Higher Rates of Traumatic Brain Injury in Blunt Trauma Patients With Cirrhosis: Worse Outcomes With Concomitant Alcohol Use Disorder.

IntroductionBlunt trauma patients (BTPs) with cirrhosis are at an elevated risk for hemorrhagic complications, including traumatic brain injury (TBI). This study assessed whether BTPs with cirrhosis experience higher rates of TBI and severe TBI compared to those without cirrhosis and whether alcohol use disorder (AUD) further impacts these outcomes.MethodsWe analyzed data from the 2017-2022 Trauma Quality Improvement Program (TQIP) for BTPs aged ≥18 years Patients were grouped by cirrhosis status, and those with cirrhosis were further stratified by AUD.

Comparing Admission Patterns Between Combined Pediatric-Adult and Pediatric-Only Trauma Centers.

Introduction: Prior studies have demonstrated improved outcomes for admitted children at pediatric-only hospitals (POHs) (e.g. children's hospitals) versus combined pediatric-adult trauma centers (CPACs).

Great Debates-Shift Work Versus One Day at a Time: 12- Versus 24-Hour Call Duration in Acute Care Surgery.

Optimal shift length for acute care surgery remains an ongoing debate that takes into consideration the impact of fatigue on performance, patient outcomes, and provider well-being. The data is conflicting on whether 12- or 24-hour calls are best. Proponents for the 24-hour shift model cite that it fosters superior continuity of care with fewer handoffs, enhances surgical training and does not negatively impact patient outcomes.

A Single-Center Evaluation of a Novel Hollow Viscus Injury Prediction Score for Abdominal Seatbelt Sign.

The diagnosis of hollow viscus injury (HVI) following blunt trauma presents a challenge in the acute clinical setting. The recently derived HVI score uses clinical and imaging findings to predict HVI with scores ranging from 0-17 (low risk: 0-5, moderate risk: 6-9, and high risk: 10-17). This study aimed to determine how frequently the use of the HVI score would change management in a cohort of patients with an abdominal seat belt sign (SBS).

Incidence and Predictors of Hollow Viscus Injury in Patients With Abdominal Morel-Lavalleé Injury.

Introduction: Abdominal Morel-Lavalleé (ML) injuries, though rare, are associated with serious clinical implications, such as concomitant hollow viscus injury (HVI). However, research on the incidence of HVI in patients with abdominal ML injuries remains lacking. This study aimed to identify the incidence and predictors of HVI in patients with abdominal ML injury.

Comparison of cervical versus thoracic spinal cord injury outcomes in pediatric trauma patients.

Purpose: To explore differences based on level of pediatric spinal cord injury (SCI), we compared cervical and thoracic SCI in pediatric trauma patients (PTPs), hypothesizing higher mortality and length of stay (LOS) for cervical SCI.

Methods: The 2017-2021 Trauma Quality Improvement Program was queried for all PTPs ≤ 17 years-old with cervical or thoracic SCI. Bivariate analyses compared the two groups.

Navigating Risk: A Comprehensive Study on Pedestrian-Vehicle Collision Factors.

Introduction: While older adults, young children, and individuals with psychiatric illnesses are commonly believed to be most susceptible to becoming pedestrians struck by motor vehicles (PSMV), substantial empirical evidence is lacking. This study aimed to discern the risk factors predisposing trauma patients requiring hospital evaluation to being struck by a vehicle.

Methods: The 2017-2021 Trauma Quality Improvement Program database was queried for all blunt trauma patients.

Standard spontaneous breathing trial parameters may not predict unplanned reintubation for trauma patients.

Background: The applicability of spontaneous breathing trial (SBT) factors such as negative inspiratory force (NIF) and rapid shallow breathing index (RSBI) as predictors of reintubation in trauma patients (TPs) is unclear. This study aimed to identify predictors of unplanned reintubation (UR) in TPs.

Methods: A single center, retrospective (1/2017-12/2023) study of TPs ≥18 years-old extubated from endotracheal mechanical ventilation was performed.

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.

Pregnancy and trauma: What you need to know.

Nearly 4% of pregnant patients have an injury-related visit to the emergency department during their pregnancy. There are important physiologic changes that occur during pregnancy that make managing pregnant trauma patients different from the standard management of a nonpregnant patient. This review discusses these changes and the initial assessment, laboratory, and imaging workups for the pregnant trauma patient.

Pre-hospital Tourniquet Use in Adolescent and Pediatric Traumatic Hemorrhage: A National Study.

Background: Tourniquet placement (TP) is a crucial intervention to control hemorrhage, but limited literature exists for use in children. This study aimed to evaluate the effectiveness of tourniquet application by different providers (Emergency Medical Services (EMS), first responder (FR), and bystanders), hypothesizing equivalent impact on outcomes for pediatric trauma patients for all providers.

Methods: Data from the National EMS Information Systems (NEMSIS) 2017-2020 was used to examine patients 0-19 years old and assess the outcomes of tourniquet application.

Stop the Bleed-Wait for the Ambulance or Get in the Car and Drive? A Post Hoc Analysis of an EAST Multicenter Trial.

The Stop the Bleed campaign gives bystanders an active role in prehospital hemorrhage control. Whether extending bystanders' role to private vehicle transport (PVT) for urban penetrating trauma improves survival is unknown, but past research has found benefit to police and PVT. We hypothesized that for penetrating trauma in an urban environment, where prehospital procedures have been proven harmful, PVT improves outcomes compared to any EMS or advanced life support (ALS) transport.

Tranexamic Acid and Pulmonary Complications: A Secondary Analysis of an EAST Multicenter Trial.

Background: Anti-inflammatory effects of tranexamic acid (TXA) in reducing trauma endotheliopathy may protect from acute lung injury. Clinical data showing this benefit in trauma patients is lacking. We hypothesized that TXA administration mitigates pulmonary complications in penetrating trauma patients.

Incidence, Risk Factors, and Outcomes of Central Line-Associated Bloodstream Infections in Trauma Patients.

Central line-associated blood stream infection (CLABSI) is a hospital-acquired infection (HAI) associated with increased morbidity and mortality among the general patient population. However, few studies have evaluated the incidence, outcomes, and risk factors for CLABSI in trauma patients. This study aimed to identify the rate of positive (+)CLABSI in trauma patients and risk factors associated with (+)CLABSI.

Washington State Assault Weapon Firearm Violence Before and After Firearm Legislation Reform.

Background: In January of 2019, Washington State (WA) passed Initiative 1639 making it illegal for persons <21 years-old to buy assault weapons (AWs). This study aimed to evaluate the effects of WA-1639 on firearm-related incidents involving AWs by those <21 years-old in WA, hypothesizing a decrease in incidents after WA-1639.

Methods: Retrospective (2016-2021) data on firearm violence (FV) events were gathered from the Gun Violence Archive.

Opportunity for a Community Health Fair Model of Bleeding Control Training.

Background: Traumatic hemorrhage is a prevalent cause of death nationally, with >50% of civilian deaths estimated to be preventable with more timely intervention. This study investigated the efficacy of training large and diverse audiences in bleeding control methods including tourniquets in community health fair settings.

Methods: A booth was utilized for bleeding control training at community health fairs via direct demonstrations of pressure, wound packing, and commercial and improvised tourniquet application followed by hands-on practice.

National Trends and Clinical Outcomes after Scooter Injury in the US: 2016 to 2020.

Background: In recent years, the adoption of electric scooters has been accompanied by a surge of scooter-related injuries in the US, raising concerns for their severity and associated healthcare costs. This study aimed to assess temporal trends and outcomes of scooter-related hospital admissions compared with bicycle-related hospitalizations.

Study Design: This was a retrospective cohort study using the 2016 to 2020 National Inpatient Sample for patients younger than 65 years who were hospitalized after bicycle- and scooter-related injuries.

Association of Early Rib Plating on Clinical and Financial Outcomes: A National Analysis.

Background: With reported improvements in patient outcomes, surgical stabilization of rib fractures (SSRF) has been increasingly adopted. While institutional series have sought to define the role of early SSRF, large scale analysis remains lacking. The present study evaluated clinical and financial outcomes of SSRF in a nationally representative cohort.

Predictors of fetal delivery in pregnant trauma patients: A multicenter study.

Background: Pregnant trauma patients (PTPs) undergo observation and fetal monitoring following trauma due to possible fetal delivery (FD) or adverse outcome. There is a paucity of data on PTP outcomes, especially related to risk factors for FD. We aimed to identify predictors of posttraumatic FD in potentially viable pregnancies.

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.