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Journal of Trauma and Acute Care Surgery

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https://www.readbyqxmd.com/read/28045742/management-of-anticoagulation-with-rivaroxaban-in-trauma-and-acute-care-surgery-complications-and-reversal-strategies-as-compared-to-warfarin-therapy
#1
Sara P Myers, Esmaeel R Dadashzadeh, Jessica Cheung, Louis Alarcon, Matthew Kutcher, Joshua B Brown, Matthew D Neal
BACKGROUND: Rivaroxaban has gained popularity as an anticoagulant (AC) for stroke prevention in nonvalvular atrial fibrillation (afib) and venous thromboembolism (VTE). Although adverse bleeding events are associated with all AC, lack of point of care testing to measure the effect of rivaroxaban in emergent situations has contributed to perceived increased risk amongst physicians. METHODS: To describe a single center experience with trauma and emergency general surgery (EGS) patients taking rivaroxaban and evaluate outcomes compared with patients taking warfarin using a propensity score analysis...
December 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28045741/is-your-graduating-general-surgery-resident-qualified-to-take-trauma-call-a-15-year-appraisal-of-the-changes-in-general-surgery-education-for-trauma
#2
Aaron Strumwasser, Daniel Grabo, Kenji Inaba, Kazuhide Matsushima, Damon Clark, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Trauma training in general surgery residency is undergoing an evolution. Hour restrictions, the growth of subspecialty care and the trend towards non-operative management have altered resident exposure to operative trauma. We sought to identify trends in resident trauma training since the inception of the 80-hour workweek. METHODS: The Accreditation Council for General Medical Education (ACGME) Case Log Statistical Reports for Surgery was abstracted for general surgery resident trauma operative volume for the years 1999-2014...
December 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030509/impact-of-early-operative-pelvic-fixation-on-long-term-self-reported-outcome-following-severe-pelvic-fracture
#3
John P Sharpe, Louis J Magnotti, Wade C Gobbell, Xin Huang, Edward A Perez, Timothy C Fabian, Martin A Croce
BACKGROUND: Traumatic disruption of the pelvic ring is a significant cause of life-threatening hemorrhage. For those patients who survive the initial injury, these fractures are associated with long periods of immobilization and intense rehabilitation. There is little published information available regarding long-term functional outcomes in these patients. This study evaluated the impact of severe pelvic fractures on those long-term outcomes. METHODS: All patients with severe pelvic fractures over an 18-year period were identified...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030508/preperitoneal-pelvic-packing-reduces-mortality-in-patients-with-life-threatening-hemorrhage-due-to-unstable-pelvic-fractures
#4
Dr Thomas M Scalea
No abstract text is available yet for this article.
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030507/defining-multiple-organ-failure-after-major-trauma-a-comparison-of-the-denver-sequential-organ-failure-assessment-and-marshall-scoring-systems
#5
Lynn Hutchings, Peter Watkinson, J Duncan Young, Keith Willett
BACKGROUND: Postinjury multiple organ failure (MOF) remains a significant cause of morbidity and mortality. A large number of scoring systems have been proposed to define MOF, with no gold-standard. The purpose of this study was to compare three commonly used scores - the Denver PostInjury Multiple Organ Failure Score, the Sequential Organ Failure Assessment (SOFA) and the Marshall Multiple Organ Dysfunction Score - by descriptive analysis of the populations described by each score, and their predictive ability for mortality...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030506/rib-fracture-fixation-in-the-65-year-and-older-population-a-paradigm-shift-in-management-strategy-at-a-level-i-trauma-center
#6
Michael T Fitzgerald, DennisW Ashley, Hesham Abukhdeir, D Benjamin Christie
BACKGROUND: Rib fractures after chest wall trauma are a common injury, however carry a significant morbidity and mortality risk. The impact of rib fractures in the ≥ 65yo patient population has been well documented as have the mortality and pneumonia rates. We hypothesize that patients ≥ 65yo receiving rib plating have decreased mortality, complication rates, and an accelerated return to normal functional states when compared to controls. METHODS: With IRB approval, a retrospective review analyzed patients ≥ 65yo with rib fractures admitted from 2009-2015 receiving rib plating(RP group)(n=23) compared to non-operative, injury-matched controls admitted from 2003-2008(NO group)(n=50)...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030505/ultrasound-assessment-of-volume-responsiveness-in-critically-ill-surgical-patients-two-measurements-are-better-than-one
#7
Sarah B Murthi, Syeda Fatima, Ashely R Menne, Jacob J Glaser, Samuel M Galvagno, Stephen Biederman, Stephen Biederman, Raymond Fang, Hegang Chen, Thomas M Scalea
BACKGROUND: The intended physiologic response to a fluid bolus is an increase in stroke volume (SV). Several ultrasound (US) measures have been shown to be predictive. The best measure(s) in critically ill surgical patients remains unclear. METHODS: This is a prospective observational study in critically ill surgical patients receiving a bolus of crystalloid, colloid or blood. A transthoracic echocardiogram (TTE) was performed before (pre-TTE) and after. A positive volume response (+VR) was defined as a ≥15% increase in SV...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030504/hospitals-with-higher-volumes-of-emergency-general-surgery-patients-achieve-lower-mortality-rates-a-case-for-establishing-designated-centers-for-emergency-general-surgery
#8
Gerald O Ogola, Adil Haider, Shahid Shafi
BACKGROUND: Higher volume has been associated with lower mortality for several surgical diseases. It is not known if this relationship exists in the management of Emergency General Surgery (EGS). Our hypothesis was that EGS patients treated at hospitals with higher EGS volume experienced lower mortality rates than those treated at low-volume hospitals. METHODS: This was a retrospective analysis of 2010 National Inpatient Sample data, maintained by the Agency for Healthcare Quality and Research as a representative national sample of inpatients...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030503/prophylaxis-against-venous-thromboembolism-in-pediatric-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-and-the-pediatric-trauma-society
#9
Arash Mahajerin, John K Petty, Sheila J Hanson, A Jill Thompson, Sarah H OʼBrien, Christian J Streck, Toni M Petrillo, E Vincent S Faustino
BACKGROUND: Despite the increasing incidence of venous thromboembolism (VTE) in hospitalized children, the risks and benefits of VTE prophylaxis, particularly for those hospitalized after trauma, are unclear. The Pediatric Trauma Society and the Eastern Association for the Surgery of Trauma convened a writing group to develop a practice management guideline on VTE prophylaxis for this cohort of children using the Grading of Recommendations Assessment, Development and Evaluation framework...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#10
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030501/apocynin-suppressed-the-nuclear-factor-%C3%AE%C2%BAb-pathway-and-attenuated-lung-injury-in-a-rat-hemorrhagic-shock-model
#11
Seok Ho Choi, Gil Joon Suh, Woon Yong Kwon, Kyung Su Kim, Min Ji Park, Taegyun Kim, Jeong In Ko
BACKGROUND: The aim of this study was to investigate whether a nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (Nox) inhibitor, apocynin, reduces reactive oxygen species (ROS) production, suppresses the nuclear factor κB (NF-κB) pathway, attenuates lung injury, and improves survival in rat hemorrhagic shock (HS) model. METHODS: Blood was drawn from male Sprague-Dawley rats (290 - 340 g) to maintain a mean arterial pressure of 20 - 25 mmHg for 40 minutes...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030500/analysis-of-aeromedical-retrieval-coverage-using-elliptical-isochrones-an-evaluation-of-helicopter-fleet-size-configurations-in-scotland
#12
Naomi Dodds, Phillip Emerson, Stephanie Phillips, David R Green, Jan O Jansen
BACKGROUND: Trauma systems in remote and rural regions often rely on helicopter emergency medical services to facilitate access to definitive care. The siting of such resources is key, but often relies on simplistic modelling of coverage, using circular isochrones. Scotland is in the process of implementing a national trauma network, and there have been calls for an expansion of aeromedical retrieval capacity. The aim of this study was to analyse population and area coverage of the current retrieval service configuration, with three aircraft, and a configuration with an additional helicopter, in the North East of Scotland, using a novel methodology...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030499/the-coalition-for-national-trauma-research-cntr-supports-the-call-for-a-national-trauma-research-action-plan
#13
Raul Coimbra, Rosemary A Kozar, Jason W Smith, Ben L Zarzaur, Carl J Hauser, Frederick A Moore, Jeffrey A Bailey, Alex Valadka, Gregory J Jurkovich, Donald H Jenkins, Kimberly A Davis, Michelle A Price, Ronald V Maier
No abstract text is available yet for this article.
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030498/re-enteral-nutrition-in-traumatic-brain-injury
#14
Asad Azim, Bellal Joseph
No abstract text is available yet for this article.
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030497/extra-corporeal-membrane-oxygenation-ecmo-following-traumatic-injury
#15
Sarwat Ahmad, Jay Menaker, Joseph Kufera, James O'Connor, Thomas M Scalea, Deborah M Stein
BACKGROUND: The use of ECMO for acute respiratory failure following injury is controversial and poorly described. METHODS: We reviewed our single-center experience with use of ECMO from January 2006 to November 2015 at a Level 1 primary adult resource center for trauma to determine the association of in-hospital mortality with patient demographics and clinical variables. RESULTS: 46 patients were treated with ECMO. Patients requiring venoarterial ECMO (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030496/temporary-arterial-shunts-in-damage-control-experience-and-outcomes
#16
Sarah Matthew, Brian P Smith, Jeremy W Cannon, Patrick M Reilly, C William Schwab, Mark J Seamon
BACKGROUND: Arterial shunting is a well-described method to control hemorrhage and rapidly re-establish flow, but optimal shunt dwell times remain controversial. We hypothesized that prolonged shunt dwell times of >6 hours are related to adverse outcomes after major arterial injury. METHODS: A review (2005-2013) of all patients with arterial shunts placed after traumatic injury at our urban Level-I trauma center was undertaken. Patients who expired prior to shunt removal (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030495/resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients-in-youth
#17
Tatsuya Norii, Shin Miyata, Yusuke Terasaka, Sundeep Guliani, Stephen W Lu, Cameron Crandall
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown. OBJECTIVES: The aim of this study was to evaluate the mortality and characteristics of patients of age ≤ 18 years with severe traumatic injury who received REBOA. METHODS: We retrospectively analyzed observational cohort data from the Japan Trauma Data Bank (JTDB) from 2004 to 2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030494/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#18
Leah Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura B Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multi-center retrospective cohort study was performed across three Level I Trauma Centers encompassing traumatic colon injuries from January 2006 through June 2014...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030493/enteral-nutrition-in-traumatic-brain-injury
#19
D Dante Yeh, Daren Heyland
No abstract text is available yet for this article.
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030492/stapled-versus-handsewn-a-prospective-emergency-surgery-study-shapes-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#20
Brandon R Bruns, David S Morris, Martin Zielinski, Nathan T Mowery, Preston R Miller, Kristen Arnold, Herb A Phelan, Jason Murry, David Turay, John Fam, John S Oh, Oliver L Gunter, Toby Enniss, Joseph D Love, David Skarupa, Matthew Benns, Alisan Fathalizadeh, Pak Shan Leung, Matthew M Carrick, Brent Jewett, Joseph Sakran, Lindsay O'Meara, Anthony V Herrera, Hegang Chen, Thomas M Scalea, Jose J Diaz
BACKGROUND: Data from the trauma patient population suggests handsewn anastomoses (HS) are superior to stapled (ST). A recent retrospective study in emergency general surgery (EGS) patients had similar findings. The aim of the current study is to evaluate HS and ST anastomoses in EGS patients undergoing urgent/emergent operations. METHODS: The study was sponsored by the AAST Multi-Institutional Studies Committee. Patients undergoing urgent/emergent bowel resection for EGS pathology were prospectively enrolled from 7/22/2013-12/31/2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
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