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  1. Article ; Online: Stressing over ulcer prophylaxis in the neurocritical trauma patient.

    Topper, Gena V / Patel, Purvi Pravinchandra / Egodage, Tanya

    Trauma surgery & acute care open

    2024  Volume 9, Issue 1, Page(s) e001418

    Language English
    Publishing date 2024-03-05
    Publishing country England
    Document type Journal Article ; Comment
    ISSN 2397-5776
    ISSN (online) 2397-5776
    DOI 10.1136/tsaco-2024-001418
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Police transport of firearm-injured patients-more often and more injured.

    Maher, Zoё / Beard, Jessica H / Dauer, Elizabeth / Carroll, Madeleine / Forman, Steven / Topper, Gena V / Pathak, Abhijit / Santora, Thomas A / Sjoholm, Lars Ola / Zhao, Huaqing / Goldberg, Amy J

    The journal of trauma and acute care surgery

    2021  Volume 91, Issue 1, Page(s) 164–170

    Abstract: Background: Police transport (PT) of penetrating trauma patients decreases the time between injury and trauma center arrival. Our study objective was to characterize trends in the rate of PT and its impact on mortality. We hypothesized that PT is ... ...

    Abstract Background: Police transport (PT) of penetrating trauma patients decreases the time between injury and trauma center arrival. Our study objective was to characterize trends in the rate of PT and its impact on mortality. We hypothesized that PT is increasing and that these patients are more injured.
    Methods: We conducted a single-center, retrospective cohort study of adult (≥18 years) patients presenting with gunshot wounds (GSWs) to a level 1 center from 2012 to 2018. Patients transported by police or ambulance (emergency medical service [EMS]) were included. The association between mode of transport (PT vs. EMS) and mortality was evaluated using χ2, t tests, Mann-Whitney U tests, and logistic regression.
    Results: Of 2,007 patients, there were 1,357 PT patients and 650 EMS patients. Overall in-hospital mortality was 23.7%. The rate of GSW patients arriving by PT increased from 48.9% to 78.5% over the study period (p < 0.001). Compared with EMS patients, PT patients were sicker on presentation with lower initial systolic blood pressure (98 vs. 110, p < 0.001), higher Injury Severity Score (median [interquartile range], 10 [2-75] vs. 9 [1-17]; p < 0.001) and more bullet wounds (3.5 vs. 2.9, p < 0.001). Police-transported patients more frequently underwent resuscitative thoracotomy (19.2% vs. 10.0%, p < 0.001) and immediate surgical exploration (31.3% vs. 22.6%, p < 0.001). There was no difference in adjusted in-hospital mortality between transport groups. Of patients surviving to discharge, PT patients had higher Injury Severity Score (9.6 vs. 8.3, p = 0.004) and lower systolic blood pressure on arrival (126 vs. 130, p = 0.013) than EMS patients.
    Conclusion: Police transport of GSW patients is increasing at our urban level 1 center. Compared with EMS patients, PT patients are more severely injured but have similar in-hospital mortality. Further study is necessary to understand the impact of PT on outcomes in specific subsets in penetrating trauma patients.
    Level of evidence: Epidemiological, level III.
    MeSH term(s) Adult ; Emergency Medical Services ; Female ; Hospital Mortality ; Humans ; Injury Severity Score ; Logistic Models ; Male ; Pennsylvania ; Police ; Retrospective Studies ; Transportation of Patients ; Trauma Centers ; Wounds, Gunshot/mortality ; Young Adult
    Language English
    Publishing date 2021-06-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000003225
    Database MEDical Literature Analysis and Retrieval System OnLINE

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