Prehospital Delta Shock Index Predicts Mortality and Need for Life Saving Interventions in Trauma Patients.

Objectives: The delta shock index (ΔSI), defined as the change in shock index (SI) over time, is associated with hospital morbidity and mortality, but prehospital studies about ΔSI are limited. We investigate the association of prehospital ΔSI with mortality and resource utilization, hypothesizing that increases in SI among field trauma patients are associated with increased mortality and blood product transfusion.

Methods: We performed a multicenter, retrospective, observational study from the Linking Investigators in Trauma and Emergency Services (LITES) network.

Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial.

Objective: To determine the feasibility, efficacy, and safety of early cold stored platelet transfusion compared with standard care resuscitation in patients with hemorrhagic shock.

Background: Data demonstrating the safety and efficacy of early cold stored platelet transfusion are lacking following severe injury.

Methods: A phase 2, multicenter, randomized, open label, clinical trial was performed at 5 US trauma centers.

Association Between Emergency Medical Service Agency Volume and Mortality in Trauma Patients.

Objective: The aim of this study was to evaluate the association of annual trauma patient volume on outcomes for emergency medical services (EMS) agencies.

Background: Regionalization of trauma care saves lives. The underlying concept driving this is a volume-outcome relationship.

The Geography of Injuries in Trauma Systems: Using Home as a Proxy for Incident Location.

Introduction: Effective trauma system organization is crucial to timely access to care and requires accurate understanding of injury and resource locations. Many systems rely on home zip codes to evaluate geographic distribution of injury; however, few studies have evaluated the reliability of home as a proxy for incident location after injury.

Methods: We analyzed data from a multicenter prospective cohort collected from 2017 to 2021.

Capillary Transfer of Self-Assembled Colloidal Crystals.

Colloidal self-assembly has attracted significant interest in numerous applications including optics, electrochemistry, thermofluidics, and biomolecule templating. To meet the requirements of these applications, numerous fabrication methods have been developed. However, these are limited to narrow ranges of feature sizes, are incompatible with many substrates, and/or have low scalability, significantly limiting the use of colloidal self-assembly.

A call for standardization: Practice patterns and management of critical illness-related corticosteroid insufficiency in surgical intensive care units.

Introduction: Critical illness-rlated corticosteroid insufficiency (CIRCI) is a known sequela of severe injury and illness, yet its diagnosis and management are challenging. We hypothesized that CIRCI has significant variability in its diagnosis and management within surgical intensive care units (SICUs). Our study aimed to assess the state of practice of CIRCI in the American College of Surgery Committee on Trauma (ACS COT) certified level 1 trauma centers.

Blunt versus penetrating trauma: Is there a resource intensity discrepancy?

Background: The rising cost of healthcare requires responsible allocation of resources. Not all trauma centers see the same types of patients. We hypothesized that patients with blunt injuries require more resources than patients with penetrating injuries.

Are We Out of the Woods Yet? The Aftermath of Resuscitative Thoracotomy.

Background: After traumatic arrest, resuscitative thoracotomy is lifesaving in appropriately selected patients, yet data are limited regarding hospital course after intensive care unit (ICU) admission. The objective of this study was to describe the natural history of resuscitative thoracotomy survivors admitted to the ICU.

Materials And Methods: We conducted a retrospective review (January 1, 2012-June 30, 2017) of all adult trauma patients who underwent resuscitative thoracotomy after traumatic arrest at two adult level 1 trauma centers.

Ideal timing of early cholecystectomy for acute cholecystitis: An ACS-NSQIP review.

Background: Current guidelines fail to specify optimal timing of early cholecystectomy for acute cholecystitis. We hypothesized delaying operation past hospital day (HD) 2 would result in increased 30-day morbidity and mortality.

Methods: The ACS-NSQIP database was queried from 2012 to 2015 for all cholecystectomies for acute cholecystitis from HD 1-7.

Comparative study of the dynamics of laser and acoustically generated bubbles in viscoelastic media.

Experimental observations of the growth and collapse of acoustically and laser-nucleated single bubbles in water and agarose gels of varying stiffness are presented. The maximum radii of generated bubbles decreased as the stiffness of the media increased for both nucleation modalities, but the maximum radii of laser-nucleated bubbles decreased more rapidly than acoustically nucleated bubbles as the gel stiffness increased. For water and low stiffness gels, the collapse times were well predicted by a Rayleigh cavity, but bubbles collapsed faster than predicted in the higher stiffness gels.

Population-level outcomes of early versus delayed appendectomy for acute appendicitis using the American College of Surgeons National Surgical Quality Improvement Program.

Background: The optimal timing of appendectomy for acute appendicitis has been analyzed with mixed results. We hypothesized that delayed appendectomy would be associated with increased 30-d morbidity and mortality.

Materials And Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients undergoing nonelective appendectomy from 2012 to 2015 with a postoperative diagnosis of appendicitis.

Needs assessment for a focused radiology curriculum in surgical residency: a multicenter study.

Background: Patient instability and limited radiology staffing may compel surgeons to make clinical decisions based on their independent interpretations of imaging studies. Despite potential implications for patients, no research to date has assessed the need for a diagnostic radiology curriculum in general surgery residency.

Methods: We performed a cross-sectional study of surgery faculty and residents at 13 teaching hospitals across the United States.

Can old dogs learn new "transfusion requirements in critical care": a survey of packed red blood cell transfusion practices among members of The American Association for the Surgery of Trauma.

Background: The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically ill patients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons.

Methods: A survey of PRBC transfusion practices was administered to the American Association for the Surgery of Trauma members.

A community traffic safety analysis of pedestrian and bicyclist injuries based on the catchment area of a trauma center.

Background: This study was designed to examine the characteristics of pedestrian and bicyclist collisions with motor vehicles within New York City's high-density hub. The primary objectives were to map crash locations and to identify hot spots within these injury clusters. The secondary objective was to quantify differences in injury severity based on road type and user behaviors.

The (f)utility of flexion-extension C-spine films in the setting of trauma.

Background: Flexion-extension radiographs are often used to assess for removal of the cervical collar in the setting of trauma. The objective of this study was to evaluate their adequacy. We hypothesized that a significant proportion is inadequate.

Racial disparities in abdominal aortic aneurysm repair among male Medicare beneficiaries.

Hypothesis: Although investigators have reported that abdominal aortic aneurysm (AAA) repair is performed less frequently in black subjects than in white subjects, these findings may be explained by a lower prevalence of AAA disease among black subjects. We examine this assumption by determining the relative rate (RR) of elective AAA repair in black men vs white men after accounting for differences in disease prevalence.

Design: We used Medicare data from January 2001 to December 2003 to identify men 65 years and older undergoing elective or urgent AAA repair.

Choosing where to have major surgery: who makes the decision?

Hypothesis: Efforts are under way to distribute hospital performance data directly to patients to inform their decisions about where to go for major surgery, but patients are not always involved in making the decision of where they will have surgery.

Design: Telephone interviews.

Participants: Five hundred ten randomly selected Medicare patients who had undergone 1 of 5 elective high-risk operations approximately 3 years earlier: abdominal aneurysm repair (n = 103), heart valve replacement surgery (n = 96), or resections for bladder (n = 119), lung (n = 128), or stomach (n = 64) cancer.

U.S. trends in CABG hospital volume: the effect of adding cardiac surgery programs.

Hospital coronary artery bypass graft (CABG) volume is inversely related to mortality--with low-volume hospitals having the highest mortality. Medicare data (1992-2003) show that the number of CABG procedures increased from 158,000 in 1992 to a peak of 190,000 in 1996 and then fell to 152,000 in 2003, while the number of hospitals performing CABG increased steadily. Predictably, the proportion of CABG procedures performed at low-volume hospitals increased, and the proportion in high-volume hospitals declined.

Perioperative intranasal mupirocin for the prevention of surgical-site infections: systematic review of the literature and meta-analysis.

Objective: To review the evidence evaluating perioperative intranasal mupirocin for the prevention of surgical-site infections according to type of surgical procedure.

Design: Systematic review and meta-analysis of published clinical trials.

Setting: Studies included were either randomized clinical trial or prospective trials at a single institution that measured outcomes both before and after an institution-wide intervention (before-after trial).