The purpose of this study was to report the prevalence of thrombus within a retrievable vena cava filter inserted prophylactically in major trauma patients referred for filter extraction. Between November 2002 and August 2005, 80 retrievable inferior vena cava filters (68 Optease and 12 Gunther-Tulip) were inserted into critically injured ...

BACKGROUND: This study investigates the influence of overweight and obesity on outcome from vehicular trauma. METHODS: All Crash Injury Research and Engineering Network patients older than 16 years involved in frontal and lateral crashes between 2000 and 2005 in vehicles with front airbags were included (n = 1,615). Obese, overweight, ...

BACKGROUND: The expression of the beta chemokine RANTES (regulated upon activation, normal T cell expressed, and secreted) has previously been shown to be elevated after traumatic brain injury (TBI) in animal models, but it was unknown whether the plasma level of RANTES was predictive of TBI in critically injured trauma ...

OBJECTIVE: The Patient Safety Indicators (PSIs) from the Agency for Healthcare Research and Quality are validated measures of quality of care. The pattern of PSIs among adult trauma patients is unknown. HYPOTHESIS: The occurrence of PSI events should be random and have no identifiable pattern across age, gender, and racial ...

INTRODUCTION: Secondary abdominal compartment syndrome (ACS) is the development of ACS in the absence of abdominal injury. The development of secondary ACS has been viewed by some authors as an unavoidable sequela of the aggressive crystalloid resuscitation often employed in the treatment of severe shock. We hypothesized that poor resuscitation ...

RATIONALE AND OBJECTIVES: Splenic preservation is currently the trend for treatment of patients with splenic trauma to avoid complications of splenectomy. This study aimed to evaluate the feasibility of emergent transcatheter arterial embolization (TAE) for hemodynamically unstable patients with blunt splenic injury. MATERIALS AND METHODS: In a period of 2 ...

BACKGROUND: The majority of patients with potentially survivable combat-related injuries die from hemorrhage. Our objective was to determine whether the use of recombinant activated factor VII (rFVIIa) decreased mortality in combat casualties with severe trauma who received massive transfusions and if its use was associated with increased severe thrombotic events. ...

BACKGROUND: Studies have identified clinical predictors to guide radiologic evaluation of the cervical spine in geriatric patients. We hypothesized that clinical predictors are not adequate in the identification of cervical spine fractures in geriatric blunt trauma patients with low-energy mechanism. METHODS: A retrospective case-control study was performed on geriatric blunt ...

Two large, prospective, randomized, controlled trials have shown a beneficial effect of intensive insulin therapy (IIT) on the kidney function of critically ill patients. The data from these trials were combined for performance of a more detailed analysis of the renoprotective effect of IIT. After exclusion of 41 patients with ...

BACKGROUND: Assessment of patients with mild traumatic brain injury (mTBI) is predominantly done using the Glasgow Coma Scale (GCS). While the GCS is universally accepted for assessment of severity of traumatic brain injury, it may not be appropriate to rely on the GCS alone when assessing patients with mTBI in ...

The aim of this study was to evaluate the effect of ventriculostomy on intracranial pressure (ICP), and related parameters, including cerebrospinal compensation, cerebral oxygenation (PbtO2) and metabolism (microdialysis) in patients with traumatic brain injury (TBI). MATERIALS AND METHODS: Twenty-four patients with parenchymal ICP sensors were prospectively included in the study. ...

CONTEXT: Acute oxidative stress following a traumatic head injury (HI) has been implicated in inducing severe secondary brain damage and influencing the clinical outcome of HI patients. AIMS: This study was performed to evaluate and compare the oxidative changes in patients with varying severity of HI in the early posttraumatic ...

Inhaled heparin/N-acetylcystine (AHA) has been reported to decrease mortality in children with inhalation injury. The use of AHA therapy in adult burn patients with inhalation injury has not been evaluated. We hypothesized that patients who received AHA therapy in the management of inhalation injury would have better pulmonary mechanics and ...

BACKGROUND: Herein, we present the largest series of penile fracture ever published. We evaluate the clinical presentation, the outcome of the treatment and the prognosis. METHODS: We retrospectively studied patients with penile fracture treated from 1975 to 2005. RESULTS: Three hundred patients were included in this study. The mean patient ...

BACKGROUND: Timely diagnosis and treatment of adrenal insufficiency (AI) dramatically reduces mortality in trauma patients. We sought to identify risk factors and populations with a high risk of developing AI. DESIGN: Retrospective registry study. SETTING: Academic level I trauma center. PATIENTS: All trauma patients in the intensive care unit who ...

INTRODUCTION: Aeromedical evacuation of patients with posttraumatic and/or post-surgical pneumocephalus has often been regarded with great concern. The expansion of intracranial air with increasing altitude can theoretically result in tension pneumocephalus, with potentially fatal results. This concern is primarily based on extremely rare case reports and theoretical models rather than ...

BACKGROUND: Recent evidence demonstrates improved survival for septic and bacteremic patients receiving 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (statins). Victims of severe traumatic injury share similar inflammatory cascades to those seen in septic patients. We hypothesized that elderly (aged >/=65 years) trauma patients might derive a similar outcome benefit from preinjury statin use. ...

The psychological consequences of electrical injury (EI) are many. Depression, posttraumatic stress disorder, anxiety, and somatic preoccupation are often concomitant with this type of injury (Kelley, Pliskin, Meyer, & Lee, 1994). The present study utilized the MMPI-2 as a tool for characterizing profiles of psychological distress in EI. We examined ...

OBJECTIVE: To determine if a change in trauma designation from level II (L2) to level I (L1) in the same institution reduces mortality. Design, Setting, and PATIENTS: A retrospective cohort study of all patients consecutively admitted to a community hospital trauma center. INTERVENTION: The upgrade to trauma L1 designation (January ...

OBJECTIVE:: Hyperglycemia (blood glucose >/=110 mg/dL) in trauma patients without a known history of diabetes mellitus (DM) is often attributed to the metabolic stress response of injury. We studied whether this hyperglycemia may actually indicate the presence of occult DM (ODM) as demonstrated by elevated glycosylated hemoglobin A1C (gHbA1C). METHODS:: ...

Pericardial tamponade (PT) after penetrating thoracic injury can be lethal if not diagnosed and treated promptly. Most patients present with PT shortly after their injuries occur, but delayed presentation of PT (delayed pericardial tamponade [DPT]) has occurred as late as 73 days after initial injury. Initial evaluation of patients with ...

INTRODUCTION: Whether discernible advantages in terms of sensitivity and specificity exist with Acute Kidney Injury Network (AKIN) criteria versus Risk, Injury, Failure, Loss of Kidney Function, End-stage Kidney Disease (RIFLE) criteria is currently unknown. We evaluated the incidence of acute kidney injury and compared the ability of the maximum RIFLE ...

A continuous process of trauma centre evaluation is essential to ensure the development and progression of trauma care at regional, national and international levels. Evaluation may be by comparison between pooled datasets or by direct benchmarking between centres. This study attempts to benchmark mortality at two trauma centres standardising this ...

AIMS: To evaluate the prevalence and the characteristics of secondary trauma among patients referred to the emergency department (ED) for a transient loss of consciousness (TLOC). METHODS AND RESULTS: Over a 24 months period, all the patients referred to our ED for a TLOC were evaluated according to the ESC ...

During the progression of heart failure (HF), phases of chronic compensation and acute decompensation alternate and the clinical status worsens during the acute phase. At the present time, few studies have focused their attention on the cycles of compensated and decompensated phases from the perspective of myocyte injury. We hypothesize ...

BACKGROUND: Disorders of water and sodium balance are frequently seen in patients with severe brain injury (SBI), and may worsen their prognosis. PURPOSE: To evaluate vasopressin (AVP) serum levels and sodium and water balance disorders during the first week post-injury in patients with SBI. METHOD: Thirty-six adult patients with SBI ...

BACKGROUND: Hypotension is a well-known predictor of mortality in pediatric trauma patients. However, it is unknown whether the mortality rate is higher in patients with traumatic brain injury (TBI) than in those without TBI. We hypothesized that systemic hypotension increases mortality in pediatric patients with TBI more than it does ...

BACKGROUND: There is no controversy about the use of CT for detection of internal injuries in patients with high-energy multitrauma. However, in most patients isolated blunt abdominal trauma is mild or moderate and the risk of injury to organs other than the liver, spleen or kidneys is minimal. CT scanning ...

Recent studies show a high prevalence of traumatic events in samples of patients with a substance use disorder. In the present study, the lifetime exposure to potentially traumatic events (PTEs) was estimated in a sample of 458 patients recruited at 17 randomly chosen alcohol-dependence treatment units in the public healthcare ...

Unilateral musculoskeletal below-knee injuries occur with great frequency. Patients who cannot bear weight on an injured limb usually mobilize themselves with standard crutches. When the patient also has an upper limb injury, however, mobilization might be impossible, and can result in a lengthy in-patient stay. A randomized control trial was ...

A sample of 38 patients aged under 14 treated at the Surgery Clinic of the University Hospital Osijek has been used in showing therapeutic guidelines supported by patients' functional status after the completed treatment. The patients suffered from supracondylar fractures caused by traffic accidents and classified into three types according ...

Rupture of the tibialis anterior tendon is an unusual injury. Most ruptures occur in elderly men with a history of minor trauma. The sudden occurrence of a "foot drop" is often the presenting symptom. The diagnosis is frequently delayed. The acute rupture is best treated by direct repair. Treatment of ...

INTRODUCTION: Acute pain still persists in patients under treatment after admission to emergency departments (ED). The objective of this study was to determine the efficacy of 1 g of paracetamol in patients presenting an osteoarticular injury. MATERIALS AND METHODS: This prospective study included all patients admitted to the ED with ...

This is a cross-sectional study design aimed to determine the prevalence of Chorda Tympani Nerve (CTN) injury and related symptoms following myringoplasty. Thirty patients were included in this study. The methods used were measuring taste thresholds using electrogustometer to map taste threshold on the anterior two-third of the tongue on ...

INTRODUCTION: Early coagulopathy after traumatic brain injury (TBI) is thought to be the result of injury-mediated local release of tissue factor, although the precise mechanisms that cause hypoperfusion and early systemic coagulopathy in TBI patients are unknown. We have previously reported that early systemic coagulopathy after trauma is present only ...

OBJECTIVES: To estimate the prevalence of ED in electrical injury patients and correlate the results with the electric voltage and the pathway of electric current at the time of injury. METHODS: Mails and phone surveys had been undertaken to 416 electrical injury patients who had been admitted with electrical injury ...

BACKGROUND: The natural history of posttraumatic renal failure (PTRF) is not well-established. Overall prognosis and risk factors for need for dialysis in the setting of PTRF need more precise definition. STUDY DESIGN: We conducted a retrospective review of the trauma registry information from Los Angeles County-University of Southern California Medical ...

Hypothermia occurs as the core temperature decreases below 35 degrees C. Many patients become hypothermic after severe injury due to environmental exposure during transportation, infusion of cold fluids, and decreased ability to maintain normal core body temperature (37 degrees C). Patients with severe trauma die because of hypothermia, metabolic acidosis, ...

BACKGROUND: Trauma to the brachial plexus may result in devastating neurologic dysfunction associated with musculoskeletal and vascular injuries. METHODS: Twenty-nine patients with unilateral brachial plexus injury caused by blunt trauma treated at a single institution were identified and divided into two subgroups: those with isolated brachial plexus injury (ISOL) (n ...

Tracheostomy is associated with increased aspiration rates, and swallowing disorders have not been well-studied in trauma patients with tracheostomy. Swallowing evaluations were conducted in 224 patients (102 trauma and 122 nontrauma patients). Half of the patients in each group had tracheostomies. Bedside swallow studies were conducted in 40 patients, videofluoroscopy ...

BACKGROUND: The autopsy remains the gold standard for evaluating traumatic deaths. The number of autopsies performed has declined dramatically. This study examines whether postmortem computed tomography ("CATopsy") can be used to determine cause of death in trauma patients. METHODS: Patients who presented to the trauma service and subsequently died within ...

BACKGROUND: The Glasgow Coma Scale (GCS) score is widely accepted as the cornerstone in the assessment of neurologic function after trauma and is being used to select patients for enrollment in prehospital (Ph) intervention trials. This study was performed to assess the degree of agreement between Ph-GCS and emergency department ...

Very little is known about the degeneration or healing process in traumatic triangular fibrocartilage complex (TFCC) lesions. Forty-two patients with symptomatic central traumatic tears in the TFCC (Palmer 1 A) were included in this study. The cartilage was debrided arthroscopically and used for histologic examination. Histologic sections were stained with ...

OBJECTIVES: Adrenal gland injury is a potentially devastating event if unrecognized in the treatment course of a trauma patient. We reviewed our single-center experience and outcomes in patients with adrenal gland trauma. METHODS: We performed a retrospective review of all patients presenting with trauma to the Regional Medical Center at ...

BACKGROUND: Predicting outcome after mild traumatic brain injury (MTBI) is notoriously difficult. Although it is recognised that milder head injuries do not necessarily mean better outcomes, less is known about the factors that do enable early identification of patients who are likely to recover well. OBJECTIVE: To develop and internally ...

BACKGROUND AND PURPOSE: The primary goal of body-weight-supported treadmill training (BWSTT) has been to improve the temporal and spatial characteristics of unsupported overground walking; however, little attention has been given to cardiorespiratory adaptations. The purpose of this case report is to describe the effects of BWSTT on cardiorespiratory fitness in ...

We demonstrate that in head injuries the degree of cerebral endothelial activation or injury depends on the type of brain injury and the patients age, and that in severe head injuries measuring the serum levels of thrombomodulin (TM) and von Willebrand factor (vWF) is useful in evaluating cerebral endothelial injury ...

BACKGROUND: This study analyzed the outcomes for clinical application of transarterial embolization (TAE) to treat intractable posttraumatic oronasal hemorrhage in patients who suffered from craniofacial injuries. METHODS: The charts and radiologic and operative records of 34 patients from January 2002 to December 2007 were retrospectively reviewed. Inclusion criteria focused on ...

A retrospective review was conducted to analyze the effect of methamphetamine use in trauma patients. Charts of all trauma patients admitted to Kern Medical Center from January 1, 2003, to January 5, 2006 (36 months) were analyzed for length of stay, intensive care unit (ICU) admission rate and number of ...

BACKGROUND: To evaluate the use of pedicle screw fixation in earthquake injured thoracolumbar spine. METHODS: Nineteen patients with posttraumatic instability of lower thoracic or upper lumbar spine were included in the study. White and Panjabi criteria was used to assess spinal instability. All patients underwent open reduction and internal fixation ...