Less is more: Streamlining management of isolated traumatic subarachnoid hemorrhage in the modified brain injury guidelines.

Background: Patients with isolated traumatic subarachnoid hemorrhage (iTSAH) are managed according to the modified Brain Injury Guidelines (mBIG) class. The current study aimed to describe patients with iTSAH and analyze their clinical outcomes.

Methods: A retrospective analysis was performed on trauma patients with iTSAH.

The Effect of Frailty in Predicting Outcomes of Rib Fractures Among Elderly Patients.

Introduction: Rib fractures are consequential injuries for geriatric trauma patients. Frailty has been associated with adverse outcomes in this population. The Rib Fracture Frailty Index (RFF) and 5-factor modified Frailty Index (mFI) are 2 validated frailty metrics.

Evaluation of the Nelson Criteria as an Indicator for Nonsurgical Admission in Trauma Patients.

Geriatric patients with complex medical comorbidities who sustain minor injuries may warrant admission to nonsurgical services. The Nelson score provides an objective scoring system that helps identify patients appropriate for nonsurgical admission (NSA). The purpose of this study is to assess the utility of the Nelson criteria in determining the most appropriate admission service.

Time is of the Essence: Impact of a More Aggressive Chemical Venous Thromboembolism Prophylaxis Regimen on Trauma Patients.

Background: Trauma patients are at high risk for venous thromboembolism (VTE). Opportunity for chemical VTE prophylaxis improvement was identified and practice was altered to start chemoprophylaxis on admission in most patients. The purpose of this study was to determine if early VTE prophylaxis is safe and reduces VTE.

Rib fractures in the elderly: physiology trumps anatomy.

Introduction: Rib fractures in elderly patients are associated with increased morbidity and mortality. Predicting which patients are at risk for complications is an area of debate. Current models use anatomic, physiologic or laboratory parameters in isolation to answer this question.

PADUA score as a predictor for pulmonary embolism: a potential strategy for reducing unnecessary imaging.

An objective tool that is easy to integrate with an electronic medical record may help reduce unnecessary imaging for diagnosing a pulmonary embolism (PE). In this study, we assess the PADUA score in stratifying patients based on their risk of a PE. We reviewed charts of patients that underwent a computed tomography pulmonary angiogram (CT-PA) between January 2014 and September 2015 at our institution.

Clostridium Difficile-Associated Infection in Trauma Patients: Development of the Clostridium Difficile Influencing Factors (CDIF) Score.

Context: Clostridium difficile-associated infection (CDAI) can result in longer hospitalization, increased morbidity, and higher mortality rates for surgical patients. The impact on trauma patients is unknown, however.

Objective: To assess the effect of CDAI on trauma patients and develop a scoring system to predict CDAI in that population.

A novel, minimally invasive approach to assure hemostasis for intercostal bleeding after trauma.

Intercostal artery injury can cause large hemothoraces. While many patients with intercostal artery injury present hemodynamically unstable and require emergent thoracotomy for hemostasis, some tamponade spontaneously. They may rebleed later, however, and cause recurrent hemothorax or retained hemothorax.

Use of Epidural Analgesia as an Adjunct in Elective Abdominal Wall Reconstruction: A Review of 4983 Cases.

Context: Use of epidural analgesia in patients undergoing elective abdominal wall reconstruction is common.

Objective: To assess the impact of epidural analgesia in patients undergoing abdominal wall reconstruction.

Design: All patients who underwent elective ventral hernia repair from 2005 to 2014 were retrospectively identified.

Development and Validation of a Scoring System to Predict Surgical Site Infection After Ventral Hernia Repair: A Michigan Surgical Quality Collaborative Study.

Introduction: Surgical site infections (SSIs) are a rare but significant complication following an elective ventral hernia repair. This study aims to develop a risk assessment tool in order to predict the risk of developing SSIs postoperatively.

Methods: All patients undergoing an elective ventral hernia repair were identified using the Michigan Surgical Quality Collaborative (MSQC) database.

Association of Unplanned Reintubation with Higher Mortality in Old, Frail Patients: A National Surgical Quality-Improvement Program Analysis.

Background: Unplanned postoperative reintubation increases the risk of mortality, but associated factors are unclear.

Objective: To elucidate factors associated with increased mortality risk in patients with unplanned postoperative reintubation.

Design: Retrospective study.

Nonoperative Damage Control: The Use of Extracorporeal Membrane Oxygenation in Traumatic Bronchial Avulsion as a Bridge to Definitive Operation.

The conventional treatment for an avulsed bronchus is emergent thoracotomy and repair or lobectomy. The principles of damage control thoracic operations include initial hemorrhage control with delayed definite repair after physiologic resuscitation. We report a multiply injured patient with avulsion of the left lower lobe bronchus.