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L W Rue

Publications and source records attributed to L W Rue.

39 records · Page 3Linked to original sources

Strategic planning: determining the impact of environmental characteristics and uncertainty.

This paper continues a line of research into the effect of environmental characteristics and uncertainty on strategic planning. Results suggest that measures of uncertainty and the environment need to be analyzed independently, and that uncertainty is a strong moderator of environmental characteristics and industry groupings but does not consistently affect strategic planning activities.

Organization and Administration↗

Thromboembolic complications in thermally injured patients.

The frequency of thromboembolic complications in burn patients has been estimated to range from 0.4% to 7%. The clinical significance of these events is often debated and has prompted some centers to adopt the routine prophylactic use of low dose heparin prophylaxis. A 10 year review of 2,103 burn patients treated at this institution was undertaken. Twenty-five (1.2%) patients, with a mean age of 40.0 years and an average burn size of 49.3% total body surface area (TBSA), were identified as having significant pulmonary thromboembolism (PTE). In only 3 (0.14%) patients was the thromboembolism considered to be a cause of death. Nineteen (0.9%) patients, with an average age of 36.7 years and a mean burn size of 48.3% TBSA, developed clinically evident deep venous thrombosis (DVT); however, in only 1 (0.05%) patient did the disease progress to fatal PTE. A review of the literature reveals a 0.6% to 5% incidence of complications related to low dose heparin therapy which includes bleeding, thrombocytopenia, and arterial thrombosis. We feel that the infrequency of clinically significant PTE and DVT in burn patients and the comparable or greater rate of complications associated with heparin prophylaxis mitigate against the routine use of low dose heparin therapy except in patients at high risk for these events.

Adolescent↗

The risk of pneumonia in thermally injured patients requiring ventilatory support.

The risk of pulmonary infectious complications in critically ill patients requiring ventilatory support is well established. To evaluate the impact of tracheal intubation on the risk of pneumonia, the records of three hundred seventy thermally injured patients (mean age, 37.6 years, mean total body surface area burn, 44.7%) who were admitted during a 6-year interval and required ventilatory support were reviewed. The mean duration of intubation in these patients was 16.6 days, the incidence of pneumonia was 50%, and observed mortality was 37% (137 patients). Though they were significantly older (42.7 vs 35.6 years, p = 0.005) and had a higher frequency of pneumonia (60% vs 46%, p = 0.015) than the 265 patients with inhalation injury, the 105 patients without documented inhalation injury had mean burn size (41.9% vs 45.9%), length of intubation (18.9 vs 15.7 days), postburn day of pneumonia (12.7 vs 10.5 days), and mortality (38.1% vs 36.6%) similar to that group. Actuarial life table analysis considering only pneumonia acquired during ventilatory support was used to evaluate the relation between the risk of pneumonia and duration of ventilatory support. In this cohort of patients with burns, no difference in the risk of pneumonia was observed between patients with and without inhalation injury who required ventilatory support; the hazard of pneumonia was relatively constant during the first 6 weeks of intubation and was similar for all who underwent ventilation.

Adult↗