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  • SAGE Publications  (2)
  • Chien, Chih-Ying  (2)
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  • SAGE Publications  (2)
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  • 1
    In: Journal of Intensive Care Medicine, SAGE Publications, Vol. 36, No. 4 ( 2021-04), p. 428-435
    Abstract: Early adequate resuscitation of patients with trauma is crucial in preventing shock and early mortality. Thus, we aimed to determine the performance of the inferior vena cava (IVC) volume and other risk factors and scores in predicting massive transfusion and mortality. Methods: We included all patients with trauma who underwent computed tomography (CT) scan of the torso, which included the abdominal area, in our emergency department (ED) from January 2014 to January 2017. We calculated the 3-dimensional IVC volume from the left renal vein to the IVC bifurcation. The primary outcome was the performance of IVC volume in predicting massive transfusion, and the secondary outcome was the performance of IVC volume in predicting 24-hour and 30-day in-hospital mortality. Results: Among the 236 patients with trauma, 7.6% received massive transfusions. The IVC volume and revised trauma score (RTS) were independent predictors of massive transfusion (adjusted odds ratio [OR]: 0.79 vs 1.86, 95% confidence interval [CI] , 0.71-0.89 vs 1.4-2.47, respectively). Both parameters showed the good area under the curve (AUC) for the prediction of massive transfusion (adjusted AUC: 0.83 and 0.82, 95% CI, 0.74-0.92 vs 0.72-0.93, respectively). Patients with a large IVC volume (fourth quartile) were less likely to receive massive transfusion than those with a small IVC volume (first quartile, ≥28.29 mL: 0% vs 〈 15.08 mL: 20.3%, OR: 0.13, 95% CI, 0.03-0.66). Conclusions: The volume of IVC measured on CT scan and RTS are independent predictors of massive transfusion in patients with trauma in the ED.
    Type of Medium: Online Resource
    ISSN: 0885-0666 , 1525-1489
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2001472-7
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  • 2
    Online Resource
    Online Resource
    SAGE Publications ; 2021
    In:  Journal of International Medical Research Vol. 49, No. 10 ( 2021-10), p. 030006052110499-
    In: Journal of International Medical Research, SAGE Publications, Vol. 49, No. 10 ( 2021-10), p. 030006052110499-
    Abstract: Most nail gun injuries involve the extremities and result from work-related accidents. Injuries to the brain or thorax are relatively rare, and cases with injuries to both regions are even rarer and often lethal. Initial evaluation, resuscitation, and surgical planning can be challenging for emergency physicians and surgeons. We present the details of a man with multiple nail gun injuries to the brain, lung, and heart following a suicide attempt. The patient presented to the emergency department in shock. After immediate resuscitation, emergent sternotomy, and subsequent craniotomy, he was discharged without significant morbidity. According to the literature, this is the only reported case involving multiple nail gun injuries to the brain, lungs, and heart. The mortality rate of multiple nail gun injuries involving the head and chest is approximately 20%. Rapid evaluation, immediate resuscitation, and appropriate imaging and surgery are crucial for increasing survival and achieving a good prognosis. Emergency sternotomy for cardiac injury is the foremost priority, and the timing of craniotomy depends on the patient’s vital sign status and whether brain injury is evident. A preprint of this article is available online: DOI: 10.21203/rs.3.rs-35448/v1.
    Type of Medium: Online Resource
    ISSN: 0300-0605 , 1473-2300
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2082422-1
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