Characterizing 30-Day Postoperative Acute Care Visits: A National Surgical Quality Improvement Program Collaborative Analysis.

Introduction: Many postoperative acute care visits (PACVs) are likely more appropriately addressed in lower acuity settings; however, the frequency and nature of PACVs are not currently tracked by the National Surgical Quality Improvement Program (NSQIP), and the overall burden to emergency departments and urgent care centers is unknown.

Methods: NSQIP collaborative data were augmented to prospectively capture 30-d PACVs for 1 y starting October 2018 across all NSQIP specialties, including visit reason and disposition. Data were analyzed using binomial logistic regression.

High ratios of plasma and platelets to packed red blood cells do not affect mortality in nonmassively transfused patients.

Background: Administration of high transfusion ratios in patients not requiring massive transfusion might be harmful. We aimed to determine the effect of high ratios of fresh frozen plasma (FFP) and platelets (PLT) to packed red blood cells (PRBC) in nonmassively transfused patients.

Methods: Records of 1,788 transfused trauma patients who received <10 units of PRBC in 24 hours at 23 United States Level I trauma centers were reviewed.

Lidocaine patches reduce pain in trauma patients with rib fractures.

Rib fracture pain is notoriously difficult to manage. The lidocaine patch is effective in other pain scenarios with an excellent safety profile. This study assesses the efficacy of lidocaine patches for treating rib fracture pain.

Red blood cells accelerate the onset of clot formation in polytrauma and hemorrhagic shock.

Background: Hemorrhage and coagulopathy are major contributors to death after trauma. The contribution of red blood cells (RBCs) in correcting coagulopathy is poorly understood. Current methods of measuring coagulopathy may fail to accurately characterize in vivo clotting.

Splenectomy leads to a persistent hypercoagulable state after trauma.

Background: It was hypothesized that splenectomy following trauma results in hypercoagulability.

Methods: A prospective, nonrandomized, single-center study was performed to evaluate coagulation parameters in trauma patients with splenic injury.

Results: Patients with splenectomy (n = 30) and nonoperative management (n = 50) were enrolled.

Lyophilized plasma for resuscitation in a swine model of severe injury.

Hypothesis: Lyophilized plasma (LP) is as safe and effective as fresh frozen plasma (FFP) for resuscitation after severe trauma.

Design: Multicenter animal study.

Setting: Animal laboratories, 2 level I trauma centers.

A highly porous silica and chitosan-based hemostatic dressing is superior in controlling hemorrhage in a severe groin injury model in swine.

Background: This study compared the efficacy of 3 hemostatic dressings in a severe groin injury model in swine.

Methods: Twenty-three swine received TraumaStat (OreMedix, Lebanon, OR), Chitoflex (HemCon, Inc., Portland, OR), or standard gauze for hemostasis.

A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of massive transfusion improves outcomes in a large multicenter study.

Background: In trauma, most hemorrhagic deaths occur within the first 6 hours. This study examined the effect on survival of high ratios of fresh frozen plasma (FFP) and platelets (PLTs) to packed red blood cells (PRBCs) in the first 6 hours.

Methods: Records of 466 massive transfusion trauma patients (>or=10 U of PRBCs in 24 hours) at 16 level 1 trauma centers were reviewed.

A comparison between patients treated at a combat support hospital in Iraq and a Level I trauma center in the United States.

Background: Combat support hospitals (CSHs) function under adverse operational conditions, delivering care to diverse patients. Appropriate allocation of resources and training are dependent on accurate assessments of the populations' needs. This study compared two patient populations treated between December 2004 and November 2005, one from a CSH in Iraq, the other at a civilian Level I trauma center.