An evaluation of multiple trauma severity indices created by different index development strategies.

Evaluation of the effectiveness of emergency trauma care systems is complicated by the need to adjust for the widely variable case mix found in trauma patient populations. Several strategies have been advanced to construct the severity indices that can control for these population differences. This article describes a validity and reliability comparison of trauma severity indices developed under three different approaches: 1) use of a multi-attribute utility (MAU) model; 2) an actuarial approach relying on empirical data bases; and 3) an "ad hoc" approach.

Nutritional evaluation of a blenderized diet in five major burn patients.

Five consecutively admitted major burn patients were successfully supported with a high calorie, high protein diet supplemented with a blenderized diet (formula) that was prepared in our hospital. The egg, rice, and milk base formula provided over 60 percent of the average daily caloric requirements essential to their recovery. It was effective in preventing significant weight loss and promoting wound healing and successful skin grafting.

Trauma score.

The Trauma Score (TS), a simple physiological measure of injury severity, is presented as a modification of the previously reported Triage Index by consensus physician peer review. Performance of the Trauma Score is presented as an index of injury severity both alone and in combination with an anatomic index of injury severity, the Injury Severity Score (ISS) and patient age. The application of these tools for field triage and evaluation of care of the trauma victim is proposed.

Intramural hematoma of the duodenum.

Five new cases of intramural duodenal hematoma are reviewed with 174 cases derived from the literature. Operative therapy with simple evacuation of the hematoma is advocated as the procedure of choice. Bypass procedures and resection should be reserved for selected cases.