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[PMID]:29305456
[Au] Autor:Sprague S; Petrisor B; Jeray K; McKay P; Heels-Ansdell D; Schemitsch E; Liew S; Guyatt G; Walter SD; Bhandari M; FLOW Investigators
[Ad] Endereço:McMaster University, 293 Wellington Street North, Suite 110, Hamilton, Ontario L8L 8E7, Canada.
[Ti] Título:Wound irrigation does not affect health-related quality of life after open fractures: results of a randomized controlled trial.
[So] Source:Bone Joint J;100-B(1):88-94, 2018 01.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The Fluid Lavage in Open Fracture Wounds (FLOW) trial was a multicentre, blinded, randomized controlled trial that used a 2 × 3 factorial design to evaluate the effect of irrigation solution (soap normal saline) and irrigation pressure (very low low high) on health-related quality of life (HRQL) in patients with open fractures. In this study, we used this dataset to ascertain whether these factors affect whether HRQL returns to pre-injury levels at 12-months post-injury. PATIENTS AND METHODS: Participants completed the Short Form-12 (SF-12) and the EuroQol-5 Dimensions (EQ-5D) at baseline (pre-injury recall), at two and six weeks, and at three, six, nine and 12-months post-fracture. We calculated the Physical Component Score (PCS) and the Mental Component Score (MCS) of the SF-12 and the EQ-5D utility score, conducted an analysis using a multi-level generalized linear model, and compared differences between the baseline and 12-month scores. RESULTS: We found no clinically important differences between irrigating solutions or pressures for the SF-12 PCS, SF-12 MCS and EQ-5D. Irrespective of treatment, participants had not returned to their pre-injury function at 12-months for any of the three outcomes (p < 0.001). CONCLUSION: Neither the composition of the irrigation solution nor irrigation pressure applied had an effect on HRQL. Irrespective of treatment, patients had not returned to their pre-injury HRQL at 12 months post-fracture. Cite this article: 2018;100-B:88-94.
[Mh] Termos MeSH primário: Fraturas Expostas/terapia
Qualidade de Vida
Irrigação Terapêutica/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Fixação Interna de Fraturas/métodos
Fraturas Expostas/reabilitação
Seres Humanos
Masculino
Meia-Idade
Pressão
Psicometria
Sabões/administração & dosagem
Cloreto de Sódio/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Soaps); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180107
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0955.R1


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[PMID]:29169601
[Au] Autor:Warrender WJ; Lucasti CJ; Chapman TR; Ilyas AM
[Ad] Endereço:Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
[Ti] Título:Antibiotic Management and Operative Debridement in Open Fractures of the Hand and Upper Extremity: A Systematic Review.
[So] Source:Hand Clin;34(1):9-16, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open fractures of the hand are thought to be less susceptible to infection than other open fractures because of the increased blood supply to the area. Current evidence for all open fractures shows that antibiotic use and the extent of contamination are predictive of infection risk, but time to debridement is not. We reviewed in a systematic review the available literature on open fractures of the hand and upper extremity to determine infection rates based on the timing of debridement and antibiotic administration. We continue to recommend prompt debridement and treatment of most open fractures of the upper extremity.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Desbridamento
Fraturas Expostas/cirurgia
Traumatismos da Mão/cirurgia
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Fixação Interna de Fraturas
Seres Humanos
Tempo para o Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29169599
[Au] Autor:Chen NC
[Ad] Endereço:Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 20114, USA. Electronic address: nchen1@partners.org.
[Ti] Título:Elbow Fractures with Instability: Evaluation and Treatment Strategies.
[So] Source:Hand Clin;34(1):75-83, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The treatment goals of elbow fracture dislocations are congruent reduction of the ulnohumeral and radiocapitellar joints, stable fixation of the proximal ulna, stable fixation or arthroplasty of the radial head, and soft tissue repair. Fracture dislocations occur in patterns, and recognition of these patterns help guide surgical treatment. In patients with persistently unstable fractures after standard fixation, additional temporary joint spanning implants are useful to protect repairs.
[Mh] Termos MeSH primário: Articulação do Cotovelo/lesões
Articulação do Cotovelo/cirurgia
Fratura-Luxação/cirurgia
Instabilidade Articular/cirurgia
[Mh] Termos MeSH secundário: Artroplastia de Substituição do Cotovelo
Ligamentos Colaterais/lesões
Ligamentos Colaterais/cirurgia
Fixação Interna de Fraturas
Seres Humanos
Instabilidade Articular/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29169595
[Au] Autor:Iorio ML; Harper CM; Rozental TD
[Ad] Endereço:Department of Orthopaedics, Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA 02215, USA. Electronic address: mattiorio@gmail.com.
[Ti] Título:Open Distal Radius Fractures: Timing and Strategies for Surgical Management.
[So] Source:Hand Clin;34(1):33-40, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Open distal radius fractures are rare injuries with few studies to guide treatment. Degree of soft tissue injury and contamination may be a primary consideration to dictate timing and operative intervention. Antibiotics should be started as early as possible and include a first-generation cephalosporin. Surgical fixation remains a matter of surgeon preference: although studies support the use of definitive internal fixation, many surgeons address contaminated injuries with external fixation. Although postoperative outcomes are similar to closed injuries for low-grade open distal radius fractures, high-grade injuries with more complex fracture patterns carry a high risk of complications, poor outcomes, and repeat surgical procedures.
[Mh] Termos MeSH primário: Fraturas Expostas/cirurgia
Fraturas do Rádio/cirurgia
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Desbridamento
Fixação Interna de Fraturas
Fraturas Expostas/classificação
Seres Humanos
Lesões dos Tecidos Moles/cirurgia
Irrigação Terapêutica
Tempo para o Tratamento
Infecção dos Ferimentos/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29169592
[Au] Autor:Tinsley BA; Ilyas AM
[Ad] Endereço:Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA.
[Ti] Título:Distal Radius Fractures in a Functional Quadruped: Spanning Bridge Plate Fixation of the Wrist.
[So] Source:Hand Clin;34(1):113-120, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients who require assistive devices with their hands for mobilization are called functional quadrupeds. These patients pose a unique challenge after they have a distal radius fracture, as their injury not only limits the wrist but also compromises ambulation. The authors propose a different treatment strategy for functional quadrupeds to improve mobilization and weight-bearing with the injured limb after a distal radius fracture. In this article, the authors define the functional quadruped and describe their technique of spanning bridge plate fixation with a retrospective review of patient outcomes.
[Mh] Termos MeSH primário: Placas Ósseas
Pessoas com Deficiência
Fixação Interna de Fraturas/métodos
Fraturas do Rádio/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


  6 / 29270 MEDLINE  
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[PMID]:29169591
[Au] Autor:Chang G; Ilyas AM
[Ad] Endereço:Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA. Electronic address: gerard.chang@gmail.com.
[Ti] Título:Radial Nerve Palsy After Humeral Shaft Fractures: The Case for Early Exploration and a New Classification to Guide Treatment and Prognosis.
[So] Source:Hand Clin;34(1):105-112, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Radial nerve palsies are a common complication associated with humeral shaft fractures. The authors propose classifying these injuries into 4 types based on intraoperative findings: type 1 stretch/neuropraxia, type 2 incarcerated, type 3 partial transection, and type 4 complete transection. The initial management of radial nerve palsies associated with closed fractures of the humerus remains a controversial topic, with early exploration reserved for open fractures, fractures that cannot achieve an adequate closed reduction requiring fracture repair, fractures with associated vascular injuries, and polytrauma patients. Outside of these recommendations, expectant observation for spontaneous recovery is recommended.
[Mh] Termos MeSH primário: Fraturas do Úmero/complicações
Fraturas do Úmero/cirurgia
Neuropatia Radial/classificação
Neuropatia Radial/cirurgia
[Mh] Termos MeSH secundário: Fixação Interna de Fraturas/efeitos adversos
Seres Humanos
Prognóstico
Nervo Radial/anatomia & histologia
Neuropatia Radial/diagnóstico
Neuropatia Radial/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


  7 / 29270 MEDLINE  
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[PMID]:29390346
[Au] Autor:Zhao B; Li H; Yan J; Han LR; Yang XF
[Ad] Endereço:Department of Orthopaedics, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, China.
[Ti] Título:Pipkin type III femoral head fracture-dislocation combined with complicated acetabular fracture: A rare case report and literature review.
[So] Source:Medicine (Baltimore);96(50):e9214, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Pipkin III fracture, which is characterized by high risk of avascular necrosis of the femoral head, is extremely rare. It is more difficult to treat and has a worse prognosis when accompanied with severe acetabular fractures. Few studies show that both Pipkin type III femoral head fracture-dislocation and complicated acetabular fracture presented in one patient. PATIENT CONCERNS: A 34-year-old male suffered a terrible traffic accident with a serious damage to the left side when he was sitting in the car's cockpit. Pelvic radiograph and 3-dimensional reconstruction of computed tomography revealed characteristics of fractures before the emergency operation. DIAGNOSIS: Pipkin III fractures combined with complicated acetabular fracture. INTERVENTIONS: Firstly, we used combined anterior and posterior approach for treatment to fix the femoral head fractures. Then, we completed anatomical reduction of fractures with countersunk head screw, hollow screw, and reconstruction plate. OUTCOMES: At the 12-months follow-up, the patient could walk freely and perform activities of daily living without necrosis of femoral head and heterotopic ossification. LESSONS: Although there are serious complications in Pipkin III fractures combined with complicated acetabular fracture, early surgical treatment with appropriate approach and fixation could get satisfactory results.
[Mh] Termos MeSH primário: Fraturas do Colo Femoral/cirurgia
Fratura-Luxação/cirurgia
Fixação Interna de Fraturas/métodos
Fraturas do Quadril/cirurgia
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Adulto
Fraturas do Colo Femoral/classificação
Fraturas do Colo Femoral/diagnóstico por imagem
Fraturas do Colo Femoral/etiologia
Fratura-Luxação/classificação
Fratura-Luxação/diagnóstico por imagem
Fratura-Luxação/etiologia
Fixação Interna de Fraturas/instrumentação
Fraturas do Quadril/diagnóstico por imagem
Fraturas do Quadril/etiologia
Seres Humanos
Fixadores Internos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009214


  8 / 29270 MEDLINE  
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[PMID]:29390311
[Au] Autor:Suwarsa O; Rahardjo RM; Sutedja E; Dharmadji HP; Hindritiani R; Gunawan H
[Ad] Endereço:Division of Allergy and Immunology, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
[Ti] Título:Systemic contact dermatitis due to corrosion of titanium-coated nickel and cobalt bone plate fixation: A case report.
[So] Source:Medicine (Baltimore);96(50):e9120, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Corrosion refers to the degradation of a material that occurs following its interaction with other substances in the environment. Corrosion of metallic substances into tissues may lead to inflammatory responses such as systemic contact dermatitis (SCD), a skin condition where an individual who has previously been sensitized to a particular allergen via the cutaneous route will subsequently react to same allergen via the systemic route. This condition occurs following exposure to allergens such as metals, medications, and certain food substances. In recent years, the use of metal plates for internal fixation has become increasingly common in bone fracture repairs. PATIENT CONCERNS: A 34-year-old Indonesian male presented with systemic erythema with itching 7 days following a bone plate fixation as a management for mandibular fracture. DIAGNOSES: Physical examination showed pruritic red macules, papules, and scales on almost his entire body, along with facial swelling. The patch test results revealed a positive reaction to nickel and cobalt. Therefore, the patient was diagnosed with SCD. INTERVENTIONS: The patient was treated with topical and systemic corticosteroids as well as bone plate removal. OUTCOME: After treatment, the eruption turned brown, the itching was resolved, and there were no facial swelling as well. LESSONS: This case report highlights the need to consider the occurrence of SCD in patients following bone plate fixation.
[Mh] Termos MeSH primário: Placas Ósseas
Dermatite de Contato/etiologia
Dermatite de Contato/terapia
Fixação Interna de Fraturas/instrumentação
Fraturas Mandibulares/cirurgia
[Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico
Adulto
Cobalto
Corrosão
Remoção de Dispositivo
Seres Humanos
Masculino
Níquel
Testes do Emplastro
Titânio
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 3G0H8C9362 (Cobalt); 7OV03QG267 (Nickel); D1JT611TNE (Titanium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009120


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[PMID]:29390258
[Au] Autor:Di HX; Liu FY; Yang SD; Wang H; Yang DL; Ding WY
[Ad] Endereço:Department of Spinal Surgery, The Third Hospital of Hebei Medical University.
[Ti] Título:Short-segment fixation with a cement-augmented pedicle screw for Kummell disease: Case report.
[So] Source:Medicine (Baltimore);96(50):e8617, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Kummell disease is described as avascular necrosis of a vertebral body that occurred in a delayed fashion after a minor trauma. Anterior, posterior, and anterior-posterior approaches have been reported. Nevertheless, there is no standard treatment for patients with Kummell disease. PATIENT CONCERNS: We reported a successful cement-augmented pedicle screw placement in a patient with Kummell disease. A 63-year-old woman with serious osteoporosis complained persistent back pain with progressive lower extremities weakness for almost 2 years. DIAGNOSES: The diagnosis of Kummell disease was mainly depended on clinical symptoms and imaging examinations. INTERVENTIONS: The application of a cement-augmented pedicle screw was designed to treat this illness. OUTCOMES: The operation was successful without any complications. The patient stated that symptoms were obviously improved in 1 week after operation. LESSONS: The application of a cement-augmented pedicle screw is an effective treatment option for Kummell disease.
[Mh] Termos MeSH primário: Cimentos para Ossos
Fixação Interna de Fraturas/instrumentação
Osteonecrose/cirurgia
Parafusos Pediculares
[Mh] Termos MeSH secundário: Dor nas Costas/etiologia
Dor nas Costas/cirurgia
Feminino
Fixação Interna de Fraturas/métodos
Fraturas por Compressão/complicações
Fraturas por Compressão/diagnóstico por imagem
Fraturas por Compressão/cirurgia
Seres Humanos
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/lesões
Vértebras Lombares/patologia
Vértebras Lombares/cirurgia
Meia-Idade
Osteonecrose/diagnóstico por imagem
Osteonecrose/etiologia
Fraturas por Osteoporose/complicações
Fraturas por Osteoporose/diagnóstico por imagem
Fraturas por Osteoporose/cirurgia
Fraturas da Coluna Vertebral/complicações
Fraturas da Coluna Vertebral/diagnóstico por imagem
Fraturas da Coluna Vertebral/cirurgia
Vértebras Torácicas/diagnóstico por imagem
Vértebras Torácicas/lesões
Vértebras Torácicas/patologia
Vértebras Torácicas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008617


  10 / 29270 MEDLINE  
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[PMID]:29183076
[Au] Autor:Pincus D; Ravi B; Wasserstein D; Huang A; Paterson JM; Nathens AB; Kreder HJ; Jenkinson RJ; Wodchis WP
[Ad] Endereço:Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery.
[So] Source:JAMA;318(20):1994-2003, 2017 11 28.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Although wait times for hip fracture surgery have been linked to mortality and are being used as quality-of-care indicators worldwide, controversy exists about the duration of the wait that leads to complications. Objective: To use population-based wait-time data to identify the optimal time window in which to conduct hip fracture surgery before the risk of complications increases. Design, Setting, and Participants: Population-based, retrospective cohort study of adults undergoing hip fracture surgery between April 1, 2009, and March 31, 2014, at 72 hospitals in Ontario, Canada. Risk-adjusted restricted cubic splines modeled the probability of each complication according to wait time. The inflection point (in hours) when complications began to increase was used to define early and delayed surgery. To evaluate the robustness of this definition, outcomes among propensity-score matched early and delayed surgical patients were compared using percent absolute risk differences (RDs, with 95% CIs). Exposure: Time elapsed from hospital arrival to surgery (in hours). Main Outcomes and Measures: Mortality within 30 days. Secondary outcomes included a composite of mortality or other medical complications (myocardial infarction, deep vein thrombosis, pulmonary embolism, and pneumonia). Results: Among 42 230 patients with hip fracture (mean [SD] age, 80.1 years [10.7], 70.5% women) who met study entry criteria, overall mortality at 30 days was 7.0%. The risk of complications increased when wait times were greater than 24 hours, irrespective of the complication considered. Compared with 13 731 propensity-score matched patients who received surgery earlier, 13 731 patients who received surgery after 24 hours had a significantly higher risk of 30-day mortality (898 [6.5%] vs 790 [5.8%]; % absolute RD, 0.79; 95% CI, 0.23-1.35) and the composite outcome (1680 [12.2%]) vs 1383 [10.1%]; % absolute RD, 2.16; 95% CI, 1.43-2.89). Conclusions and Relevance: Among adults undergoing hip fracture surgery, increased wait time was associated with a greater risk of 30-day mortality and other complications. A wait time of 24 hours may represent a threshold defining higher risk.
[Mh] Termos MeSH primário: Fraturas do Quadril/mortalidade
Fraturas do Quadril/cirurgia
Complicações Pós-Operatórias/epidemiologia
Tempo para o Tratamento
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seguimentos
Fixação Interna de Fraturas
Seres Humanos
Masculino
Complicações Pós-Operatórias/mortalidade
Pontuação de Propensão
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17606



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