The Role of Endovascular Repair of Popliteal Arterial Injuries in the Acute Setting.

Background: The role of endovascular surgery in the treatment of popliteal arterial injuries is not well established. As with other popliteal pathology, open repair has traditionally been considered the gold standard. As data has accumulated and technology advanced, however, a reassessment of the role of endovascular surgery is warranted.

Contemporary management and time to revascularization in upper extremity arterial injury.

Introduction: Upper extremity arterial injury is associated with significant morbidity and mortality for trauma patients, but there is a paucity of data to guide the clinician in the management of these injuries. The goals of this review were to characterize the demographics, presentation, clinical management, and outcomes, and to evaluate how time to intervention associates with outcomes in trauma patients with upper extremity vascular injuries.

Methods: The National Trauma Data Bank (NTDB) Research Data Set for the years 2007-2016 was queried in order to identify adult patients (age ≥ 18) with an upper extremity arterial injury.

Repair of the Iliac Arterial Injury in Trauma: An Endovascular Operation?

Background: Endovascular therapy is effective for non-traumatic iliac arterial diseases. The role of endovascular surgery in traumatic iliac lesions is unclear. The aim of this study is to compare outcomes for open versus endovascular management of traumatic iliac injuries.

Penetrating Injury to the Carotid Artery: Characterizing Presentation and Outcomes from the National Trauma Data Bank.

Background: Penetrating injury to the neck can be devastating because of the multiple vital structures in close proximity. In the event of injury to the carotid artery, there is a significantly increased likelihood of morbidity or mortality. The purpose of this study was to assess presenting characteristics associated with penetrating injury to the carotid artery and directly compare approaches to surgical management.

Differences in Facial Fracture Patterns in Pediatric Nonaccidental Trauma.

Background: The purpose of this study was to characterize differences in facial fracture injury patterns among pediatric patients at highest risk of abusive head trauma/nonaccidental trauma (age ≤ 5 years).

Methods: Using the National Trauma Databank from 2007 to 2015, patients (age ≤ 5 years) suffering facial fractures were included. Demographics and injury characteristics were compared between those sustaining accidental versus nonaccidental trauma (NAT).

Timing of intervention may influence outcomes in blunt injury to the carotid artery.

Objective: Blunt carotid artery injury (BCI) is present in approximately 1.0% to 2.7% of all blunt trauma admissions and can result in significant morbidity and mortality.

Contemporary Characterization of Injury Patterns, Initial Management, and Disparities in Treatment of Facial Fractures Using the National Trauma Data Bank.

Background: Contemporary description of facial fracture patterns and factors associated with early operative intervention at trauma centers is lacking. The purpose of this study was to characterize injuries and initial treatment patterns of patients suffering from facial fractures.

Methods: Using the National Trauma Databank from 2007 to 2015, patients suffering from facial fractures were included.

Characterization of Age-Related Injury Patterns and Surgical Treatment of Pediatric Facial Fractures: Analysis of the National Trauma Data Bank.

Background: Presentation of pediatric facial fractures varies widely and many injuries are encountered infrequently by most practitioners. This study summarizes injury patterns in a large cohort of facial fractures and their subsequent surgical management.

Methods: Demographic and clinical characteristics of patients 18 years of age or younger admitted between 2009 and 2015 to trauma centers participating in the National Trauma Data Bank were examined.

A Surgical Endovascular Trauma Service Increases Case Volume and Decreases Time to Hemostasis.

Objectives: The aim of this study was to evaluate the effect of a recently active endovascular trauma service (ETS) on case volume and time to hemostasis, as a complement to an existing interventional radiology (IR) service.

Summary Background Data: Endovascular techniques are vital for trauma care, but timely access can be a challenge. There is a paucity of data on the effect of a multispecialty team for delivery of endovascular hemorrhage control.

Accuracy of the Ventilator Automated Displayed Respiratory Mechanics in Passive and Active Breathing Conditions: A Bench Study.

Background: New-generation ventilators display dynamic measures of respiratory mechanics, such as compliance, resistance, and auto-PEEP. Knowledge of the respiratory mechanics is paramount to clinicians at the bedside. These calculations are obtained automatically by using the least squares fitting method of the equation of motion.

Blunt Thoracic Aortic Injury: Endovascular Repair Is Now the Standard.

Background: Incidence and treatment of blunt thoracic aortic injury (BTAI) has evolved, likely from improved imaging and emergence of endovascular techniques; however, multicenter data demonstrating this are lacking. We examined trends in incidence, management, and outcomes in BTAI.

Study Design: The American College of Surgeons National Trauma Databank (2003 to 2013) was used to identify adults with BTAI.

Small volume resuscitation with 20% albumin in intensive care: physiological effects : The SWIPE randomised clinical trial.

Purpose: We set out to assess the resuscitation fluid requirements and physiological and clinical responses of intensive care unit (ICU) patients resuscitated with 20% albumin versus 4-5% albumin.

Methods: We performed a randomised controlled trial in 321 adult patients requiring fluid resuscitation within 48 h of admission to three ICUs in Australia and the UK.

Results: The cumulative volume of resuscitation fluid at 48 h (primary outcome) was lower in the 20% albumin group than in the 4-5% albumin group [median difference - 600 ml, 95% confidence interval (CI) - 800 to - 400; P < 0.

Time of day variation in door-to-balloon time for STEMI patients in Los Angeles County: does time of day make a difference?

Objective: Evaluate treatment times and clinical outcome in a consecutive series of ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) in Los Angeles County.

Background: Primary PCI for STEMI is beneficial if performed in a timely manner. Conflicting data exist regarding potential treatment delays for primary PCI performed during off hours.

Does insurance status matter at a public, level I trauma center?

Background: It has previously been demonstrated that a lack of insurance impedes access to health care services and may affect outcome after acute medical events. Very little data exists on the impact of insurance status on outcomes after traumatic injury. The purpose of this study was to determine whether insurance status has an impact on the outcomes of trauma patients admitted to a publicly funded county level I trauma center.

Prospective evaluation of a predictive model of mortality in patients with isolated head injury.

Background: In a previous retrospective study, we developed a predictive model of survival in isolated head injuries based on easily available parameters such as age, mechanism of injury, Glasgow Coma Scale, and head Abbreviated Injury Scale (AIS). The purpose of the present study is to prospectively evaluate this predictive model.

Methods: Isolated head injuries admitted to a Level I urban trauma center were prospectively accrued from May 1, 2006 through April 30, 2007.

An international fellowship in trauma research and the potential benefits for fellows, sponsoring institution, and the global trauma community.

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.

Does age matter? The relationship between age and mortality in penetrating trauma.

Purpose: Trauma is a significant cause of mortality among elderly patients, with blunt mechanisms accounting for the majority of deaths in this population. Penetrating trauma promises to evolve as an increasingly important aetiology of mortality in the elderly; particularly as the age composition of the overall population continues to shift. Unfortunately, very little data regarding outcomes following penetrating trauma in the elderly exists.

Severe traumatic brain injury: is there a gender difference in mortality?

Background: Emerging evidence suggests that male and female nervous systems respond differently to traumatic brain injury (TBI). The objective of this study was to examine outcomes between the sexes after TBI.

Patients And Methods: A retrospective review of all severe TBI patients admitted between January and December 2005 was performed.

Predictors of positive angiography in pelvic fractures: a prospective study.

Background: Severe pelvic fractures continue to be a major problem for trauma surgeons. Early identification of patients who would benefit from therapeutic angiographic embolization (AE) of pelvic bleeding would be beneficial. We hope to identify simple risk factors that would pinpoint patients who would benefit from therapeutic AE.

Intraabdominal injury is common in blunt trauma patients who sustain spinal cord injury.

The evaluation of the abdomen in patients with spinal cord injury (SCI) is challenging for obvious reasons. There are very little data on the incidence and complications of patients who sustain SCI with concomitant intraabdominal injury (IAI). To determine the incidence and outcomes of IAI in blunt trauma patients with SCI, a trauma registry and record review was performed between January 1998 and December 2005.