Arch Surg Chicago
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Despite a paucity of validation, the Ranson score is still the most popular method for gauging the severity of pancreatitis. ⋯ The Ranson score remains a valid predictor of outcomes in patients with SAP, and individual Ranson variables determined 48 hours after hospital admission predicted adverse outcomes more accurately than early Ranson variables in patients with SAP.
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Patients with traumatic intracranial hemorrhagic injuries (IHIs) are at high risk for venous thromboembolism (VTE). The safety of early anticoagulation for IHI has not been established. ⋯ Enoxaparin can be safely used for VTE prophylaxis in trauma patients with IHI when started 24 hours after hospital admission or after craniotomy.
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Comparative Study
Standardized trauma resuscitation: female hearts respond better.
Women respond better to standardized shock resuscitation compared with similarly severely injured men. ⋯ Review of prospective data from standardized shock resuscitation for female and male cohorts demonstrates that women respond better to standardized resuscitation compared with similarly severely injured men.
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Comparative Study
Prophylactic and therapeutic inferior vena cava filters to prevent pulmonary emboli in trauma patients.
Insertion of inferior vena cava filters (IVCFs) can prophylactically reduce pulmonary embolism (PE) in trauma patients. ⋯ Prophylactic IVCFs should be inserted within 48 hours of injury in specific trauma patients at high risk for PE and with contraindications to anticoagulation.
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Abandoning mandatory angiography in patients with blunt lower-extremity trauma and normal neurovascular examination results does not affect limb salvage. ⋯ Angiography is unnecessary in the routine evaluation of the patient with blunt lower-extremity trauma who presents with a normal neurovascular examination result and can be used selectively for patients with diminished pulses who lack associated indications for mandatory operative exploration.