Effectiveness of the P.A.R.T.Y. (Prevent Alcohol and Risk-related Trauma in Youth) program in preventing traumatic injuries: a 10-year analysis.

Background: The P.A.R.

Access to trauma systems in Canada.

Background: Trauma is a leading cause of morbidity, potential years of life lost and health care expenditure in Canada and around the world. Trauma systems have been established across North America to provide comprehensive injury care and to lead injury control efforts. We sought to describe the current status of trauma systems in Canada and Canadians' access to acute, multidisciplinary trauma care.

General surgery 2.0: the emergence of acute care surgery in Canada.

Over the past 5 years, there has been a groundswell of support in Canada for the development of organized, focused and multidisciplinary approaches to caring for acutely ill general surgical patients. Newly forged acute care surgery (ACS) services are beginning to provide prompt, evidence-based and goal-directed care to acutely ill general surgical patients who often present with a diverse range of complex pathologies and little or no pre- or postoperative planning. Through a team-based structure with attention to processes of care and information sharing, ACS services are well positioned to improve outcomes, while finding and developing efficiencies and reducing costs of surgical and emergency health care delivery.

Extravasation of intravenous computed tomography scan contrast in blunt abdominal and pelvic trauma.

Background: Intravenous contrast extravasation (CE) on computed tomography (CT) scan in blunt abdominal trauma is generally regarded as an indication for the need for invasive intervention (either angiography or laparotomy). More recently, improvements in CT scan technology have increased the sensitivity in detecting CE, and, thus, we postulate that not all patients with this finding require intervention.

Methods: This study is a retrospective review of all patients who underwent a CT scan for blunt abdominal trauma between January 1999 and September 2003.

Retrograde urethrocystography impairs computed tomography diagnosis of pelvic arterial hemorrhage in the presence of a lower urologic tract injury.

Background: There is controversy about the appropriate sequence of urologic investigation in patients with pelvic fracture. Use of retrograde urethrography or cystography may interfere with regular pelvic CT scanning for arterial extravasation.

Study Design: We performed a retrospective study at a regional trauma center in Toronto, Canada.

Radiation exposure from diagnostic imaging in severely injured trauma patients.

Background: Trauma patients often require multiple imaging tests, including computed tomography (CT) scans. CT scanning, however, is associated with high-radiation doses. The purpose of this study was to measure the radiation doses trauma patients receive from diagnostic imaging.

Preventable deaths from hemorrhage at a level I Canadian trauma center.

Background: Studies of trauma deaths have had a tremendous impact on the quality of contemporary trauma care. We studied causes of trauma death at a Level I Canadian trauma center, and tabulated preventable deaths from hemorrhage using explicit criteria.

Methods: Trauma registry data were used to identify all trauma deaths at our institution from January 1, 1999 to December 31, 2003.

Association between alcohol and mortality in patients with severe traumatic head injury.

Hypothesis: Admission blood alcohol concentration (BAC) is associated with in-hospital death in patients with severe brain injury from blunt head trauma.

Design: Retrospective cohort study.

Setting: Academic level I trauma center in Toronto, Ontario.

Recombinant activated coagulation factor VII and bleeding trauma patients.

Background: Recombinant activated coagulation factor VII (rFVIIa) is increasingly being administered to massively bleeding trauma patients. rFVIIa has been shown to correct coagulopathy and to decrease transfusion requirements. However, there is no conclusive evidence to suggest that rFVIIa improves the survival of these patients.

Traumatic abdominal wall hernia: epidemiology and clinical implications.

Background: Traumatic abdominal wall hernias (TAWHs) are uncommon, and it remains controversial whether such patients require urgent laparotomy. As such, this study was undertaken to assess the clinical sequelae of operative versus nonoperative management of TAWH, and whether certain patient or injury characteristics are predictive of the need for early surgery.

Methods: Retrospective review of all patients presenting acutely with a TAWH at a Regional Trauma Center from January 2000 to December 2004.

Diagnosis and outcome of blunt caval injuries in the modern trauma center.

Background: Blunt vena caval injury (BCI) is uncommon with only a few published reports in the literature. Recently, with high resolution computed tomography (CT) scan imaging signs of caval injury are sometimes found in hemodynamically stable patients. The purpose of this study was to assess the current course of patients with BCI.

Noncompliance with seat-belt use in patients involved in motor vehicle collisions.

Background: Seat-belt compliance in trauma patients involved in motor vehicle collisions (MVCs) appears low when compared with compliance of the general public. In this study we wished to define the relative frequency of seat-belt use in injured Canadian drivers and passengers and to determine if there are risk factors particular to seat-belt noncompliance in this cohort.

Methods: We identified trauma patients who were involved in MVCs over a 24-month period and contacted them 2-4 years after the injury by telephone to administer a standardized survey.

The increasing incidence of severe pelvic injury in motor vehicle collisions.

Background: Pelvic fractures constitute a major cause of death and residual disability in motor vehicle collisions (MVC). To date there has been poor documentation of the epidemiology of severe pelvic injuries. A detailed retrospective examination of all abbreviated injury score (AIS) > or = 4 pelvic fractures sustained in occupants of MVCs seen at this lead trauma hospital over the last 12 years and in the province of Ontario over the last 6 years was completed.

Long-term outcomes after injury in the elderly.

Background: The lasting impact of injury on lifestyle in the elderly remains poorly defined. The purpose of this study was to determine the long-term quality-of-life outcomes in elderly trauma patients.

Methods: The trauma registry at a regional trauma center was used to identify hospital survivors of injury > or = 65 years old discharged from April 1996 to March 1999.