Pub Date : 2024-04-30DOI: 10.1097/ta.0000000000004362
Erin Feeney, Katrina M Morgan, Philip C Spinella, Barbara A Gaines, Christine M Leeper
Some studies in both children and adults have shown a mortality benefit for the use of low titer group O whole blood (LTOWB) compared to component therapy for traumatic resuscitation. Although LTOWB is not widely available at pediatric trauma centers, its use is increasing. We hypothesized that in children who received whole blood after injury, the proportion of whole blood in relation to the total blood product resuscitation volume would impact survival.
一些针对儿童和成人的研究表明，与创伤复苏中的成分疗法相比，使用低滴度 O 组全血（LTOWB）可降低死亡率。尽管低滴度 O 组全血在儿科创伤中心并不普及，但其使用率正在不断上升。我们假设，在受伤后接受全血的儿童中，全血与血液制品复苏总量的比例将影响存活率。
{"title":"Whole blood: total blood product ratio impacts survival in injured children.","authors":"Erin Feeney, Katrina M Morgan, Philip C Spinella, Barbara A Gaines, Christine M Leeper","doi":"10.1097/ta.0000000000004362","DOIUrl":"https://doi.org/10.1097/ta.0000000000004362","url":null,"abstract":"Some studies in both children and adults have shown a mortality benefit for the use of low titer group O whole blood (LTOWB) compared to component therapy for traumatic resuscitation. Although LTOWB is not widely available at pediatric trauma centers, its use is increasing. We hypothesized that in children who received whole blood after injury, the proportion of whole blood in relation to the total blood product resuscitation volume would impact survival.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30DOI: 10.1097/ta.0000000000004346
Nishant Gohel, Pranav Khambete, Laura Gerhardinger, Anna N Miller, Philip Wolinsky, Molly Jarman, John W Scott, Rahul Vaidya, Mark R Hemmila, Bryant W Oliphant
Early operative intervention in orthopaedic injuries is associated with decreased morbidity and mortality. Relevant process measures (e.g. femoral shaft fixation <24 hours) are used in trauma quality improvement programs to evaluate performance. Currently, there is no mechanism to account for patients who are unable to undergo surgical intervention (i.e. physiologically unstable). We characterized the factors associated with patients who did not meet these orthopaedic process measures.
{"title":"Characterizing Trauma Patients with Delays in Orthopaedic Process Measures.","authors":"Nishant Gohel, Pranav Khambete, Laura Gerhardinger, Anna N Miller, Philip Wolinsky, Molly Jarman, John W Scott, Rahul Vaidya, Mark R Hemmila, Bryant W Oliphant","doi":"10.1097/ta.0000000000004346","DOIUrl":"https://doi.org/10.1097/ta.0000000000004346","url":null,"abstract":"Early operative intervention in orthopaedic injuries is associated with decreased morbidity and mortality. Relevant process measures (e.g. femoral shaft fixation <24 hours) are used in trauma quality improvement programs to evaluate performance. Currently, there is no mechanism to account for patients who are unable to undergo surgical intervention (i.e. physiologically unstable). We characterized the factors associated with patients who did not meet these orthopaedic process measures.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.1097/TA.0000000000004344
Shelbie D Kirkendoll, Ashley B. Hink, Deborah A Kuhls, F. P. Rivara, Joseph V Sakran, Lauren L. Agoubi, Alex Winchester, Jacy Richards, Christopher J. Hoeft, Bhavin Patel, Holly N Michaels, A. Nathens
INTRODUCTION While the U.S. 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 multi-center prospective cohort study of patients treated for firearm-related injuries at 128 U.S. trauma centers from 3/2021-2/2022. Data collected included patient-level sociodemographic, injury and clinical characteristics, community characteristics, and context of injury. The outcome of interest was the association between these factors and the intent of firearm injury. Measures of urbanicity, community distress, and strength of state firearm laws were utilized to characterize patient communities. RESULTS 15,232 patients presented with firearm-related injuries across 128 centers in 41 states. Overall, 9.5% of patients died, and deaths were more common among law enforcement and self-inflicted (SI) firearm injuries (80.9% and 50.5%, respectively). These patients were also more likely to have a history of mental illness. SI firearm injuries were more common in older White men from rural and less distressed communities, whereas firearm assaults were more common in younger, Black men from urban and more distressed communities. Unintentional injuries were more common among younger patients and in states with lower firearm safety grades whereas law enforcement-related injuries occurred most often in unemployed patients with a history of mental illness. CONCLUSIONS Injury, clinical, sociodemographic, and community characteristics among patients injured by a firearm significantly differed between intents. With the goal of reducing firearm-related deaths, strategies and interventions need to be tailored to include community improvement and services that address specific patient risk factors for firearm injury intent. LEVEL OF EVIDENCE Level III, Prognostic/Epidemiological.
{"title":"Characteristics of Firearm Injury by Injury Intent: The Need for Tailored Interventions.","authors":"Shelbie D Kirkendoll, Ashley B. Hink, Deborah A Kuhls, F. P. Rivara, Joseph V Sakran, Lauren L. Agoubi, Alex Winchester, Jacy Richards, Christopher J. Hoeft, Bhavin Patel, Holly N Michaels, A. Nathens","doi":"10.1097/TA.0000000000004344","DOIUrl":"https://doi.org/10.1097/TA.0000000000004344","url":null,"abstract":"INTRODUCTION\u0000While the U.S. 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.\u0000\u0000\u0000METHODS\u0000This was a multi-center prospective cohort study of patients treated for firearm-related injuries at 128 U.S. trauma centers from 3/2021-2/2022. Data collected included patient-level sociodemographic, injury and clinical characteristics, community characteristics, and context of injury. The outcome of interest was the association between these factors and the intent of firearm injury. Measures of urbanicity, community distress, and strength of state firearm laws were utilized to characterize patient communities.\u0000\u0000\u0000RESULTS\u000015,232 patients presented with firearm-related injuries across 128 centers in 41 states. Overall, 9.5% of patients died, and deaths were more common among law enforcement and self-inflicted (SI) firearm injuries (80.9% and 50.5%, respectively). These patients were also more likely to have a history of mental illness. SI firearm injuries were more common in older White men from rural and less distressed communities, whereas firearm assaults were more common in younger, Black men from urban and more distressed communities. Unintentional injuries were more common among younger patients and in states with lower firearm safety grades whereas law enforcement-related injuries occurred most often in unemployed patients with a history of mental illness.\u0000\u0000\u0000CONCLUSIONS\u0000Injury, clinical, sociodemographic, and community characteristics among patients injured by a firearm significantly differed between intents. With the goal of reducing firearm-related deaths, strategies and interventions need to be tailored to include community improvement and services that address specific patient risk factors for firearm injury intent.\u0000\u0000\u0000LEVEL OF EVIDENCE\u0000Level III, Prognostic/Epidemiological.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140661916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1097/TA.0000000000004360
M. Harfouche, Rishi Kundi, T. Scalea
{"title":"Response to the letter to the editor for our article entitled \"A Pseudo-dilemma: Are we over-diagnosing and over-treating traumatic splenic intraparenchymal pseudoaneurysms?\"","authors":"M. Harfouche, Rishi Kundi, T. Scalea","doi":"10.1097/TA.0000000000004360","DOIUrl":"https://doi.org/10.1097/TA.0000000000004360","url":null,"abstract":"","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"325 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1097/TA.0000000000004333
Ceri Battle
{"title":"Letter to the Editor - External validation of novel Revised Intensity Battle Score and comparison of static rib fracture scoring systems.","authors":"Ceri Battle","doi":"10.1097/TA.0000000000004333","DOIUrl":"https://doi.org/10.1097/TA.0000000000004333","url":null,"abstract":"","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"151 6‐8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-12DOI: 10.1097/ta.0000000000004340
Adam D Price, Ryan C Chae, Taylor E Wallen, Ellen R Becker, Matthew R Baucom, Rebecca Schuster, Lisa England, Timothy A Pritts, Michael D Goodman
Prior literature has implicated Red Blood Cells (RBCs) in the initiation of thrombosis and suggests that post-transfusion hypercoagulability may occur secondary to the effects of RBCs. Elevated serum tissue factor is a known sequelae of acute trauma. Phosphatidylserine is a pro-thrombotic phospholipid present within the RBC cell membrane. We hypothesized that RBC aggregation is dependent on the interaction between RBC membrane bound (exposed) PS, extracellular calcium, and tissue factor.
{"title":"Direct red blood cell effect on thrombosis is dependent on the interaction of tissue factor and calcium with membrane phosphatidylserine.","authors":"Adam D Price, Ryan C Chae, Taylor E Wallen, Ellen R Becker, Matthew R Baucom, Rebecca Schuster, Lisa England, Timothy A Pritts, Michael D Goodman","doi":"10.1097/ta.0000000000004340","DOIUrl":"https://doi.org/10.1097/ta.0000000000004340","url":null,"abstract":"Prior literature has implicated Red Blood Cells (RBCs) in the initiation of thrombosis and suggests that post-transfusion hypercoagulability may occur secondary to the effects of RBCs. Elevated serum tissue factor is a known sequelae of acute trauma. Phosphatidylserine is a pro-thrombotic phospholipid present within the RBC cell membrane. We hypothesized that RBC aggregation is dependent on the interaction between RBC membrane bound (exposed) PS, extracellular calcium, and tissue factor.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/ta.0000000000004343
Nicolas Cazes, Simon-Pierre Corcostegui, Steven Lovi, Emeric Romary, Vincent Desrobert, Lionel Lidzborski, Clément Derkenne
Tranexamic acid is an inexpensive antifibrinolytic treatment that reduces morbidity and mortality in civilian and military trauma patients. It must be administered within 3 hours of the injury, and its efficacy is greater the earlier it is given. It is already used preventively in the civilian environment in a number of indications to reduce bleeding and bleeding-related mortality. We wondered about the potential benefits of preventive oral administration of tranexamic acid prior to an assault for military personnel with a potential risk of injury.
{"title":"Should Soldiers Take Oral Tranexamic Acid Before Going into Battle?","authors":"Nicolas Cazes, Simon-Pierre Corcostegui, Steven Lovi, Emeric Romary, Vincent Desrobert, Lionel Lidzborski, Clément Derkenne","doi":"10.1097/ta.0000000000004343","DOIUrl":"https://doi.org/10.1097/ta.0000000000004343","url":null,"abstract":"Tranexamic acid is an inexpensive antifibrinolytic treatment that reduces morbidity and mortality in civilian and military trauma patients. It must be administered within 3 hours of the injury, and its efficacy is greater the earlier it is given. It is already used preventively in the civilian environment in a number of indications to reduce bleeding and bleeding-related mortality. We wondered about the potential benefits of preventive oral administration of tranexamic acid prior to an assault for military personnel with a potential risk of injury.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"242 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/TA.0000000000004359
M. Harfouche, Rishi Kundi, T. Scalea
{"title":"Response to the letter to the editor for our article entitled \"A Pseudo-dilemma: Are we over-diagnosing and over-treating traumatic splenic intraparenchymal pseudoaneurysms?\"","authors":"M. Harfouche, Rishi Kundi, T. Scalea","doi":"10.1097/TA.0000000000004359","DOIUrl":"https://doi.org/10.1097/TA.0000000000004359","url":null,"abstract":"","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"554 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140719280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/ta.0000000000004349
Dhara Shukla, Geoff Shapiro, E Reed Smith, Babak Sarani
Tourniquet (TQ) use for hemorrhage control is a core skill for many law enforcement officers (LEO) and all emergency medical services (EMS) providers. However, LEO TQ training is not as intensive as EMS. Overuse of TQ can result in over triage. We hypothesize that LEO are more liberal than EMS with TQ placement.
{"title":"Comparison of Law Enforcement Officer versus Emergency Medical Services Placed Tourniquets.","authors":"Dhara Shukla, Geoff Shapiro, E Reed Smith, Babak Sarani","doi":"10.1097/ta.0000000000004349","DOIUrl":"https://doi.org/10.1097/ta.0000000000004349","url":null,"abstract":"Tourniquet (TQ) use for hemorrhage control is a core skill for many law enforcement officers (LEO) and all emergency medical services (EMS) providers. However, LEO TQ training is not as intensive as EMS. Overuse of TQ can result in over triage. We hypothesize that LEO are more liberal than EMS with TQ placement.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1097/ta.0000000000004352
Adam Fields, Ali Salim
Colorectal injuries are commonly encountered by trauma surgeons. The management of colorectal injuries has evolved significantly over the past several decades, beginning with wartime experience and subsequently refining with prospective randomized studies. Colon injuries were initially nonoperative, evolved towards fecal diversion for all, then became anatomic based with resection and primary anastomosis with selective diversion, and now primary repair, resection with primary anastomosis, or delayed anastomosis after damage control laparotomy are all commonplace. Rectal injuries were also initially considered non-operative until diversion came into favor. Diversion in addition to direct repair, presacral drain placement, and distal rectal washout became the gold standard for extraperitoneal rectal injuries until drainage and washout fell out of favor. Despite a large body of evidence, there remains debate on the optimal management of some colorectal injuries. This article will focus on how to diagnose and manage colorectal injuries. The aim of this review is to provide an evidence-based summary of the contemporary diagnosis and management of colorectal injuries.
{"title":"CONTEMPORARY DIAGNOSIS AND MANAGEMENT OF COLORECTAL INJURIES: WHAT YOU NEED TO KNOW.","authors":"Adam Fields, Ali Salim","doi":"10.1097/ta.0000000000004352","DOIUrl":"https://doi.org/10.1097/ta.0000000000004352","url":null,"abstract":"Colorectal injuries are commonly encountered by trauma surgeons. The management of colorectal injuries has evolved significantly over the past several decades, beginning with wartime experience and subsequently refining with prospective randomized studies. Colon injuries were initially nonoperative, evolved towards fecal diversion for all, then became anatomic based with resection and primary anastomosis with selective diversion, and now primary repair, resection with primary anastomosis, or delayed anastomosis after damage control laparotomy are all commonplace. Rectal injuries were also initially considered non-operative until diversion came into favor. Diversion in addition to direct repair, presacral drain placement, and distal rectal washout became the gold standard for extraperitoneal rectal injuries until drainage and washout fell out of favor. Despite a large body of evidence, there remains debate on the optimal management of some colorectal injuries. This article will focus on how to diagnose and manage colorectal injuries. The aim of this review is to provide an evidence-based summary of the contemporary diagnosis and management of colorectal injuries.","PeriodicalId":501845,"journal":{"name":"The Journal of Trauma and Acute Care Surgery","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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