Injury Severity Score Precision for Determining Undertriage in Trauma Consultation Patients: A Retrospective Study.

Objectives Because the Injury Severity Score (ISS) has not been fully endorsed for determining trauma undertriage, we investigated its precision. This study aimed to 1) compute undertriage proportions using the Peng and Cribari methods; 2) compare risk conditions and outcomes for patients with ISS ≥16 who were classified according to an activation or consultation status; 3) calculate proportions of patients with ISS ≥16, without and with qualifications (death or increased length of stay), as potential categories for assessing undertriage in trauma consultation patients; and 4) compute the undertriage proportion among trauma consultation patients by using an intracranial hemorrhage (ICH)-Glasgow Coma Scale score (GCS)-ISS categorization method and employing targeted electronic medical record audits (EMRA). Methodology Age, ISS, GCS, activation status (full, partial, or consultation), injury mechanism, death, intensive care stay, and hospital stay were obtained from the trauma registry.

Associations of Age, Preinjury Morbidity, Injury Severity, and Cognitive Impairment With Mortality and Length of Stay in Trauma Consultation Patients: A Retrospective Study.

Background To the best of our knowledge, we have found no trauma consultation study investigating Injury Severity Score (ISS) ≥16, Glasgow Coma Scale score (GCS), intracranial hemorrhage (ICH), age, preexisting medical conditions (PEMC), and smoking as risk conditions for mortality. Objective We aimed to assess ISS ≥16 and other postinjury and preinjury conditions for associations with death and adverse outcomes (AO). Methodology Consecutive consultations of patients admitted to a trauma center over 18 months were investigated.

Association of Cigarette Smoking History With Drug Abuse History and Arterial Carboxyhemoglobin in Trauma Activation Patients: A Retrospective Study.

Introduction The relationship between cigarette smoking and arterial carboxyhemoglobin (CoHb) in trauma activation patients has not been investigated. The aim was to determine if cigarette smoking is associated with drug abuse history and arterial CoHb levels. Methodology This is a retrospective review of level I trauma center activations aged 18-60 during 2018-2020.

Laryngeal Cancer Screening During Flexible Video Laryngoscopy Using Large Computer Vision Models.

Objective: Develop an artificial intelligence assisted computer vision model to screen for laryngeal cancer during flexible laryngoscopy.

Methods: Using laryngeal images and flexible laryngoscopy video recordings, we developed computer vision models to classify video frames for usability and cancer screening. A separate model segments any identified lesions on the frames.

Endoscopic surgical field clarity index: An artificial intelligence-based measure of transnasal endoscopic surgical field quality.

Clear visualization during transnasal endoscopic surgery (TNES) is crucial for safe, efficient surgery. The endoscopic surgical field clarity index (ESFCI) is an artificial intelligence-enabled measure of surgical field quality. The ESFCI allows researchers to evaluate interventions to improve visualization during TNES.

Traumatic Brain Injury Outcome Associations With Computed Tomography and Glasgow Coma Scale Score Interactions: A Retrospective Study.

Background Numerous investigators have shown that early postinjury Glasgow Coma Scale (GCS) values are associated with later clinical outcomes in patients with traumatic brain injury (TBI), in-hospital mortality, and post-hospital discharge Glasgow Outcome Scale (GOS) results. Following TBI, early GCS, and brain computed tomography (CT) scores have been associated with clinical outcomes. However, only one previous study combined GCS scores with CT scan results and demonstrated an interaction with in-hospital mortality and GOS results.

New Medical Device and Therapeutic Approvals in Otolaryngology: State of the Art Review of 2022.

Objective: To review new drugs and devices relevant to otolaryngology approved by the Food and Drug Administration (FDA) in 2022.

Data Sources: Publicly available FDA data on drugs and devices approved in 2022.

Review Methods: A preliminary screen was conducted to identify drugs and devices relevant to otolaryngology.

Occurrence of Numerous Cerebral White Matter Hyperintensities in Trauma Patients With Cerebral Fat Embolism: A Systematic Review and Report of Two Cases.

There has been little effort to identify an overall occurrence of numerous cerebral white matter hyperintensities (NCWMH) on relevant brain magnetic resonance imaging (MRI) sequences in postinjury cerebral fat embolism syndrome (CFES) patients. Also, quantification of pre-CFES cognitive status, degree of neurologic deterioration, and presence of a skeletal fracture with CFES is nominal. The authors performed a PubMed search and identified 24 relevant manuscripts.

Computational fluid dynamics model of laryngotracheal stenosis and correlation to pulmonary function measures.

3D models of airway lumens were created from CT scans of 19 patients with laryngotracheal stenosis. Computational fluid dynamics (CFD) simulations were completed for each, and results were compared to measured peak inspiratory flow rate, grade of lumen constriction, and measures of airway geometry. Results demonstrate flow resistance and shear stress correlate with degree of lumen constriction and absolute cross-sectional area as well as flow rate.

Trauma activation patient preinjury toxicology-positive proportions and associated risk conditions: A retrospective study.

Background: Unlike prior guidelines for a positive toxicology screen, the 2022 national trauma data bank dictionary requires the exclusion of postinjury drugs. We aimed to (1) investigate the proportion of drugs in the toxicology screen that were given postinjury; (2) determine preinjury toxicology-positive associations with smoking, psychiatric, and drug abuse histories in an activation patient (ACT-Pt) cohort; and (3) explore whether ACT-Pt varied toxicology testing rates would produce similar preinjury toxicology-positive results.

Methods: In this retrospective study, the historic parent database included consecutive trauma center admissions where toxicology testing was discretionary.

Establishing an open and robotic pancreatic surgery program in a level 1 trauma center community teaching hospital and comparing its outcomes to high-volume academic center outcomes: a retrospective review.

Background: The debate of whether to centralize hepato-pancreato-biliary surgery has been ongoing. The principal objective was to compare outcomes of a community pancreatic surgical program with those of high-volume academic centers.

Methods: The current pancreatic surgical study occurred in an environment where (1) a certified abdominal transplant surgeon performed all surgeries; (2) complementary quality enhancement programs had been developed; (3) the hospital's trauma center had been verified; and (4) the hospital's surgical training had been accredited.

Trauma center admission risk conditions and the probability for developing alcohol withdrawal syndrome: A retrospective study.

Background: Because the proportion of trauma patients developing alcohol withdrawal syndrome (AWS) is low, AWS risk conditions have not been precisely delineated. We aimed to create multifactor screening strategies to assess probabilities for the likelihood of developing AWS.

Methods: We performed a retrospective chart review of 1,011 trauma patients admitted to a Level I trauma center to investigate the associations between AWS and probable AWS risk conditions.

A modular surgical simulator for microlaryngoscopy using standard instruments and the carbon dioxide laser.

Objective: Build a microlaryngoscopy surgical simulator for endoscopic laryngeal surgery using standard microsurgical instruments and a CO laser.

Study Design: Anatomical modeling, CAD design and 3D printed manufacturing.

Subjects And Methods: We created a modular design for a microlaryngoscopy simulator in CAD software.

Machine-learning-assisted spontaneous Raman spectroscopy classification and feature extraction for the diagnosis of human laryngeal cancer.

The early detection of laryngeal cancer significantly increases the survival rates, permits more conservative larynx sparing treatments, and reduces healthcare costs. A non-invasive optical form of biopsy for laryngeal carcinoma can increase the early detection rate, allow for more accurate monitoring of its recurrence, and improve intraoperative margin control. In this study, we evaluated a Raman spectroscopy system for the rapid intraoperative detection of human laryngeal carcinoma.

Autonomous diagnosis of pediatric cutaneous vascular anomalies using a convolutional neural network.

Objectives: Design and validate a novel handheld device for the autonomous diagnosis of pediatric vascular anomalies using a convolutional neural network (CNN).

Study Design: Retrospective, cross-sectional study of medical images. Computer aided design and 3D printed manufacturing.

Influence of a Stay-At-Home Order on Trauma Volume and Injury Patterns at a Level I Trauma Center in Ohio.

Background: Changes in injury patterns during the COVID pandemic have been reported in other states. The objective was to explore changes to trauma service volume and admission characteristics at a trauma center in northeast Ohio during a stay-at-home order (SAHO) and compare the 2020 data to historic trauma census data.

Methods: Retrospective chart review of adult trauma patients admitted to a level I trauma center in northeast Ohio.

Detection of pancreatic cancer by convolutional-neural-network-assisted spontaneous Raman spectroscopy with critical feature visualization.

Pancreatic cancer is the deadliest cancer type with a five-year survival rate of less than 9%. Detection of tumor margins plays an essential role in the success of surgical resection. However, histopathological assessment is time-consuming, expensive, and labor-intensive.

Bispectral Index Alterations and Associations With Autonomic Changes During Hypnosis in Trauma Center Researchers: Formative Evaluation Study.

Background: Previous work performed by our group demonstrated that intermittent reductions in bispectral index (BIS) values were found during neurofeedback following mindfulness instructions. Hypnosis was induced to enhance reductions in BIS values.

Objective: This study aims to assess physiologic relaxation and explore its associations with BIS values using autonomic monitoring.

Optical Biopsy: Automated Classification of Airway Endoscopic Findings Using a Convolutional Neural Network.

Objectives/hypothesis: Create an autonomous computational system to classify endoscopy findings.

Study Design: Computational analysis of vocal fold images at an academic, tertiary-care laryngology practice.

Methods: A series of normal and abnormal vocal fold images were obtained from the image database of an academic tertiary care laryngology practice.

Classification of tracheal stenosis in children based on computational aerodynamics.

Tracheal stenosis is a health condition in which local narrowing of the upper trachea can cause breathing difficulties and increased incidence of infection, among other symptoms. Occurring most commonly due to intubation of infants, tracheal stenosis often requires corrective surgery. It is challenging to determine the most effective surgical strategy for a given patient as current clinical methods used to assess tracheal stenosis are simplistic and subjective, and are not rigorously based on aerodynamic considerations.

A Surgical Simulator for Tympanostomy Tube Insertion Incorporating Capacitive Sensing Technology to Track Instrument Placement.

We describe a device engineered for realistic simulation of myringotomy and tympanostomy tube insertion that tracks instrument placement and objectively measures operator proficiency. A 3-dimensional computer model of the external ear and cartilaginous external auditory canal was created from a normal maxillofacial computed tomography scan, and models for the bony external auditory canal and tympanic cavity were created with computer-aided design software. Physical models were 3-dimensionally printed from the computer reconstructions.

Detecting delayed intracranial hemorrhage with repeat head imaging in trauma patients on antithrombotics with no hemorrhage on the initial image: A retrospective chart review and meta-analysis.

Background: There is debate regarding routine repeat head computed tomography (CT) in blunt trauma patients on a pre-injury antithrombotic when the initial CT is negative for intracranial hemorrhage (ICH).

Data Sources: Retrospective chart review and systematic literature review with meta-analysis.

Conclusions: In the chart review, 32.