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Errington C. Thompson - One of the best experts on this subject based on the ideXlab platform.
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The Impact of BMI on Adult Blunt Trauma Outcomes.
The American surgeon, 2019Co-Authors: Rahman Barry, Milad Modarresi, Rodrigo Aguilar, Jacqueline Sanabria, Thao T. Wolbert, David Denning, Errington C. ThompsonAbstract:Traumatic injuries account for 10% of all mortalities in the United States. Globally, it is estimated that by the year 2030, 2.2 billion people will be overweight (BMI ≥ 25) and 1.1 billion people will be obese (BMI ≥ 30). Obesity is a known risk factor for suboptimal outcomes in Trauma; however, the extent of this impact after Blunt Trauma remains to be determined. The incidence, prevalence, and mortality rates from Blunt Trauma by age, gender, cause, BMI, year, and geography were abstracted using datasets from 1) the Global Burden of Disease group 2) the United States Nationwide Inpatient Sample databank 3) two regional Level II Trauma centers. Statistical analyses, correlations, and comparisons were made on a global, national, and state level using these databases to determine the impact of BMI on Blunt Trauma. The incidence of Blunt Trauma secondary to falls increased at global, national, and state levels during our study period from 1990 to 2015, with a corresponding increase in BMI at all levels (P < 0.05). Mortality due to fall injuries was higher in obese patients at all levels (P < 0.05). Analysis from Nationwide Inpatient Sample database demonstrated higher mortality rates for obese patients nationally, both after motor vehicle collisions and mechanical falls (P < 0.05). In obese and nonobese patients, regional data demonstrated a higher Blunt Trauma mortality rate of 2.4% versus 1.2%, respectively (P < 0.05) and a longer hospital length of stay of 4.13 versus 3.26 days, respectively (P = 0.018). The obesity rate and incidence of Blunt Trauma secondary to falls are increasing, with a higher mortality rate and longer length of stay in obese Blunt Trauma patients.
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The Impact of Obesity on Outcomes in Geriatric Blunt Trauma.
The American surgeon, 2019Co-Authors: Rahman Barry, Milad Modarresi, David Denning, Errington C. Thompson, Rafael Duran, Stephen L Wilson, Jacqueline SanabriaAbstract:Blunt Trauma is poorly tolerated in the elderly, and the degree to which obesity, a known risk factor for suboptimal outcomes in Trauma affects this population remains to be determined. The incidence, prevalence, and mortality rates of Blunt Trauma by demographics, year, and geography were found using datasets from both the Global Burden of Disease database, and a Regional Level II Trauma registry. Global Burden of Disease data were extracted from 284 country-year and 976 subnational-year combinations from 27 countries for the period 1990 to 2015. The regional Trauma registry was interrogated for patients ≥70 years admitted with Blunt Trauma between 2014 and 2016. The incidence of elderly Blunt Trauma from falls increased at a global, national (United States), and state (WV) level from 1990 to 2015 by 78.3 per cent, 54.7 per cent, and 42.7 per cent, respectively with concomitant increases in mortality rates of 5.7 per cent, 102.6 per cent, and 89.3 per cent (P 0.05). The hospital length-of-stay, Glasgow Coma Scale score, and systolic blood pressure on presentation were similar (P > 0.05) as was the Injury Severity Score. Major medical comorbidities were identified in 280 (87.5%) and 783 (84.6%) patients in the obese and nonobese groups, respectively. Blunt Trauma, secondary to falls, has increased in elderly patients at a global, national, and state level with a concomitant increase in mortality rates. Although a similar increase in the incidence of Blunt Trauma in the elderly was noted at a regional center, its mortality has not been increased by obesity, possibly because of similar comorbidity rates.
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Outcomes after rib fractures in geriatric Blunt Trauma patients.
American journal of surgery, 2018Co-Authors: Rahman Barry, Errington C. ThompsonAbstract:Abstract Introduction Rib fractures after Blunt Trauma contribute substantially to morbidity and mortality in the elderly. Methods Retrospective review of 255 patients ≥65 years old at a level 2 Trauma center over 6 years, who sustained Blunt Trauma resulting in rib fractures. Outcomes measured include mortality, hospital length of stay(LOS), intensive care unit(ICU) admission, ICU LOS, need for MV, and MV days. Results There were 24 deaths (9.4%), of which 7 were early ( 15, bilateral rib fractures, pneumothorax or hemothorax on chest x-ray (All p 5 rib fractures (All p Conclusion Rib fractures in elderly Blunt Trauma patients are associated with significant mortality and morbidity, but outcomes can be predicted to improve care.
John A. Morris - One of the best experts on this subject based on the ideXlab platform.
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Outcome of isolated pulmonary contusion in Blunt Trauma patients.
American Surgeon, 1994Co-Authors: S. J. Hoff, S. D. Shotts, V. A. Eddy, John A. MorrisAbstract:To determine outcome in young, healthy Blunt Trauma patients with isolated pulmonary contusion, and to identify factors associated with poor outcome, we reviewed 6012 consecutive adult (aged 16-49) Blunt Trauma admissions. Ninety-four (7.9%) presented with an isolated pulmonary contusion defined by chest radiograph and Injury Severity Score 7 days), or a severe complication (pneumonia, empyema, atelectasis requiring bronchoscopy, or bronchopleural fistula). None of the 94 study patients died. Admission chest radiograph demonstrated no contusion in 34 patients (36%). Fifteen patients (16%) required intubation, but 13 were extubated within 48 hours
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Outcome of Cardiovascular Collapse in Pediatric Blunt Trauma
Annals of emergency medicine, 1994Co-Authors: Mary Fran Hazinski, A Alfred Chahine, George W. Holcomb, John A. MorrisAbstract:Abstract Study objectives: To determine the survival and functional outcome of pediatric Blunt Trauma victims demonstrating cardiovascular collapse, including pulseless cardiopulmonary arrest or severe hypotension, on initial presentation in an emergency department. Design: Seven-year consecutive case-control series. Setting: Level I Trauma center and university teaching hospital. Participants: Two thousand one hundred twenty consecutive pediatric victims of Blunt Trauma less than 16 years old admitted to a Level I Trauma center from August 1984 through December 1991 had a mortality of 5.2%. Thirty-eight patients (1.8%) demonstrated pulseless cardiac arrest or severe hypotension (systolic blood pressure of 50 mm Hg or less) on initial presentation in the ED. Interventions: All patients received basic and advanced life support consistent with guidelines published by the American Heart Association, American Academy of Pediatrics, and American College of Surgeons. Measurements and main results: Survival, functional outcome, and donor status were reviewed. Outcome of ED resuscitation (death or reanimation), post-ED destination (morgue, operating room, or pediatric ICU) length of hospitalization, functional outcome after hospital discharge, time to death (time from admission to ED to declaration of death), cause of death, total hospital costs, total hospital charges, and organ donation were reviewed. There were no functional survivors among 38 pediatric victims of Blunt Trauma who presented to the ED in pulseless cardiac arrest or with severe hypotension. Eleven of the 12 patients who were transferred to the pediatric ICU died; the single survivor demonstrated profound neurologic impairment six years after hospitalization. Six of these 12 patients were eligible potential donors and resulted in four multiorgan donors during the seven-year study. The mean hospital unreimbursed care for the 38 study patients was $3,514 per patient. Conclusion: No child who presented with pulseless cardiac arrest or severe hypotension following Blunt Trauma achieved functional survival. Reimbursed care for pediatric victims of Blunt Trauma demonstrating cardiovascular collapse is disproportionately poor compared with that for pediatric patients who maintain hemodynamic integrity in the ED. Half of all patients who were stabilized sufficiently for transfer to the pediatric ICU were eligible potential organ donors. Therefore aggressive resuscitation of these patients may be justified if organ donation is seriously contemplated and aggressively pursued. [Hazinski MF, Chahine AA, Holcomb GW III, Morris JA Jr: Outcome of cardiovascular collapse in pediatric Blunt Trauma. Ann Emerg Med June 1994;23:1229-1235.]
Rahman Barry - One of the best experts on this subject based on the ideXlab platform.
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The Impact of BMI on Adult Blunt Trauma Outcomes.
The American surgeon, 2019Co-Authors: Rahman Barry, Milad Modarresi, Rodrigo Aguilar, Jacqueline Sanabria, Thao T. Wolbert, David Denning, Errington C. ThompsonAbstract:Traumatic injuries account for 10% of all mortalities in the United States. Globally, it is estimated that by the year 2030, 2.2 billion people will be overweight (BMI ≥ 25) and 1.1 billion people will be obese (BMI ≥ 30). Obesity is a known risk factor for suboptimal outcomes in Trauma; however, the extent of this impact after Blunt Trauma remains to be determined. The incidence, prevalence, and mortality rates from Blunt Trauma by age, gender, cause, BMI, year, and geography were abstracted using datasets from 1) the Global Burden of Disease group 2) the United States Nationwide Inpatient Sample databank 3) two regional Level II Trauma centers. Statistical analyses, correlations, and comparisons were made on a global, national, and state level using these databases to determine the impact of BMI on Blunt Trauma. The incidence of Blunt Trauma secondary to falls increased at global, national, and state levels during our study period from 1990 to 2015, with a corresponding increase in BMI at all levels (P < 0.05). Mortality due to fall injuries was higher in obese patients at all levels (P < 0.05). Analysis from Nationwide Inpatient Sample database demonstrated higher mortality rates for obese patients nationally, both after motor vehicle collisions and mechanical falls (P < 0.05). In obese and nonobese patients, regional data demonstrated a higher Blunt Trauma mortality rate of 2.4% versus 1.2%, respectively (P < 0.05) and a longer hospital length of stay of 4.13 versus 3.26 days, respectively (P = 0.018). The obesity rate and incidence of Blunt Trauma secondary to falls are increasing, with a higher mortality rate and longer length of stay in obese Blunt Trauma patients.
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The Impact of Obesity on Outcomes in Geriatric Blunt Trauma.
The American surgeon, 2019Co-Authors: Rahman Barry, Milad Modarresi, David Denning, Errington C. Thompson, Rafael Duran, Stephen L Wilson, Jacqueline SanabriaAbstract:Blunt Trauma is poorly tolerated in the elderly, and the degree to which obesity, a known risk factor for suboptimal outcomes in Trauma affects this population remains to be determined. The incidence, prevalence, and mortality rates of Blunt Trauma by demographics, year, and geography were found using datasets from both the Global Burden of Disease database, and a Regional Level II Trauma registry. Global Burden of Disease data were extracted from 284 country-year and 976 subnational-year combinations from 27 countries for the period 1990 to 2015. The regional Trauma registry was interrogated for patients ≥70 years admitted with Blunt Trauma between 2014 and 2016. The incidence of elderly Blunt Trauma from falls increased at a global, national (United States), and state (WV) level from 1990 to 2015 by 78.3 per cent, 54.7 per cent, and 42.7 per cent, respectively with concomitant increases in mortality rates of 5.7 per cent, 102.6 per cent, and 89.3 per cent (P 0.05). The hospital length-of-stay, Glasgow Coma Scale score, and systolic blood pressure on presentation were similar (P > 0.05) as was the Injury Severity Score. Major medical comorbidities were identified in 280 (87.5%) and 783 (84.6%) patients in the obese and nonobese groups, respectively. Blunt Trauma, secondary to falls, has increased in elderly patients at a global, national, and state level with a concomitant increase in mortality rates. Although a similar increase in the incidence of Blunt Trauma in the elderly was noted at a regional center, its mortality has not been increased by obesity, possibly because of similar comorbidity rates.
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Outcomes after rib fractures in geriatric Blunt Trauma patients.
American journal of surgery, 2018Co-Authors: Rahman Barry, Errington C. ThompsonAbstract:Abstract Introduction Rib fractures after Blunt Trauma contribute substantially to morbidity and mortality in the elderly. Methods Retrospective review of 255 patients ≥65 years old at a level 2 Trauma center over 6 years, who sustained Blunt Trauma resulting in rib fractures. Outcomes measured include mortality, hospital length of stay(LOS), intensive care unit(ICU) admission, ICU LOS, need for MV, and MV days. Results There were 24 deaths (9.4%), of which 7 were early ( 15, bilateral rib fractures, pneumothorax or hemothorax on chest x-ray (All p 5 rib fractures (All p Conclusion Rib fractures in elderly Blunt Trauma patients are associated with significant mortality and morbidity, but outcomes can be predicted to improve care.
Mary Fran Hazinski - One of the best experts on this subject based on the ideXlab platform.
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Outcome of Cardiovascular Collapse in Pediatric Blunt Trauma
Annals of emergency medicine, 1994Co-Authors: Mary Fran Hazinski, A Alfred Chahine, George W. Holcomb, John A. MorrisAbstract:Abstract Study objectives: To determine the survival and functional outcome of pediatric Blunt Trauma victims demonstrating cardiovascular collapse, including pulseless cardiopulmonary arrest or severe hypotension, on initial presentation in an emergency department. Design: Seven-year consecutive case-control series. Setting: Level I Trauma center and university teaching hospital. Participants: Two thousand one hundred twenty consecutive pediatric victims of Blunt Trauma less than 16 years old admitted to a Level I Trauma center from August 1984 through December 1991 had a mortality of 5.2%. Thirty-eight patients (1.8%) demonstrated pulseless cardiac arrest or severe hypotension (systolic blood pressure of 50 mm Hg or less) on initial presentation in the ED. Interventions: All patients received basic and advanced life support consistent with guidelines published by the American Heart Association, American Academy of Pediatrics, and American College of Surgeons. Measurements and main results: Survival, functional outcome, and donor status were reviewed. Outcome of ED resuscitation (death or reanimation), post-ED destination (morgue, operating room, or pediatric ICU) length of hospitalization, functional outcome after hospital discharge, time to death (time from admission to ED to declaration of death), cause of death, total hospital costs, total hospital charges, and organ donation were reviewed. There were no functional survivors among 38 pediatric victims of Blunt Trauma who presented to the ED in pulseless cardiac arrest or with severe hypotension. Eleven of the 12 patients who were transferred to the pediatric ICU died; the single survivor demonstrated profound neurologic impairment six years after hospitalization. Six of these 12 patients were eligible potential donors and resulted in four multiorgan donors during the seven-year study. The mean hospital unreimbursed care for the 38 study patients was $3,514 per patient. Conclusion: No child who presented with pulseless cardiac arrest or severe hypotension following Blunt Trauma achieved functional survival. Reimbursed care for pediatric victims of Blunt Trauma demonstrating cardiovascular collapse is disproportionately poor compared with that for pediatric patients who maintain hemodynamic integrity in the ED. Half of all patients who were stabilized sufficiently for transfer to the pediatric ICU were eligible potential organ donors. Therefore aggressive resuscitation of these patients may be justified if organ donation is seriously contemplated and aggressively pursued. [Hazinski MF, Chahine AA, Holcomb GW III, Morris JA Jr: Outcome of cardiovascular collapse in pediatric Blunt Trauma. Ann Emerg Med June 1994;23:1229-1235.]
Eufronio G. Maderazo - One of the best experts on this subject based on the ideXlab platform.
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Depressed neutrophil chemotaxis in children suffering Blunt Trauma
Pediatrics, 1994Co-Authors: Peter J. Krause, Charles L. Woronick, Georgine Burke, Nadia Slover, Catherine Kosciol, Timothy Kelly, Betty S. Spivack, Eufronio G. MaderazoAbstract:OBJECTIVE: Impaired neutrophil (PMN) function, due in part to release of immature PMNs into the circulation, contributes to the increased rate of infection observed in adults suffering Blunt Trauma. The objective of this study was to determine whether similar events occur in children. METHODS: We assessed PMN chemotaxis and PMN maturation in 25 children (7 young children and 18 adolescents) and 25 adults 1 to 9 days after suffering Blunt Trauma, and in healthy adult control subjects. PMN chemotaxis was determined using a standard micropore filter assay, whereas PMN maturation was determined with 31D8, a novel monoclonal antibody that binds to mature PMNs more avidly than immature PMNs and band forms. RESULTS: In patients suffering Blunt Trauma, mean PMN chemotactic values were similar among children (44.6 +/- 2.3 microns) and adults (41.3 +/- 2.1 microns) and both were significantly less than among healthy adults (53.5 +/- 2.4 microns, P < .0005). PMN chemotactic values increased significantly in the 9 days after Trauma for both children and adults (F = 13.8, df = 1, P < .0002). Mean PMN 31D8 binding among children with Trauma (92.5 +/- 5.2) was significantly less than among healthy adults (117.6 +/- 5.4, P < .0009). CONCLUSIONS: Impairment in PMN chemotaxis occurs in children after Blunt Trauma and is due in part to release of immature PMNs into the circulation.