儿科麻木骨创伤:管理和结果的差异
Kayla Peña1, Abhilasha Borad1, Sathyaprasad Burjonrappa1
1Rutgers, RWJMS, New Brunswick, New Jersey.
The Journal of surgical research
|October 25, 2023
概括
儿科脏创伤的非手术治疗显示出差异. 少数民族患者经历了更长的住院时间,这表明非手术护理在创伤中心中没有标准化.
科学领域:
- 儿科创伤外科手术 儿科创伤外科
- 重物伤害管理 重物伤害管理
- 医疗保健中的健康差异
背景情况:
- 非手术管理 (NOM) 越来越多地被接受为儿科突发脏创伤.
- 在儿童创伤中心和种族群体中对NOM的标准化需要调查.
研究的目的:
- 量化儿科骨创伤管理中的差异.
- 分析基于创伤中心,伤害严重程度,种族,种族和保险的变化.
主要方法:
- 2018-2019年国家创伤数据库对20岁以下患有形骨创伤的患者的分析.
- 主要结局包括脊髓切除术,栓塞,输血,死亡率,伤害严重程度得分 (ISS) 和停留时间.
- 倾向性得分匹配用于比较少数群体和白人患者群体.
主要成果:
- 种族群体间的脊髓切除术,栓塞,输血或死亡率没有显著差异.
- 少数群体患者在倾向性得分匹配后,平均住院时间 (LOS) (5.44比4.72天,P=0.05) 显着更长.
- 在匹配后的少数群体中,受伤严重程度得分 (ISS) 仍然较高.
结论:
- 在少数群体患者中,较长的住院LOS可能会受到较高的伤害严重程度的影响.
- 这项研究强调了儿童脏创伤在不同中心的非手术治疗中缺乏标准化.
相关概念视频
01:26Flail Chest-II
184
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
184
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
01:28Esophageal Perforation-II: Clinical Manifestations and Management
69
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
69
01:28Esophageal Varices-II: Clinical Features and Management
73
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
73
01:24Flail Chest-I
199
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
199