Feasibility and accuracy of continuous intraabdominal pressure monitoring with a capsular device in human pilot trial.

Background: Intrabdominal pressure (IAP) is an important parameter. Elevated IAP can reduce visceral perfusion, lead to intraabdominal hypertension, and result in life-threatening abdominal compartment syndrome. While ingestible capsular devices have been used for various abdominal diagnoses, their application in continuous IAP monitoring remains unproven.

Time delay and evidence profiles forming clinical recommendations of US surgical society guidelines.

Introduction: Surgical society guidelines facilitate implementation of up-to-date, evidence-based care, but concerns regarding the contemporality and quality of evidence can hinder adherence. We aimed to evaluate the time gap between evidence publication and their inclusion within clinical guidelines-the publication-to-guideline delay-and characterize the quality of evidence within contemporary surgical society guidelines.

Study Design: This cross-sectional study analyzed guidelines published by U.

Resident-Applicant Buddy Program Increases Applicant Interest and Program Transparency.

Objective: Resident-Applicant Buddy Programs (RABPs) are a new initiative designed to improve resident recruitment. This study aims to evaluate the impact and perceived value of RABPs and to identify areas for improvement for future recruitment cycles.

Design: Anonymous online survey study of RABP participants with mixed-methods approach to evaluate participants' experience and perceived impact of the program.

Ethnoracial Differences in Social Determinants of Health and Acute Mental Health Symptoms Among Adults Hospitalized After Emergency Care.

Research has established relationships between social determinants of health (SDOH) and mental health, with mixed findings on which ethnoracial groups are most vulnerable to deleterious outcomes. The current study examines ethnoracial differences in SDOH and their associations with acute mental health symptoms among patients hospitalized after emergency care. Using data collected in a multi-site study of 1,318 diverse adults admitted to inpatient units, we performed analyses using linear regression models.

Comparative Analysis of Frailty Scores for Predicting Adverse Outcomes in Hip Fracture Patients: Insights from the United States National Inpatient Sample.

The aim of the current investigation was to compare the ability of several frailty scores to predict adverse outcomes in hip fracture patients. All adult patients (18 years or older) who suffered a hip fracture due to a fall and underwent surgical fixation were extracted from the 2019 National Inpatient Sample (NIS) Database. A combination of logistic regression and bootstrapping was used to compare the predictive ability of the Orthopedic Frailty Score (OFS), the Nottingham Hip Fracture Score (NHFS), the 11-factor modified Frailty Index (11-mFI) and 5-factor (5-mFI) modified Frailty Index, as well as the Johns Hopkins Frailty Indicator.

The burden of readmissions after rib fractures among older adults.

Background: The index hospitalization morbidity and mortality of rib fractures among older adults (aged ≥65 years) is well-known, yet the burden and risks for readmissions after rib fractures in this vulnerable population remain understudied. We aimed to characterize the burdens and etiologies associated with 3-month readmissions among older adults who suffer rib fractures. We hypothesized that readmissions would be common and associated with modifiable etiologies.

Palliative Intervention for Malignant Bowel Obstruction Comes at a Cost: A National Inpatient Study.

Malignant bowel obstruction (MBO) due to peritoneal carcinomatosis (PC) is associated with poor outcomes. Optimal management for palliation remains unclear. This study aims to characterize nonoperative, procedural, and operative management strategies for MBO and evaluate its association with mortality and cost.

Career Trajectory After General Surgery Residency: Do Academic Program Graduates Pursue Academic Surgery?

Objective: Determine the proportion of contemporary US academic general surgery residency program graduates who pursue academic careers and identify factors associated with pursuing academic careers.

Summary Background Data: Many academic residency programs aim to cultivate academic surgeons, yet the proportion of contemporary graduates who choose academic careers is unclear. The potential determinants that affect graduates' decisions to pursue academic careers remain underexplored.

Management of Uncomplicated Appendicitis in Adults: A Nationwide Analysis From 2018 to 2019.

Introduction: Nonoperative management (NOM) of uncomplicated appendicitis (UA) has been increasingly utilized in recent years. The aim of this study was to describe nationwide trends of sociodemographic characteristics, outcomes, and costs of patients undergoing medical versus surgical management for UA.

Methods: The 2018-2019 National (Nationwide) Inpatient Sample was queried for adults (age ≥18 y) with UA; diagnosis, as well as laparoscopic and open appendectomy, were defined by the International Classification of Diseases, 10th Revision, Clinical Modification codes.

Firearm-Related Injuries and the US Opioid and Other Substance Use Epidemic: A Nationwide Evaluation of Emergency Department Encounters.

Introduction: There has been a sharp climb in the Unites States' death rate among opioid and other substance abuse patients, as well as an increased prevalence in gun violence. We aimed to investigate the association between substance abuse and gun violence in a national sample of patients presenting to US emergency departments (EDs).

Methods: We queried the 2018-2019 Nationwide Emergency Department Sample for patients ≥18 years with substance abuse disorders (opioid and other) using International Classification of Diseases, 10th Revision, Clinical Modification codes.

Development and Initial Performance of the Hospital Mental Health Risk Screen.

Background: Patients hospitalized after emergency care are at risk for later mental health problems such as depression, anxiety, and posttraumatic stress disorder symptoms. The American College of Surgeons Committee on Trauma standards for verification require Level I and II trauma centers to screen patients at high risk for mental health problems. This study aimed to develop and examine the performance of a novel mental health risk screen for hospitalized patients based on samples that reflect the diversity of the US population.

Development and Validation of a Model to Quantify Injury Severity in Real Time.

Importance: Quantifying injury severity is integral to trauma care benchmarking, decision-making, and research, yet the most prevalent metric to quantify injury severity-Injury Severity Score (ISS)- is impractical to use in real time.

Objective: To develop and validate a practical model that uses a limited number of injury patterns to quantify injury severity in real time through 3 intuitive outcomes.

Design, Setting, And Participants: In this cohort study for prediction model development and validation, training, development, and internal validation cohorts comprised 223 545, 74 514, and 74 514 admission encounters, respectively, of adults (age ≥18 years) with a primary diagnosis of traumatic injury hospitalized more than 2 days (2017-2018 National Inpatient Sample).

TraumaICD Bidirectional Encoder Representation From Transformers: A Natural Language Processing Algorithm to Extract Injury International Classification of Diseases, 10th Edition Diagnosis Code From Free Text.

Objective: To develop and validate TraumaICDBERT, a natural language processing algorithm to predict injury International Classification of Diseases, 10th edition (ICD-10) diagnosis codes from trauma tertiary survey notes.

Background: The adoption of ICD-10 diagnosis codes in clinical settings for injury prediction is hindered by the lack of real-time availability. Existing natural language processing algorithms have limitations in accurately predicting injury ICD-10 diagnosis codes.

Mental health symptoms are comparable in patients hospitalized with acute illness and patients hospitalized with injury.

Background: High rates of mental health symptoms such as depression, anxiety, and posttraumatic stress disorder (PTSD) have been found in patients hospitalized with traumatic injuries, but little is known about these problems in patients hospitalized with acute illnesses. A similarly high prevalence of mental health problems in patients hospitalized with acute illness would have significant public health implications because acute illness and injury are both common, and mental health problems of depression, anxiety, and PTSD are highly debilitating.

Methods And Findings: In patients admitted after emergency care for Acute Illness (N = 656) or Injury (N = 661) to three hospitals across the United States, symptoms of depression, anxiety, and posttraumatic stress were compared acutely (Acute Stress Disorder) and two months post-admission (PTSD).

The relationship and predictive value of dementia and frailty for mortality in patients with surgically managed hip fractures.

Background: Both dementia and frailty have been associated with worse outcomes in patients with hip fractures. However, the interrelation and predictive value of these two entities has yet to be clarified. The current study aimed to investigate the predictive relationship between dementia, frailty, and in-hospital mortality after hip fracture surgery.

Impact of Medicaid Expansion and Firearm Legislation on Cost of Firearm Injuries.

Introduction: Firearm injury-related hospitalizations in the U.S. cost $900 million annually.

Validation of the orthopedic frailty score for measuring frailty in hip fracture patients: a cohort study based on the United States National inpatient sample.

Background: The Orthopedic Frailty Score (OFS) has been proposed as a tool for measuring frailty in order to predict short-term postoperative mortality in hip fracture patients. This study aims to validate the OFS using a large national patient register to determine its relationship with adverse outcomes as well as length of stay and cost of hospital stay.

Methods: All adult patients (18 years or older) registered in the 2019 National Inpatient Sample Database who underwent emergency hip fracture surgery following a traumatic fall were eligible for inclusion.

The acute care surgery model and elective surgery.

Two senior surgeons with active elective surgery practices call on their personal experiences to encourage acute care surgery programs to explore ways to incorporate elective surgery into their practice models. Although there are obstacles, these are not insurmountable problems, potential solutions exist, and this may help protect against burnout.

Ensuring excellence in patient care, research, and education: thoughts on leadership and teamwork.

There are many ways to develop your leadership skills and many ways to be an effective leader. This is one perspective. The best style is the one that works for you and your environment.

FasterRib: A deep learning algorithm to automate identification and characterization of rib fractures on chest computed tomography scans.

Objective: Characterizing and enumerating rib fractures are critical to informing clinical decisions, yet in-depth characterization is rarely performed because of the manual burden of annotating these injuries on computed tomography (CT) scans. We hypothesized that our deep learning model, FasterRib , could predict the location and percentage displacement of rib fractures using chest CT scans.

Methods: The development and internal validation cohort comprised more than 4,700 annotated rib fractures from 500 chest CT scans within the public RibFrac.