https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19101 Sat 24 Mar 2018 08:05:15 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19658 15. Patients were identified from the trauma registry, and data for age, sex, mechanism of injury, ISS, survival to discharge, and length of stay were collected. Mortality was examined for patients with severe injury (ISS > 15) and patients with critical injury (ISS > 24) and compared for the three periods: 2002–2004 (without trauma specialist), 2005–2007 (with trauma specialist), and 2008–2011 (with specialist trauma service). Results: A total of 3,869 severely injured (ISS > 15) trauma patients were identified during the 10-year period. Of these, 2,826 (73%) were male, 1,513 (39%) were critically injured (ISS > 24), and more than 97% (3,754) were the victim of blunt trauma. Overall mortality decreased from 12.4% to 9.3% (relative risk, 0.75) from period one to period three and from 25.4% to 20.3% (relative risk, 0.80) for patients with critical injury. A 0.46% per year decrease (p = 0.018) in mortality was detected (odds ratio, 0.63; p < 0.001). For critically injured (ISS > 24), the trend was (0.61% per year; odds ratio, 0.68; p = 0.039). Conclusion: The introduction of a specialist trauma service decreased the mortality of patients with severe injury, the model of care should be considered to implement state- and nationwide in Australia. Level of Evidence: Epidemiologic study, level III.]]> Sat 24 Mar 2018 08:01:13 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19109 Sat 24 Mar 2018 07:55:59 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19102 =10 units of PRBC. Average PRBC use was 7.2 ± 6.6 units and fresh frozen plasma use 4.3 ± 5.2 units. Thirty-nine percent (25/64) had a pelvic ring injury or acetabular fracture. Thirty-seven percent (24/64) had at least one femoral shaft fracture. Twenty patients had a total of 23 tibia fractures. Conclusions: Orthopaedic trauma patients consume the majority of the blood products <24 hours among blunt trauma patients. This resource-intensive group requires frequent urgent surgical interventions and intensive care unit admission.]]> Sat 24 Mar 2018 07:55:50 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20178 110 g/l). Conclusion: The prospective evaluation of acutely transfused trauma patients showed a distinct pattern of transfusion triggers as the patient passes from ED to the OT and arrives to the ICU. The conventional transfusion trigger (haemoglobin level) is not appropriate in ET as early transfusion triggers are based on vital signs, blood gas results, injury patterns and anticipated major bleeding.]]> Sat 24 Mar 2018 07:51:40 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:21022 p = 0.003), 3 days (p = 0.003), and 5 days (p = 0.0014). Preoperative mtDNA levelswere greater with shorter time from injury to surgery (p = 0.0085). Postoperative mtDNA level negatively correlated with intraoperative crystalloid infusion (p = 0.0017). Major pelvic surgery (vs. minor) was associated with greater mtDNA release 5 days postoperatively (p < 0.05). Conclusion: This pilot of heterogeneous orthopedic trauma patients showed that the release of mtDNA and nDNA is sustained for 5 days following orthopedic trauma surgery. Postoperative, circulating DNA is not associated with markers of tissue necrosis but is associated with surgical invasiveness and is inversely related to intraoperative fluid administration. Sustained elevation of mtDNA levels could be of inflammatory origin and may contribute to postinjury dysfunctional inflammation.]]> Sat 24 Mar 2018 07:50:33 AEDT ]]>