Identifying trauma patients who benefit from whole blood transfusion: An effect decomposition analysis on patient survival.

Background: Although whole blood (WB) transfusion has gained attention as a potentially superior alternative to component therapy (CT) for patients experiencing severe traumatic hemorrhage, conflicting evidence leaves its optimal use unclear.

Methods: We conducted a retrospective review of adult trauma patients treated at civilian trauma centers participating in Trauma Quality Improvement Program (TQIP) from 2020 to 2021. All received either WB or CT within four hours of emergency department arrival.

Operative neurosurgery for traumatic subdural hematoma: association between trauma center variation and patient outcomes.

Objective: Traumatic subdural hematoma (SDH) is a common form of traumatic brain injury (TBI) that often represents a neurosurgical emergency. Surgical evacuation is recommended for SDH with midline shift (MLS) > 5 mm, regardless of the presenting Glasgow Coma Scale (GCS) score; however, real-world practice is unknown. The objective of this study was to test the hypothesis that significant variation exists in the tendency for operative neurosurgical intervention for traumatic SDH among trauma centers (TCs) and that this variation is associated with patient outcomes.

Interhospital Variation in Operative Intervention for Firearm-Related Penetrating Traumatic Brain Injury and Associations With Inpatient Mortality.

Background And Objectives: Firearm-related penetrating traumatic brain injury (pTBI) carries a high mortality risk and grim prognosis. This study aimed to quantify interhospital variation in operative intervention for this patient population and assess whether cranial surgery tendency is associated with inpatient mortality.

Methods: We conducted a retrospective cohort study using the American College of Surgeons Trauma Quality Improvement Program (TQIP) data set to identify adult patients presenting with firearm-related pTBI.

Barriers in an East African Refugee Camp: Applying the Three Delays Framework to Pediatric Surgical Care.

Purpose: In global health, the three-delays framework helps assess barriers associated with seeking (D1), reaching (D2), and receiving health care (D3). This study applies this model to identify factors contributing to delays in surgical care among children living in a Tanzanian refugee camp.

Methods: A validated surgical needs survey was administered to parents/guardians of children (0-18 years) living in Tanzania's Nyarugusu refugee camp.

Caesarean sections among east African refugees and their host population: a 20-year retrospective study in western Tanzania.

Background: Half of the 35.3 million refugees worldwide are women and a third are of childbearing age, making reproductive healthcare in humanitarian settings indispensable. Caesarean section (CS) is the most common operation worldwide, accounting for 18.

Evaluation of a Firearm Safe Storage Device Distribution Program at a Break the Cycle of Violence Summit.

This study assesses the feasibility and acceptability of a Firearm Safe Storage Device Distribution Program. The distribution took place at the Break the Cycle of Violence Summit hosted by the Johns Hopkins Medicine, the Break the Cycle Hospital Violence Intervention Program, and the Johns Hopkins Bloomberg School of Public Health Center for Gun Violence Solutions. The findings will guide future efforts to distribute safe storage devices in clinical settings.

Association of pediatric firearm injury with neighborhood social deprivation in Philadelphia.

Background: Firearm-related injury is the leading cause of death among children and adolescents. There is a need to clarify the association of neighborhood environment with gun violence affecting children. We evaluated the relative contribution of specific social determinants to observed rates of firearm-related injury in children of different ages.

Characteristics of firearm injury by injury intent: The need for tailored interventions.

Introduction: While the United States has high quality data on firearm-related deaths, less information is available on those who arrive at trauma centers alive, especially those discharged from the emergency department. This study sought to describe characteristics of patients arriving to trauma centers alive following a firearm injury, postulating that significant differences in firearm injury intent might provide insights into injury prevention strategies.

Methods: This was a multicenter prospective cohort study of patients treated for firearm-related injuries at 128 US trauma centers from March 2021 to February 2022.

AOA Critical Issues Symposium: Gun Violence as a Public Health Crisis.

Gun violence is an epidemic throughout the United States and is increasing around the world-it is a public health crisis. The impact of gun violence is not limited to the victims (our patients); it also extends to the physicians and caregivers who are taking care of these patients every day. Even more broadly, gun violence affects those living and going to work in potentially dangerous environments.

Trauma Demographics and Injury Prevention.

Traumatic injury is a leading cause of death in the United States. Risk of traumatic injury varies by sex, age, geography, and race/ethnicity. Understanding the nuances of risk for a particular population is essential in designing, implementing, and evaluating injury prevention initiatives.

Robotic Technology in Emergency General Surgery Cases in the Era of Minimally Invasive Surgery.

Importance: Although robotic surgery has become an established approach for a wide range of elective operations, data on its utility and outcomes are limited in the setting of emergency general surgery.

Objectives: To describe temporal trends in the use of laparoscopic and robotic approaches and compare outcomes between robotic and laparoscopic surgery for 4 common emergent surgical procedures.

Design, Setting, And Participants: A retrospective cohort study of an all-payer discharge database of 829 US facilities was conducted from calendar years 2013 to 2021.

Documentation of Trauma-Informed Care Elements for Young People Hospitalized After Assault Trauma.

Introduction: Violent traumatic injury, including firearm violence, can adversely impact individual and community health. Trauma-informed care (TIC) can promote resilience and prevent future violence in patients who have experienced trauma. However, few protocols exist to facilitate implementation of TIC for patients who survive traumatic injury.

Association between geospatial access to trauma center care and motor vehicle crash mortality in the United States.

Background: Motor vehicle crashes (MVCs) are a leading cause of preventable trauma death in the United States. Access to trauma center care is highly variable nationwide. The objective of this study was to measure the association between geospatial access to trauma center care and MVC mortality.

A core outcome set for appendicitis: A consensus approach utilizing modified Delphi methodology.

Background: Appendicitis is one of the most common pathologies encountered by general and acute care surgeons. The current literature is inconsistent, as it is fraught with outcome heterogeneity, especially in the area of nonoperative management. We sought to develop a core outcome set (COS) for future appendicitis studies to facilitate outcome standardization and future data pooling.

What Proportion of East African Refugees Report Musculoskeletal Problems? A Cross-sectional Survey.

Background: Musculoskeletal conditions are the leading cause of disability worldwide and disproportionally affect individuals in low-income and middle-income countries. There is a dearth of evidence on musculoskeletal problems among refugees, 74% of whom reside in low-income and middle-income countries.

Questions/purposes: (1) What proportion of refugees in Nyarugusu Camp, Kigoma, western Tanzania, are affected by musculoskeletal problems and what are the characteristics of those individuals? (2) What are the characteristics of these musculoskeletal problems, including their causes, location, and duration? (3) What forms of healthcare do those with musculoskeletal problems seek, including those for both musculoskeletal and nonmusculoskeletal problems?

Methods: We conducted a cross-sectional study among refugees in Nyarugusu Camp, using the Surgeons OverSeas Assessment of Surgical Need tool.

Patterns, procedures, and indications for pediatric surgery in a Tanzanian Refugee Camp: a 20-year experience.

Background: There are 103 million displaced people worldwide, 41% of whom are children. Data on the provision of surgery in humanitarian settings are limited. Even scarcer is literature on pediatric surgery performed in humanitarian settings, particularly protracted humanitarian settings.

The evolution and development of a robotic acute care surgery program.

Background: Acute care surgeons perform more than 850,000 operations annually on emergency general surgery patients in the United States. Emergency general surgery conditions are associated with a disproportionate excess of patient complications and death. Innovative quality improvement strategies have focused on addressing the excess morbidity and mortality among this patient population.