The Journal of Trauma: Injury, Infection, and Critical Care 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.

Accessibility of Level III trauma centers for underserved populations: A cross-sectional study
CONCLUSION Level III trauma centers are a potential source of trauma care for underserved populations. While Black and AIAN disproportionately rely on Level III centers for care, most with access to Level III centers also have access to Level I/II centers. The proportion of the US population with timely access to trauma care has not improved since 2010. LEVEL OF EVIDENCE Prognostic/Epidemiological; Level IV. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Coming in hot: Police transport and prehospital time after firearm injury
BACKGROUND In Philadelphia, PA, police and emergency medical services (EMS) transport patients with firearm injuries. Prior studies evaluating this system have lacked reliable prehospital times. By linking police and hospital data sets, we established a complete timeline from firearm injury to outcome. We hypothesized that police-transported patients have shorter prehospital times that, in turn, are associated with improved survival and increased unexpected survivorship at 6 and 24 hours. METHODS This retrospective study linked patient-level data from OpenDataPhilly Shooting Victims and the Pennsylvania Trauma S...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Integrating traffic safety data with area deprivation index: A method to better understand the causes of pediatric pedestrian versus automobile collisions
BACKGROUND The purpose of this study was to identify clinical and traffic factors that influence pediatric pedestrian versus automobile collisions (P-ACs) with an emphasis on health care disparities. METHODS A retrospective review was performed of pediatric (18 years or younger) P-ACs treated at a Level I pediatric trauma center from 2008 to 2018. Demographic, clinical, and traffic scene data were analyzed. Area deprivation index (ADI) was used to measure neighborhood socioeconomic disadvantage (NSD) based on home addresses. Traffic scene data from the California Statewide Integrated Traffic Records System were ...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

N-acetylcysteine is associated with reduction of postconcussive symptoms in elderly patients: A pilot study
This study evaluated the effects of NAC on postconcussion symptoms in elderly patients diagnosed with mild TBI. METHODS This prospective, quasirandomized, controlled trial enrolled patients 60 years or older who suffered mild TBI. Patients were excluded if cognitive function could not be assessed within 3-hours postinjury. Patients were allocated to receive NAC plus standard care, or standard care alone, based on the trauma center where they presented. The primary study outcome was the severity of concussive symptoms measured using the Rivermeade Postconcussion Symptoms Questionnaire (RPQ). Symptoms were evaluated o...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Prospective evaluation of the selective nonoperative management of abdominal stab wounds: When is it safe to discharge?
BACKGROUND The optimal observation time required to exclude hollow viscus injury in patients undergoing selective nonoperative management (SNOM) for abdominal stab wounds (SWs) remains unclear. The aim of this study was to determine the safe period of observation required before discharge. METHODS In this prospective observational study, all patients who sustained an abdominal SW were screened for study inclusion (July 2018 to May 2021). The primary study outcome was time to SNOM failure, defined as the need for surgical intervention after an initial period of observation. RESULTS During the study period,...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Reading the signs in penetrating cervical vascular injuries: Analysis of hard/soft signs and initial management from a nationwide vascular trauma database
CONCLUSION Although hard signs in PCVIs are associated with the need for operative intervention, initial CT imaging can facilitate endovascular options or nonoperative management in a significant subgroup. Hard signs should not be considered an absolute indication for immediate surgical exploration. LEVEL OF EVIDENCE Prognostic/Epidemiological; Level IV. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Can we really make catheter-associated urinary tract infections a never event? A level 1 trauma center's experience with prophylactic antibiotic bladder irrigation
CONCLUSION Prophylactic antibiotic bladder irrigation was associated with a zero incidence of CAUTI among trauma patients at risk for CAUTI. This practice holds promise as effective infection prophylaxis for such patients. The optimal duration and frequency of irrigation remain to be determined. LEVEL OF EVIDENCE Therapeutic/care management, Level III. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

A comparison of management and outcomes following blunt versus penetrating pancreatic trauma: A secondary analysis from the Western Trauma Association Multicenter Trials Group on Pancreatic Injuries
CONCLUSION Management of grades I to III, but not grades IV/V, pancreatic injuries varies based on mechanism. Penetrating injury is an independent risk factor for PRCs, but main pancreatic duct injury and resection are associated with high rates of PRCs regardless of the injury mechanism. Resection appears to offer better outcomes for grade IV/V injuries, and grade I and II injuries should be managed nonoperatively. LEVEL OF EVIDENCE Therapeutic/Care Management; Level III. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Recombinant human MG53 protein attenuates brain lesion size in a large animal model of traumatic brain injury
This study was performed to test whether intravenous administration of rhMG53 protein would decrease the lesion size in a clinically relevant large animal model of traumatic brain injury (TBI). METHOD Yorkshire swine (40–45 kg; n = 5/group) were subjected to controlled cortical impact TBI and randomized to either: (1) rhMG53 protein (2 mg/kg, intravenous) or (2) normal saline control. Hemodynamics, intracranial pressure, and brain oxygenation were monitored for 7 hours. Brains were then harvested and sectioned into 5-mm slices and stained with 2,3,5-triphenyltetrazolium chloride to quantify the lesion size. Blood-...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Postinjury platelet aggregation and venous thromboembolism
BACKGROUND Posttraumatic venous thromboembolism (VTE) remains prevalent in severely injured patients despite chemoprophylaxis. Importantly, although platelets are central to thrombosis, they are not routinely targeted in prevention of posttraumatic VTE. Furthermore, platelets from injured patients show ex vivo evidence of increased activation yet impaired aggregation, consistent with functional exhaustion. However, the relationship of this platelet functional phenotype with development of posttraumatic VTE is unknown. We hypothesized that, following injury, impaired ex vivo platelet aggregation (PA) is associated with ...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Tissue plasminogen activator resistance is an early predictor of posttraumatic venous thromboembolism: A prospective study from the CLOTT research group
CONCLUSION Early development of a hypercoagulable state as defined by tPA-R at 12 hours after admission represents a potentially modifiable risk factor for postinjury VTE. LEVEL OF EVIDENCE Therapeutic/Care Management; Level II. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Postinjury complement C4 activation is associated with adverse outcomes and is potentially influenced by plasma resuscitation
CONCLUSION C4 activation has an important inflammatory role postinjury, and FFP has the potential to augment this complement activation during resuscitation. LEVEL OF EVIDENCE Prognostic/epidemiological, level III. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Plasma-based assays distinguish hyperfibrinolysis and shutdown subgroups in trauma-induced coagulopathy
CONCLUSION This exploratory study using PPP-based assays identified differences in thrombin generation, fibrin formation and structure, and lysis in hyperfibrinolysis and shutdown subgroups. These groups did not differ in their ability to promote tPA-triggered plasmin generation. The ability to characterize these activities in PPP facilitates studies to identify mechanisms that promote adverse outcomes in trauma. LEVEL OF EVIDENCE Prognostic/Epidemiological; Level III. (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

Biomarkers of endothelial cell dysfunction persist beyond resuscitation in patients with hemorrhagic shock
The objective of the current study was to assess longitudinal changes in miR-19b and syndecan-1 in HS patients. METHODS Blood samples from HS patients (blood pressure (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PODIUM 2022 Source Type: research

The VIPoma
No abstract available (Source: The Journal of Trauma: Injury, Infection, and Critical Care)
Source: The Journal of Trauma: Injury, Infection, and Critical Care - November 1, 2022 Category: Orthopaedics Tags: WTA PRESIDENTIAL ADDRESS 2022 Source Type: research