Assessing the Safety of Nonintensive Care Unit Admission for Select Grade III Blunt Splenic Trauma.

Introduction: Patients with grade III blunt splenic injuries (BSIs) may require splenectomy. Currently, there is practice variation for admission of these patients to an intensive care unit (ICU) or non-ICU floor. We hypothesized that select BSI patients may be admitted to non-ICU locations without increased complications, death, or need for splenectomy.

Predictors of ventilator-associated pneumonia in intubated pediatric trauma patients.

Purpose: Ventilator-associated pneumonia (VAP) is the most common complication among intubated pediatric trauma patients (PTPs) in pediatric intensive care units. Early identification of associated risk factors may help mitigate adverse outcomes linked to VAP, such as increased mortality and healthcare costs. This study aims to identify risk factors associated with VAP for intubated PTPs.

Increased Associated Risk of Surgical Site Infections in Trauma Patients Who Are Smokers.

Introduction: Smoking has been shown to increase the risk of surgical site infection (SSI) in elective surgery. This study aimed to determine the association between smoking and SSI in trauma patients (TPs), hypothesizing that TPs who are smokers have an increased associated risk of SSI compared to nonsmokers.

Methods: The Trauma Quality Improvement Program database (2017-2022) was queried for adults (age ≥ 18 y) undergoing any surgery related to trauma.

Trauma, firearms, and pregnancy: Beyond the cushion.

Background: Pregnancy introduces unique anatomical and physiological changes that could influence injury susceptibility, including redistribution of abdominal organs and adipose tissue that could provide a protective "cushion effect" against penetrating trauma. This study aimed to understand how injury patterns and clinical outcomes differ between pregnant trauma patients (PTPs) and their non-pregnant counterparts presenting after penetrating trauma, hypothesizing that PTPs have a lower mortality risk and incur less severe abdominal injuries due to the proposed cushion effect.

Methods: The 2020-2021 Trauma Quality Improvement Program database was queried for all female patients <50-years-old presenting after penetrating trauma.

Risk Factors and Timing of Fasciotomy for Isolated Pediatric Lower Extremity Trauma.

BackgroundPrevious single-center reports have demonstrated a longer time from traumatic leg injury to fasciotomy in pediatric trauma patients (PTPs) with compartment syndrome. We hypothesized most fasciotomies in isolated pediatric lower extremity trauma (LET) are delayed (6 hours from admission) and sought to investigate risk factors for pediatric fasciotomy.MethodsThe 2017-2020 TQIP database was queried for PTPs 17 years old with isolated injury to the leg.

Trauma patients with metastatic cancer undergoing emergent surgery: A matched cohort analysis.

Background: There is a paucity of literature guiding trauma surgeons in the care of patients with active metastatic cancer (MC). Even less is known regarding outcomes for MC patients requiring emergent surgery after trauma. We hypothesized that trauma patients with active Metastatic Cancer (MC) have an increased mortality rate and undergo increased rates of withdrawal of care (WoC) within 72-hours following emergent operations, compared to similarly matched patients without MC.

Similar rate of venous thromboembolism (VTE) and failure of non-operative management for early versus delayed VTE chemoprophylaxis in adolescent blunt solid organ injuries: a propensity-matched analysis.

Background: Early initiation of venous thromboembolism (VTE) chemoprophylaxis in adults with blunt solid organ injury (BSOI) has been demonstrated to be safe but this is controversial in adolescents. We hypothesized that adolescent patients with BSOI undergoing non-operative management (NOM) and receiving early VTE chemoprophylaxis (eVTEP) (≤ 48 h) have a decreased rate of VTE and similar rate of failure of NOM, compared to similarly matched adolescents receiving delayed VTE chemoprophylaxis (dVTEP) (> 48 h).

Methods: The 2017-2019 Trauma Quality Improvement Program database was queried for adolescents (12-17 years of age) with BSOI (liver, kidney, and/or spleen) undergoing NOM.

Firearm Violence Involving Adults 65 and Older During the Novel Coronavirus Disease Pandemic.

Background: Rates of firearm violence (FV) surged during the COVID-19 pandemic. However, there is a paucity of data regarding older adults (OAs) (≥65 years old). This study aimed to evaluate patterns of FV against OAs before and after the COVID-19 pandemic, hypothesizing decreased firearm incidents, injuries, and deaths for OAs due to restricted social movement.

The Effect of 2019 Coronavirus Stay-at-Home Order on Geriatric Trauma Patients in Southern California.

Background: California issued stay-at-home (SAH) orders to mitigate COVID-19 spread. Previous studies demonstrated a shift in mechanisms of injuries (MOIs) and decreased length of stay (LOS) for the general trauma population after SAH orders. This study aimed to evaluate the effects of SAH orders on geriatric trauma patients (GTPs), hypothesizing decreased motor vehicle collisions (MVCs) and LOS.

Trauma Patients With Cirrhosis Have a Similar Risk of Unplanned Operation and Decreased Associated Risk of Mortality With Venous Thromboembolism Chemoprophylaxis.

Introduction: Patients with cirrhosis have an increased risk of complications after trauma, including bleeding, unplanned operations, and death. The benefit of venous thromboembolism (VTE) chemoprophylaxis in trauma patients with cirrhosis (CTPs) is not clear, especially since cirrhotic patients are hypercoagulable. We hypothesized that CTPs receiving VTE chemoprophylaxis (vCP) have a lower risk of death with no increased risk for unplanned operations compared to patients with cirrhosis not receiving vCP.

Field Measures Are All You Need: Predicting Need for Surgery in Elderly Ground-Level Fall Patients via Machine Learning.

Background: As ground-level falls (GLFs) are a significant cause of mortality in elderly patients, field triage plays an essential role in patient outcomes. This research investigates how machine learning algorithms can supplement traditional t-tests to recognize statistically significant patterns in medical data and to aid clinical guidelines.

Methods: This is a retrospective study using data from 715 GLF patients over 75 years old.

Predictors of Mortality in Trauma patients Receiving massive Transfusion Protocol.

Introduction: Massive transfusion protocol (MTP) is often defined as the transfusion of ≥10 units of packed red blood cells (PRBCs) in 24 hours. The purpose of this study is to determine which factors most significantly contribute to mortality in patients receiving MTP after trauma.

Methods: An initial database search followed by retrospective chart review was performed on patients treated at four trauma centers in Southern California.

Medical Student Perspectives on Sexual and Gender Minority Acceptance in Surgical Specialties and Sexual and Gender Minority Education.

Background: The topics of healthcare for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) patients and inclusion of LGBTQ+ health providers remain overlooked. Some specialties may be perceived as less inclusive to LGBTQ+ trainees. This study aimed to describe the perspectives of current medical students regarding LGBTQ+ education and the acceptance of LGBTQ+ trainees among different specialties.

Educational assessment of intrathoracic and extrathoracic surgical stabilization of rib fractures.

Background: Surgical stabilization of rib fractures (SSRF) is being done with increased frequency and new advances. Intrathoracic SSRF is a new less invasive approach compared to the traditional extrathoracic plating procedure. Educational assessment can be done through descriptive analysis of learning curves with operation time used as a proxy measurement for learning.

Comparing outcomes of cholecystectomies in white vs. minority patients.

Background: This study aimed to investigate the disparity between white and minority patients undergoing cholecystectomies, including presentation, outcomes, and financial burden.

Methods: This was an IRB approved retrospective review of all cholecystectomies at an academic medical center from 2013 to 2018. Data collected include demographics, insurance type, charge of admission, and clinical outcomes.

Predicting Unplanned Intensive Care Unit Admission for Trauma Patients: The CRASH Score.

Introduction: Unplanned transfer of trauma patients to the intensive care unit (ICU) carries an associated increase in mortality, hospital length of stay, and cost. Trauma teams need to determine which patients necessitate ICU admission on presentation rather than waiting to intervene on deteriorating patients. This study sought to develop a novel Clinical Risk of Acute ICU Status during Hospitalization (CRASH) score to predict the risk of unplanned ICU admission.

Comparison of Same and Different Level Height Falls on Subsequent Midline Shift in Pediatric Traumatic Brain Injury.

Objectives: Up to 44% of pediatric traumatic brain injury occurs as a result of a fall. We hypothesized that a fall from height is associated with higher risk for subsequent midline shift in pediatric traumatic brain injury compared with a fall from same level.

Methods: The Pediatric Trauma Quality Improvement Program 2016 was queried for kids younger than 16 years with an injury in the abbreviated injury scale for the head after a fall.

Blunt Trauma Mortality: Does Trauma Center Level Matter?

Introduction: Trauma centers have improved outcomes compared to nontrauma centers when caring for injured patients. A multicenter report found blunt trauma patients treated at American College of Surgeons' Level I trauma centers have improved survival compared to Level II centers. In a subsequent multicenter study, Level II centers had improved survival in all trauma patients.

Association of Blood Alcohol and Alcohol Use Disorders with Emergency Department Disposition of Trauma Patients.

Introduction: Trauma patients who present to the emergency department (ED) intoxicated or with an alcohol use disorder (AUD) undergo more procedures and have an increased risk of developing complications. However, how AUD and blood alcohol concentration (BAC) impact a trauma patient's disposition from the ED remains inconclusive. In this study we aimed to identify the associations between positive BAC or an AUD with admission to the hospital, including the intensive care unit (ICU).

Post-Trauma Follow-up Phone Call Shows Lower Readmission Rates for Patients Discharged From Emergency Department Compared to Inpatient Stay.

Background: Studies show follow-up phone calls decrease readmission rates (RR) in trauma patients and social vulnerabilities may play a role as well. Minimal literature exists comparing RR of trauma patients who required an inpatient stay to those whose treatment was limited to the Emergency Department (ED), as they are at high risk of recidivism. We hypothesized post-trauma follow-up calls would show higher RR for ED patients than those requiring inpatient stay, as well as potentially differing outcomes for minorities.

Investigating a Substance Abuse Screening in a Trauma Setting.

Introduction: Drug and alcohol consumption are often associated with trauma-related injuries. Various studies have been conducted which have shown the benefits of screening and brief intervention (SBI) tools for alcohol consumption. Despite their success, there are few SBI tools utilized for substance use and minimal reports of computerized versions.