Publications by authors named "Ramsey Walter"

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

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Introduction: Pectus excavatum is the most prevalent chest wall deformity. Repair may be offered via Nuss or Ravitch technique. This study aims to investigate the outcomes of these repairs using a national cohort.

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  • * The study found that most burn cases were among Black children, with scald burns being the most common type, affecting younger kids; overall, the rate of burn injuries was 5.5 per 100,000 children, with no seasonal trends.
  • * Results suggest that most pediatric burn injuries occur in low-income, predominantly Black neighborhoods, highlighting the need for targeted injury prevention efforts in these populations to improve public health outcomes.
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Background: Traumatic hemothorax (HTX) is common, and while it is recommended to drain it with a tube thoracostomy, there is no consensus on the optimal catheter size. We performed a systematic review to test the hypothesis that small bore tube thoracostomy (SBTT) (≤14 F) is as effective as large-bore tube thoracostomy (LBTT) (≥20F) for the treatment of HTX.

Methods: Pubmed, EMBASE, Scopus, and Cochrane review were searched from inception to November 2022 for randomized controlled trials or cohort studies that included adult trauma patients with HTX who received a tube thoracostomy.

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Introduction: Venous thromboembolism (VTE) continues to be a major cause of morbidity in trauma. It is unclear whether the type of hemorrhage control procedure (i.e.

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A National Trauma Research Action Plan identified the involvement of burn survivors as critical informants to determine the direction of research. This study employed a web-based survey to identify care gaps in a sample of burn survivors. We surveyed burn survivors from around the United States through social media and email contact with the Phoenix Society for Burn Survivors.

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  • Patients with duodenal leaks (DL) who received enteral nutrition (EN) experienced shorter time to leak closure, fewer infectious complications, and reduced hospital stays compared to those receiving parenteral nutrition (PN) or a combination of both.
  • The study analyzed data from 113 patients across 35 trauma centers, highlighting that EN patients had significantly fewer days without oral intake and less severe complications.
  • The findings suggest that EN is a preferable nutritional strategy for DL patients, as it promotes quicker recovery and fewer hospital-related issues.
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Introduction: Relative to other hospitalized patients, trauma patients are younger with fewer comorbidities, but the incidence and outcomes of in-hospital cardiopulmonary arrest (IHCA) with cardiopulmonary resuscitation (CPR) in this population is unknown. Therefore, we aimed to investigate factors associated with survival in trauma patients after IHCA to test the hypothesis that compared to other hospitalized patients, trauma patients with IHCA have improved survival.

Methods: Retrospective review of the Trauma Quality Improvement Program database 2017 to 2019 for patients who had IHCA with CPR.

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Background: Thromboprophylaxis after blunt splenic trauma is complicated by the risk of bleeding, but the risk after angioembolization is unknown. We hypothesized that earlier thromboprophylaxis initiation was associated with increased bleeding complications without mitigating venous thromboembolism events.

Methods: All blunt trauma patients who underwent splenic angioembolization within 24 hours of arrival were identified from the American College of Surgeons Trauma Quality Improvement Program datasets from 2017 to 2019.

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Purpose: Motor vehicle collisions (MVC) are the second leading cause of death in children and adolescents, but appropriate restraint use remains inadequate. Our previous work shows that about half of pediatric MVC victims presenting to our trauma center were unrestrained. This study evaluates restraint use among children and adolescents who did not survive after MVC.

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Purpose: Pectus excavatum (Pectus) repair may be offered for those with significant cardiopulmonary compromise or severe cosmetic defects. The influence of hospital center volume on postoperative outcomes in children is unknown. This study aimed to investigate the outcomes of children undergoing Pectus repair, stratified by hospital surgical volume.

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Growing cannabis use among young adults in the United States surpasses research and public understanding, raising health concerns despite potential benefits. Limited research focuses on their knowledge, attitudes, risks, and motivations, especially in states with limited legalization. This study explores cannabis knowledge and attitudes among healthy young adult cannabis consumers to understand their risk and benefit perceptions.

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Article Synopsis
  • * An analysis of over 6,000 patients showed that while Early Repair was more frequently employed (88%), Deferral led to significantly higher readmissions in the first 30 days but similar rates within a year.
  • * The study found that Deferral resulted in lower rates of severe complications like orchiectomy and infections, though there remains a risk of repeat incarceration upon readmission.
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Purpose: The incidence of pulmonary embolism (PE) in hospitalized children has increased in recent years. This study sought to characterize factors and outcomes associated with PE using a national pediatric cohort.

Methods: The Nationwide Readmissions Database was queried (2016-2018) for patients (<18 years) with a diagnosis of PE.

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Background: Previous studies have shown improved survival for severely injured adult patients treated at American College of Surgeons verified level I/II trauma centers compared to level III and undesignated centers. However, this relationship has not been well established in pediatric trauma centers (PTCs). We hypothesize that severely injured children will have lower mortality at verified level I/II PTCs compared to centers without PTC verification.

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  • The study focuses on high ligation of the inferior mesenteric artery in surgeries for low left-sided colon and rectal cancer, aiming to assess how often this technique is used at a particular academic center and its impact on patient outcomes.
  • Out of 169 patients analyzed, 61.5% had high ligation noted in their surgical reports, with 55.6% showing radiographic evidence of the technique, particularly successful in 70.2% of intended cases.
  • Despite the successful implementation of high ligation, there were no significant differences observed in lymph node yield, time to chemotherapy, or recurrence rates, indicating that high ligation may not affect short-term outcomes compared to low ligation.
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Introduction: Ballistic injuries cause both a temporary and permanent cavitation event, making them far more destructive and complex than other penetrating trauma. We hypothesized that global injury scoring and physiologic parameters would fail to capture the lethality of gunshot wounds (GSW) compared to other penetrating mechanisms.

Methods: The 2019 American College of Surgeons Trauma Quality Programs participant use file was queried for the mortality rate for GSW and other penetrating mechanisms.

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Introduction: Cryptorchidism is commonly treated with orchiopexy at 6-12 months of age, often allowing time for undescended testicle(s) (UT) to descend spontaneously. However, when an inguinal hernia (IH) is also present, some surgeons perform orchiopexy and inguinal hernia repair (IHR) immediately rather than delaying surgery. We hypothesize that early surgical intervention provides no benefit for newborns with both IH and UT.

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  • The study investigates the factors linked to the choice of open appendectomy as the final surgical approach for patients with appendicitis, particularly focusing on the impact of the AAST Emergency General Surgery (EGS) grade.
  • Analysis of a large appendicitis database revealed that patients undergoing open appendectomy often had more severe conditions, including higher AAST EGS grades, longer duration of symptoms, and more frequent complications like perforated appendicitis.
  • Only the most severe cases, specifically AAST Clinical Grade 5 appendicitis, showed a significant association with the likelihood of requiring an open appendectomy, suggesting that higher severity directly influences surgical decisions.
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Introduction: Synthetic mesh is widely utilized for clean ventral hernia repair; however, it is unclear if synthetic mesh provides the same benefits with high-risk patients or during contaminated cases. Many surgeons use biologic mesh in these settings, but there is little evidence to support this practice. Our objective was to compare the clinical outcomes of utilizing biologic mesh versus synthetic mesh during ventral hernia repair.

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Introduction: The utility of incidental appendectomy (IA) during many ovarian operations has not been evaluated in the pediatric population. This study sought to compare outcomes after ovarian surgery with IA in the pediatric population.

Methods: Females (≤20 y old) undergoing ovarian surgeries (oophorectomy, detorsion and/or drainage) were identified from the Nationwide Readmissions Database (2016-2018).

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Elective resection of congenital pulmonary airway malformations (CPAM) has been debated for decades and varies significantly between individual surgeons. However, few studies have compared outcomes and costs associated with thoracoscopic and open thoracotomy approaches on a national level. This study sought to compare nationwide outcomes and resource utilization in infants undergoing elective lung resection for CPAM.

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Necrotizing soft tissue infections (NSTIs) are rapidly spreading, life-threatening infections that require emergent surgical intervention with immediate antibiotic initiation. However, there is no consensus regarding duration of antibiotic therapy after source control. We hypothesized that a short course of antibiotic therapy is as effective as a long course of antibiotic therapy after final debridement for NSTI.

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Background: Pediatric pedestrian injuries (PPI) are a major public health concern. This study utilized geospatial analysis to characterize the risk and injury severity of PPI.

Methods: A retrospective chart review of PPI patients (age < 18) from a level 1 trauma center was performed (2013-2020).

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Background: Duodenal leak is a feared complication of repair, and innovative complex repairs with adjunctive measures (CRAM) were developed to decrease both leak occurrence and severity when leaks occur. Data on the association of CRAM and duodenal leak are sparse, and its impact on duodenal leak outcomes is nonexistent. We hypothesized that primary repair alone (PRA) would be associated with decreased duodenal leak rates; however, CRAM would be associated with improved recovery and outcomes when leaks do occur.

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