Planning for the Worst: The impact of a comprehensive, risk associated treatment protocol on unanticipated ICU admissions in patients affected by rib fractures.
Autor: | Kyriakakis R; Spectrum Health, Butterworth Hospital, General Surgery Residency, 100 Michigan St Ne, 49301, Grand Rapids, MI, USA. Electronic address: Roxanne.Kyriakakis@spectrumhealth.org., Johnson B; Spectrum Health, Butterworth Hospital, General Surgery Residency, 100 Michigan St Ne, 49301, Grand Rapids, MI, USA. Electronic address: Benjaminjohnson08@gmail.com., Krech L; Trauma Research Institute, Division of Acute Care Surgery, Spectrum Health, 100 Michigan St Ne, Grand Rapids, MI, USA. Electronic address: laura.krech@spectrumhealth.org., Pounders S; Trauma Research Institute, Division of Acute Care Surgery, Spectrum Health, 100 Michigan St Ne, Grand Rapids, MI, USA. Electronic address: Steffen.Pounders@spectrumhealth.org., Lypka M; Bioinformatics Core, Spectrum Health, 100 Michigan St Ne, Grand Rapids, MI, 49503, USA. Electronic address: Matthew.Lypka@spectrumhealth.org., Chapman A; Trauma Research Institute, Division of Acute Care Surgery, Spectrum Health, 100 Michigan St Ne, Grand Rapids, MI, USA. Electronic address: Alistair.Chapman@spectrumhealth.org., Valdez C; Division of Trauma, Critical Care, and Burn, Wexner Medical Center, The Ohio State University, Faculty Office Tower, 395 12th Ave Room 614A, Columbus, OH 43210, USA. Electronic address: Carrie.Valdez@osumc.edu. |
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Jazyk: | angličtina |
Zdroj: | American journal of surgery [Am J Surg] 2022 Jul; Vol. 224 (1 Pt B), pp. 602-606. Date of Electronic Publication: 2022 Apr 02. |
DOI: | 10.1016/j.amjsurg.2022.03.042 |
Abstrakt: | Background: There is no agreed upon triage criteria to identify traumatic rib fracture patients at the highest risk for decline. We developed a comprehensive triage tool that assigns patients to high, moderate, and low risk categories. The primary outcome of our study was to evaluate unplanned intensive care unit (ICU) admissions. Methods: We conducted a single-center, retrospective review at our level 1 trauma center comparing two cohorts of patients (≥18 years of age) six months before and after implementation of our risk-associated rib fracture protocol. Results: After implementation of the risk-associated rib fracture protocol, the unplanned ICU admission rate decreased from 6.60% (PRE) to 2.60% (POST) (p = 0.014). Conclusions: Implementation of our rib fracture protocol demonstrates that a comprehensive triage tool with a cascading risk associated treatment plan reduces in-hospital clinical decline of patients with traumatic rib fractures, as measured by unplanned ICU admissions. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
Databáze: | MEDLINE |
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