Abstract:
BACKGROUND:Base Deficit (BD) and lactate have been used as indicators of shock and resuscitation. This study was done to determine the association of BD and lactate and to determine if one is superior. METHODS:A retrospective review from 3/2014-12/2016 was performed. Data included demographics, systolic BP, ISS, BD, lactate, blood transfusion, and outcomes. BD and lactate were modeled continuously and categorically and compared. RESULTS:1191 patients were included. BD and lactate correlated strongly (r = -0.76 p < 0.001). Higher lactate and more negative BD were associated with transfusion and mortality. On multivariate regression, only BD was associated with transfusion (OR = 0.8, p < 0.001). As a categorical variable, worsening BD was associated with decreased BP, higher ISS, increased transfusions and worse outcomes. CONCLUSIONS:BD and lactate are strongly related. BD was superior to lactate in assessing the need for transfusion. The BD categories discriminate high risk trauma patients better than lactate.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Davis JW,Dirks RC,Kaups KL,Tran Pdoi
10.1016/j.amjsurg.2018.01.025subject
Has Abstractpub_date
2018-04-01 00:00:00pages
682-685issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(17)30545-7journal_volume
215pub_type
杂志文章abstract:BACKGROUND:Management of patients with thoracic empyema ranges from tube thoracostomy drainage, with or without fibrinolytics, to operative intervention, with the optimal intervention remaining uncertain. Streptococcus milleri, typically a benign bacterium colonizing the oropharynx, has recently been reported as a pote...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.050
更新日期:2006-12-01 00:00:00
abstract::A prospective clinical trial was designed to evaluate the efficacy of postoperative jejunostomy feedings using high (44 percent) and low (15 percent) branched-chain amino acid elemental diet formulations compared with no jejunostomy feedings in a homogeneous surgical population. Twenty-eight patients undergoing radica...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(87)90815-4
更新日期:1987-02-01 00:00:00
abstract::This study evaluates the impact of the autopsy on a general surgical training program from 1984 through 1988. We have retrospectively examined the charts of all patients who died during this period. Included in this analysis are the records of patients from the general, cardiac, pediatric, and transplant surgery depar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90114-s
更新日期:1991-12-01 00:00:00
abstract::Substitution of segments of traumatized or diseased ureter has been attempted often with little success. The ideal ureteral subsitute has yet to be found, and experiments with the newer biologically inert prosthetic materials such as the bovine carotid artery heterograft are warranted. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90010-6
更新日期:1976-05-01 00:00:00
abstract::Ninety carotid endarterectomies with venous patch angioplasty were performed in 83 patients between July 1980 and December 1985. The primary indication for patching was a small-caliber internal carotid artery (ICA) with a diameter less than 3.0 mm in 54 arteriotomies (60%). Patency of the endarterectomy was evaluated ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90201-n
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:In contrast to conventional cytotoxic chemotherapy and radiation therapy, a new method of targeted cancer therapeutics is being directed towards molecular pathways that underlie the malignant phenotype. These therapies target specific tumor cell receptors or signaling events that are critical to tumor progre...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(03)00212-5
更新日期:2003-09-01 00:00:00
abstract::A plan is advocated for the management of the dominant breast mass with use of local anesthesia in the outpatient setting as the primary diagnostic tool, but with selection of certain patients for immediate general anesthesia biopsy in the "conventional" manner. Experience with this plan in 2,492 patients during a per...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90030-1
更新日期:1976-05-01 00:00:00
abstract::A number of factors are known to be related to increased mortality of surgery in obstructive jaundice, yet precise identification of patients at greatest risk is difficult. We have studied the elimination of the minor analgesic antipyrine as a dynamic measure of hepatic metabolic function in patients with obstructive ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80023-4
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Endoscopic retrograde cholangiopancreatography is a challenging procedure performed by surgeons and gastroenterologists. We employed cognitive task analysis to identify steps and decision points for this procedure. METHODS:Standardized interviews were conducted with expert gastroenterologists (7) and surgeo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.05.006
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The anastomotic leak and stricture formation after esophagectomy and cervical esophagogastric anastomosis deny patients with esophageal carcinoma the benefits of surgery. The present study was designed to ascertain whether a wide cross-sectional area at the site of anastomosis leads to lesser anastomotic com...
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(01)00616-x
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:mesh techniques are the preferable methods for repair of small ventral hernias, as a primary suture repair shows high recurrence rates. The aim of this prospective study was to compare the retromuscular sublay technique with the intraperitoneal underlay technique for primary umbilical hernias. METHODS:from ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2010.01.022
更新日期:2011-01-01 00:00:00
abstract::William Stewart Halsted and John Chalmers DaCosta are two of the most distinguished surgeons in the history of medicine in the United States. Although their personalities were completely opposite, they enjoyed a long and devoted friendship. During their relationship, a fairly continuous correspondence was maintained. ...
journal_title:American journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1016/0002-9610(89)90622-3
更新日期:1987-09-01 00:00:00
abstract::Controversy continues about how often a negative laparotomy should be accepted in the management of patients with blunt and penetrating trauma. A key issue is the complications, especially small bowel obstruction. To define these complications, the charts of 248 patients who underwent negative laparotomy for trauma we...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80549-x
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.05.004
更新日期:2020-01-01 00:00:00
abstract::One hundred patients with advanced, recurrent, or metastatic squamous cell carcinoma of the head and neck were treated with chemotherapy and BCG as adjuvant immunotherapy. The overall response rate was 35 per cent, and the median duration of response was seventeen weeks. BCG does not prolong duration of remission or s...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(77)90381-6
更新日期:1977-10-01 00:00:00
abstract::This is the Presidential Address from the 104th meeting of the North Pacific Surgical Association held in Tacoma, Washington November 8-9, 2016. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.01.041
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Outpatient surgery is cost effective and convenient. The aim of this study was to determine the safety and feasibility of outpatient thyroidectomy. METHODS:Retrospective review was performed of all thyroidectomy patients from a tertiary care center between January 2004 and March 2010. RESULTS:One hundred f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.023
更新日期:2011-05-01 00:00:00
abstract::Trovafloxacin, a new fluoronaphthyridone derivative related to fluoroquinolone antimicrobial drugs, has demonstrated the following characteristics: significant gram-positive and gram-negative activity; significant activity against anaerobes and atypical respiratory pathogens; approximately 11-hour elimination half-lif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00213-x
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically ill patients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons. METHODS:A s...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.024
更新日期:2015-07-01 00:00:00
abstract::Fixation of polypropylene (Marlex) mesh in the epigastrium and at the iliac crest can be ineffective because of insufficient local fascia; however, two techniques have been described to obtain firm and durable attachment of polypropylene grafts at these sites. Perichondral slips at the costal margin permit very satisf...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80194-x
更新日期:1985-06-01 00:00:00
abstract::Studies using a refined substrate, n-acetyl-L-phenylalanyl-L-diiodotyrosine [n-APDT], demonstrate that bile salts inhibit pepsin activity in vitro by a noncompetitive effect on the enzyme. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90262-7
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:The purpose of this paper is to review the experience of a community surgeon performing laparoscopic antireflux procedures (LAP). The experience has been difficult and at times unsettling, and underscores the need for advanced laparoscopic expertise not normally obtained performing laparoscopic cholecystecto...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(97)89608-0
更新日期:1996-05-01 00:00:00
abstract::Paraplegia or paraparesis after operations on the thoracic and abdominal aorta is a devastating event, both for the patient and the surgeon. While its incidence varies from under 1% with operations at the top and bottom of the aorta, its occurrence in the midportion of the aorta, just above the diaphragm, even in the ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(98)00133-0
更新日期:1998-08-01 00:00:00
abstract::Consistent weight reduction by gastroplasty requires precise construction of an appropriately sized stoma that will not dilate. The technique described constructs such a stoma around a 32 French Hurst dilator with an external ring of Silastic tubing over polypropylene suture. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90206-3
更新日期:1981-03-01 00:00:00
abstract:BACKGROUND:We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. METHODS:Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.07.024
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:This study descriptively analyzes characteristics of general surgery residency and practice and their influence on student interest in surgical careers. METHODS:Fourth-year medical students were invited to complete an Internet-based survey. A 5-point Likert scale described characteristics of general surgery...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2005.03.019
更新日期:2005-06-01 00:00:00
abstract::Seven patients with carcinoma in a thyroglossal duct cyst have received treatment over a 15 year period. Findings in all of these patients reflect the likelihood of carcinoma arising within thyroglossal duct tissue. In each patient there was sufficient histologic evidence of the presence of a thyroglossal duct cyst an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90077-6
更新日期:1983-02-01 00:00:00
abstract::The integrity of the normal mature intestinal mucosal barrier to unaltered proteins was evaluated with tritiated bovine albumin in rats. Intact H3-BSA placed into either colon or small intestinal lumen regularly reached the bloodstream in quantities sufficient to be antigenic or toxigenic, although the fraction of H3-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90193-3
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Anorectal malformations represent a continuing challenge for the pediatric surgeon. A significant number of these children suffer from fecal incontinence, urinary incontinence, and sexual inadequacy. However, major advances in the management of these children have occurred during the last 10 years. The poste...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(00)00491-8
更新日期:2000-11-01 00:00:00
abstract::Chronic granulating wounds were established in rats by excising burns inoculated with Escherichia coli. Recombinant human basic fibroblast growth factor was applied at dosages of 1, 10, and 100 micrograms/cm2 to the wounds of three groups of 20 animals on days 5, 9, 12, 15, and 18 after injury. The rate of wound closu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90004-b
更新日期:1992-03-01 00:00:00