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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/29782482/trauma-patients-are-safe-to-fly-72-hours-after-tube-thoracostomy-removal
#1
David Zonies, Joel Elterman, Christopher Burns, Vincent Paul, John Oh, Jeremy Cannon
BACKGROUND: Current recommendations for safe air travel following traumatic pneumothorax are 2-3 weeks after radiographic resolution. These recommendations are based on several small observational studies and expert consensus which cite a theoretical risk of recurrence and hypoxia due to decreased oxygen tension at altitude. We sought to systematically study the timing of chest drain removal after traumatic pneumothorax and risk of recurrence in relation to air travel. METHODS: A retrospective cohort study of consecutively admitted patients who sustained a traumatic chest injury treated with tube thoracostomy over a 5-year period was undertaken...
May 18, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29677083/east-multicenter-trial-on-targeted-temperature-management-for-hanging-induced-cardiac-arrest
#2
Cindy H Hsu, Bryce E Haac, Mack Drake, Andrew C Bernard, Alberto Aiolfi, Kenji Inaba, Holly E Hinson, Chinar Agarwal, Joseph Galante, Emily M Tibbits, Nicholas J Johnson, David Carlbom, Mina F Mirhoseini, Mayur B Patel, Karen R OʼBosky, Christian Chan, Pascal O Udekwu, Megan Farrell, Jeffrey L Wild, Katelyn A Young, Daniel C Cullinane, Deborah J Gojmerac, Alexandra Weissman, Clifton Callaway, Sarah M Perman, Mariana Guerrero, Imoigele P Aisiku, Raghu R Seethala, Ivan N Co, Debbie Y Madhok, Bryan Darger, Dennis Y Kim, Lara Spence, Thomas M Scalea, Deborah M Stein
BACKGROUND: We sought to determine the outcome of suicidal hanging and the impact of targeted temperature management (TTM) on hanging-induced cardiac arrest (CA) through an Eastern Association for the Surgery of Trauma (EAST) multicenter retrospective study. METHODS: We analyzed hanging patient data and TTM variables from January 1992 to December 2015. Cerebral performance category (CPC) score of 1 or 2 was considered good neurologic outcome, while CPC of 3 or 4 was considered poor outcome...
April 19, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29677082/artificial-intelligence-can-predict-daily-trauma-volume-and-average-acuity
#3
David P Stonko, Bradley M Dennis, Richard D Betzold, Allan B Peetz, Oliver L Gunter, Oscar D Guillamondegui
INTRODUCTION: The goal of this study was to integrate temporal and weather data in order to create an artificial neural network (ANN) to predict trauma volume, the number of emergent operative cases, and average daily acuity at a level 1 trauma center. METHODS: Trauma admission data from TRACS and weather data from the National Oceanic and Atmospheric Administration (NOAA) was collected for all adult trauma patients from July 2013-June 2016. The ANN was constructed using temporal (time, day of week), and weather factors (daily high, active precipitation) to predict four points of daily trauma activity: number of traumas, number of penetrating traumas, average ISS, and number of immediate OR cases per day...
April 19, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29672441/six-month-follow-up-of-the-injured-trauma-survivor-screen-itss-clinical-implications-and-future-directions
#4
Joshua C Hunt, Samantha A Chesney, Karen Brasel, Terri A deRoon-Cassini
BACKGROUND: The Injured Trauma Survivor Screen (ITSS) has been shown to predict PTSD and depression risk at one-month after traumatic injury. This study explored the ability of the ITSS to predict chronic distress after injury, as well as the impact of combining the ITSS with an additional screening measure. METHOD: Patients were enrolled following admission to a Level 1 trauma center. Baseline measurements were collected during initial hospitalization, and follow-up measures were collected an average of 6...
April 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29672440/the-epidemiology-of-emergency-department-thoracotomy-in-a-statewide-trauma-system-does-center-volume-matter
#5
Ryan P Dumas, Mark J Seamon, Brian P Smith, Wei Yang, Jeremy W Cannon, C William Schwab, Patrick M Reilly, Daniel N Holena
INTRODUCTION: The relationship between high volume and improved outcomes has been described for a host of elective high-impact, low-frequency procedures, but there are little data to support such a relationship in high-impact low-frequency procedures in trauma. Using emergency department thoracotomy (EDT) as a model, we hypothesized that patients presenting to centers with higher institutional volumes of EDT would have improved survival referent to those presenting to lower volume institutions...
April 17, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29664893/occupational-exposure-during-emergency-department-thoracotomy-a-prospective-multi-institution-study
#6
Andrew Nunn, Priya Prakash, Kenji Inaba, Alvarez Escalante, Zoë Maher, Seiji Yamaguchi, Dennis Y Kim, James Maciel, William C Chiu, Byron Drumheller, Joshua P Hazelton, Kaushik Mukherjee, Xian Luo-Owen, Rachel M Nygaard, Ashley P Marek, Bryan C Morse, Caitlin A Fitzgerald, Patrick L Bosarge, Randeep S Jawa, Susan E Rowell, Louis J Magnotti, Adrian W Ong, Tejal S Brahmbhatt, Michael D Grossman, Mark J Seamon
BACKGROUND: Occupational exposure is an important consideration during emergency department thoracotomy (EDT). While HIV/hepatitis prevalence in trauma patients (0-16.8%) and occupational exposure rates during operative trauma procedures (1.9-18.0%) have been reported, exposure risk during EDT is unknown. We hypothesized that occupational exposure risk during EDT would be greater than other operative trauma procedures. METHODS: A prospective, observational study at 16 US trauma centers was performed (2015-2016)...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29664892/the-role-of-4-factor-prothrombin-complex-concentrate-4-pcc-in-coagulopathy-of-trauma-a-propensity-matched-analysis
#7
Faisal Jehan, Hassan Aziz, Terence O'Keeffe, Muhammad Khan, El Rasheid Zakaria, Mohammad Hamidi, Muhammad Zeeshan, Narong Kulvatunyou, Bellal Joseph
INTRODUCTION: Coagulopathy is a common complication after severe trauma. The efficacy of 4-factor Prothrombin Complex Concentrate (4-PCC) as an adjunct to FFP in reversal of coagulopathy of trauma has not been studied. The aim of our study is to compare 4-PCC+FFP vs. FPP alone for the treatment of COT. METHODS: We reviewed all trauma patients >18y who received PCC+FFP or FFP alone at our Level I trauma center from 2015-16. We excluded patients on preinjury oral anticoagulants...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29664891/reinventing-the-wheel-impact-of-prolonged-antibiotic-exposure-on-multi-drug-resistant-ventilator-associated-pneumonia-in-trauma-patients
#8
Richard H Lewis, John P Sharpe, Joseph M Swanson, Timothy C Fabian, Martin A Croce, Louis J Magnotti
INTRODUCTION: Multi-drug resistant (MDR) strains of both Acinetobacter baumannii (AB) and Pseudomonas aeruginosa (PA) as causative VAP pathogens are becoming increasingly common. Still, the risk factors associated with this increased resistance have yet to be elucidated. The purpose of this study was to examine the changing sensitivity patterns of these pathogens over time and determine which risk factors predict MDR in trauma patients with VAP. METHODS: Patients with either AB or PA VAP over 10 years were stratified by pathogen sensitivity (sensitive (SEN) and MDR), age, severity of shock and injury severity...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29664890/health-literacy-and-quality-of-physician-trauma-patient-communication-opportunity-for-improvement
#9
Jonathan L Dameworth, Jordan A Weinberg, Pamela W Goslar, Dana J Stout, Sharjeel Israr, Jordan V Jacobs, Thomas L Gillespie, Terrell M Thompson, Scott R Petersen
BACKGROUND: Although physician-patient communication and health literacy (HL) have been studied in diverse patient groups, there has been little focus on trauma patients. A quality improvement project was undertaken at our level 1 trauma center to improve patient perception of physician-patient communication, with consideration of the effect of HL. We report the first phase of this project, namely the reference level of satisfaction with physician-patient communication as measured by levels of interpersonal care among patients at an urban level 1 trauma center...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29664889/transfer-status-a-significant-risk-factor-for-mortality-in-emergency-general-surgery-patients-requiring-colon-resection
#10
Michael P DeWane, Kimberly A Davis, Kevin M Schuster, Scott P Erwin, Adrian A Maung, Robert D Becher
BACKGROUND: Patients requiring emergency surgery have increased rates of morbidity and mortality. Transfer from outside institution delays effective control of ongoing infection and has been linked with worse outcomes. Previous research suggests transfer status negatively impacts survival but hasn't examined the effect of location and type of institution prior to transfer. This study aims to characterize the effect of type of transferring institution on postoperative outcomes after emergency colon surgery...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659476/prospective-evaluation-of-low-health-literacy-and-its-impact-on-outcomes-in-trauma-patients
#11
Tianyi Swartz, Faisal Jehan, Andrew Tang, Lynn Gries, Muhammad Zeeshan, Narong Kulvatunyou, Mohammad Hamidi, Terence O'Keeffe, Bellal Joseph
INTRODUCTION: Health-literacy is emerging focus of interest in public health and is evolving as an important component of national health policy. Low-health-literacy (LHL) is associated with poor outcomes. We aimed to identify factors associated with LHL and its relationship with health outcomes in trauma patients. METHODS: We prospectively enrolled all adult trauma patients (age>18y) in our analysis. Patients were surveyed at discharge and followed up at 4-weeks post-discharge...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659475/frailty-screening-and-a-frailty-pathway-decrease-length-of-stay-loss-of-independence-and-30-day-readmission-rates-in-frail-geriatric-trauma-and-emergency-general-surgery-patients
#12
Kathryn E Engelhardt, Quentin Reuter, Jessica Liu, Jonathan F Bean, Joliette Barnum, Michael B Shapiro, Allison Ambre, Amanda Dunbar, Mara Markzon, Tara Reddy, Christine Schilling, Joseph Posluszny
BACKGROUND: Frail geriatric trauma and emergency general surgery (TEGS) patients have longer lengths of stay (LOS), more readmissions, and higher rates of post-discharge institutionalization than their non-frail counterparts. Despite calls to action by national trauma coalitions, there are few published reports of prospective interventions. The objective of this quality improvement (QI) project was to first develop a frailty screening program, and, then, if frail, implement a novel Frailty Pathway to reduce LOS, 30-day readmissions, and loss of independence (LOI)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659474/comparing-appendectomies-performed-by-trauma-surgeons-and-pediatric-surgeons-in-children-5-to-10-years-of-age
#13
Stephanie F Polites, Matthew C Hernandez, Martin D Zielinski
No abstract text is available yet for this article.
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659473/external-validation-of-a-5-variable-clinical-prediction-rule-for-identifying-children-at-very-low-risk-for-intra-abdominal-injury-following-blunt-abdominal-trauma
#14
Chase A Arbra, Adam M Vogel, Leah Plumblee, Jingwen Zhang, Patrick D Mauldin, Melvin S Dassinger, Robert T Russell, Martin L Blakely, Christian J Streck
BACKGROUND: A clinical prediction rule was previously developed by the Pediatric Surgery Research Collaborative (PedSRC) to identify patients at very low risk for intra-abdominal injury (IAI) and intra-abdominal injury receiving an acute intervention (IAI-I) who could safely avoid abdominal computed tomography (CT) scans following blunt abdominal trauma (BAT). Our objective was to externally validate the rule. METHODS: The public use dataset was obtained from the Pediatric Emergency Care Applied Research Network (PECARN) Intra-abdominal Injury Study...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659472/evaluation-and-management-of-abdominal-stab-wounds-a-western-trauma-association-critical-decisions-algorithm
#15
Matthew J Martin, Carlos V R Brown, David V Schatz, Hasan Alam, Karen Brasel, Carl Hauser, Marc de Moya, Ernest E Moore, Susan Rowell, Gary Vercruysse, Bonny Baron, Kenji Inaba
No abstract text is available yet for this article.
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659471/management-of-colorectal-injuries-a-western-trauma-association-critical-decisions-algorithm
#16
Walter L Biffl, Ernest E Moore, David V Feliciano, Roxie M Albrecht, Martin A Croce, Riyad Karmy-Jones, Nicholas Namias, Susan E Rowell, Martin A Schreiber, David V Shatz, Karen J Brasel
No abstract text is available yet for this article.
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29659470/meta-analysis-of-perioperative-outcomes-of-acute-laparoscopic-vs-open-repair-of-perforated-gastroduodenal-ulcers
#17
Roberto Cirocchi, Kjetil Soreide, Salomone Di Saverio, Elena Rossi, Alberto Arezzo, Mauro Zago, Iosief Abraha, Nereo Vettoretto, Massimo Chiarugi
BACKGROUND: Surgery is the treatment of choice for perforated peptic ulcer disease (PUD). The aim of the present review is to compare the perioperative outcomes of acute laparoscopic versus open repair for PUD. METHODS: A systematic literature search was performed for randomized controlled trials (RCTs) published in PubMed, SCOPUS and Web of Science RESULTS: The search included eight RCTs: 615 patients comparing laparoscopic (307 patients) versus open peptic perforated ulcer repair (308 patients)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29634677/eastern-association-for-the-surgety-of-trauma-scott-b-frame-md-memorial-lecture-the-poverty-of-theory-evidence-based-medicine-and-the-social-contract
#18
(no author information available yet)
No abstract text is available yet for this article.
April 9, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29613947/nationwide-trends-in-mortality-following-penetrating-trauma-are-we-up-for-the-challenge
#19
Joseph V Sakran, Ambar Mehta, Ryan Fransman, Avery B Nathens, Bellal Joseph, Alistair Kent, Elliott R Haut, David T Efron
OBJECTIVES: Despite a focus on improved pre-hospital care, penetrating injuries contribute substantially to trauma mortality in the United States (U.S.). We therefore analyzed contemporary trends in pre-hospital mortality from penetrating trauma in the past decade. METHODS: We identified patients in the The National Trauma Data Bank from 2007-2010 ('early period') and 2011-2014 ('late period') with gunshot (GSW) and stab wounds (SW), who were treated at hospitals that recorded dead-on-arrival statistics...
April 3, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29613959/evaluation-and-management-of-traumatic-diaphragmatic-injuries-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#20
Amy A McDonald, Bryce R H Robinson, Louis Alarcon, Patrick L Bosarge, Heath Dorion, Elliott R Haut, Jeremy Juern, Firas Madbak, Srinivas Reddy, Patricia Weiss, John J Como
BACKGROUND: Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. METHODS: The working group formulated five Patient, Intervention, Comparator, Outcome (PICO) questions regarding the following topics: 1) diagnostic approach (laparoscopy vs...
April 2, 2018: Journal of Trauma and Acute Care Surgery
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