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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-pros-into-trauma-registries-the-forte-project
#1
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of post-discharge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) project we included patients with an ISS ≥9, admitted to the Brigham and Women's Hospital in Boston, MA who were identified retrospectively using the institutional trauma registry and contacted 6 or 12-months post-injury to participate in a telephone survey evaluating: HRQoL (Short Form-12 [SF-12]), PROs (Trauma Quality of Life [T-QoL]), post-traumatic stress disorder (PTSD), return to work, residential status, and healthcare utilization...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426562/asymptomatic-cervical-spine-fractures-current-guidelines-can-fail-older-patients
#2
Christopher D Healey, Sarah K Spilman, Bradley D King, Joseph E Sherrill, Carlos A Pelaez
BACKGROUND: Older adults represent a growing proportion of trauma patients treated in the United States, and cervical spine (c-spine) fracture is an injury that is increasingly common in this population. Neck pain is a major component of current clinical clearance guidelines, but some older adults with c-spine fractures report no neck pain after injury. The objective of this study was to investigate the frequency at which c-spine fractures were unassociated with neck pain in an aging population...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426561/unfractionated-heparin-versus-low-molecular-weight-heparin-for-venous-thromboembolism-prophylaxis-in-trauma
#3
Benjamin N Jacobs, Anne H Cain-Nielsen, Jill L Jakubus, Judy N Mikhail, John J Fath, Scott E Regenbogen, Mark R Hemmila
BACKGROUND: Venous thromboembolism (VTE) is a common complication in trauma patients. Pharmacologic prophylaxis is utilized in trauma patients to reduce their risk of a VTE event. The Eastern Association for the Surgery of Trauma guidelines recommend use of low molecular weight heparin (LMWH) as the preferred agent in these patients. However, there is literature suggesting that unfractionated heparin (UFH) is an acceptable, and less costly, alternative VTE prophylaxis agent with equivalent efficacy in trauma patients...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426560/universal-screening-for-intimate-partner-and-sexual-violence-in-trauma-patients-an-east-multicenter-trial
#4
Tanya L Zakrison, Xiomara Ruiz, Rondi Gelbard, John Cline, David Turay, Xian Luo-Owen, Nicholas Namias, Marie Crandall, Jessica George, Brian H Williams
BACKGROUND: A single center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) amongst both male and female trauma patients, regardless of mechanism of injury. We aimed to determine if this phenomenon was similar to rates in other trauma centers by assessing the feasibility of universal screening, and determining the prevalence and association of IPSV with other trauma-associated comorbidities. METHODS: We designed an EAST- supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426559/ct-evidence-of-fluid-in-the-hernia-sac-predicts-surgical-site-infection-following-mesh-repair-of-acutely-incarcerated-ventral-and-groin-hernias
#5
Tyler J Loftus, Kristina L Go, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Mesh placement during repair of acutely incarcerated ventral and groin hernias is associated with high rates of surgical site infection (SSI). The utility of preoperative CT in this setting is unclear. We hypothesized that CT evidence of bowel wall compromise would predict SSI while accounting for physiologic parameters. METHODS: We performed a four-year retrospective cohort analysis of 50 consecutive patients who underwent mesh repair of acutely incarcerated ventral or groin hernias...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426558/combat-surgical-workload-in-oif-oef-the-definitive-analysis
#6
Caryn A Turner, Zsolt T Stockinger, Jennifer M Gurney
BACKGROUND: Relatively few publications exist on surgical workload in the deployed military setting. This study analyses U.S. Military combat surgical workload in Iraq and Afghanistan to gain a more thorough understanding of surgical training gaps and personnel requirements. METHODS: A retrospective analysis of the Department of Defense Trauma Registry (DoDTR) was performed for all Role 2 (R2) and Role 3 (R3) Military Treatment Facilities (MTFs), from January 2001 to May 2016...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426557/loop-ileostomy-vs-total-colectomy-as-surgical-treatment-for-clostridium-difficile-associated-disease-an-eastern-association-for-the-surgery-of-trauma-multicenter-trial
#7
Paula Ferrada, Rachael Callcut, Martin D Zielinski, Brandon Bruns, Daniel Dante Yeh, Tanya L Zakrison, Jonathan P Meizoso, Babak Sarani, Richard D Catalano, Peter Kim, Valerie Plant, Amelia Pasley, Linda A Dultz, Asad J Choudhry, Elliott R Haut
OBJECTIVES: The mortality of patients with Clostridum Dificile Associated Disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single center study. To date, no reproducible results have been published. The objective of this study is to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. METHODS: This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma (EAST)...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426556/limited-transthoracic-echocardiogram-this-is-how-i-do-it
#8
Paula Ferrada
No abstract text is available yet for this article.
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422924/-pay-it-forward-eastern-association-for-the-surgery-of-trauma-2017-presidential-address
#9
Nicole A Stassen
No abstract text is available yet for this article.
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422923/a-cross-sectional-study-of-emergency-care-utilization-and-associated-costs-of-violent-related-assault-injuries-in-the-united-states
#10
Michael C Monuteaux, Eric W Fleegler, Lois K Lee
BACKGROUND: Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to: (1) estimate rates of violent-related injuries evaluated in United States EDs; (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010; and (3) to determine the associated healthcare and work-loss costs. METHODS: We examined adults 18 years of age and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422922/the-spatial-epidemiology-of-pediatric-trauma-a-statewide-assessment
#11
Allison Ertl, Kirsten Beyer, Sergey Tarima, Yuhong Zhou, Jonathan I Groner, Laura D Cassidy
INTRODUCTION: Despite significant advances in the prevention and treatment of pediatric trauma, preventable injuries continue to burden the lives of millions of children. In order to target prevention strategies, it is critical to identify areas with high burdens of pediatric trauma. Therefore, this study analyzed statewide data from the Ohio Trauma Registry (OTR) from 2007-2012 to identify geographical patterns in pediatric injury. METHODS: Data from the first hospital of care for 16,330 pediatric trauma patients under 16 years old were analyzed using the disease mapping method adaptive spatial filtering to estimate a series of maps that display age- and sex-adjusted rates of pediatric trauma, severe trauma, and standardized mortality ratios (SMR) while controlling for population size to create stable estimates throughout the study area...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422921/population-based-estimate-of-trauma-related-deaths-for-law-enforcement-personnel-risks-for-death-are-higher-and-increasing-over-time
#12
Alexander L Eastman, Michael W Cripps, Kareem R Abdelfattah, Kenji Inaba, Thomas G Weiser, David A Spain, Kristan L Staudenmayer
OBJECTIVE: Trauma-related deaths remain an important public health problem. One group susceptible to death due to traumatic mechanisms is U.S. Law Enforcement (LE). We hypothesized that LE officers experienced a higher chance of violent death compared to the general U.S. population and that risks have increased over time. METHODS: The National Institute on Occupational Safety and Health (NIOSH) National Occupational Mortality Surveillance (NOMS) is a population-based survey of occupational deaths...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422920/a-multi-year-assessment-of-a-hospital-school-program-to-promote-teen-motor-vehicle-safety
#13
Purnima Unni, Cristina M Estrada, Dai H Chung, Emily B Riley, Lesley Worsley-Hynd, Neil Stinson
BACKGROUND: Motor vehicle crashes are the leading cause of death among teen drivers. The main goal of this program was to reduce texting while driving among high school teens through a unique peer-generated anti-texting campaign. METHODS: The program consisted of two phases. In Phase 1, student leaders participated in a half-day, hospital-based experiential program that emphasized safe teen driving. In Phase 2, these students conceptualized and implemented an anti-texting while driving campaign during the school year...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422919/the-lung-rescue-unit-lru-does-a-dedicated-intensive-care-unit-for-veno-venous-extra-corporeal-membrane-oxygenation-vv-ecmo-improve-survival-to-discharge
#14
Jay Menaker, Katelyn Dolly, Raymond Rector, Joseph Kufera, Eugenia E Lee, Ali Tabatabai, Ronald P Rabinowitz, Zachary Kon, Pablo Sanchez, Si Pham, Daniel L Herr, James V O'Connor, Deborah M Stein, Thomas M Scalea
BACKGROUND: The use of veno-venous extra corporeal membrane oxygenation (VV ECMO) for acute respiratory failure/distress syndrome (ARF/ARDS) has increased since 2009. Specialized units for patients requiring VV ECMO are not standard and patients are often cohorted with other critically ill patients. The purpose of this study was to report the outcome of adult patients admitted in 2015 to the LRU, which, to our knowledge, is the first intensive care unit in the United States that has been specifically created to provide care for patients requiring VV ECMO...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422918/reassessing-the-cardiac-box-a-comprehensive-evaluation-of-the-relationship-between-thoracic-gunshot-wounds-and-cardiac-injury
#15
Rashi Jhunjhunwala, Michael J Mina, Elizabeth I Roger, Christopher J Dente, Michael Heninger, Jacquelyn S Carr, Stacy D Dougherty, Rondi B Gelbard, Jeffrey M Nicholas, Amy D Wyrzykowski, David V Feliciano, Bryan C Morse
BACKGROUND: High energy missiles can cause cardiac injury regardless of entrance site. This study assesses the adequacy of the anatomic borders of the current "cardiac box" to predict cardiac injury. METHODS: Retrospective autopsy review was performed to identify patients with penetrating torso gunshot wounds 2011-2013. Using a circumferential grid system around the thorax, logistic regression analysis was performed to detect differences in rates of cardiac injury from entrance/exit wounds in the "cardiac box" vs...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422917/an-adapted-clavien-dindo-scoring-system-in-trauma-as-a-clinically-meaningful-non-mortality-endpoint
#16
David N Naumann, Laura E Vincent, Nicola Pearson, Alastair Beaven, Iain M Smith, Kieran Smith, Emma Toman, Helen R Dorrance, Keith Porter, Charles E Wade, Bryan A Cotton, John B Holcomb, Mark J Midwinter
BACKGROUND: There is no consensus on reporting non-mortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery, and requires adaptation to provide meaningful data for trauma patients. In particular the original score does not account for those treated without surgery. We report an adapted Clavien-Dindo in trauma (ACDiT) scale and apply it to patients managed operatively and non-operatively. METHODS: A combined prospective and retrospective international multi-center observational study was undertaken to apply the ACDiT scale to 484 trauma patients at 3 university teaching hospitals (Birmingham, England (n=303); Houston, Texas (n=113); and Glasgow, Scotland (n=68))...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422916/beware-of-the-interval-cholecystectomy
#17
James Ackerman, Ryan Abegglen, Mark Scaife, Andrew Peitzman, Matthew Rosengart, Wallis Marsh, Kurt Stahlfeld
BACKGROUND *: Despite limited data regarding the indications and effectiveness of percutaneous cholecystostomy (PC) in the treatment of acute cholecystitis (AC), usage has increased by over 500% since 1994. Many of these patients subsequently undergo interval cholecystectomy (IC), a procedure that has not been rigorously evaluated. This aim of this study was to quantify the morbidity and mortality associated with the IC. METHODS *: We included all consecutive adult patients (>18 years old) who underwent PC and IC from January 2008 to December 2013...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422915/enteral-tranexamic-acid-attenuates-vasopressor-resistance-and-changes-in-%C3%AE-1-adrenergic-receptor-expression-in-hemorrhagic-shock
#18
Marco Santamaria, Federico Aletti, Joyce B Li, Aaron Tan, Monica Chang, Jessica Leon, Geert W Schmid-Schönbein, Erik B Kistler
BACKGROUND: Irreversible hemorrhagic shock is characterized by hyporesponsiveness to vasopressor and fluid therapy. Little is known, however, about the mechanisms that contribute to this phenomenon. Previous studies have shown that decreased intestinal perfusion in hemorrhagic shock leads to proteolytically-mediated increases in gut permeability, with subsequent egress of vasoactive substances systemically. Maintenance of blood pressure is achieved in part by α1 receptor modulation, which may be affected by vasoactive factors; we thus hypothesized that decreases in hemodynamic stability and vasopressor response in shock can be prevented by enteral protease inhibition...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422914/delays-to-the-operating-room-increase-mortality-in-sick-trauma-patients
#19
Jonathan P Meizoso, Rishi Rattan, Nicholas Namias
No abstract text is available yet for this article.
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422913/confessions-of-a-dinosaur
#20
J David Richardson
No abstract text is available yet for this article.
April 18, 2017: Journal of Trauma and Acute Care Surgery
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