Abstract：
BACKGROUND:Physiologic variables used in trauma triage criteria may be significantly affected by age, decreasing their predictive value in geriatric trauma. METHODS:The study population was all adult patients in the Washington State Trauma Registry from 2000 to 2004. Elderly patients were defined as those aged >65 years. Multivariate analyses were conducted to evaluate the relationship between age and trauma triage decisions, need for emergent interventions, and outcomes. RESULTS:Of 51,227 trauma admissions, 13,820 (27%) were for elderly patients. Elderly patients were significantly less likely to have trauma team activation (14% vs 29%, P <.01), despite a similar percentage of severe injuries (injury severity score > 15), and more often required urgent craniotomy (10% vs 6%, P <.01) and orthopedic procedures (67% vs 51%, P <.01). Heart rate and blood pressure were not predictive of severe injury for those aged >65 years. Undertriaged elderly patients had 4 times the mortality rate and discharge disability of younger patients (both P values <.001). CONCLUSIONS:Elderly trauma victims are less likely to undergo rapid trauma evaluation and have significantly worse outcomes compared with younger patients. Standard physiologic triage variables may not identify severe injury in older patients.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Lehmann R,Beekley A,Casey L,Salim A,Martin Mdoi
10.1016/j.amjsurg.2008.12.037subject
Has Abstractpub_date
2009-05-01 00:00:00pages
571-4; discussion 574-5issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(09)00175-5journal_volume
197pub_type
杂志文章abstract：INTRODUCTION:The aim of this study was to assess the malignancy rate in patients with Hürthle cell metaplasia (HCM) on fine-needle aspiration biopsy (FNAB). METHODS:The pathology results of patients with benign colloid (BC) and HCM on FNAB were compared using a prospective database. RESULTS:One hundred fifty-three (6...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.09.019
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Axillary lymph node status is still considered the most significant prognostic factor for breast cancer outcome, and treatment decisions are based on the presence or absence of nodal disease. Intramammary lymph nodes (IMLNs) can be a site of regional spread. Is this a marker for more aggressive disease? MET...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.05.011
更新日期：2006-10-01 00:00:00
abstract：:From 1972 to 1981, 430 patients were treated for bleeding peptic ulcer. Two hundred ten of the patients were treated surgically and 220 medically. In the surgically treated patients, mortality was high among those with posterior duodenal peptic ulcer and after gastrectomy rather than after vagotomy. Mortality after em...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90170-3
更新日期：1984-03-01 00:00:00
abstract：PURPOSE:The goal of this study was to evaluate the efficacy, morbidity and safety of local parastomal hernia repair using biological mesh. PATIENTS AND METHODS:A retrospective analysis of a prospectively maintained database was performed for parastomal hernia repairs. All patients who underwent local parastomal hernia...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.05.005
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Medical schools are undergoing major curricular reform, partly in attempts to increase the number of graduates pursuing careers in the generalist disciplines. These reforms have often resulted in a shortening of the surgery clerkship, decreasing students' experiences in several domains important to the gener...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)89595-5
更新日期：1997-03-01 00:00:00
abstract：:Abdominal muscular contractions may have a protective influence against the development of indirect inguinal hernia. A portion of the transversus abdominus muscles acts on the internal inguinal rings and produces a closure mechanism during voluntary abdominal muscular activity. It follows, therefore, that injury or in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90108-8
更新日期：1982-03-01 00:00:00
abstract：:Between September 1982 and April 1988, 60 cirrhotic patients with prior variceal hemorrhage were randomized to undergo the placement of an elective shunt (distal splenorenal: 26; nonselective: 4) or long-term endoscopic sclerotherapy (n = 30). Eighty-six percent of patients had alcoholic cirrhosis, and 33% were classi...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(05)80400-3
更新日期：1993-01-01 00:00:00
abstract：:An adaptable on-line computer system for entry, retrieval, and analysis of medical discharge summaries has been developed and applied in the Trauma Service of a busy city hospital. Each summary occupied 5 to 10 minutes of the physician's time and compared favorably in cost to the standard dictated summary. While the a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90049-0
更新日期：1976-08-01 00:00:00
abstract：:Small intestinal epithelium digests and absorbs nutrients. Crypt stem cell transplantation can generate neomucosa with normal morphology, but the digestive and absorptive capacities of this neomucosa are unknown. This study evaluates stem cell induced neomucosal brush border digestive enzyme activity and nutrient tran...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80119-6
更新日期：1995-01-01 00:00:00
abstract：:There has been a continuing evolution of the clinical spectrum of Candida infection in nonneutropenic patients. With better understanding of the predisposing factors for fungemia in critically ill patients, interest now centers on indications for early therapy, prior to the progression of colonization to fungemia. Rec...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(96)00350-9
更新日期：1996-12-01 00:00:00
abstract：BACKGROUND:Perihilar cholangiocarcinoma is usually unresectable at the time of diagnosis. Only few patients are candidates for a potential curative treatment. For those patients, prognosis is strongly related to negative resection margin and lymph node status. Thus, a certain benchmark of lymph node count is necessary ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2015.05.015
更新日期：2015-10-01 00:00:00
abstract：:A combination of heparin and dihydroergotamine mesylate (Heparin-Dihydergot) has been shown to be more effective than either of these drugs alone in preventing postoperative venous thromboembolism. The possible mechanism for the synergistic effect of heparin and dihydroergotamine was assessed. Phlebograms obtained aft...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：
更新日期：1985-10-08 00:00:00
abstract：:We have confirmed earlier findings that treatment with allopurinol offers some protection to the kidney from ischemic damage caused by total interruption of renal circulation. With this evidence, a clinical trial is warranted, particularly when periods of warm ischemia are unavoidable. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90171-9
更新日期：1976-06-01 00:00:00
abstract：BACKGROUND:Although partial splenectomy is preferable to total splenectomy for maintaining an immune response, several techniques by which splenic parenchyma were divided in partial splenectomy have been controversial. METHODS:Partial splenectomy using a new and simple device that irradiates radiofrequency combined wi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.12.003
更新日期：2006-08-01 00:00:00
abstract：PURPOSE:To investigate the frequency, presentation, clinical management, and prognosis of appendiceal carcinoid tumors in children. METHOD:A review of our institution's experience over 50 years. RESULTS:Twenty-two patients below the age of 20 presented with appendiceal carcinoid tumor. The mean age at presentation wa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80025-7
更新日期：1995-12-01 00:00:00
abstract：BACKGROUND:Many surgeons continue to use prosthetic arteriovenous grafts for dialysis access despite the clear superiority of native arteriovenous fistulas. This study was undertaken to review our experience with elevated brachial-basilic fistulas as an alternative to prosthetic grafts in patients lacking veins suitabl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00102-6
更新日期：1999-06-01 00:00:00
abstract：BACKGROUND:The extent of tissue loss amenable to primary healing after revascularization is unknown. Salvage of limbs with large soft-tissue defects with exposed tendon, joint, or bone lies beyond the limits of conventional techniques. We report our results using free tissue transfer as an adjunct to lower extremity va...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00175-x
更新日期：1997-12-01 00:00:00
abstract：:A mock disaster at Orange County's John Wayne Airport provided a basis for examining correct triage of patients and their arrival time for definitive care. The ability to triage critically injured patients in a timely fashion was found to be only slightly better than chance routing. For most of the seriously and criti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90070-4
更新日期：1985-09-01 00:00:00
abstract：BACKGROUND:Training surgeons in vital decision-making skills remains unstructured. We aimed to map a process of care from the perspective of surgical decision making and test whether it could be deconstructed into an accessible format for trainees. METHODS:Semistructured interviews were conducted with 10 experienced s...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2007.02.016
更新日期：2008-05-01 00:00:00
abstract：:Our experience from 1960 to 1976 with total infrarenal aortic thrombosis (Leriche syndrome) was reviewed. Sixteen heavy smokers (14 men and 2 women) with an average age of fifty-four years underwent thrombectomy with aortoiliac (12 patients) or aortofemoral (4) Dacron bypasses. The last ten patients were hydrated for ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90331-2
更新日期：1977-12-01 00:00:00
abstract：:Five methods for preventing deep venous thrombosis in postoperative patients were evaluated and compared with a control group. Five hundred patients from five surgical specialties were studied. The incidence of deep venous thrombosis was 37.3 percent in the control group but significantly less within all treatment gro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90168-9
更新日期：1981-02-01 00:00:00
abstract：:Peripheral vascular complications after cardiac catheterization constitute an increasing portion of traumatic vascular injuries. To determine the incidence of these complications and the sequelae of their treatment, we reviewed 7,690 catheterizations performed over a 40-month period. One hundred eleven vascular compli...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90119-8
更新日期：1994-04-01 00:00:00
abstract：BACKGROUND:Sustained intraabdominal pressures of 14 to 20 mm Hg have significant pathophysiological consequences, but there is currently no satisfactory low-morbidity procedure appropriate for intervention early in the disease process of abdominal compartment syndrome (ACS). The anatomical principles of abdominal wall ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00171-5
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:The objective of this study was to compare the outcome of patients presenting with heel ulcers or gangrene (HEEL group) with those having lesions in other parts of the foot (non-HEEL group). METHODS:Treatment and outcomes of all HEEL and non-HEEL patients between June 2001 and October 2006 were compared. R...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.008
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS:A surgical qu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.11.014
更新日期：2020-11-09 00:00:00
abstract：BACKGROUND:Pain is the most common symptom associated with hernias. The aim was to assess the frequency of pain and its effects on physical activity and quality of life in patients with inguinal and ventral hernias. METHODS:All patients undergoing elective inguinal or ventral hernia repair over a 16-month period were ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.02.011
更新日期：2014-09-01 00:00:00
abstract：:Eighty-two femoropopliteal reconstructions were performed on sixty-six consecutive patients. Of seventeen late failures, thirteen were secondarily reconstructed. Clinical and angiographic studies demonstrated the reasons for failure in all patients except one. Seven patients were improved and six unimproved by reopera...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90107-1
更新日期：1978-02-01 00:00:00
abstract：BACKGROUND:Data on the hemoglobin (Hb) after transfusion, or the "target," which reflects the "dose" of blood given are not well studied. We sought to examine the incidence and causes of "over transfusion" of red blood cells after surgery. METHODS:Data on blood utilization including Hb triggers and targets were obtain...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.12.020
更新日期：2016-07-01 00:00:00
abstract：BACKGROUND:Protection of the bronchial stump after pneumonectomy reduces the incidence of bronchopleural fistula. However, which technique provides the most satisfactory results remains open for debate. MATERIALS AND METHODS:We describe a study in which a bronchial stump coverage technique was performed using 2 layers...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.01.022
更新日期：2008-10-01 00:00:00
abstract：:This commentary identifies important differences in patient groups that affect the observations in the accompanying article. ...
journal_title：American journal of surgery
pub_type： 评论,杂志文章
doi：10.1016/j.amjsurg.2007.11.014
更新日期：2008-07-01 00:00:00
