Journal of Trauma and Acute Care Surgery This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Time to OR for patients with abdominal gunshot wounds: A potential process measure to assess the quality of trauma care?
CONCLUSION Time to OR for patients with abdominal GSWs and shock might be a useful process measure to evaluate rapid decision making and OR access. Surgeon and center experience as measured by annual case volumes, coupled with a rapid surgical response required through Level I trauma center standards might be contributory. There was no association between outlier status and complications or mortality suggesting other factors apart from time to the OR are of greater significance. LEVEL OF EVIDENCE Therapeutic/care management, Level IV. (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Traumatic brain injury patients with platelet inhibition receiving platelet transfusion demonstrate decreased need for neurosurgical intervention and decreased mortality
BACKGROUND Platelet dysfunction is known to occur in patients with traumatic brain injury (TBI), and the correction of platelet dysfunction may prevent hemorrhagic progression in TBI. Thromboelastography with platelet mapping (TEG-PM; Haemonetics) evaluates the degree of platelet function inhibition through the adenosine diphosphate (ADP) and arachidonic acid (AA) pathways. We hypothesized that ADP and AA inhibition would improve with the transfusion of platelets in patients with TBI. METHODS A retrospective review was conducted at a Level I trauma center of all patients presenting with TBI from December 2019 to...
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Socioeconomic disadvantage is associated with greater mortality after high-risk emergency general surgery
We examined the association of socioeconomic disadvantage and outcomes after EGS procedures and investigated whether admission to hospitals with comprehensive clinical and social resources mitigated this effect. METHODS Adults undergoing 1 of the 10 most burdensome high- and low-risk EGS procedures were identified in six 2014 State Inpatient Databases. Socioeconomic disadvantage was assessed using Area Deprivation Index (ADI) of patient residence. Multivariable logistic regression models adjusting for patient and hospital factors were used to evaluate the association between ADI quartile (high>75 percentile vs. low ...
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Length of stay and trauma center finances: A disparity of payer source at a Level I trauma center
The objective of this cross-sectional study was to evaluate the impact of exceeding GMLOS on hospital profit/loss with respect to payer source. METHODS Contribution margin for each insured patient admitted to a Level I trauma center between July 1, 2016, and June 30, 2019, was determined. Age, ethnicity, race, DRG weight, DRG version, injury severity, intensive care unit admission status, mechanical ventilation, payer, exceeding GMLOS, and the interaction between payer and exceeding the GMLOS were regressed on contribution margin to determine significant predictors of positive contribution margin. RESULTS Amo...
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Sex dimorphisms in coagulation characteristics in the pediatric trauma population appear after puberty
BACKGROUND The role of age and sex in mediating coagulation characteristics in injured children is not well defined. We hypothesize that thromboelastography (TEG) profiles are equivalent across sex in younger children and diverge after puberty. METHODS Consecutive trauma patients younger than 18 years were identified from a university-affiliated, Level I, pediatric trauma center (2016–2020) database. Demographics, injury characteristics, and TEG parameters were recorded. Children were categorized by sex and age (younger, ≤10 years; older, ≥11 years). Baseline characteristics, outcomes, and TEG parameters w...
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Revision of the AAST grading scale for acute cholecystitis with comparison to physiologic measures of severity
CONCLUSION The revised AAST grade and the preoperative AAST grade demonstrated improved discrimination; however, a purely anatomic grade based on chart review is unlikely to predict outcomes without addition of physiologic variables. Follow-up validation will be necessary. LEVEL OF EVIDENCE Diagnostic Test or Criteria, Level IV. (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Trauma transfers discharged from the emergency department—Is there a role for telemedicine?
CONCLUSION Our study demonstrates that patients who are transferred to our facility and subsequently discharged have a common pattern of injuries; typically, isolated hand and face/ophthalmology. This is likely attributed to the lack of resources in rural facilities to evaluate and develop treatment plans for these injuries; however, only 36% of discharged patients required a bedside procedure. Excluding Level I traumas, head and spine injuries, and patients requiring complex bedside procedures, there was a 13% inappropriate rate of transfer (310/2,350). Development and implementation of a telemedicine system could pot...
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

A national study defining 1.0 full-time employment in trauma and acute care surgery
CONCLUSION Defining the workload of a full-time trauma and ACS surgeon is nuanced and requires consideration of local volume, acuity and culture. Between the quantitative and qualitative analysis, a reasonable workload for a 1.0 FTE acute care surgeon at a Level I center is 24 to 28 service weeks per year and four to five in-house calls per month. Nighttime and daytime staffing needs can be divergent and may lead to conflict with administration. Future research should consider the individual surgeon's perspective on the definition of an FTE. LEVEL OF EVIDENCE Prognostic and epidemiological, Level III. (Source: J...
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

The use of predefined scales and scores with eye-tracking devices for symptom identification in critically ill nonverbal patients
CONCLUSION Eye tracking enables symptom identification in critically ill voiceless patients with impaired communication options. The results of our study may provide guidance for improvement measures in the care of voiceless ICU patients. We believe that ET is useful for symptom identification and therefore may be capable of improving patient-medical team interaction and patient satisfaction. LEVEL OF EVIDENCE Diagnostic Test or Criteria, Level III. (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Adenosine, lidocaine, and magnesium for attenuating ischemia reperfusion injury from resuscitative endovascular balloon occlusion of the aorta in a porcine model
BACKGROUND Minimally invasive resuscitative endovascular balloon occlusion of the aorta (REBOA) following noncompressible hemorrhage results in significant ischemia reperfusion injury (IRI). Adverse outcomes from IRI include organ dysfunction and can result in profound hemodynamic and molecular compromise. We hypothesized that adenosine, lidocaine, and magnesium (ALM) attenuates organ injury and inflammation responses following REBOA IRI in a porcine model of hemorrhage. METHODS Animals underwent a 20% controlled hemorrhage followed by 45 minutes of supraceliac balloon occlusion. They were randomized into two gr...
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: 2021 AAST PODIUM PAPERS Source Type: research

Toward improved reporting and use of race, ethnicity, sex, and gender: An editorial
No abstract available (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - March 31, 2022 Category: Surgery Tags: EDITORIAL Source Type: research

Meetings/Courses
No abstract available (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - February 24, 2022 Category: Surgery Tags: DEPARTMENT Source Type: research

Featured articles for cme credit march 2022
No abstract available (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - February 24, 2022 Category: Surgery Tags: CONTINUING MEDICAL EDUCATION PROGRAM Source Type: research

Response to “letter to the editor: Points to consider the readmission rate following surgical stabilization of rib fractures”
No abstract available (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - February 24, 2022 Category: Surgery Tags: LETTER TO THE EDITOR Source Type: research

Letter to the editor: Points to consider the readmission rate following surgical stabilization of rib fractures
No abstract available (Source: Journal of Trauma and Acute Care Surgery)
Source: Journal of Trauma and Acute Care Surgery - February 24, 2022 Category: Surgery Tags: LETTER TO THE EDITOR Source Type: research