Trauma Surgery & Acute Care Open最新文献

{"title":"Unveiling the economic value of equitable care for the traumatically injured: is it cost-effective to decrease trauma disparities?","authors":"Tandis Soltani, Anamaria J Robles, Kathryn M Stadeli, Sydney Timmer-Murillo, Bethany Lauren Strong, Cynthia Lizette Villarreal, Shayan Rakhit, Vanessa P Ho, Michelle A Price, Arpana Jain, Michaela A West","doi":"10.1136/tsaco-2024-001470","DOIUrl":"10.1136/tsaco-2024-001470","url":null,"abstract":"<p><p>In the USA, traumatic injury results in a significant financial burden, which is unevenly distributed in our society. In this paper, we will highlight some of the data around the costs of injury associated with a focus on socially vulnerable and historically resilient groups at risk for disparate outcomes. We delve into the concept of economic return on investment from multiple perspectives: the patient perspective, the community perspective and from a national and policy perspective. Targeted policy changes and dedicated efforts towards minimizing gaps in trauma care and enhancing survivorship can yield substantial economic benefits. This paper also describes several national funding agencies and their current priorities related to funding in equity and trauma research. This manuscript will demonstrate that reducing disparities in trauma care not only serves a moral imperative but also a necessary and financially sound strategy with a good economic return on investment.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 Suppl 4","pages":"e001470"},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-sensitive surgery: the devil's in the details.","authors":"Anamika Veeramani, Laurie Antonik, Alistair Kent","doi":"10.1136/tsaco-2025-001920","DOIUrl":"10.1136/tsaco-2025-001920","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001920"},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern vascular trauma and preparing tomorrow's workforce.","authors":"Navpreet K Dhillon, Alexander C Schwed, Rishi Kundi, Stephanie A Savage, Megan Brenner, Thomas M Scalea","doi":"10.1136/tsaco-2025-001842","DOIUrl":"10.1136/tsaco-2025-001842","url":null,"abstract":"<p><p>Modern vascular trauma is complex and requires multidisciplinary care to assure optimal patient outcomes. Recognizing this, the American Association for the Surgery of Trauma (AAST) Associate Member Council hosted grand rounds to explore key issues in contemporary vascular trauma care and potential solutions. Current training paradigms may not adequately prepare either general surgery residents or integrated vascular surgery residents to care for these patients alone. The current iteration of the AAST Acute Care Surgery fellowship program hopes to overcome these limitations with a formal curriculum in vascular trauma. New attending surgeons must actively seek out and maintain vascular surgery skills, which can be done in collaboration with fellow trauma partners or vascular colleagues and will depend on the local culture of each institution. We also share a model of care implemented at the R Adams Cowley Shock Trauma Center, highlighting lessons learned from a team-based approach to modern vascular trauma care.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001842"},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thromboembolism prophylaxis initiation in adults with traumatic brain injury: elusive and hard to pin down.","authors":"Michele N Fiorentino, Asanthi Ratnasekera","doi":"10.1136/tsaco-2025-001942","DOIUrl":"10.1136/tsaco-2025-001942","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001942"},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thromboembolism prophylaxis in adults with acute traumatic brain injury: a systematic review.","authors":"Mary L Forte, Sallee Brandt, Amy Marie Claussen, Christopher J Tignanelli, Surbhi Shah, Mary Butler","doi":"10.1136/tsaco-2024-001691","DOIUrl":"10.1136/tsaco-2024-001691","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing and type of venous thromboembolism chemoprophylaxis (VTEp) for adults with acute traumatic brain injury (TBI) remains unknown. This systematic review synthesized evidence on the timing and type of VTEp in adults with TBI and highlights evidence gaps.</p><p><strong>Methods: </strong>We searched Ovid MEDLINE, Embase, and the Cochrane Library through November 4, 2024 for English language, randomized or non-randomized studies with a comparator that reported VTEp timing or agent in adults with acute TBI, and reported intracranial hemorrhage progression (ICHP), VTE, pulmonary embolism (PE), deep vein thrombosis (DVT), neurosurgical intervention (NSI), adverse events (AEs), length of stay (LOS), function, or mortality. Risk of bias (ROB) was assessed with ROBINS-I as low, moderate, serious, or critical risk in studies that used advanced analytic methods (AAMs) to control selection bias; all other studies were deemed critical risk. We qualitatively synthesized evidence and focused text reporting on studies with AAM.</p><p><strong>Results: </strong>From 738 citations, 21 non-randomized studies met criteria (1 moderate, 20 critical ROB): 16 on VTEp timing, 7 on agents. Seven studies used AAM. For VTEp timing (five AAM studies), one study of adults with mostly mild TBI found no significant difference between Early and Late VTEp on ICHP (moderate ROB); no timing studies with AAM reported ICHP for adults with moderate or severe TBI. Findings were mixed for VTE timing on NSI and PE. Early VTEp was associated with fewer DVTs. There was no difference in mortality or serious AEs by VTEp timing. For VTEp agents, three studies with AAM found no significant difference between low molecular weight heparin (LMWH) and unfractionated heparin (UH) on ICHP, PE, DVT, and serious or overall AEs. Results were mixed for LMWH versus UH effects on NSI after VTEp, VTE, LOS and mortality. TBI severity labeling varied across studies and within measures, reducing comparability.</p><p><strong>Conclusions: </strong>Clinical evidence on the timing and type of VTEp for adults with acute TBI is of insufficient quality for clinical decision-making. Prospective research designs, standardization of TBI severity labeling, and improved reporting of interventions and outcomes would advance the field.</p><p><strong>Prospero registration number: </strong>CRD42023421534.</p><p><strong>Level of evidence: </strong>Systematic Review, Level IV.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001691"},"PeriodicalIF":2.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different outcomes after surgical stabilization of one versus both fractures in patients with flail chest.","authors":"Alicia Privette, Evert Austin Eriksson","doi":"10.1136/tsaco-2025-001929","DOIUrl":"10.1136/tsaco-2025-001929","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001929"},"PeriodicalIF":2.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive lower gastrointestinal bleeding due to Meckel's diverticulum in an atypical position.","authors":"Vladislav Muldiiarov, Keely Buesing, Kevin M Kemp","doi":"10.1136/tsaco-2025-001831","DOIUrl":"10.1136/tsaco-2025-001831","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001831"},"PeriodicalIF":2.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond mortality: what a 30,000-foot view of opportunities for improvement can teach us about trauma center maturity.","authors":"Galinos Barmparas","doi":"10.1136/tsaco-2025-001923","DOIUrl":"10.1136/tsaco-2025-001923","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001923"},"PeriodicalIF":2.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma in India: current status and the path forward.","authors":"Joses Dany James, Srujan Lam Sharma, Deepak Agrawal, Ramana Rao, Sanjeev Bhoi, Tej Prakash Sinha, Vignesh Kumar, Amit Gupta, Suresh Sangi, Vijayan Purushothaman, Sukria Nayak, Mahesh Chand Misra, Krishnan Raghavendran","doi":"10.1136/tsaco-2025-001803","DOIUrl":"10.1136/tsaco-2025-001803","url":null,"abstract":"<p><p>Trauma care in India has made significant progress in the past two decades. However, a coordinated and concerted effort has sometimes been lacking. Information on the various aspects of injury prevention, trauma education, and prehospital and in-hospital trauma care in India has been available in a fragmented manner so far. This comprehensive review aims to understand in detail and bring together the various facets of injury prevention and trauma care in India, including the efforts being put at various levels to tackle the problem. The article also includes a detailed SWOT analysis, assessing strengths, weaknesses, opportunities, and threats and suggests strategies to overcome them.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001803"},"PeriodicalIF":2.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content assessment and readability of online injury prevention resources on firearm safety: a cross-sectional analysis of hospital and national injury prevention literature.","authors":"Arnav Mahajan, Pooja Podugu, Nicholas Beattie, Anthony Zalewski, Megen Simpson, Sarah A Sweeney, Vanessa P Ho","doi":"10.1136/tsaco-2024-001665","DOIUrl":"10.1136/tsaco-2024-001665","url":null,"abstract":"<p><strong>Background: </strong>Firearm-related injuries are a preventable public health epidemic and the leading cause of pediatric death in America. Online injury prevention resources (OIPRs) offer potential for educating the public on firearm safety. National public health organizations recommend a sixth-grade reading level for these resources. We hypothesize that OIPRs for firearm safety may not meet this standard and are inconsistent in content.</p><p><strong>Methods: </strong>We analyzed firearm injury OIPRs from three sources: verified trauma centers (TCs), national health organizations, and gun violence prevention advocacy groups. We assessed readability using reading time, Flesch-Kincaid grade level, and Flesch reading ease. We also assessed whether OIPRs included child safety, safe handling, and safe storage of firearms.</p><p><strong>Results: </strong>Among 587 TCs, 105 had publicly accessible OIPRs. After removing duplicates, we analyzed 53 unique hospital OIPRs, 25 from national organizations, and 8 from advocacy groups. The mean reading time of hospital-based OIPRs was 2 min and 49 s, and 5 min and 30 s for advocacy organizations. The average Flesch-Kincaid Grade Level for hospital OIPRs was 8.2, national organizations 8.4, and advocacy groups 9.7. Only 21% of hospital and 22% of national OIPRs met the sixth-grade level; none of the advocacy groups met this standard. 79% of hospital-based OIPRs content related to child safety, compared with 44% of national organizations and none of the advocacy groups. Only 21% of TCs and no advocacy groups provided information on safe handling practices.</p><p><strong>Conclusion: </strong>Few OIPRs meet recommended readability guidelines and often fail to address key topics such as child safety or safe handling of firearms. This gap in accessible educational information highlights the need for standardized resources to reduce firearm injury. Future research should aim to improve these resources to ensure usability and effective outreach to our communities.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001665"},"PeriodicalIF":2.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}