Frailty impacts outcomes for all older adult age groups in emergency laparotomy.

Background: The quantitative effect of frailty on post-operative complications in older adults undergoing surgical emergencies is not well understood.

Methods: The 2013-2019ACS-NSQIP database was used to identify emergency laparotomy patients≥65 years. Frailty was measured using the modified-frailty-index-5 factors (mFI-5).

Examining the racial and ethnic disparities in pediatric surgery using the surgical Desirability of Outcome Ranking (DOOR).

Introduction: The Desirability of Outcome Ranking (DOOR) ranks multiple postoperative outcomes, potentially enhancing detection of risks influenced by social determinants of health. We examined the relationship between race, ethnicity, and DOOR scores in pediatric surgical patients.

Methods: Using NSQIP-Pediatric 2012-2022, we identified patients (≤18 years) who underwent general, urological, and gynecological surgery.

Predictors of Survival in Patients With Severe Traumatic Brain Injury Undergoing Extracorporeal Membrane Oxygenation.

Introduction: The selection of patients for Extracorporeal Membrane Oxygenation (ECMO) needs to be optimized, especially in patients with severe traumatic brain injury (TBI). We aimed to identify predictors of survival in severe TBI patients. We also characterized trends of ECMO use in patients with severe TBI.

Equipping School Nurses to Address Firearm Safety: A Pilot Curriculum Study.

Background: Firearm violence is the leading cause of death among US children and adolescents, and school nurses are increasingly recognized as key partners in prevention efforts. While school nurses are uniquely positioned to counsel on firearm safety, existing training curricula often lack content tailored to their specific roles and settings.

Methods: We adapted a hospital-based curriculum for school nurses, comprising a didactic session on firearm violence, secure storage, and counseling frameworks, followed by standardized patient simulations.

Hospital Factors Associated with Fragmentation of Care in Emergency General Surgery: Less Continuity, Higher Mortality.

Background: Fragmentation of Care (FOC) is defined as re-admission to a non-index hospital and may be associated with worse outcomes among Emergency General Surgery (EGS) patients. This study assesses hospital characteristics associated with patterns of FOC in EGS patients and the effect of interfacility transfer after FOC on mortality.

Methods: Using the Nationwide Readmissions Database 2019, we included patients ≥ 18 years old who were admitted to an index hospital with an EGS diagnosis managed operatively, and had an emergency readmission within 90 days.

Understanding School Nurses' Perspectives on Firearm Violence Prevention: Attitudes, Beliefs, and Training Needs.

This study examined school nurses' experiences and beliefs about firearm violence and related policies. A cross-sectional survey was conducted at the National Association of School Nurses Annual Conference in July 2023, gathering data on attitudes and knowledge regarding firearm violence prevention. Of the 363 respondents (65% response rate), 98% were female, and 44.

Using Interpretable Artificial Intelligence Algorithms in the Management of Blunt Splenic Trauma: Applications of Optimal Policy Trees as a Treatment Prescription Aid to Improve Patient Mortality.

Background: The identification of the optimal management for blunt splenic trauma-angioembolization (AE), splenectomy, or observation-remains a challenge. This study applies Optimal Policy Trees (OPT), an artificial intelligence (AI) model, to prescribe appropriate management and improve in-hospital mortality.

Methods: OPTs were trained on patients with blunt splenic injuries in the ACS-TQIP 2013-2019 to prescribe one of the three interventions: splenectomy, angioembolization (AE), or observation.

Rib Fixation in Severe Isolated Chest Trauma with Pulmonary Contusion: Rib fixation in pulmonary contusion.

Background: Pulmonary contusion (PC) is considered a relative contraindication to surgical stabilization of rib fractures (SSRF). This study compared outcomes in patients undergoing SSRF vs. non-operative management (NOM).

Blood product use in emergency resuscitative thoracotomy: A nationwide analysis.

Background: Emergency resuscitative thoracotomy survival rates range widely depending on the mechanism of injury and signs of life at presentation. Given ongoing shortages of blood products, we sought to examine blood product use across this patient population and corresponding survival.

Methods: We identified patients in the American College of Surgeons-Trauma Quality and Improvement Program (2017-2019) undergoing an emergency resuscitative thoracotomy within 30 minutes of hospital arrival.

Home care visits: The key to reducing loss to follow-up in emergency colorectal surgery.

Background: Emergency colorectal surgery has a high incidence of postdischarge complications, and loss to follow-up can delay the identification of complications. Amid evolving postdischarge care practices, it is important to assess predictors of loss to follow-up. We aimed to characterize the predictors of loss to follow-up.

Volume Matters: Examining The Management Of Necrotizing Pancreatitis In The United States.

Objective: To examine the impact of hospital volume on mortality and healthcare utilization in patients admitted with necrotizing pancreatitis (NP).

Background: Over 20% of patients with acute pancreatitis develop NP, which has been associated with higher rates of procedural intervention, morbidity, and mortality.

Methods: Adult patients admitted with NP were identified in the 2016-2019 Nationwide Readmissions Database 2016-2019.

Predictors against discharge to home in geriatric emergency general surgery patients.

Purpose: This study aims to identify predictors of discharge to post-acute care in geriatric emergency general surgery (EGS) patients.

Methods: This is a retrospective study of geriatric emergency general surgery (EGS) patients at a tertiary care facility between 2017 and 2018. Inclusion criteria were ≥ 65 years old and presented directly from home.

Impact of intraoperative adverse events in general and gastrointestinal surgery: A nationwide study.

Background: Intraoperative adverse events (iAEs) during general surgery can lead to significant morbidity and healthcare burden, yet their impact remains underexplored. We aimed to estimate the nationwide incidence of iAEs in general surgery and explore their associations with mortality, complications, length of stay, and costs.

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database 2019 and included adult patients (aged 18 years and older) who underwent general surgical procedures.

Percutaneous and endoscopic transpapillary cholecystoduodenal stenting in acute cholecystitis-A viable long-term option in high-risk patients?

Background: The prolonged use of percutaneous cholecystostomy tubes (PCTs) in patients with acute cholecystitis, deemed inoperable, is fraught with complications. Transpapillary cholecystoduodenal stenting (TCDS) is an alternative technique that restores the physiologic outflow of bile, avoiding the need for an external drain. However, the long-term safety and efficacy of this approach remain unclear.

Racial and Ethnic Disparities in Emergency General Surgery Outcomes Among Older Adult Patients.

Introduction: Racial and ethnic disparities in emergency general surgery (EGS) patients have been well described in the literature. Nonetheless, the burden of these disparities, specifically within the more vulnerable older adult population, is relatively unknown. This study aims to investigate racial and ethnic disparities in clinical outcomes among older adult patients undergoing EGS.

Outcomes of severe isolated blunt chest trauma in young and geriatric patients.

Purpose: Our understanding of the growing geriatric population's risk factors for outcomes after traumatic injury remains incomplete. This study aims to compare outcomes of severe isolated blunt chest trauma between young and geriatric patients and assess predictors of mortality.

Methods: The ACS-TQIP 2017-2020 database was used to identify patients with severe isolated blunt chest trauma.

Lost in transition: Impact of interhospital transfer on outcomes after emergency general surgery in the older adult population.

Background: Emergency general surgery performed among patients over 65 years of age represents a particularly high-risk population. Although interhospital transfer has been linked to higher mortality in emergency general surgery patients, its impact on outcomes in the geriatric population remains uncertain. We aimed to establish the effect of interhospital transfer on postoperative outcomes in geriatric emergency general surgery patients.

Discharge to Skilled Nursing Facility Is a Risk Factor for Readmission: A Nationwide Propensity-Matched Study.

Introduction: General surgery procedures place stress on geriatric patients, and postdischarge care options should be evaluated. We compared the association of discharge to a skilled nursing facility (SNF) versus home on patient readmission.

Methods: We retrospectively reviewed the Nationwide Readmission Database (2016-2019) and included patients ≥65 y who underwent a general surgery procedure between January and September.

Two big bones, one big decision: When to fix bilateral femur fractures.

Purpose: For polytrauma patients with bilateral femoral shaft fractures (BFSF), there is currently no consensus on the optimal timing of surgery. This study assesses the impact of early (≤ 24 h) versus delayed (>24 h) definitive fixation on clinical outcomes, especially focusing on concomitant versus staged repair. We hypothesized that early definitive fixation leads to lower mortality and morbidity rates.