Trauma Surgery & Acute Care Open最新文献

{"title":"Conundrums in the surgical intensive care unit: fevers and antibiotic prophylaxis.","authors":"Diane N Haddad, Patricia Martinez Quinones, Sriharsha Gummadi, Niels D Martin","doi":"10.1136/tsaco-2023-001352","DOIUrl":"10.1136/tsaco-2023-001352","url":null,"abstract":"<p><p>This editorial is in response to the three latest clinical consensus guidelines authored by the Critical Care Committee of the American Association for the Surgery of Trauma. Herein, we discuss their main findings and recommendations and their impact on the practice of Surgical Critical Care.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001352"},"PeriodicalIF":2.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248607","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":"From across the globe - traumatic injuries are an international concern at the US-Mexico border wall.","authors":"Sarah Lagan, Laura Haines, Gabriella Waters, Jarrett Santorelli, Allison E Berndtson, Jay Doucet, Todd W Costantini, Laura Adams","doi":"10.1136/tsaco-2023-001308","DOIUrl":"10.1136/tsaco-2023-001308","url":null,"abstract":"<p><strong>Introduction: </strong>Socio-economic and political events of recent years have caused a significant increase in immigrants attempting to illegally cross the United States (US)-Mexico border. While a 30-foot border wall separates the US and Mexico, immigrants from around the world have used this location as their point of entry to the US. These border crossings have led to a dramatic increase in major trauma resulting in increased inpatient resource utilization and the need for comprehensive hospital services. The aim of this study was to describe the nationality of injured immigrants admitted to a Trauma Center serving a segment of the US-Mexico border wall and to report their ultimate destinations after discharge.</p><p><strong>Methods: </strong>We performed a retrospective review of patients admitted to an academic, Level 1 Trauma Center after injury at the US-Mexico border wall from 2021 to 2022. Demographic information was obtained from the trauma registry. The electronic medical record was searched to identify each patient's self-reported country of origin. Patients' nationality was then stratified by region of the world to understand geographic representation of border injury admissions.</p><p><strong>Results: </strong>We identified 597 patients injured while crossing the US-Mexico border wall representing 38 different countries. The mean age of patients was 32.2±10.4 years and 446 (75%) were male. Most patients (405, 67.8%) were Mexican, followed by 23 (3.9%) patients from Peru, 17 (2.8%) patients from India, 14 (2.3%) patients from El Salvador, 13 (2.2%) patients from Cuba and 12 (2.0%) patients from Jamaica. When considering regions of the world other than Mexico, patients were most commonly from Africa, South America and Central America.</p><p><strong>Conclusion: </strong>The increased volume of trauma associated with the US-Mexico border wall is a humanitarian and health crisis.(1) The diverse national origin of patients admitted after injury from border wall falls has shed new light on the social and interpreter services needed to care for these border injury patients and the challenges that exist in their post-discharge care.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001308"},"PeriodicalIF":2.1,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11308883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907775","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":"Review of a large trauma registry in Addis Ababa, Ethiopia: insights into prehospital care and provider training for trauma quality improvement.","authors":"Nichole Starr, Mengistu Ayehu, Alex Zhuang, Habtamu Tamiru Minalu, Genet Kifle Alemu, Samuel Fisseha, Sisay Chekol, Aklile Habtemariam, Makida Hadis, Biruh Alemtsehay, Minale Mengiste, Ashenafi Kefeni Bori","doi":"10.1136/tsaco-2024-001453","DOIUrl":"10.1136/tsaco-2024-001453","url":null,"abstract":"<p><strong>Background: </strong>Injury is a major cause of death and disability in Ethiopia. ALERT Hospital, one of only three designated trauma centers in the country, has employed a basic trauma registry since its inception in 2016; however, these data had not been used. In joint efforts with the Federal Ministry of Health, we aimed to understand patient injury characteristics and predictors of mortality, to inform priorities in resource and training investments.</p><p><strong>Methods: </strong>Data from 12 816 consecutive patients in the first 3 years of the trauma registry were reviewed retrospectively. Modified Early Warning Score was used at triage to indicate injury severity (red=critically injured, green=minor injury). No physiologic data for calculating Injury Severity Scores or in-hospital intervention data were available. Triage groups were compared and multivariate logistic regression conducted to determine predictors of in-emergency department (ED) mortality.</p><p><strong>Results: </strong>Most patients presented with minor injuries with 64.7% triaged as 'yellow' and 16.4% triaged as 'green', and most (75.9%) referred from another facility. Of those who were critically injured, only 31.0% arrived by ambulance. Most injuries were soft tissue (51.1%) and fractures (23.0%); when stratified by triage category, most critical ('red') patients had sustained head injuries (52.7%). Arrival by ambulance (OR 2.20, p=0.017) and head injury (OR 3.11, p<0.001) were independent predictors of death in the ED.</p><p><strong>Conclusion: </strong>This study of injured patients presenting to an Ethiopian trauma center is one of the largest to date, highlighting the need for more accessible and streamlined prehospital trauma care. Opportunities for improvement include staff training in initial trauma management and implementation of a more comprehensive trauma registry containing physiologic, intervention, and outcomes data to support a robust quality improvement program. Efforts by the Federal Ministry of Health are ongoing to support these improvements in care.</p><p><strong>Level of evidence: </strong>Level 3, observational study.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001453"},"PeriodicalIF":2.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082029","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":"When the fungus is among us: does colonization portend later invasive fungal infection?","authors":"Lauren B Nosanov, Laura Johnson","doi":"10.1136/tsaco-2024-001472","DOIUrl":"10.1136/tsaco-2024-001472","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001472"},"PeriodicalIF":2.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082055","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":"Balanced resuscitation: the role during non-massive hemorrhage.","authors":"Kent Garber, Lucy Kornblith, Joseph Cuschieri","doi":"10.1136/tsaco-2024-001486","DOIUrl":"10.1136/tsaco-2024-001486","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001486"},"PeriodicalIF":2.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081866","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":"Putting the golf cart before the horse: pediatric head trauma outpaces education and safety regulations.","authors":"John Sincavage, Michael L Nance","doi":"10.1136/tsaco-2024-001481","DOIUrl":"10.1136/tsaco-2024-001481","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001481"},"PeriodicalIF":2.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081999","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":"Stabilization of the anterior flail chest and lung resection in a patient with blunt chest trauma and hepatic injuries.","authors":"Zoran Dakic, Marko Kantar, Radovan Juric","doi":"10.1136/tsaco-2024-001496","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001496","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001496"},"PeriodicalIF":2.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082030","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":"Intentionally self-injured patients have lower mortality when treated at trauma centers versus non-trauma centers in South Korea.","authors":"Jin Woo, Han Zo Choi, Jongkyeong Kang","doi":"10.1136/tsaco-2023-001258","DOIUrl":"10.1136/tsaco-2023-001258","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the characteristics and survival rates of patients with intentional severe trauma (self-harm or suicide) who were transported to either a regional trauma center (TC) or a non-TC facility.</p><p><strong>Methods: </strong>This retrospective, national, population-based, observational, case-control study included patients who sustained intentional severe trauma and had an abnormal Revised Trauma Score at the injury site between January 2018 and December 2019. The data were a community-based severe trauma survey based on data collected from severe injury and multiple casualty patients transported by 119 emergency medical services (EMS), distributed by the Korea Disease Control and Prevention Agency. The treatment hospitals were divided into two types, TC and non-TCs, and several variables, including in-hospital mortality, were compared. Propensity score matching (PSM) was used to mitigate the influence of confounding variables on the survival outcomes.</p><p><strong>Results: </strong>Among the 3864 patients, 872 and 2992 visited TC and non-TC facilities, respectively. The injury severity did not differ significantly between patients treated at TCs and non-TCs (TC, 9; non-TC, 9; p=0.104). However, compared with those treated at non-TCs, patients treated at TCs had a higher rate of surgery or transcatheter arterial embolization (14.2% vs 38.4%; p<0.001) and a higher admission rate to the emergency department (34.4% vs 60.6%; p<0.001). After PSM, 872 patients from both groups were analyzed. Patients treated at TCs exhibited a higher overall survival rate than those treated at non-TCs (76.1% vs 66.9%; p<0.001), and multiple variable logistic regression analysis demonstrated that the causes of injury and transport to the TC were significantly associated.</p><p><strong>Conclusion: </strong>Using Korean EMS data, the results of this study revealed that initial transport to TCs was associated with reduced mortality rates. However, considering the limitations of using data from only 2 years and the retrospective design, further research is warranted.</p><p><strong>Study type: </strong>Retrospective national, population-based observational case-control study.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001258"},"PeriodicalIF":2.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081959","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":"Small bowel obstruction due to a migrated pyloric stent.","authors":"James Paul Agolia, Simeng Wang, Andrea Fisher, Jaimie L Bryan, Lisa Marie Knowlton","doi":"10.1136/tsaco-2024-001443","DOIUrl":"https://doi.org/10.1136/tsaco-2024-001443","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001443"},"PeriodicalIF":2.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959313","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":"Golf cart injuries have similar severity to all-terrain vehicle injuries in children: a multicenter comparison over a 5-year period.","authors":"Henry L Chang, Brian K Yorkgitis, Lindsey B Armstrong, Keith A Thatch, Donald A Plumley, Robin T Petroze, Shawn D Larson, John W Fitzwater, Oliver B Lao, Michele A Markley, Anne Fischer, Felipe Pedroso, Holly L Neville, Christopher W Snyder","doi":"10.1136/tsaco-2023-001286","DOIUrl":"10.1136/tsaco-2023-001286","url":null,"abstract":"<p><strong>Background: </strong>Golf carts (GCs) and all-terrain vehicles (ATVs) are popular forms of personal transport. Although ATVs are considered adventurous and dangerous, GCs are perceived to be safer. Anecdotal experience suggests increasing numbers of both GC and ATV injuries, as well as high severity of GC injuries in children. This multicenter study examined GC and ATV injuries and compared their injury patterns, resource utilization, and outcomes.</p><p><strong>Methods: </strong>Pediatric trauma centers in Florida submitted trauma registry patients age <16 years from January 2016 to June 2021. Patients with GC or ATV mechanisms were identified. Temporal trends were evaluated. Injury patterns, resource utilization, and outcomes for GCs and ATVs were compared. Intensive care unit admission and immediate surgery needs were compared using multivariable logistic regression.</p><p><strong>Results: </strong>We identified 179 GC and 496 ATV injuries from 10 trauma centers. GC and ATV injuries both increased during the study period (R² 0.4286, 0.5946, respectively). GC patients were younger (median 11 vs 12 years, p=0.003) and had more intracranial injuries (34% vs 19%, p<0.0001). Overall Injury Severity Score (5 vs 5, p=0.27), intensive care unit (ICU) admission (20% vs 16%, p=0.24), immediate surgery (11% vs 11%, p=0.96), and mortality (1.7% vs 1.4%, p=0.72) were similar for GCs and ATVs, respectively. The risk of ICU admission (OR 1.19, 95% CI 0.74 to 1.93, p=0.47) and immediate surgery (OR 1.04, 95% CI 0.58 to 1.84, p=0.90) remained similar on multivariable logistic regression.</p><p><strong>Conclusions: </strong>During the study period, GC and ATV injuries increased. Despite their innocuous perception, GCs had a similar injury burden to ATVs. Heightened safety measures for GCs should be considered.</p><p><strong>Level of evidence: </strong>III, prognostic/epidemiological.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"9 1","pages":"e001286"},"PeriodicalIF":2.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911760","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}