Trauma Surgery & Acute Care Open最新文献

{"title":"Identifying blunt duodenal injury by bicycle handlebar with methylene blue.","authors":"Rachna Vemireddy, Hima Bindu Thota, Mitchell Chaar, Bruno Molino","doi":"10.1136/tsaco-2024-001527","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001527","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001527"},"PeriodicalIF":2.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296399","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":"Appendicitis- Patient education series: understanding trauma and emergency surgery conditions.","authors":"Raafat John Kuk, Kimberly Hendershot","doi":"10.1136/tsaco-2024-001623","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001623","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001623"},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296305","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":"Rib fractures - Patient education series: understanding trauma and emergency surgery conditions.","authors":"Joshua Dilday, Elliott R Haut","doi":"10.1136/tsaco-2024-001622","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001622","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001622"},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296406","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":"Patient education series: understanding trauma and emergency general surgery conditions.","authors":"Joshua Dilday, Patrick M Reilly, Elliott R Haut, Matthew J Martin, Kimberly Hendershot","doi":"10.1136/tsaco-2024-001589","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001589","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001589"},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296402","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":"Percutaneous cryoneurolysis: new kid on the rib fracture pain 'Block'.","authors":"Simeng Wang, Alexandra A Myers, Joseph D Forrester","doi":"10.1136/tsaco-2024-001575","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001575","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001575"},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296403","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":"Lighting the way forward: using resonance Raman spectroscopy to non-invasively assess tissue perfusion.","authors":"Chavi Rehani, Rosemary Kozar","doi":"10.1136/tsaco-2024-001600","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001600","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001600"},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296400","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":"Population need versus trauma center financial sustainability: striking the right balance.","authors":"Kristan Staudenmayer","doi":"10.1136/tsaco-2024-001540","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001540","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001540"},"PeriodicalIF":2.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296404","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":"Racial disparities in end-of-life suffering within surgical intensive care units.","authors":"Diane N Haddad, Nicole Meredyth, Justin Hatchimonji, Elizabeth Merulla, Amy Matta, Jason Saucier, Catherine E Sharoky, Gary Alan Bass, Jose L Pascual, Niels D Martin","doi":"10.1136/tsaco-2024-001367","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001367","url":null,"abstract":"<p><strong>Background: </strong>End-of-life (EOL) care is associated with high resource utilization. Recognizing and effectively communicating that EOL is near promotes more patient-centered care, while decreasing futile interventions. We hypothesize that provider assessment of futility during the surgical intensive care unit (SICU) admission would result in higher rates of Do Not Resuscitate (DNR).</p><p><strong>Methods: </strong>We performed a retrospective review of a prospective SICU registry of all deceased patients across a health system, 2018-2022. The registry included a subjective provider assessment of patient's expected survival. We employed multivariable logistic regression to adjust for clinical factors while assessing for association between code status at death and provider's survival assessment with attention to race-based differences.</p><p><strong>Results: </strong>746 patients-105 (14.1%) traumatically injured and 641 (85.9%) non-traumatically injured-died over 4.5 years in the SICU (mortality rate 5.9%). 26.3% of these deaths were expected by the ICU provider. 40.9% of trauma patients were full code at the time of death, compared with 15.6% of non-traumatically injured patients. Expected death was associated with increased odds of DNR code status for non-traumatically injured patients (OR 1.8, 95% CI 1.03 to 3.18), but not for traumatically injured patients (OR 0.82, 95% CI 0.22 to 3.08). After adjusting for demographic and clinical characteristics, black patients were less likely to be DNR at the time of death (OR 0.49, 95% CI 0.32 to 0.75).</p><p><strong>Conclusion: </strong>20% of patients who died in our SICU had not declared a DNR status, with injured black patients more likely to remain full code at the time of death. Further evaluation of this cohort to optimize recognition and communication of EOL is needed to avoid unnecessary suffering.</p><p><strong>Level of evidence: </strong>Level III/prognostic and epidemiological.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001367"},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296405","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 prescribing patterns for patients with orthopedic trauma: a clinical vignette survey.","authors":"Nathan N O'Hara, Deborah M Stein, Elliott R Haut, Stephen Breazeale, Katherine P Frey, Gerard P Slobogean, Reza Firoozabadi, Renan Castillo, Robert V O'Toole","doi":"10.1136/tsaco-2024-001511","DOIUrl":"10.1136/tsaco-2024-001511","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Background: </strong>A recent clinical trial suggested aspirin is a viable alternative to enoxaparin for venous thromboembolism (VTE) prophylaxis in patients after orthopedic trauma. The initial impact of these findings on VTE prophylaxis prescribing is unknown. The study aimed to evaluate stated VTE prophylaxis prescribing patterns among clinicians who treat patients after orthopedic trauma.</p><p><strong>Methods: </strong>For this clinical vignette survey, we recruited surgeons and advanced practice providers who prescribed VTE prophylaxis to patients with orthopedic trauma across 40 states. Clinicians were shown seven clinical vignettes describing hypothetical patients with orthopedic trauma based on their fracture type, treatment, VTE risk factors, additional injuries and health insurance status. We assessed the stated VTE prophylaxis medications prescribed in-hospital and at discharge, patient factors associated with changes in medication prescribing preferences and practice variation by specialty and provider training.</p><p><strong>Results: </strong>Among the 287 respondents, the median age was 43 years (IQR, 38-50), and 154 (weighted average, 63%) were men. For in-hospital VTE prophylaxis, enoxaparin was prescribed in 83% of the presented scenarios, and aspirin was prescribed in 13% (p<0.001). At discharge, aspirin was prescribed more frequently than enoxaparin (50% vs 41%, p<0.001). Healthcare providers with an aspirin discharge preference were 12% more likely to switch to enoxaparin if the patient had additional VTE risk factors, such as obesity (95% CI 4% to 19%, p=0.005).</p><p><strong>Conclusions: </strong>Despite new clinical evidence, in-hospital VTE prophylaxis prescribing practices for patients with orthopedic trauma remain consistent with those reported a decade ago. However, compared with historical data, clinicians have significantly increased their preference for aspirin for thromboprophylaxis at discharge-unless the patient has additional thromboembolic risk factors.</p><p><strong>Level of evidence: </strong>5-expert opinion.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001511"},"PeriodicalIF":2.1,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296407","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":"Defining characteristics of categorical general surgery resident lateral transfers.","authors":"Ava K Mokhtari, Marinda G Scrushy, Hassan Naser A Mashbari, Noelle N Saillant, Ryan Peter Dumas, Brittany K Bankhead","doi":"10.1136/tsaco-2023-001333","DOIUrl":"10.1136/tsaco-2023-001333","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Background: </strong>Few studies describe rationales for intraspecialty ('lateral') general surgery (GS) resident program transfers.</p><p><strong>Objective: </strong>We aimed to describe the key features of GS residency programs reporting lateral transfers, to characterize reasons behind transfer events, and to compare transferring resident skill sets against their new institutional peers.</p><p><strong>Methods: </strong>A survey was administered in October 2020 to capture program features and demographic information of residents who transferred into or out of a GS residency program during a 5-year period. This survey was approved and distributed by the Association of Program Directors in Surgery to all participating GS program directors and coordinators. Survey responses were collected, and descriptive analyses were performed.</p><p><strong>Results: </strong>Of 69 program responses (21.5% survey response rate), 42 (61%) indicated the presence of any type of transfer event (in or out); 19 of 69 (27.5%) programs reported having at least one categorical GS resident transfer out, and 31 of 69 (44.9%) programs reported having at least one transfer in. Most transfer-out events (94.7%) were resident initiated, and the most commonly cited rationale was family obligation (78.9%). Most programs reported that residents who transferred in were on par with the existing resident cohort with respect to their medical knowledge, administrative abilities, and communication skills.</p><p><strong>Conclusion: </strong>GS transfers were not uncommon and most were resident initiated secondary to family obligations. The majority of transfer resident skill sets met institutional expectations by the time of graduation. Programs surveyed were content with their decision to accept transfer residents.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001333"},"PeriodicalIF":2.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120709","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}