The Journal of surgical research
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Although many frailty scales exist, a single scale has not been agreed upon to define frailty. Herein, we determined whether the Canadian Study on Health and Aging Clinical Frailty Scale (CSHA CFS) can predict the risk of elderly patients for hospital mortality and discharge to skilled nursing facilities (SNFs) following traumatic injury. ⋯ CSHA CFS is simple and provides frailty scores that can help identifying elderly patients at high risk for in-hospital mortality and discharge to SNF following traumatic injury.
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Comparative Study
Is less more? Laparoscopic versus open Ladd's procedure in children with malrotation.
With the advent of minimally invasive techniques, laparoscopic Ladd's procedure is increasingly used to treat children with malrotation, yet evidence regarding its safety and efficacy is lacking. We hypothesize that operative and postoperative outcomes with the open technique are superior to the laparoscopic Ladd's procedure. ⋯ Although minimally invasive approaches are becoming increasingly used, no evidence supports laparoscopic superiority over open Ladd's procedure. We found that open surgery was associated with shorter operating times and fewer clinic visits. Furthermore, laparotomy remains the favored procedure for patients presenting with volvulus.
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The three known systems for evaluation of patients with rib fractures are rib fracture score (RFS), chest trauma score (CTS), and RibScore (RS). The aim was to establish critical values for these systems in different patient populations. ⋯ Physicians should choose score to match specific population and collected variables. RFS is simple but sensitive in elderly population. CTS is recommended for geriatric patients as it predicts PN the best. RS is recommended for assessment of severely injured patients with high ISS.
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Multicenter Study Observational Study
Assessment of the predictive value of the International Classification of Diseases Injury Severity Score for trauma mortality in urban India.
Trauma is the cause of 1.2 million deaths in India annually. Injury severity scores play an important role in trauma research and care because these scores enable the adjustment of trauma severity when comparing mortality outcomes. The generalizability of the International Classification of Diseases Injury Severity Score (ICISS) between different populations is not fully known, and the validity of the ICISS has not been assessed in the Indian context. The aim of this study was to assess the predictive performances of three international versions of the ICISS, derived from data from Australia, New Zealand and pooled data from seven different high-income countries, in trauma patients admitted to four public hospitals in urban India. ⋯ None of the international versions of the ICISS adequately predicted mortality within the study population, indicating the need for an ICISS version specifically adapted to the Indian context.
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The optimal timing of appendectomy for acute appendicitis has been analyzed with mixed results. We hypothesized that delayed appendectomy would be associated with increased 30-d morbidity and mortality. ⋯ Data from the American College of Surgeons National Surgical Quality Improvement Program demonstrate similar outcomes of appendectomy for acute appendicitis when the operation is performed on HD 1 or 2; however, outcomes are significantly worse for appendectomies delayed until HD 3. Increased complications in this group are likely not attributable to HD of operation, but rather decreased baseline health status and procedure type.