The European journal of surgery = Acta chirurgica
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Multicenter Study
Why does the clinical diagnosis fail in suspected appendicitis?
To identify systematic errors in surgeons' estimations of the importance of diagnostic variables in the decision to explore patients with suspected appendicitis. ⋯ Negative explorations in patients with suspected appendicitis are related to systematic errors in the clinical diagnosis with too strong an emphasis on pain and tenderness, and too little attention paid to duration of symptoms and objective signs of inflammation. Rectal tenderness is not a sign of appendicitis. The risk of diagnostic errors is similar in men and women.
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To evaluate the efficiency (sensitivity, specificity, positive predictive value, overtriage, and undertriage) of activation of the trauma team in a Norwegian trauma referral centre. ⋯ The undertriage rate of 15% and a positive predictive value of only 0.47 indicates a need for improvement of our activation system. Female sex and age over 70 years were significantly associated with undertriage in severely injured patients. Our protocol for triage and the initial treatment of severely injured patients has been revised in the light of these findings, and we have established a trauma registry.
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To evaluate the incidence, types of injury, medical consequences, and mortality of patients with stab wounds in Sweden. ⋯ The incidence of stab wounds was low and the annual incidence stable. Young men in urban areas were the commonest victims. Injuries of the trunk were commonest, followed by injuries to the head and neck and limbs, 80% of the patients were discharged from hospital within a week, and 3% of those treated in hospital for stab wounds died.