Publications by authors named "Gustavo Recinos"

Background: The purpose of this study was to evaluate the optimal timing and type of pharmacological venous thromboembolism prophylaxis (VTEp) in patients with severe blunt head trauma with acute subdural hematomas (ASDH).

Methods: Matched cohort study using ACS-TQIP database (2013-2016) including patients with isolated ASDH. Outcomes of matched patients receiving early prophylaxis (EP, ≤48 h) and late prophylaxis (LP, >48 h) were compared with univariable and multivariable regression analysis.

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Background: Nonoperative management (NOM) has become more common in hemodynamically stable patients with high-grade blunt splenic injury. However, there are no widely accepted guidelines for an optimal and safe timeframe for the initiation of venous thromboembolism (VTE) prophylaxis. The purpose of this study was to explore the association between the timing of VTE prophylaxis initiation and NOM failure rate in isolated high-grade blunt splenic injury.

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Background: Motocross-related injury patterns and outcomes are poorly understood. The purpose of this analysis was to characterize the epidemiology, injury patterns, and outcomes of motocross collisions. These parameters were compared with motorcycle collisions for context.

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Introduction: Optimal timing of pharmacological thromboprophylaxis (VTEp) in patients with severe pelvic fractures remains unclear. The high risk of venous thromboembolic (VTE) complications after severe pelvic fractures supports early VTEp however concern for fracture-associated hemorrhage can delay initiation. Patients with pelvic fractures also frequently have additional injuries that complicate the interpretation of the VTEp safety profiles.

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Intraoperative consultations are an important component of acute care surgery (ACS). The nature of these consultations is incompletely characterized by the existing literature. The study objective was to define the characteristics of intraoperative consults managed by a mature ACS program at a Level I trauma center.

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Background: Historically, hemorrhage has been attributed as the leading cause (40%) of early death. However, a rigorous, real-time classification of the cause of death (COD) has not been performed. This study sought to prospectively adjudicate and classify COD to determine the epidemiology of trauma mortality.

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Introduction: Flail chest is considered a highly morbid condition with reported mortality ranging from 10 to 20%. It is often associated with other severe injuries, which may complicate management and interpretation of outcomes. The physiologic impact and prognosis of isolated flail chest injury is poorly defined.

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Background: The effect of prehospital helicopter emergency medical services (HEMS) on mortality has been analyzed previously in polytrauma patients with discordant results.

Objective: Our aim was to compare outcomes in patients with isolated severe blunt traumatic brain injuries (TBIs) transported by HEMS or ground emergency medical services (GEMS).

Methods: We conducted a National Trauma Data Bank study (2007-2014).

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Background: Computed tomography of the abdomen and pelvis (CTAP) is highly specific for injury identification and commonly used in the evaluation of blunt trauma patients. Despite this, there is no consensus on the required clinical observation period after negative imaging, often impacting patient flow and hospital cost. The purpose of this study was to evaluate the use of CTAP after blunt trauma and the need for observation after negative imaging.

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Objective: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI).

Summary Background Data: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients.

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Background: Traumatic, non-iatrogenic esophageal injuries, despite their rarity, are associated with significant morbidity and mortality. The optimal management of these esophageal perforations remains largely debated. To date, only a few small case series are available with contrasting results.

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The purpose of this study was to examine the impact of in-house attending surgeon supervision on the rate of preventable deaths (PD) and complications (PC) at the beginning of the academic year. All trauma patients admitted to the Los Angeles County + University of Southern California Medical Center over an 8-year period ending in December 2009 were reviewed. Morbidity and mortality reports were used to extract all PD/PC.

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Background: In asymptomatic patients with penetrating thoracic trauma and a normal initial chest x-ray, successive prospective trials have decreased the minimum observation period required for exclusion of significant injury from 6 to 3 h. Despite the quality of these studies, this interval remains arbitrary and the true requisite observation time for safe discharge remains unknown. The current study evaluates the ability of "early" repeat chest x-ray, at intervals approaching 1 h, to exclude clinically significant injury.

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Background: Although uncomfortable for the operating team, trauma operating room (OR) temperatures have traditionally been kept warm in an attempt to mitigate intraoperative heat loss. The purpose of this study was to examine how ambient OR temperatures impact core temperature in patients undergoing emergent surgery for trauma.

Methods: Injured adult patients requiring emergent surgery at a Level 1 trauma center were prospectively enrolled between July 2008 and January 2010.

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Background: The optimal chest tube size for the drainage of traumatic hemothoraces and pneumothoraces is unknown. The purpose of this study was to compare the efficacy of small versus large chest tubes for use in thoracic trauma. Our hypothesis was that (1) there would be no difference in clinically relevant outcomes including retained hemothoraces, the need for additional tube insertion, and invasive procedures and (2) there would be an increase in pain with the insertion of large versus small tubes.

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Introduction: The relationship between outcomes following severe trauma and American College of Surgeons (ACS) trauma centre designation has been studied. Little is known, however, about the association between ACS level and outcomes associated with ventilator-associated pneumonia (VAP).

Methods: The National Trauma Databank (NTDB, Version 5.

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Background: Reference inaccuracy in scientific articles brings the scientific validity of the research into question and may create difficulty when accessing the cited background data. The objective of this study was to examine the reference accuracy in the general surgery literature and its correlation with the journal impact factor.

Methods: Five general surgery journals were chosen with varying impact factors.

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Background: The "July Phenomenon" refers to the propensity for increased errors to occur with new housestaff, as they assume new responsibilities at the beginning of the academic year. The purpose of this study was to examine the impact of the new residents presenting in July at a high volume Level I Academic Trauma Center.

Methods: The trauma registry at the Los Angeles County + University of Southern California Medical center was retrospectively reviewed to identify all injured patients admitted over a 5-year period ending in December 2006.

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The rate of methicillin-resistant Staphylococcus aureus (MRSA) infections has increased significantly over the last years, especially from community-associated MRSA (CA-MRSA) sources. The true prevalence of these multidrug-resistant infections among the trauma patient population, however, is not well defined. A retrospective review of our surgical intensive care unit (SICU) database from April 2003 to April 2007 was performed to identify all trauma patients surviving 48 hours or more that had a positive culture result during their SICU stay.

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Background: Empyema is a rare, but morbid complication of diaphragmatic injury. The purpose of this study was to use the National Trauma Databank of the American College of Surgeons to determine (1) the incidence of empyema after diaphragmatic injury, (2) risk factors for development of empyema after these injuries, and (3) the effect of empyema on mortality, hospital, and intensive care unit (ICU) length of stay (LOS) after diaphragm injury.

Methods: The National Trauma Databank (v.

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The epidemiology of sternal fractures has been poorly described. The objective of this study was to examine the demographics, outcomes and injuries associated with sternal fractures. The trauma registry at a level I trauma center was retrospectively reviewed to identify all patients with sternal fractures over a 10 year period.

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For over a decade, the Los Angeles County/University of Southern California Hospital has supported an international fellowship in trauma that provides research experience, education, and opportunity for clinical observation at a high-volume American College of Surgeons (ACS) designated Level I trauma center. We performed a descriptive study of the design, implementation, and results of an international fellowship in trauma and critical care. Fellows from 27 countries throughout the world have actively engaged in trauma research at Los Angeles County/University of Southern California Hospital.

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Background: Several authors have examined the relationship between outcomes following severe trauma and American College of Surgeons (ACS) trauma centre designation. Little is known, however, about the association between ACS level and outcomes following complications of trauma.

Methods: The National Trauma Databank (NTDB, v.

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Objective: The association between hospital volume and outcomes following mechanical ventilation has been previously examined in diverse patient populations. The American College of Surgeons (ACS) Committee on Trauma has outlined criteria for trauma centre level designations with specific requirements for both specialty capabilities and hospital volume. Our objective is to determine the relationship between ACS centre designation and outcomes for trauma patients undergoing mechanical ventilation.

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