Rib Fractures and Frailty in Geriatric Trauma Patients
Am Surg. 2024 Mar 29:31348241241660. doi: 10.1177/00031348241241660. Online ahead of print.ABSTRACTAs rib fractures are a common injury in the geriatric trauma population and can result in increased morbidity and mortality, we sought to understand predicting outcomes in this population. We hypothesized that frail geriatric rib fracture patients would have worse outcomes than their non-frail counterparts. This single-center retrospective study includes patients from July 2019 to June 2022 who were ≥65 years-old, had ≥ 2 rib fractures, and a documented Clinical Frailty Scale score. Univariate analysis was conducted compa...
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Joan H Brown Samantha K LaRosa Katherine G Moore Lindsey L Perea Source Type: research
Healing Beyond the Knife: The Power of a Surgeon's Dialogue
Am Surg. 2024 Mar 29:31348241241724. doi: 10.1177/00031348241241724. Online ahead of print.NO ABSTRACTPMID:38553787 | DOI:10.1177/00031348241241724 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Joseph Abraham Kavian Source Type: research
Size of Splenic Subcapsular Hematoma Is Associated With Varying Outcomes of Nonoperative Management
Am Surg. 2024 Mar 29:31348241241734. doi: 10.1177/00031348241241734. Online ahead of print.ABSTRACTThe presence of a splenic subcapsular hematoma (SCH) has been associated with higher rates of failure of nonoperative management (FNOM) in patients with blunt splenic injury (BSI), with rates up to 80%. We hypothesized that contemporary rates are lower. A retrospective review was conducted of patients admitted with BSI to a level I trauma center (2016-2021). Patients with SCH who had FNOM were compared to those who did not. There were 661 BSI patients, of which 102 (15.4%) had SCH. Among the SCH patients, 8 (7.8%) had FNOM. F...
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Navpreet K Dhillon Melike N Harfouche Joseph J DuBose Rosemary A Kozar Thomas M Scalea Source Type: research
A Daily Checklist Method Increases Documentation of Code Status in Trauma Patients
CONCLUSION: Including code status in a daily checklist involving key aspects of care for trauma patients is an effective method for improving code status documentation. Capturing code status for more patients in trauma allows us to provide patient-centered, goal-concordant care.PMID:38553854 | DOI:10.1177/00031348241241649 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Alexandria M Bontrager Sarah J Ouadah Malini Anand Michael C Smith Source Type: research
Geriatric Bariatric Surgery: Outcomes at a Single Institution
Am Surg. 2024 Mar 29:31348241241732. doi: 10.1177/00031348241241732. Online ahead of print.ABSTRACTObesity, especially in those over the age of 65, is associated with multiple comorbidities and decreased quality of life. Bariatric surgery is an effective method of weight loss and management of comorbidities and is increasingly utilized in younger and middle-aged populations. A retrospective review was performed of patients ≥65 years old who underwent bariatric surgery between 2018 and 2021 at a single institution to evaluate the safety and efficacy of bariatric surgery in older populations. A total of 11 patients were id...
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Samantha Zhan-Moodie Brianna Stadsvold Elinor Mannon Madeleine Schlafly Taylor Lee Gabrielle Moore Kate Marino Viktoriya Sapkalova Hana Ghiathi Jack McClain Aaron Bolduc Lisa R Hilton Source Type: research
The Cost of Poverty: The Relationship Between Insurance Status, Length of Stay, and Discharge Disposition in Trauma Patients
CONCLUSIONS: Excess LOS and complications associated with ELOS were not associated with IS. Although UIPs were younger and had fewer baseline comorbidities, they had longer LOS after regression analysis. While discharge recommendations differed based on insurance status, UIPs had limited access to rehabilitation due to financial disparities. Despite initial treatment team recommendations, UIPs had to be sent home as their lack of insurance precluded inpatient rehabilitation placement.PMID:38554144 | DOI:10.1177/00031348241241656 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Alexandria M Bontrager Andrew J Medvecz Candice Smith Michael C Smith Source Type: research
Stage-Based Detection Methods and Recurrence Patterns for Cutaneous Melanoma
Am Surg. 2024 Mar 28:31348241241718. doi: 10.1177/00031348241241718. Online ahead of print.ABSTRACTMelanoma surveillance guidelines vary. Melanoma recurrence patterns and detection methods were examined. Resected melanoma patients were reviewed. Recurrence detection included patient complaint (PC), physical exam (PE), cross-sectional imaging (CSI), and ultrasound (US). 276 patients were included: 131 stage I, 83 stage II, and 62 stage III. Recurrence rates were 8%, 24%, and 27%, respectively. For stage I patients, 46% of recurrences were local, 18% regional, and 36% distant. Patient complaint identified 55% of recurrences,...
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: F Grace Sullivan Keith B Adler Madeleine D Boudreaux Lexie M Hensley Morgan E Roberts J Spencer Liles J Harrison Howard Source Type: research
Utilizing Video-Assisted Retroperitoneal Debridement for Retroperitoneal Abscess Following Penetrating Trauma
We describe our experience utilizing VARDs in two patients that developed retroperitoneal abscesses following gunshot injuries to bowel and proximal urinary system. Both failed a conservative approach including antibiotic and percutaneous drains. Rapid improvement and subsequent discharge were observed within days of VARD procedure. We believe VARD to be a viable approach to post-trauma retroperitoneal abscesses when surgical drainage is indicated, and anatomy is favorable.PMID:38549202 | DOI:10.1177/00031348241241651 (Source: The American Surgeon)
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Brian B McCluskey Cory J Nonnemacher Dennis W Ashley Rafael T Ponce Source Type: research
Repair of Tracheoesophageal Fistula via Median Sternotomy Approach
We present a neonatal patient diagnosed with EA/TEF in conjunction with pulmonary agenesis requiring definitive repair via median sternotomy. The child was born at 33 weeks gestational age with post-delivery respiratory distress necessitating intubation. A nasogastric tube was unable to be passed. After subsequent imaging, TEF and pulmonary agenesis were diagnosed. During planned staged repair with ligation of TEF via standard right thoracotomy approach, significant ventilatory compromise was encountered. Due to concern for ventilatory compromise and anatomical variance limiting visualization, a median sternotomy approach ...
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Savannah C Walker Brenda L Ma David E Sawaya Source Type: research
The Integrated Prediction of Clinical and Pathological Factors on the Prognosis of Intrahepatic Cholangiocarcinoma
CONCLUSION: We successfully developed and validated a prognostic nomogram for iCCA, demonstrating its excellent accuracy in predicting patient outcomes and providing clinicians with a potential prognostic tool.PMID:38549438 | DOI:10.1177/00031348241241730 (Source: The American Surgeon)
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Guoliang Chen Song Li Adong Xia Yuelong Xing Wenbo Liang Source Type: research
Further Distance From Treating Facility is Associated With Advanced Colon Cancer at Presentation and Increased Mortality
CONCLUSIONS: Increased distance from the treating facility resulted in a significantly higher stage at presentation, increased time to surgery, and increased mortality. These results suggest that there are significant disparities in access to cancer care for patients who live in rural areas. Targeted interventions by treating facilities are needed to improve screening and timely treatment for rural colon cancer patients.PMID:38551581 | DOI:10.1177/00031348241241613 (Source: The American Surgeon)
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Ryan K Schmocker Laura M Enomoto Gregory K Low James M McLoughlin Mark A Casillas Andrew C Antill Robert E Heidel Andrew J Russ Source Type: research
Race/Ethnicity and Social Determinants of Health and Their Impact on the Timely Receipt of Appropriate Operative Treatment of Colon Cancer
CONCLUSION: Patients who receive surgery at a Community Cancer Program, have fewer comorbidities, have lower household income, are younger, and receive surgery within 50 miles of their primary residence are more likely to have timely surgery.PMID:38551594 | DOI:10.1177/00031348241241697 (Source: The American Surgeon)
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Edward C Tobin Erica Dobbs Stacie Deslich Bryan K Richmond Source Type: research
Patient Resiliency and Caregiver Burden After Traumatic Spinal Cord Injury Resulting in Quadriplegia
Am Surg. 2024 Mar 29:31348241241737. doi: 10.1177/00031348241241737. Online ahead of print.ABSTRACTTraumatic spinal cord injury (tSCI) resulting in quadriplegia is a life-altering injury for patients and caregivers. We conducted a retrospective review of patients treated for tSCI and quadriplegia at a level 1 trauma center to assess quality of life (QOL), socioeconomic factors, and mortality. Patients and caregivers were surveyed. Of the 65 patients included, 33 contacts were made. Seventeen surveys were completed (12 caregivers and 5 patients). Six unreachable patients were confirmed alive via medical record. Mortality ra...
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Caroline W Howell James A Lawrence Hannah M Hinkel Caroline H Clutton Yann-Leei L Lee Jon D Simmons Ashley Y Williams Source Type: research
Trends of Self-Inflicted Firearm Injuries at a Rural Level 1 Trauma Center
This study included 201 patients, of which 124 (61.7%) were accidental and 77 (38.3%) were intentional self-inflicted gunshot wounds (GSWs) sustained over 6 years at a rural level 1 trauma center. Injury severity scores (P < .001), hospital days (P < .001), and mortality (P < .001) were significantly higher among intentional self-inflicted GSWs. Injuries to the head were the most common injury among patients with intentional self-inflicted GSWs (P < .001).Accidental and intentional self-inflicted GSWs make up a large portion of firearm injuries seen at our rural level 1 trauma center, and defining these injurie...
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Aliya G Burns Alex P Rasarmos Matthew A Leonard Hannah W Collins J Bracken Burns Source Type: research
Effects of Trauma Center Consolidation on Adult Trauma at a Rural Level 1 Trauma Center
CONCLUSION: The consolidation of trauma services to a single level 1 trauma center in a rural Appalachian health system led to higher trauma volume and acuity, but most importantly decreased mortality for the most severely injured trauma patients.PMID:38551609 | DOI:10.1177/00031348241241703 (Source: The American Surgeon)
Source: The American Surgeon - March 29, 2024 Category: Surgery Authors: Matthew A Heard Sheree Bray Allen Archer Payton C O'Quinn Hannah Wheeler Matthew Leonard J Bracken Burns Source Type: research
