Abstract:
OBJECTIVE:To determine the impact of smoking on intensive care unit (ICU) outcomes in patients who underwent operative fixation for spine trauma. DESIGN:Retrospective cohort study. SETTING:Single academic level I trauma center. PATIENTS:One hundred eighty-one consecutive surgical spine trauma patients from January 2010 to December 2014 requiring ICU stay. INTERVENTION:Patients with smoking history compared to patients with no previous smoking history. MAIN OUTCOME MEASUREMENTS:ICU length of stay, postoperative complications. RESULTS:There were 297 spine trauma patients identified, of which 181 had an ICU stay (61%). There were 96 patients in the smoker cohort (53%) and 85 in the nonsmoker cohort (47%). On univariate analysis, the smoking cohort had a significantly longer ICU length of stay (11.0 ± 12.0 days vs. 8.01 ± 7.98 days, P = 0.046). Adjusting for confounders, smoking (beta: 3.99, P = 0.023), age ≥65 years (beta: 7.61, P = 0.001), body mass index ≥30 (beta: 4.47, P = 0.010), and American Spinal Injury Association Impairment Scale (beta: -1.39, P = 0.013) were independently associated with increased ICU length of stay. Smoking was not significantly associated with pneumonia (P = 0.238) or adult respiratory distress syndrome (P = 0.387) on multivariate analysis. CONCLUSIONS:A history of smoking, older age, obesity, and increasing American Spinal Injury Association Impairment Scale was independently associated with increased ICU length of stay in patients with surgical spine trauma. This study highlights the health care burden of smoking in the trauma population and may help physicians triage scarce ICU resources. LEVEL OF EVIDENCE:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Du JY,Weinberg DS,Moore TA,Vallier HAdoi
10.1097/BOT.0000000000001739subject
Has Abstractpub_date
2020-07-01 00:00:00pages
e250-e255issue
7eissn
0890-5339issn
1531-2291journal_volume
34pub_type
杂志文章abstract:OBJECTIVES:Open fractures with bone loss are common, disabling injuries. Biodegradable, load-bearing scaffolds able to carry high concentrations of local antibiotics are an emerging technology to address these injuries. This study investigates the use of such scaffolds with gentamicin (along with bone morphogenetic pro...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181ed1349
更新日期:2010-09-01 00:00:00
abstract::A prospective randomized study was set up, comparing a compression hip screw with the Vandeputte (VDP) endoprosthesis treatment for fresh, unstable peritrochanteric fractures, according to the Evans-Jensen and AO systems. Ninety patients, ages > or = 70 years, 47 of whom were treated with a compression hip screw and 4...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199509040-00004
更新日期:1995-01-01 00:00:00
abstract::The 2-step closed reduction maneuver was developed to aid in the rarely encountered inferior shoulder dislocation. The maneuver converts the humeral head from an inferior dislocation to an anterior dislocation and then reduces the humeral head into the glenoid. The operator places one hand on the shaft of the humerus ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200605000-00010
更新日期:2006-05-01 00:00:00
abstract::The indications for surgical stabilization of a pediatric diaphyseal femur fracture are expanding. Children with multiple system injuries, a head injury, and/or multiple fractures have fewer local and distant complications if the femur fracture is treated operatively. Other indications include a pathological fracture ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199212000-00011
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:Lateral locked plating for proximal tibial fractures with metaphyseal disruption provides a biomechanically stable and biologically favorable alternative to conventional medial/lateral plate fixation. New polyaxial screw technology incorporates expanding screw bushings, allowing variable angle screw placemen...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/QAI.0b013e3181a25368
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To determine if there are differences in healing, complications, or number of procedures required to obtain union among open and closed tibia fractures treated with intramedullary (IM) nails inserted with and without reaming. DESIGN:Prospective, surgeon-randomized comparative study. SETTING:Level One traum...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-200003000-00007
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To study the effect of tourniquet control on intramedullary reaming. DESIGN:An experimental prospective nonsurvival animal study was performed using 5 mongrel dogs. A pneumatic tourniquet was randomized to either the right or left hind limb. Tibial intramedullary reaming was performed with progressively larg...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200411000-00004
更新日期:2004-11-01 00:00:00
abstract::Fractures of the distal humerus involving the articular surface can be challenging. The complexity of these fracture patterns increases when the distal fracture is associated with a concomitant humeral shaft fracture with significant proximal extension. The combined exposure technique described here allows for consist...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000245988.23684.79
更新日期:2007-02-01 00:00:00
abstract:UNLABELLED:To determine which of 2 techniques for the treatment of periprosthetic femoral shaft fractures is of greater stiffness. DESIGN:A laboratory study using 8 pairs of matched, embalmed femurs. METHODS:Femurs implanted with a cemented total hip prosthesis had a simulated periprosthetic femur fracture created di...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000199119.38359.96
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare the relative stiffness of four common external fixation (XF) configurations used to span and stabilize the knee after knee dislocation. METHODS:Synthetic composite femora and tibiae connected with cords were used to simulate a knee. Four configurations of external fix...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181e3cd4b
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To compare the strength of fixation obtained using two unicortical 4.0 mm diameter cancellous screws versus two bicortical 3.5 mm diameter cortical screws in the fixation of intra-articular calcaneus fractures. DESIGN:In eight paired fresh frozen cadaver feet, the subtalar joint complex, consisting of the ta...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199701000-00008
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Combined rupture of the anterior cruciate ligament (ACL) and patellar tendon (PT) is a rare injury pattern. Currently, little evidence exists to help guide management decisions for these patients. METHODS:A systematic literature search was conducted using PubMed (MEDLINE) and Scopus (EMBASE and MEDLINE) for...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001219
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To compare the mechanical stability of fixation of an unstable bicondylar tibial plateau fracture with several different fixation techniques in a cadaveric model. DESIGN:Randomized laboratory investigation using a simulated bicondylar tibial plateau fracture with metaphyseal-diaphyseal dissociation. SETTING...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199911000-00005
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:To determine the rate of pelvic vein thrombosis following acetabular or pelvic fracture identified by enhanced computed tomography venography or magnetic resonance venography. DESIGN:Prospective evaluation of computed tomography venography and magnetic resonance venography in patients with pelvic and acetabu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200210000-00001
更新日期:2002-10-01 00:00:00
abstract::Successful treatment of periprosthetic femur fractures, like all fractures, requires careful attention to understand the fracture pattern nuances, identifying and executing a rational treatment approach, and providing an appropriate postoperative recovery protocol. Unlike most other fractures, modification of standard...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000282
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of both high-pressure pulsatile lavage and bulb syringe irrigation on the biomechanical parameters of fracture healing using an in vivo open noncontaminated diaphyseal femoral fracture model in rats. BACKGROUND:The utility of high-pressure pulsatile lavage irrigation on soft tissue de...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200207000-00008
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of exchange reamed nails for treatment of aseptic femoral delayed unions and nonunions. DESIGN:Retrospective chart review. PATIENTS:Nineteen patients admitted to the Carolinas Medical Center Level I trauma center from 1990 to 1996 for repair of femoral shaft fracture nonunion ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200006000-00005
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To determine if cancellous screw (CS) and sliding hip screw (SHS) technical factors during low-energy femoral neck fracture fixation affects a 24-month revision surgery rate and health-related quality of life (HRQL). DESIGN:Prospective randomized controlled study. SETTING:International, multicenter. PATIEN...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001891
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVES:To compare the efficacy of negative pressure wound therapy (NPWT) versus conventional dressings (CD) in the management of open fractures. DATA SOURCES:A systematic search of English articles in the PubMed/MEDLINE, Embase, and the Cochrane Library through April 2019 comparing NPWT versus CD in the management...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001750
更新日期:2020-05-01 00:00:00
abstract::The first known reported case of volar radiocarpal dislocation with ulnar translocation is described with a review of previous literature on the isolated components of these injuries. Radiographic criteria for their diagnosis are presented with recommendations for early operative intervention to minimize the risk of s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-198802040-00009
更新日期:1988-01-01 00:00:00
abstract::Difficulty in maintaining the reduction of displaced radial fractures has prompted the use of numerous techniques to address this problem. The purpose of this study was to determine if four or five 0.045-in Kirschner pins when placed percutaneously through the ulna into the radius could maintain the reduction of this ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198906000-00004
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:To review the clinical course, complication rates, and mid-term functional outcomes associated with the treatment of displaced femoral neck stress fractures (FNSFs). DESIGN:Retrospective Case Series. SETTING:Military Tertiary Referral Center. PATIENTS:Twenty-one operatively treated displaced FNSFs between...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001810
更新日期:2020-11-01 00:00:00
abstract::Healthcare policy has changed drastically, and with the 50-year anniversary of the passage of Medicare approaching in 2015, the authors evaluate the development of the current healthcare system and its relationship to the development of modern orthopaedic trauma. With more changes in healthcare policy forthcoming, it ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000214
更新日期:2014-10-01 00:00:00
abstract::A case is presented of scaphocapitate fracture syndrome associated with a Salter-Harris type II fracture of the distal radius and ulna occurring in an 11-year-old girl. The proximal fragment of the fractured capitate was rotated 180 degrees. The injury was treated by open reduction and internal fixation. One year afte...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199704000-00017
更新日期:1997-04-01 00:00:00
abstract::Pilon and ankle fractures and ligamentous injuries about the ankle often require external fixation to allow for soft tissue stabilization before definitive surgery. Often used external fixator constructs can cause obscuring of the site of injury on radiographs, pin tract infections, loosening of calcaenal pin fixation...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182604639
更新日期:2013-02-01 00:00:00
abstract::After open reduction of a burst fracture of L1, transpedicular bone grafting of the fractured vertebral body was performed. Bone grafts accidentally slipped into the spinal canal through the damaged medial wall of the pedicle. No adverse effects were noted clinically, but this case illustrates that transpedicular bone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199209000-00019
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:To explore the effect of intramedullary pin size on the biology of a healing fracture, specifically endochondral angiogenesis. We hypothesized that fracture fixation with a smaller pin would permit greater interfragmentary strain resulting in increased total amount of vascular endothelial growth factor withi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001555
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:A new device for the treatment of intertrochanteric fractures that uses 2 cephalocervical screws in an integrated mechanism allowing linear intraoperative compression and rotational stability of the head/neck fragment has been developed. The aim of this study was to describe the results using this device for ...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0b013e31819211b2
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The open reduction and internal fixation of radial shaft fractures and osteotomies with standard 3.5-mm plates can be complicated by tendon irritation, hardware prominence, and fracture through the screw holes. With the advent of locking plate technology, implant companies and some surgeons have recommended e...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f8bf9b
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with bone loss. The purpose of this study was to evaluate the patients' risk factors and timing for requiring adjunctive stabilization. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PAT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000840
更新日期:2017-07-01 00:00:00