Pain management after laparoscopic appendectomy: Comparative effectiveness of innovative pre-emptive analgesia using liposomal bupivacaine.

Background: Laparoscopic appendectomy is standard of care for appendicitis in the US. Pain control that limits opioids is an important area of research given the opioid epidemic. This study examined post-appendectomy inpatient opioid use and pain scores following intraoperative use of liposomal bupivacaine (LB) versus non-liposomal bupivacaine.

Better with age? A comparison of geriatric and non-geriatric trauma patients' psychological outcomes 6 months post-injury.

This is the first study to compare both physical and psychological outcomes in geriatric and non-geriatric patients (= 268) at baseline and 6 months post-trauma. Demographic, clinical, and psychological data, including screens for alcohol use, depressive symptoms, and post-traumatic stress symptoms (PTSS) were collected from 67 geriatric patients (70.7 ± 8.

The role of depression and social support on readmission rates within one year of traumatic injury.

Objective: Hospital readmission rates have become a quality metric-particularly in trauma and acute care, where up to one third of individuals with traumatic injury return to the hospital. Thus, identifying predictors of readmission is a priority in an effort to reduce readmissions. Based on previous theoretical work, this study tests the utility of social support and depression in predicting readmissions up to one year after initial injury.

Traumatic colon injury in damage control laparotomy-A multicenter trial: Is it safe to do a delayed anastomosis?

Background: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes.

Hospital-Based Health Care After Traumatic Brain Injury.

Objective: To investigate trends of hospital-based health care utilization after admission to a level I trauma center after acute traumatic brain injury (TBI).

Design: Retrospective review.

Setting: Large urban trauma hospital and a hospital council data registry consisting of 88 member institutions (>150 hospitals) covering 15,000 square miles.

Trauma patient readmissions: Why do they come back for more?

Background: Hospital readmissions are a frequent challenge. Speculation exists that rates of readmission following traumatic injury will be publicly disclosed. The primary aim of this study was to characterize and model 1-year readmission patterns to multiple institutions among patients originally admitted to a single, urban Level I trauma center.

Validation of a brief, two-question depression screen in trauma patients.

Background: Increasingly, depression following traumatic injury is recognized as a complication of injury. Unlike mandated screening for risky alcohol use in trauma centers, screening for psychological risks is not required by the American College of Surgeons' Committee on Trauma. Limited resources and time constraints are commonly given reasons against routine screening.

Evaluation and management of blunt traumatic aortic injury: a practice management guideline from the Eastern Association for the Surgery of Trauma.

Background: Blunt traumatic aortic injury (BTAI) is the second most common cause of death in trauma patients. Eighty percent of patients with BTAI will die before reaching a trauma center. The issues of how to diagnose, treat, and manage BTAI were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the practice management guidelines on this topic published in 2000.

Evaluation and management of blunt traumatic aortic injury: a practice management guideline from the Eastern Association for the Surgery of Trauma.

Background: Blunt traumatic aortic injury (BTAI) is the second most common cause of death in trauma patients. Eighty percent of patients with BTAI will die before reaching a trauma center. The issues of how to diagnose, treat, and manage BTAI were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the practice management guidelines on this topic published in 2000.

Psychological factors predicting outcome after traumatic injury: the role of resilience.

Background: Increasingly, studies have examined the psychological impact on individuals who survive a traumatic physical injury. The primary aim of this study was to determine the stability of resilience and its association with depressive symptoms.

Methods: This study included 110 adults admitted to a Level I trauma center.

Predictors of PTSD symptoms in adults admitted to a Level I trauma center: a prospective analysis.

Trauma centers are an ideal point of intervention in efforts to prevent posttraumatic stress disorder (PTSD). In order to assist in the development of prevention efforts, this study sought to identify early predictors of PTSD symptoms among adults admitted to a Level I trauma center using a novel analytic strategy (Fournier et al., 2009).

Posttraumatic stress disorder following traumatic injury at 6 months: associations with alcohol use and depression.

Background: Posttraumatic stress disorder (PTSD) is progressively recognized as a psychological morbidity in injured patients. Participants in a longitudinal study were identified as PTSD positive or PTSD negative at 6 months following injury. Risky alcohol use, depression, demographic, and injury-related variables were explored.

Clamping thoracostomy tubes: a heretical notion?

To determine the safety and complications of chest tube clamping, a retrospective chart review was conducted at Baylor University Medical Center's level I trauma center. The records of 243 patients with pneumothoraces, hemothoraces, or a combination were identified and analyzed; 134 patients underwent clamping according to the care path, and 109 did not. The demographic characteristics of age, gender, and mechanism of injury were similar in both groups, as was the frequency of pneumothoraces, hemothoraces, and combined hemo/pneumothoraces.

Active intravascular rewarming for hypothermia associated with traumatic injury: early experience with a new technique.

Hypothermia is a significant contributor to mortality in severely injured patients. Rewarming is an enormous challenge, especially in those who require operative or angiographic intervention. In this patient population, external warming methods are only capable of reducing further heat loss, whereas active rewarming adds heat to the body's core but is invasive.