Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries.

Objective: We hypothesized that lung injury and rib cage fracture quantification would be associated with adverse outcomes.

Subjects And Methods: Consecutive admissions to a trauma center with Injury Severity Score ≥ 9, age 18-75, and blunt trauma. CT scans were reviewed to score rib and sternal fractures and lung infiltrates.

Geriatric preinjury activities of daily living function is associated with glasgow coma score and discharge disposition: a retrospective, consecutive cohort study.

The primary objective was to evaluate the associations of the Injury Severity Score (ISS), age, Glasgow Coma Score (GCS), preexisting medical conditions (PEMC), and preinjury activities of daily living (ADL) Katz score with discharge disposition in surviving geriatric trauma patients.Data were obtained from the trauma registry. The preinjury Katz ADL score was prospectively ascertained.

Early tracheostomy in severe traumatic brain injury: evidence for decreased mechanical ventilation and increased hospital mortality.

Objective: In the past, the authors performed a comprehensive literature review to identify all randomized controlled trials assessing the impact of early tracheostomy on severe brain injury outcomes. The search produced only two trials, one by Sugerman and another by Bouderka.

Subjects And Methods: The current authors initiated an Institutional Review Board-approved severe brain injury randomized trial to evaluate the impact of early tracheostomy on ventilator-associated pneumonia rates, intensive care unit (ICU)/ventilator days, and hospital mortality.

Laparoscopic splenectomy for blunt trauma: a safe operation following embolization.

Background: Embolization of the injured spleen from blunt trauma reduces the risk of continued or delayed hemorrhage in patients being treated with nonoperative management (NOM). Splenectomy is required in some patients following embolization due to continued bleeding or infarction with abscess formation. Laparoscopic splenectomy for blunt trauma can be done safely in patients following embolization.

Laparoscopic splenectomy following embolization for blunt trauma.

Background: Grade III through V splenic injuries as defined by the American Association for the Surgery of Trauma (AAST) grading scale are associated with hemorrhage and nonoperative failure. Embolization has been reported to reduce splenic bleeding in 50% to 75% of patients with a high-grade injury. However, splenectomy following embolization may be necessary in patients who continue to bleed or develop splenic infarction with abscess formation.

Severe brain injury ICU outcomes are associated with Cranial-Arterial Pressure Index and noninvasive Bispectral Index and transcranial oxygen saturation: a prospective, preliminary study.

Introduction: The purpose of this study was to determine if noninvasive transcranial oxygen saturation (StcO2) and Bispectral Index (BIS) correlate with severe traumatic brain injury intensive care unit (ICU) outcomes.

Methods: This is a prospective observational study. Values of intracranial pressure (ICP), mean arterial pressure (MAP), BIS, and StcO2 were recorded hourly for the first six, post-injury days in 18 patients with severe brain injury.

Assessment of early tracheostomy in trauma patients: a systematic review and meta-analysis.

The objective of this review was to assess outcomes in trauma patients undergoing early tracheostomy (ET). Abstract databases for the Eastern and American Associations for the Surgery of Trauma and Medline were searched to find trauma patient studies comparing ET and late tracheostomy (LT) or ET and no ET. Fixed-effects meta-analyses were performed on the randomized controlled trial (RCT) studies.

Cerebral hypoxia in severely brain-injured patients is associated with admission Glasgow Coma Scale score, computed tomographic severity, cerebral perfusion pressure, and survival.

Background: The purpose of this study was to determine the relationship of cerebral hypoxia with admission Glasgow Coma Scale (GCS) score, brain computed tomographic (CT) severity, cerebral perfusion pressure (CPP), and survival in patients with severe brain injury.

Methods: CPP and noninvasive transcranial oximetry (Stco2) were recorded hourly for 6 days in patients with a GCS score < or = 8 (3,722 observations). CT score was derived from midline shift (0/1) plus abnormal cisterns (0/1) plus subarachnoid hemorrhage (SAH) (0/1) (range, 0-3).