How Many Trauma Admissions Require Acute Trauma Team Interventions?

Introduction: The aim of this study was to assess the percentage of trauma patients admitted and receiving intervention, and to identify which of these interventions were performed by non-trauma specialists.

Methods: The authors conducted a retrospective chart review of all adult patients who presented to the trauma service between January 2019 and June 2019. Collected data included demographics, trauma activation level, total interventions performed, interventions performed by the trauma team, interventions performed by subspecialty teams, and isolated injuries requiring orthopedic, neurosurgical, or other specialized care.

Main versus segmental hepatic artery angioembolization in patients with traumatic liver injuries: A Western Trauma Association multicenter study.

Introduction: Hepatic angioembolization is highly effective for hemorrhage control in hemodynamically stable patients with traumatic liver injuries and contrast extravasation. However, there is a paucity of data regarding the specific location of angioembolization within the hepatic arterial vasculature and its implications on patient outcomes.

Methods: A post-hoc analysis of a multicenter prospective observational study across 23 centers was performed.

Observation-first versus angioembolization-first approach in stable patients with blunt liver trauma: A WTA multicenter study.

Background: Prior studies evaluating observation versus angioembolization (AE) for blunt liver injuries (BLT) with contrast extravasation (CE) on computed tomography imaging have yielded inconsistent conclusions, primarily due to limitations in single-center and/or retrospective study design. Therefore, this multicenter study aims to compare an observation versus AE-first approach for BLT, hypothesizing decreased liver-related complications (LRCs) with observation.

Methods: We conducted a post hoc analysis of a multicenter, prospective observational study (2019-2021) across 23 centers.

Stop the Bleed-Wait for the Ambulance or Get in the Car and Drive? A Post Hoc Analysis of an EAST Multicenter Trial.

The Stop the Bleed campaign gives bystanders an active role in prehospital hemorrhage control. Whether extending bystanders' role to private vehicle transport (PVT) for urban penetrating trauma improves survival is unknown, but past research has found benefit to police and PVT. We hypothesized that for penetrating trauma in an urban environment, where prehospital procedures have been proven harmful, PVT improves outcomes compared to any EMS or advanced life support (ALS) transport.

Tranexamic Acid and Pulmonary Complications: A Secondary Analysis of an EAST Multicenter Trial.

Background: Anti-inflammatory effects of tranexamic acid (TXA) in reducing trauma endotheliopathy may protect from acute lung injury. Clinical data showing this benefit in trauma patients is lacking. We hypothesized that TXA administration mitigates pulmonary complications in penetrating trauma patients.

Evaluating the Long-Term Neurologic Sequelae Among Trauma Patients who Received Flexion-Extension Radiographs.

Introduction: This study evaluated the presence of neurologic sequelae among trauma patients after flexion-extension (F/E) radiographs.

Methods: Authors of the study conducted a retrospective review of patients (age ≥ 14 years) with a Glasgow Coma Score of 15 who sustained a blunt traumatic injury and received F/E radiographs. Radiographic scans were defined as positive, negative, inconclusive, or incomplete.

Thoracic irrigation for prevention of secondary intervention after thoracostomy tube drainage for hemothorax: A Western Trauma Association multicenter study.

Background: Retained hemothorax (rHTX) requiring intervention occurs in up to 20% of patients who undergo chest tube (TT) placement for a hemothorax (HTX). Thoracic irrigation at the time of TT placement decreases the need for secondary intervention in this patient group but those findings are limited because of the single-center design. A multicenter study was conducted to evaluate the effectiveness of thoracic irrigation.

Bone Anchor Fixation in the Repair of Blunt Traumatic Abdominal Wall Hernias: A Western Trauma Association Multicenter Study.

Background: Blunt traumatic abdominal wall hernias (TAWHs) are rare but require a variety of operative techniques to repair including bone anchor fixation (BAF) when tissue tears off bony structures. This study aimed to provide a descriptive analysis of BAF technique for blunt TAWH repair. Bone anchor fixation and no BAF repairs were compared, hypothesizing increased hernia recurrence with BAF repair.

Placement of Intracranial Pressure Monitors by Non-neurosurgeons: A Follow-Up Study.

Background: Some research suggests that physicians who are not neurosurgeons can safely place intracranial pressure (ICP) monitors. The purpose of this study was to compare intracranial pressure monitor placement complications between neurosurgeons, trauma physicians, and general surgery residents. We hypothesized that with appropriate training, general residents can safely place ICP monitors.

A western trauma association multicenter comparison of mesh versus non-mesh repair of blunt traumatic abdominal wall hernias.

Background: Blunt traumatic abdominal wall hernias (TAWH) occur in <1 % of trauma patients. Optimal repair techniques, such as mesh reinforcement, have not been studied in detail. We hypothesize that mesh use will be associated with increased surgical site infections (SSI) and not improve hernia recurrence.

Falls Among Older Adults During the COVID-19 Pandemic Compared to a Pre-pandemic Period: A Case-Control Study.

Background: Little is known about how the COVID-19 pandemic impacted older adults admitted to the hospital with fall-related injuries. This research sought to determine if there was a difference in patient characteristics and hospital outcomes among older adults with fall-related injuries during the COVID-19 pandemic compared to a non-pandemic period.

Methods: A retrospective chart review of patients 65 years or older admitted for traumatic falls before and during COVID-19 was undertaken.

Should Infants with Blunt Traumatic Brain Injuries and Intracranial Hemorrhage Have Routine Repeat Imaging?

Introduction: The practice of repeat head CT imaging in infants as a distinct population is poorly studied. The purpose of this study was to evaluate the incidence and utility of repeat head CT in the infant population.

Methods: A 10-year retrospective review was conducted of infants with blunt traumatic head injuries (N = 50) that presented to a trauma center.

Evaluation of Resuscitative Endovascular Balloon Occlusion of the Aorta Complications in a Community-Based Trauma Center.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a method of management of noncompressible torso hemorrhage in trauma patients. Increased utilization has shown increased vascular complications and mortality. This study aimed to evaluate complications of REBOA placement in a community trauma setting.

Evaluation of Outcomes and Treatment Options Among Trauma Patients with Abdominal Vascular Injuries.

Introduction: Abdominal vascular injuries are associated with significant morbidity and mortality. Treatment options include non-operative management, open repair, and endovascular procedures. This study aimed to characterize patients and detail treatment modalities among those who sustained a traumatic abdominal vascular injury.

An observation-first strategy for liver injuries with "blush" on computed tomography is safe and effective.

Introduction: The management of liver injuries in hemodynamically stable patients is variable and includes primary treatment strategies of observation (OBS), angiography (interventional radiology [IR]) with angioembolization (AE), or operative intervention (OR). We aimed to evaluate the management of patients with liver injuries with active extravasation on computed tomography (CT) imaging, hypothesizing that AE will have more complications without improving outcomes compared with OBS.

Methods: This is a prospective, multicenter, observational study.

Rodeo Trauma: Outcome Data from 10 Years of Injuries.

Introduction: There are few data addressing rodeo injury outcomes, though injury incidence has been well described. The purpose of this study was to describe rodeo-related injury patterns and outcomes.

Methods: A 10-year retrospective case series was performed of patients injured in rodeo events and who were treated at an ACS-verified level I trauma center.

Pre-Hospital Spinal Immobilization: Neurological Outcomes for Spinal Motion Restriction Versus Spinal Immobilization.

Introduction: New recommendations for emergency medical services spinal precautions limit long spinal board use to extrication purposes only and are to be removed immediately. Outcomes for spinal motion restriction against spinal immobilization were studied.

Methods: A retrospective chart review of trauma patients was conducted over a six-month period at a level I trauma center.

AAST multicenter prospective analysis of prehospital tourniquet use for extremity trauma.

Background: Tourniquet use for extremity hemorrhage control has seen a recent increase in civilian usage. Previous retrospective studies demonstrated that tourniquets improve outcomes for major extremity trauma (MET). No prospective study has been conducted to date.

An analysis of missed injuries at a level 1 trauma center with a tertiary survey protocol.

Background: Tertiary surveys can help identify missed injuries, but how and when to conduct them remains uncertain. This study aimed to evaluate the outcomes of a policy requiring tertiary survey completion within 24 h post-admission.

Methods: A retrospective review was performed with a pre-intervention time-period of 8/1/2019-1/31/2020, where tertiary surveys were performed prior to discharge (n = 762).

Geriatric Trauma Patients: Outcomes Before and After Addition of a Hospitalist Consultation.

Background: Research has shown improvements in patient care and outcomes with addition of a rounding geriatrician. The purpose of this study was to determine if addition of a hospitalist consultation improved patient outcomes.

Methods: A retrospective review was conducted of all trauma patients, ≥65 years, before (n=481) and after (n=430) addition of a hospitalist consultant.

An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients.

Background: Police transport (PT) of penetrating trauma patients in urban locations has become routine in certain metropolitan areas; however, whether it results in improved outcomes over prehospital Advanced life support (ALS) transport has not been determined in a multicenter study. We hypothesized that PT would not result in improved outcomes.

Methods: This was a multicenter, prospective, observational study of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers.