD-9-CM injury coding.
Two hundred ninety-five injury descriptions from 135 consecutive patients treated at a level-I trauma center were coded by three human coders (H1, H2, H3) and by TRI-CODE (T), a PC-based artificial intelligence software program. Two study coders are nationally recognized experts who teach AIS coding for its developers (the Association for the Advancement of Automotive Medicine); the third has 5 years experience in ICD and AIS coding. A "correct coding" (CC) was established for the study injury descriptions. ⋯ Coders H1 and H2 were in excellent agreement. Coder H3 was in good agreement with H1 and H2. However, errors among the human coders often occur for different codes, accentuating the variability.(ABSTRACT TRUNCATED AT 250 WORDS)
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We present an uncommon case of traumatic atlantoaxial distractive instability which manifested itself clinically in a respirator-dependent quadriplegic. The initial radiographic finding was anterior atlantoaxial dislocation. The patient was managed initially by halo traction and, 8 weeks later, demonstrated occipitocervical fusion with gratifying results.
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The purpose of this study is to describe our experience with thoracoscopic drainage and decortication as definitive treatment for empyema thoracis following penetrating chest trauma. ⋯ Thoracoscopic drainage and decortication offers an alternative to thoracotomy for definitive therapy of empyema thoracis developing after penetrating chest trauma.
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Multicenter Study
Measuring health status among survivors of burn injury: revisions of the Burn Specific Health Scale.
This study examined the reliability of a revised version of the Burn Specific Health Scale (BSHS). Two hundred fifty-four former patients recruited from eight burn centers in the southeastern United States participated in the study. Data were collected via chart review and mailed questionnaire. ⋯ Each subscale exhibited a high level of reliability (Cronbach's alpha ranged from 0.82 to 0.94). Each subscale also correlated in a predictable manner with measures used for validation. The revised measure should improve the ability of both researchers and clinicians to assess the impact of non-fatal burn injury accurately and comprehensively.