Growing injury threats to longevity in the older population: American Association for the Surgery of Trauma Prevention Committee topical update.

As the exponential growth in the elderly population occurs, it is essential that we identify age-specific risk factors that impact the outcome of injury in the elderly. In this review article, we describe the different mechanisms of injury that threaten the elderly. There will be a description of ground-level falls-the most common form of trauma-related injury in that group (and how community-based programs can help prevent the complications associated with them).

Examining the relationship between social deprivation index and pedestrian injuries in a suburban setting: Is that the only factor?

Background: Increased efforts to understand the reasons for the rise in pedestrian related traffic fatalities have demonstrated that these injuries occur in minority and lower income neighborhoods. The purpose of our study was to characterize the patient population suffering from pedestrian injuries in suburban setting, to determine whether the incidence of pedestrian injuries is associated with the social deprivation index (SDI) and to identify zip codes with a higher incidence of pedestrian injuries.

Methods: Single center, descriptive, retrospective cohort study of all patients suffering from pedestrian injuries admitted to our Level I Trauma Center (01/2014-10/2022).

Female gender and racial minority status is associated with Poor clinical outcomes and higher healthcare resource utilization in necrotizing fasciitis: Analysis of a Nationwide database in the United States.

Introduction: Necrotizing fasciitis is a rapidly progressive infection associated with high mortality and complications. It mainly involves subcutaneous tissue and fascia. More quality data on disparities in clinical outcomes of necrotizing fasciitis must be provided.

Role of peak D-dimer in predicting mortality and venous thromboembolism in COVID-19 patients.

Covid 19 patients often present with elevated D-dimer levels. The purpose of this study is to evaluate the role of D-Dimer levels in Covid 19 patients to predict mortality and venous thromboembolism (VTE) events. This is a retrospective chart review study from 1 April 2020 to 30 June 2020, during the peak Covid pandemic.

Stop The Falls! A framework for injury prevention outreach for older adults presented by the American Association for the Surgery of Trauma Geriatric Trauma and Injury Prevention Committees.

With the increasing age of the population in the USA, fall prevention events to target older patients are imperative. The American Association for the Surgery of Trauma hosted a fall prevention event at the host city of the 2023 Annual Meeting. We review the planning and implementation of this "Stop the Falls" event, in hopes that other institutions may benefit and sustainably effectuate fall prevention events for an increasingly geriatric population.

See one, do one, teach one - Trends in resident autonomy and teaching assistant cases during general surgery residency in the United States: A nationwide retrospective analysis.

Introduction: Autonomy during residency is crucial to the training and development of competent surgeons. An essential component of this process is the 'teaching assistant (TA)' case, an indispensable opportunity for residents to gain confidence and hone intraoperative skills. However, high-quality data on the volume and diversity of cases that graduates perform are scarce.

A Quality Improvement Initiative to Implement Focused Family Meetings in the Surgical Intensive Care Unit: Does It Matter?

Communication with families is essential to improve satisfaction, especially in the critical care setting. We sought to identify patients who were not recovering as expected and to improve communication with their families. We implemented a novel algorithm, incorporating clinical and social criteria, to determine which patients could benefit from additional communication.

Trends in Surgical Critical Care Fellowship Match: An Analysis of National Resident Matching Program Data.

Introduction: Surgical Critical Care (SCC) fellowship applications are made through March-July the year prior to the fellowship, while the match process takes place through the National Resident Matching Program (NRMP). There is paucity of high quality data on matching trends in SCC fellowship in the United States.

Methods: We conducted a retrospective cohort study of all applicants in the SCC match over a period of fifteen years (2009-2023).

Takotsubo cardiomyopathy following blunt trauma: Early recognition and diagnosis.

Background: Takotsubo Cardiomyopathy (TTC) is characterized by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery disease. While TTC is usually preceded by an emotionally stressful event, physical trauma has been documented as a precipitating incident as well.

Case Summary: An 82-year-old female with no past medical history, presented to the emergency department following a motor vehicle collision.

Screening and intervention for intimate partner violence at trauma centers and emergency departments: an evidence-based systematic review from the Eastern Association for the Surgery of Trauma.

Background: Intimate partner violence (IPV) is a serious public health issue with a substantial burden on society. Screening and intervention practices vary widely and there are no standard guidelines. Our objective was to review research on current practices for IPV prevention in emergency departments and trauma centers in the USA and provide evidenced-based recommendations.

Coronavirus Disease 2019 and the Injured Patient: A Multicenter Review.

Introduction: Coronavirus disease 2019 (COVID-19) has been shown to affect outcomes among surgical patients. We hypothesized that COVID-19 would be linked to higher mortality and longer length of stay of trauma patients regardless of the injury severity score (ISS).

Methods: We performed a retrospective analysis of trauma registries from two level 1 trauma centers (suburban and urban) from March 1, 2019, to June 30, 2019, and March 1, 2020, to June 30, 2020, comparing baseline characteristics and cumulative adverse events.

Stop the Bleed: A Prospective Evaluation and Comparison of Tourniquet Application in Security Personnel Versus Civilian Population.

Introduction: Stop the Bleed (STB) is a national training program aiming to decrease the mortality associated with life-threatening bleeding due to injury. The purpose of this study was to evaluate the efficacy and confidence level of security personnel placing a tourniquet (TQ) compared to civilians.

Methods: Pre and post questionnaires were shared with security personnel (Group 1) and civilians (Group 2).

Outcomes in Obese vs Non-Obese Injured Patients at a Level 1 Trauma Center and Bariatric Surgery Center of Excellence.

Background: We hypothesized that the outcomes of trauma patients with a body mass index (BMI) equal to or greater than 30 compared to patients with BMI less than 30 would not differ at a level 1 trauma center that is also a Metabolic and Bariatric Surgery Center of Excellence in the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP).

Study Design: Patients equal to and greater than 18 years old treated between 1/1/2018 and 12/31/2020 were included. Demographics, BMI, comorbidities, and outcomes (hospital-LOS, ICU-LOS, blood products used, and mortality) were compared between 2 groups: obese (BMI ≥30) vs non-obese (BMI <30).

Assessment of Safety of Remdesivir in Covid - 19 Patients with Estimated Glomerular Filtration Rate (eGFR) < 30 ml/min per 1.73 m^2.

Purpose: Safety of remdesivir in patients with renal impairment is unknown. Incidence of liver injury secondary to remdesivir is also unknown. The objective of this study is to assess the incidence of acute kidney injury (AKI) and to trend the liver enzymes during remdesivir treatment and change in eGFR from baseline to end of treatment as well as 48 h post completion of remdesivir therapy.

Fatal and non-fatal injuries due to suspension trauma syndrome: A systematic review of definition, pathophysiology, and management controversies.

Background: Suspension trauma syndrome is a life-threatening event that occurs when a person is "trapped" in a prolonged passive suspension. It is most commonly seen in people who engage in occupational or sport activities that require harness suspension. The aim of this study is to identify the predisposing factors, pathophysiology, and management of suspension trauma.

Smartphone application alerts for early trauma team activation: Millennial technology in healthcare.

Background: Data access through smartphone applications (apps) has reframed procedure and policy in healthcare, but its impact in trauma remains unclear. Citizen is a free app that provides real-time alerts curated from 911 dispatch data. Our primary objective was to determine whether app alerts occurred earlier than recorded times for trauma team activation and emergency department arrival.

Management of mass casualties due to COVID-19: handling the dead.

A high number of fatalities can occur during major disasters or during events like the COVID-19 pandemic. In a natural disaster, the dead must be removed from disaster sites while rescue work is in progress; otherwise, the health and safety of the community are threatened. The COVID-19 pandemic is analogous to a natural disaster with mass casualties where the disaster sites are hospitals with morgues that are overwhelmed.

Prone ventilation as treatment of acute respiratory distress syndrome related to COVID-19.

Prone ventilation refers to the delivery of mechanical ventilation with the patient lying in the prone position. The improvement of oxygenation during prone ventilation is multifactorial, but occurs mainly by reducing lung compression and improving lung perfusion. CT imaging modeling data demonstrated that the asymmetry of lung shape leads to a greater induced pleural pressure gravity gradient when supine as compared to prone positioning.

Equity on the frontlines of trauma surgery: An #EAST4ALL roundtable.

Background: Inequity exists in surgical training and the workplace. The Eastern Association for the Surgery of Trauma (EAST) Equity, Quality, and Inclusion in Trauma Surgery Ad Hoc Task Force (EAST4ALL) sought to raise awareness and provide resources to combat these inequities.

Methods: A study was conducted of EAST members to ascertain areas of inequity and lack of inclusion.

Bullet embolization to the heart: A rare and confounding penetrating cardiac injury case report.

Gunshot wounds to the cardiac region usually result in devastating injuries. However, if bullets embolize into the myocardium without significant damage to the organ, optimal evaluation and management remains unclear. We present the case of a hemodynamically stable gunshot wound patient who presented with a bullet to the heart.

Sinking skin flap syndrome in the multi-trauma patient: a paradoxical management to TBI post craniectomy.

Sinking skin flap syndrome is a rare syndrome leading to increased intracranial pressure, known to neurosurgeons, yet uncommon and hardly ever reported in trauma patients. In a hospitalized trauma patient with declining neurological status, rarely do we encounter further deterioration by elevating the patients' head, diuresis and hyperventilation. However, after craniectomy for trauma, a partially boneless cranium may be compressed by the higher atmospheric pressure, that intracranial pressure rises to dangerous levels.