Low left ventricular ejection fraction, complication rescue, and long-term survival after coronary artery bypass grafting.

Objectives: To evaluate the association between low left ventricular ejection fraction (LVEF), complication rescue, and long-term survival after isolated coronary artery bypass grafting.

Methods: National cohort study of patients who underwent isolated coronary artery bypass grafting (2000-2016) using Veterans Affairs Surgical Quality Improvement Program data. Left ventricular ejection fraction was categorized as ≥35% (n = 55,877), 25%-34% (n = 3893), or <25% (n = 1707).

Adequacy and accuracy of nontrauma center computed tomography: What are we missing?

Background: Timely and appropriate use of computed tomography (CT) scans is critical to the evaluation of traumatic injuries. The objective of this study was to assess the adequacy of CT scans performed at nontrauma centers (NTCs) as they pertain to the management of trauma patients.

Methods: Adult patients transferred to our ACS-verified Level I trauma center from any NTC between May and December 2012 were enrolled prospectively.

The effects of the addition of a pediatric surgery fellow on the operative experience of the general surgery resident.

Adding fellows to surgical departments with residency programs can affect resident education. Our specific aim was to evaluate the effect of adding a pediatric surgery (PS) fellow on the number of index PS cases logged by the general surgery (GS) residents. At a single institution with both PS and GS programs, we examined the number of logged cases for the fellows and residents over 10 years [5 years before (Time 1) and 5 years after (Time 2) the addition of a PS fellow].

Immediate versus delayed repair of destructive bowel injuries in patients with an open abdomen.

Trauma surgeons frequently encounter destructive bowel injuries. The timing of the repair of the bowel injury should be performed in patients with planned open abdomen management and second-look laparotomy has not been specifically addressed. Our primary objective was to determine if there was a significant difference in the incidence of major complications between immediate and delayed repair among patients with traumatic bowel injuries and planned open abdomens.

Traumatic liver injuries in the elderly as compared to younger adults.

Background: Comparing elderly (> 55 years) and younger (< 55 and > 15 years) traumatic liver injury patients, we evaluated differences in the need for operative intervention as well as transfusion requirements in those treated non-operatively.

Methods: This was a retrospective cohort study of adult patients with liver trauma. The analyses evaluated overall adjusted differences in treatment option and packed red blood utilization in those treated non-operatively by age group.

Pediatric appendicitis: the prevalence of systemic inflammatory response syndrome upon presentation and its association with clinical outcomes.

Introduction: To our knowledge, the prevalence of Systemic Inflammatory Response Syndrome (SIRS) in pediatric patients with appendicitis has not been previously investigated. Our specific aim was to determine the prevalence of SIRS at the time of presentation of pediatric patients with appendicitis. Additionally, we sought to determine if the presence of SIRS had any value in predicting their clinical outcomes.

Initial inferior vena cava diameter on computed tomographic scan independently predicts mortality in severely injured trauma patients.

Background: In the trauma population, patients with physiologic compromise may present with "normal" vital signs. We hypothesized that the inferior vena cava (IVC) diameter could be used as a surrogate marker for hypovolemic shock and predict mortality in severely injured trauma patients.

Methods: A retrospective cohort study was performed at a Level I trauma center on 161 severely injured adult (aged ≥ 16 years) trauma patients who were transported from the scene and underwent abdominal computed tomography within 1 hour.