Discrepancies in Mass Shootings and Access to Trauma Care Across the United States, 2014-2018
CONCLUSION: States in the southern regions of the US experience the greatest disparity due to a high burden of mass shootings with less access to trauma centers. Interventions are needed to increase access to trauma care and reduce mass shootings in these medically underserved areas.PMID:38520302 | DOI:10.1177/00031348241241748 (Source: The American Surgeon)
Source: The American Surgeon - March 23, 2024 Category: Surgery Authors: Kaylin J Beiter Stacey M Knowles Alexandra Tedesco Claudia Leonardi Peter L Scharf Brett M Chapman Tommy A Brown Jonathan E Schoen Lance E Stuke Patrick P Greiffenstein Alan B Marr John P Hunt Alison A Smith Source Type: research
Assessing Futile Trauma Transfers in Rural Appalachia Following a Regional Health Care System Consolidation
This study sought to define and analyze rates of futile trauma transfers (FTTs) after the consolidation of two rural level 1 trauma centers into one. Data was extracted from the regional trauma registry for a period of 5 years (2017-2022) for all trauma patients transferred into our level 1 trauma center (n = 3369). An FTT was defined as a transfer that (1) received no major interventions and (2) died or was discharged to a hospice facility within 72 hours. Out of the 3369 transfer patients analyzed during the 33-month pre-consolidation and 33-month post-consolidation periods, 34 patients met the criteria of an FTT within ...
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Michelle A Everly Allen Archer Matt Heard Keelin Roche J Bracken Burns Source Type: research
Management of a Complex Fistula Involving Abdominal Wall, Small Bowel, Colon, and Bladder
We present a challenging case involving a Jackson-Pratt (JP) drain from prior surgery causing a complex intra-abdominal fistula. The JP drain traversed multiple small bowel loops and the sigmoid colon before terminating in the bladder. Management required multi-disciplinary coordination involving colorectal surgery and urology. The patient's definitive surgery included anterior resection, colostomy takedown, right colectomy, three small bowel resections, and bladder repair. The use of JP drains after abdominal surgery is not without risk. Clinicians should have standardized indications for placement of JP drains and consis...
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Mishal Gillani Seth A Rosen Source Type: research
Opioid Use in Pelvic Fractures: The Impact of Opioid Prescribing Laws in Pennsylvania
This study suggests a modest impact of these laws, but further study is needed.PMID:38516756 | DOI:10.1177/00031348241241644 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Nicole Ann E Villa Kristina Shum Allison Atkinson Adrian Ong Alison Muller Eduardo Espiridion Source Type: research
Effect of Sarcopenia on the Prognosis of Clinical Outcomes in Patients With Hepatocellular Carcinoma After Hepatic Resection
CONCLUSION: Sarcopenia was identified as a prognostic factor for poor OS after hepatic resection, and major postoperative complications were more frequent in sarcopenia. Early sarcopenia detection and management may improve OS and clinical outcomes in postoperative HCC.PMID:38516765 | DOI:10.1177/00031348241241713 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Thanatchawan Polvieng Sermsak Hongjinda Anuparp Thienhiran Pipit Burasakarn Pusit Fuengfoo Source Type: research
Application of the Geriatric Trauma Outcome Score in a Rural Setting
CONCLUSIONS: Our analysis demonstrates that the GTO score is a validated measure in a rural setting and can be an easily calculated metric to help determine a geriatric patient's probability of mortality following a trauma. The results of our study also found that GTO score can be used to inform goals of care discussions with patients.PMID:38516793 | DOI:10.1177/00031348241241624 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Allen D Archer Henrik A Hahamyan Melissa L White-Archer Elizabeth A Mannino Keelin F Roche J Bracken Burns Source Type: research
Diabetes in Trauma Patients: A Potential Gateway to a Medical Home
DISCUSSION: One in four trauma patients would benefit from improved outpatient glycemic management, representing a missed opportunity for preventative health care. Trauma centers should develop strategies to meet this need as part of their post-discharge care.PMID:38516800 | DOI:10.1177/00031348241241615 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Kaylee Hart Margaret A Thames Ashley Caroline Massey Thomas Capasso Yannlei L Lee Maryann Mbaka Christopher M Kinnard Andrew C Bright Ashley Y Williams Nathan M Polite Jon D Simmons C Caleb Butts Source Type: research
Weight-Based Dosing for Low-Molecular-Weight Heparin (Enoxaparin) Administration to Achieve Optimal VTE Prophylaxis in Trauma Patients
CONCLUSIONS: In our study, weight-based dosing of LMWH yielded a significantly higher proportion of patients who achieved goal prophylactic anti-Xa levels than fixed-dosing of LMWH. Larger-scale studies are needed to assess the risk of VTE events and bleeding with these dosing strategies.PMID:38518208 | DOI:10.1177/00031348241241620 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Tarendeep Thind Thomas Heye Curran Henson Rebecca Reif Hanna K Jensen Kyle J Kalkwarf Avi Bhavaraju Ronald Robertson Allison Jenkins Source Type: research
Surgical Regret and Intraoperative Decision-Making: A Living Donor Kidney Case
This article explores surgical regret from the lens of an altruistic donor case and a surgeon's inaction, discussing the ethics of the operative decision-making and surgeon's viewpoint intra- and post-operatively.PMID:38518210 | DOI:10.1177/00031348241241742 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Devon E Cassidy Christian Vercler Michael Englesbe Janice Firn Source Type: research
Two-Stage Liver Transplantation and Tricuspid Valve Replacement After Blunt Trauma in a Pediatric Patient
We present a 14-year-old male injured in an all-terrain vehicle accident, who sustained a devastating disruption of the common bile duct and celiac artery injury, leading to acute hepatic failure, necessitating a two-stage liver transplantation. He was subsequently found to have a severe traumatic tricuspid injury, which required tricuspid valve replacement. At 4 years post-injury, he is without major complications. This is the first case presentation of the cooccurrence of these complex pathologies. Importantly, we demonstrate the complex decision-making surrounding traumatic liver transplantation and timing of subsequent...
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Marshall W Wallace Zachary J Kastenberg Robert A Swendiman Aaron W Eckhauser Manuel Rodriguez-Davalos Katie W Russell Source Type: research
Assessing Futile Trauma Transfers in Rural Appalachia Following a Regional Health Care System Consolidation
This study sought to define and analyze rates of futile trauma transfers (FTTs) after the consolidation of two rural level 1 trauma centers into one. Data was extracted from the regional trauma registry for a period of 5 years (2017-2022) for all trauma patients transferred into our level 1 trauma center (n = 3369). An FTT was defined as a transfer that (1) received no major interventions and (2) died or was discharged to a hospice facility within 72 hours. Out of the 3369 transfer patients analyzed during the 33-month pre-consolidation and 33-month post-consolidation periods, 34 patients met the criteria of an FTT within ...
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Michelle A Everly Allen Archer Matt Heard Keelin Roche J Bracken Burns Source Type: research
Management of a Complex Fistula Involving Abdominal Wall, Small Bowel, Colon, and Bladder
We present a challenging case involving a Jackson-Pratt (JP) drain from prior surgery causing a complex intra-abdominal fistula. The JP drain traversed multiple small bowel loops and the sigmoid colon before terminating in the bladder. Management required multi-disciplinary coordination involving colorectal surgery and urology. The patient's definitive surgery included anterior resection, colostomy takedown, right colectomy, three small bowel resections, and bladder repair. The use of JP drains after abdominal surgery is not without risk. Clinicians should have standardized indications for placement of JP drains and consis...
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Mishal Gillani Seth A Rosen Source Type: research
Opioid Use in Pelvic Fractures: The Impact of Opioid Prescribing Laws in Pennsylvania
This study suggests a modest impact of these laws, but further study is needed.PMID:38516756 | DOI:10.1177/00031348241241644 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Nicole Ann E Villa Kristina Shum Allison Atkinson Adrian Ong Alison Muller Eduardo Espiridion Source Type: research
Effect of Sarcopenia on the Prognosis of Clinical Outcomes in Patients With Hepatocellular Carcinoma After Hepatic Resection
CONCLUSION: Sarcopenia was identified as a prognostic factor for poor OS after hepatic resection, and major postoperative complications were more frequent in sarcopenia. Early sarcopenia detection and management may improve OS and clinical outcomes in postoperative HCC.PMID:38516765 | DOI:10.1177/00031348241241713 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Thanatchawan Polvieng Sermsak Hongjinda Anuparp Thienhiran Pipit Burasakarn Pusit Fuengfoo Source Type: research
Application of the Geriatric Trauma Outcome Score in a Rural Setting
CONCLUSIONS: Our analysis demonstrates that the GTO score is a validated measure in a rural setting and can be an easily calculated metric to help determine a geriatric patient's probability of mortality following a trauma. The results of our study also found that GTO score can be used to inform goals of care discussions with patients.PMID:38516793 | DOI:10.1177/00031348241241624 (Source: The American Surgeon)
Source: The American Surgeon - March 22, 2024 Category: Surgery Authors: Allen D Archer Henrik A Hahamyan Melissa L White-Archer Elizabeth A Mannino Keelin F Roche J Bracken Burns Source Type: research
