The Journal of surgical research
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Early initiation of thromboprophylaxis is highly desired in pelvic fracture patients, but it is often delayed due to the fear of hemorrhage. Aim of our study was to assess the safety of early initiation of venous thromboprophylaxis in patients with pelvic trauma managed nonoperatively. ⋯ Early initiation of thromboprophylaxis with LMWH in patients with pelvic fractures managed nonoperatively is safe and decreases the risk of symptomatic deep venous thrombosis.
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This 2017 Presidential Address for the Association for Academic Surgery was delivered on February 8, 2017. It addresses the difficult topic of gender disparities in surgery. Mixing empirical data with personal anecdotes, Dr. Caprice Greenberg provides an insightful overview of this difficult challenge facing the surgical discipline and practical advice on how we can begin to address it.
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Emergency general surgery (EGS) admissions account for more than three million hospitalizations in the US annually; and interhospital transfers (IHTs) are costly. We aimed to better understand the population of transferred EGS patients and their subsequent care in a nationally representative sample. ⋯ The percent of patients with an EGS diagnosis requiring IHT is increasing, which may reflect a trend toward regionalization of EGS. Transfers require significant resources and may delay care. More than half of the EGS patients did not require surgical intervention. Future studies to identify populations who benefit from IHT and ideal timing of transfer can establish opportunities for optimizing resource utilization and patient outcomes.
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Comparative Study
Cervical spine injuries in young children: pattern and outcomes in accidental versus inflicted trauma.
The aim of the study was to compare the cervical spine (c-spine) pattern of injury and outcomes in children below 3 y with a head injury from confirmed inflicted versus accidental trauma. ⋯ Compared to accidental trauma, young children with inflicted c-spine injuries have more multisystem trauma, long-term disability from brain injury, and an injury pattern consistent with shaking.
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Blunt thoracic trauma in the elderly has been associated with adverse outcomes. As an internal quality improvement initiative, direct intensive care unit (ICU) admission of nonmechanically ventilated elderly patients with clinically important thoracic trauma (primarily multiple rib fractures) was recommended. ⋯ Admission of geriatric trauma patients with clinically important blunt thoracic trauma directly to the ICU was associated with improved outcomes.