Gunshot Wound to the Right Superior Pulmonary Vein With Bullet Embolization to the Aortic Bifurcation: Emergent Surgical Repair.

Bullet embolization is a rare complication of gunshot wound injuries with most of the literature consisting of case reports. We report a case regarding bullet embolization to the distal aorta following entry into the right superior pulmonary vein as a result of a gunshot wound to the posterior chest. The patient presented with signs of lower extremity ischemia.

Time to stroke: A Western Trauma Association multicenter study of blunt cerebrovascular injuries.

Background: Screening for blunt cerebrovascular injuries (BCVIs) in asymptomatic high-risk patients has become routine. To date, the length of this asymptomatic period has not been defined. Determining the time to stroke could impact therapy including earlier initiation of antithrombotics in multiply injured patients.

Traumatic tension pneumocephalus - Two cases and comprehensive review of literature.

Unlabelled: Although traumatic pneumocephalus is not uncommon, it rarely evolves into tension pneumocephalus (TP). Characterized by the presence of increasing amounts of intracranial air and concurrent appearance or worsening neurological symptoms, TP can be devastating if not recognized and treated promptly. We present two cases of traumatic TP and a concise review of literature on this topic.

Comorbidity-polypharmacy scoring facilitates outcome prediction in older trauma patients.

Objectives: To determine the association between comorbidity-polypharmacy score (CPS) and clinical outcomes in a large sample of older trauma patients, focusing on outcome prognostication.

Design: The CPS combines number of preinjury medications and comorbidities to more objectively quantify the severity of comorbid conditions.

Setting: An urban tertiary care level 1 trauma center in the Midwest.

Comorbidity-polypharmacy score: a novel adjunct in post-emergency department trauma triage.

Objective: Post-emergency department triage of older trauma patients continues to be challenging, as morbidity and mortality for any given level of injury severity tend to increase with age. The comorbidity-polypharmacy score (CPS) combines the number of pre-injury medications with the number of comorbidities to estimate the severity of comorbid conditions. This retrospective study examines the relationship between CPS and triage accuracy for older (≥45y) patients admitted for traumatic injury.

Pre-injury polypharmacy as a predictor of outcomes in trauma patients.

Background: One of the hallmarks of modern medicine is the improving management of chronic health conditions. Long-term control of chronic disease entails increasing utilization of multiple medications and resultant polypharmacy. The goal of this study is to improve our understanding of the impact of polypharmacy on outcomes in trauma patients 45 years and older.

Tree stands, not guns, are the midwestern hunter's most dangerous weapon.

Although the prevailing stereotype is that most hunting injuries are gunshot wounds inflicted by intoxicated hunting buddies, our experience led us to hypothesize that falls comprise a significant proportion of hunting related injuries. Trauma databases of two Level I trauma centers in central Ohio were queried for all hunting related injuries during a 10-year period. One hundred and thirty patients were identified (90% male, mean age 41.

Postdischarge outcomes of blunt cerebrovascular injuries.

A retrospective review was conducted to assess outcomes of blunt cerebrovascular injuries (BCVIs) diagnosed in a 14-month period at a level-1 trauma center and evaluated postdischarge at a single vascular practice. Twenty-nine patients with 34 BCVIs (10 carotid; 24 vertebral) were admitted. Eleven (37.

Computed tomographic angiography versus conventional angiography for the diagnosis of blunt cerebrovascular injury in trauma patients.

Background: Blunt cerebrovascular injuries (BCVI) in trauma patients are rare but potentially devastating injuries, particularly if the diagnosis is delayed. Conventional angiography (CA) has been the screening and diagnostic modality of choice for identifying BCVI. With the advent of high-resolution computed tomography (CT), CT angiography has become a common modality for the screening of BCVI.

Does a category II trauma activation warrant the initial presence of an attending trauma surgeon?

Background: Previous studies have examined the impact of the immediate presence of attending trauma surgeons on category I trauma alert activation outcomes.

Study Objectives: This study sought to determine if the initial presence of an attending surgeon influences category II trauma activation outcomes.

Methods: This 2-year retrospective review of category II alert activations involved a trauma database query to identify patients and extract pertinent variables.

Transthoracic echocardiography is not cost-effective in critically ill surgical patients.

Background: Echocardiography has been shown to be valuable in critically ill surgical patients. Transthoracic echocardiography (TTE) often fails to provide adequate imaging in critically ill patients, necessitating subsequent transesophageal echocardiography (TEE). The objective of this study was to determine and quantify factors associated with failure of transthoracic echocardiography (TTE) in critically ill surgical patients, and to define a cost-effective strategy for echocardiography in these patients.