Trauma Surgery & Acute Care Open最新文献

{"title":"Beyond performance metrics: evaluating clinical artificial intelligence (AI) post deployment.","authors":"Derek J Baughman, Woo Yeon Park, Khyzer B Aziz","doi":"10.1136/tsaco-2026-002469","DOIUrl":"10.1136/tsaco-2026-002469","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002469"},"PeriodicalIF":2.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689837","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":"One voice at the bedside: aligning goals of care and prognostic communication in trauma and acute care surgery.","authors":"Elizabeth Gorman, Julia Coleman, Jennifer Hartwell, Mackenzie Cook, Joseph Cuschieri","doi":"10.1136/tsaco-2025-002218","DOIUrl":"10.1136/tsaco-2025-002218","url":null,"abstract":"<p><p>High-acuity surgical and trauma care requires rapid decision-making under conditions of uncertainty, fragmented information flow, and competing physiological priorities. Patients frequently move across multiple services, each bringing distinct clinical expertise and discrete perspectives on prognosis, treatment goals, and acceptable outcomes. Within this dynamic environment, variation in prognostic framing and communication is common. Families often receive subtly different messages about the patient's expected trajectory, which can foster confusion and mistrust. Clear, aligned communication is therefore not an adjunct to technical excellence; it is an essential component of high-quality trauma and surgical care. Contemporary surgical practice increasingly intersects with palliative care principles. Surgical patients experience significant symptom burden, uncertain recovery, and frequent inflection points requiring reconsideration of goals of care. Surgeons occupy a central role in these early conversations. Early surgeon-initiated discussions about values and acceptable outcomes improve alignment between treatment plans and patient preferences, clarify expectations as clinical conditions evolve, and support family decision-making under stress. Yet, there is little formal training of surgeons in this area. Specialty palliative care is an essential partner when complexity, symptom burden, or decisional conflict exceed routine surgical management. Together, surgeon-led communication and selective palliative collaboration create a model in which trauma care remains both aggressive when appropriate and consistently grounded in what matters most to patients and families. This review, recently discussed at the American Association for the Surgery of Trauma online Grand Rounds, will address several of the most common obstacles encountered by acute care surgeons navigating multidisciplinary goals-of-care and prognostic discussions, as well as complex surrogate situations. Specifically, it examines how to create and deliver a cohesive and consistent message from a multidisciplinary team, the role of surgeon-led palliative care discussions with and without formal palliative care service consultation, and strategies for managing discordant surrogate decision-makers.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002218"},"PeriodicalIF":2.5,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689991","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":"Evaluation framework for assessing the quality and safety of artificial intelligence solutions for the acute care surgeon: a narrative review from the Eastern Association for the Surgery of Trauma quality, safety, and outcomes committee.","authors":"Tandis Soltani, Phillip Kim, William Ian McKinley, Lane Frasier, Phillip Dowzicky, Daniel N Holena, Rachael A Callcut","doi":"10.1136/tsaco-2025-002163","DOIUrl":"10.1136/tsaco-2025-002163","url":null,"abstract":"<p><p>Artificial intelligence (AI) has been developing as a field for decades. As acute care surgeons, we have been using AI in the clinical realm and in our everyday lives for years. However, with the public release of conversational large language models, there has been a rapid increase in the uptake of AI, with numerous new products on the market and evolving conversations around what this means for the future of surgery. Given acute care surgeons are leaders in healthcare systems, interfacing with patients and impacting quality and safety through critical timepoints in the emergency department, operating rooms, wards, and intensive care units, it is imperative that we have an understanding of this technology, its potential for bias, its assessment and implementation, and its governance. In this review, we cover these critical concepts and aim to provide a framework for acute care surgeons to understand and evaluate the quality and safety of AI solutions.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002163"},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631433","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":"Centering HVIPs within the community violence prevention ecosystem.","authors":"Matt Vogel, Taylor Kaser Mph","doi":"10.1136/tsaco-2026-002376","DOIUrl":"10.1136/tsaco-2026-002376","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002376"},"PeriodicalIF":2.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631307","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":"Importance of patient-centered research for hospital-based violence intervention programs.","authors":"James Dodington, Christopher Morrison","doi":"10.1136/tsaco-2026-002377","DOIUrl":"10.1136/tsaco-2026-002377","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002377"},"PeriodicalIF":2.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631438","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":"Building an emergency general surgery registry to track and benchmark outcomes.","authors":"Patrick B Murphy, Caroline Reinke, Susannah Nicholson, Nicole L Werner, Samuel W Ross, Catherine McKnight, Erik Kuncir, Stephanie A Savage, Matthew D Neal","doi":"10.1136/tsaco-2026-002323","DOIUrl":"10.1136/tsaco-2026-002323","url":null,"abstract":"<p><p>Emergency general surgery (EGS) represents a significant portion of admissions to hospitals and overall surgical care delivery, yet comprehensive outcome tracking and quality improvement efforts have lagged behind elective surgery and trauma care. This article outlines the gap in data and provides three practical solutions to registry development: third-party registry software with dedicated registrars, leveraging existing National Surgical Quality Improvement Program (NSQIP) infrastructure through the EGS-NSQIP module, and automated data extraction from electronic medical records. Each approach offers unique advantages in addressing the dual challenges of case identification and risk-adjusted outcome measurement for both local quality improvement and national benchmarking. The aim of this white paper is to provide pragmatic, scalable data solutions for EGS leaders seeking to implement contemporary quality improvement and verification efforts.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002323"},"PeriodicalIF":2.5,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13409273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621490","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":"\"It is nice, but it can't keep me safe\": perspectives on the effectiveness of hospital-based violence intervention programs.","authors":"William Wical, Tyrique Glasgow, Thomas Williams, Kathryn Bocanegra, Bethany L Strong, Cassandra Crifasi, Nazsa Baker, Angel Boulware, Joseph Richardson","doi":"10.1136/tsaco-2025-002087","DOIUrl":"10.1136/tsaco-2025-002087","url":null,"abstract":"<p><strong>Background: </strong>Hospital-based violence intervention programs (HVIPs) have been identified as an important intervention to reduce the likelihood that people who are violently injured return to the hospital for a similar injury. However, these programs often struggle with the recruitment and retention of participants.</p><p><strong>Methods: </strong>Drawing on long-term multisited ethnographic research at the programs associated with the two busiest trauma centers in the state of Maryland, we examine how survivors of violent injury, their loved ones, and program staff evaluate the effectiveness of HVIPs.</p><p><strong>Results: </strong>In centering the perspectives of these stakeholders, our analysis shows a clear disconnect between the goals of HVIPs and the realities survivors face. Thematic analysis included the inability of program services to increase participant safety, the limited impact of HVIP services on reducing retaliatory violence, and the need for community-engaged collaboration.</p><p><strong>Conclusions: </strong>These insights suggest a need for HVIP models that prioritize long-term care and social change.Level of EvidenceLevel IV, Economic & Value-based Evaluations.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 Suppl 4","pages":"e002087"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607783","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":"Goal completion among participants of a region-wide hospital-based violence intervention program: an observational cohort study.","authors":"Lashaunda Johnson, Taylor Kaser, Zoe Miller, Benjamin Cooper, Kateri Chapman-Kramer, Melik Coffey, Keyria Page, Vidya Eswaran, Nick Szoko, Micheal A Mancini, Kristen Mueller","doi":"10.1136/tsaco-2025-002073","DOIUrl":"10.1136/tsaco-2025-002073","url":null,"abstract":"<p><strong>Background: </strong>Hospital-based violence intervention programs (HVIPs) provide victims of violence with case management services to promote healing and reduce violent reinjury. Life Outside Violence (LOV), the St. Louis region-wide HVIP, is the first multisystem HVIP in the country. The objective of this study was to describe rates of individualized treatment plan (ITP) goal completion among adolescent and young adult LOV participants and explore differences across ITP goal categories.</p><p><strong>Methods: </strong>This is a retrospective observational cohort study of patients aged 8-30 who presented to a LOV partner hospital for a violent injury between August 15, 2018 and December 31, 2024 and participated in LOV. The LOV REDCap database was queried for patient demographics, injury type, ITP goal category, and goal completion. Analysis included descriptive statistics of participant characteristics and goal categories set and completed.</p><p><strong>Results: </strong>This cohort included 263 LOV participants who were primarily black (96%), male (63%) young adults (51%) and injured by a firearm (63%). A majority of LOV participants (85%) identified an ITP goal; of these 139 (62%) completed at least one goal. The most common goal category identified was Health and healthcare (34%), within which the subcategory of Mental health was prominent (58%). Social and community goals were completed at the highest rate (70%).</p><p><strong>Conclusions: </strong>HVIPs are highly individualized programs that address the unique needs of violent injury survivors. Overall, LOV participants set and completed ITP goals at a high rate. Findings indicated robust support for social and community related goals. These findings can inform patient-centered service provision and evaluation methods among other HVIPs and violence intervention programs.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 Suppl 4","pages":"e002073"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607789","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":"How hospital-based violence prevention professionals work: a qualitative study.","authors":"Lars Erik Almquist, Ellen A Ahlness, Ali Rowhani-Rahbar, Sarah Cusworth Walker, Christian D Helfrich","doi":"10.1136/tsaco-2025-002050","DOIUrl":"10.1136/tsaco-2025-002050","url":null,"abstract":"<p><strong>Background: </strong>Hospital-based violence intervention programs (HVIP) hinge on the ability of violence prevention professionals to assist the recovery of intentionally injured patients to prevent further spread of violence. Yet, we know little about the tactics these professionals use or whether the tactics developed by one violence prevention professional transfer to another. To address these gaps, this research catalogs the tactics frontline professionals use to meet the recovery needs of violently injured patients.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 23 hospital-based violence prevention professionals to identify tactics used in everyday work. Interviews were organized around 10 \"hinge points\" on the patient's recovery continuum deemed integral to program success, identified a priori. The Action Actor Context Target Time (AACTT) rubric helped ascertain essential information about each tactic identified via inductive thematic analysis.</p><p><strong>Results: </strong>We identified 214 tactics used by violence prevention professionals. Tactics addressing the initial patient encounter (n=49), trustbuilding efforts with patients (n=44), and service navigation (n=39) represented the largest and most diverse share of tactics identified. Comparably few tactics engaged patient retention (n=11) or aftercare as patients exited the program (n=3).</p><p><strong>Significance: </strong>Dissemination of these tactics will strengthen the skillsets of current HVIP professionals, while enhancing the training of future violence prevention personnel. Findings may support the creation of practical, readily deployable toolkits to translate tactical insight to diverse contexts where HVIPs operate, including HVIPs not yet established.</p><p><strong>Level of evidence: </strong>VI: Evidence from a single descriptive or qualitative study.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 Suppl 4","pages":"e002050"},"PeriodicalIF":2.5,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13410694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621526","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":"2026 Donald Trunkey Lecture: strengthening care for the injured globally: successes, challenges, opportunities.","authors":"Charles Mock","doi":"10.1136/tsaco-2026-002462","DOIUrl":"10.1136/tsaco-2026-002462","url":null,"abstract":"<p><p>Trauma is a major health problem, killing 4.5 million people each year. Most (84%) of these deaths are in low- and middle-income countries (LMICs), where resources for trauma care are constrained, often severely. These resource constraints lead to discrepancies in outcomes, with higher case-fatality rates for similar injuries in LMICs compared with high-income countries. Over one million trauma deaths could be averted each year if case-fatality rates in LMICs could be brought down to high-income country levels. There have been many local examples of affordable and sustainable improvements in trauma care and trauma outcomes in LMICs. The WHO and professional societies have worked to make more sustained progress globally. These efforts have resulted in moderate improvements in the availability of resources for trauma care, as assessed by consensus panels over the past 20 years. During this time, mortality for trauma has declined by 24% in the richer half of the world (high-income and upper middle-income countries) and by 15% in the poorer half (low-income and lower middle-income countries). To make further progress, there are several priorities (long-term efforts that probably require significant investment and new technology) and opportunities (which are immediately actionable). Priorities include increased availability of blood; improved care for traumatic brain injury; and improved prehospital care. Several opportunities are calling out for immediate action: increased use of trauma short courses and quality improvement programs; development of an international trauma registry for benchmarking; and use of the newly updated edition of the International Association for Trauma Surgery and Intensive Care's <i>Guidelines for Essential Trauma Care</i> for needs assessments of trauma care resources, with advocacy to fill identified gaps.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"11 3","pages":"e002462"},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608001","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}