When public health crises collide: 5 years of pediatric firearm injury prevention opportunities.

Objectives: Prior publications on pediatric firearm-related injuries have emphasized significant social disparities. The pandemic has heightened a variety of these societal stresses. We sought to evaluate how we must now adapt our injury prevention strategies.

Initial Laboratory Values Can Predict Mortality in Burn Patients.

Background: There are several burn scores used to predict mortality in burn patients. However, minimal data exists on the role of laboratory values in risk stratification. We hypothesized that laboratory derangements seen on admission can predict mortality in burn patients.

Outcomes in Blunt vs Penetrating Pelvic Vascular Injuries.

Objectives: The purpose of this study is to determine if there is a difference in outcomes for patients with blunt and penetrating vascular injuries of the pelvis.

Methods: Data were abstracted from the Trauma Quality Improvement Program database from 2011 to 2015. Patients >18 years with hypogastric, iliac, uterine, or ovarian arterial or venous injuries were included.

Surgical stabilization versus nonoperative treatment for flail and non-flail rib fracture patterns in patients with traumatic brain injury.

Purpose: Literature on outcomes after SSRF, stratified for rib fracture pattern is scarce in patients with moderate to severe traumatic brain injury (TBI; Glasgow Coma Scale ≤ 12). We hypothesized that SSRF is associated with improved outcomes as compared to nonoperative management without hampering neurological recovery in these patients.

Methods: A post hoc subgroup analysis of the multicenter, retrospective CWIS-TBI study was performed in patients with TBI and stratified by having sustained a non-flail fracture pattern or flail chest between January 1, 2012 and July 31, 2019.

The tight rope act: A multicenter regional experience of tourniquets in acute trauma resuscitation.

Background: As tourniquets have become more prevalent, device use has been questioned. This study sought to characterize the incidence, indication, and efficacy of tourniquet placement in acute trauma resuscitation.

Methods: Nine regional level 1 trauma centers prospectively enrolled for 12 months adult patients (18 years or older) who had a tourniquet placed.

The Windlass Tourniquet: Is It Taking the Wind Out of the "Stop the Bleed" Sails?

Background: Civilians are often first-line responders in hemorrhage control; however, windlass tourniquets are not intuitive. Untrained users reading enclosed instructions failed in 38.2% of tourniquet applications.

Pediatric Firearm-Related Injuries: Taking Kids Out of Harm's Way Begins with Targeted Prevention.

Background: Firearm-related injury is a public health crisis and remains the 3rd most common cause of death from ages 1 15 years. By evaluating events surrounding such injuries, evidence-based intervention strategies efforts may be targeted to maximize impact.

Material And Methods: A retrospective chart review was performed for firearm-related injuries in patients 15 years-old and under at an urban Pediatric Level 1 Trauma Center between January 2016 and December 2020.

Changes in trends during the COVID-19 lockdown: An urban, Level-1 trauma center's experience.

Background: A community lockdown has a profound impact on its citizens. Our objective was to identify changes in trauma patient demographics, volume, and pattern of injury following the COVID-19 lockdown.

Methods: A retrospective review was conducted at a Level-1 Trauma Center from 2017 to 2020.

Age itself or age-associated comorbidities? A nationwide analysis of outcomes of geriatric trauma.

Purpose: Geriatric trauma patients present physiological challenges to care providers. A nationwide analysis was performed to evaluate the roles of age alone versus age-associated comorbidities in the morbidity and mortality of elderly patients with blunt abdominal trauma (BAT).

Methods: Patients with BAT registered in the National Trauma Data Bank from 2013 to 2015 were analyzed using propensity score matching (PSM) to evaluate the mortality rate, complication rate, hospital length of stay (LOS), intensive care unit (ICU) LOS and ventilator days between young (age < 65) and elderly (age ≥ 65) patients.

Severe burn injury: Body Mass Index and the Baux score.

Objective: The revised Baux score (age total body surface area (TBSA) burned and inhalation injury)) is predictive of mortality in burn patients. Our study objective was to assess whether the addition of body mass index (BMI) to the revised Baux score would be of value. We posited that increasing BMI follows a pattern similar to age and TBSA in the revised Baux score after severe burn injury.

Association between Torso Gunshot Wound Volumes of Trauma Centers and Outcomes of Torso Gunshot Wound Patients. A Propensity-Matched Nationwide Cohort Study.

: The number and type of patients treated by trauma centers can vary widely because of a number of factors. There might be trauma centers with a high volume of torso GSWs that are not designated as high-level trauma centers. We proposed that, for torso gunshot wounds (GSWs), the treating hospital's trauma volume and not its trauma center level designation drives patient prognosis.

Outcome after surgical stabilization of rib fractures versus nonoperative treatment in patients with multiple rib fractures and moderate to severe traumatic brain injury (CWIS-TBI).

Background: Outcomes after surgical stabilization of rib fractures (SSRF) have not been studied in patients with multiple rib fractures and traumatic brain injury (TBI). We hypothesized that SSRF, as compared with nonoperative management, is associated with favorable outcomes in patients with TBI.

Methods: A multicenter, retrospective cohort study was performed in patients with rib fractures and TBI between January 2012 and July 2019.

Obesity May Require a Higher Level of Trauma Care: A Propensity-Matched Nationwide Cohort Study.

Stable patients with less severe injuries are not necessarily triaged to high-level trauma centers according to current guidelines. Obese patients are prone to comorbidities and complications. We hypothesized that stable obese patients with low-energy trauma have lower mortality and fewer complications if treated at Level-I/II trauma centers.

Patients With Combined Thermal and Intraabdominal Injuries: More Salvageable Than Not.

This study aims to better characterize the course and outcome of the uncommon subset of trauma patients with combined thermal and intraabdominal organ injuries. The National Trauma Data Bank was queried for burn patients with intraabdominal injury treated in all U.S.

The scales of recovery: Balancing posttraumatic stress with resilience in the violently injured.

Background: Community violence remains a clinical concern for urban hospitals nationwide; however, research on resilience and posttraumatic growth (PTG) among survivors of violent injury is lacking. This study intends to assess survivors of violent injury for resilience and PTG to better inform mental health interventions.

Methods: Adults who presented with nonaccidental penetrating trauma to an urban level 1 trauma center and were at least 1 month, but no more than 12 months, from treatment were eligible.

Obesity is Associated with Worse Outcomes Among Abdominal Trauma Patients Undergoing Laparotomy: A Propensity-Matched Nationwide Cohort Study.

Introduction: Obesity is associated with increased morbidity and mortality in abdominal trauma patients. The characteristics of abdominal trauma patients with poor outcomes related to obesity require evaluation. We hypothesize that obesity is related to increased mortality and length of stay (LOS) among abdominal trauma patients undergoing laparotomies.

Missing expectations: Windlass tourniquet use without formal training yields poor results.

Background: Despite significant attempts to educate civilians in hemorrhage control, the majority remain untrained. We sought to determine if laypersons can successfully apply one of three commercially available tourniquets; including those endorsed by the United States Military and the American College of Surgeons.

Methods: Preclinical graduate health science students were randomly assigned a commercially available windless tourniquet: SAM XT, Combat Application Tourniquet (CAT), or Special Operation Forces Tactical Tourniquet (SOFT-T).

Right hospital, right patients: Penetrating injury patients treated at high-volume penetrating trauma centers have lower mortality.

Background: The recognition of the relationship between volume and outcomes led to the regionalization of trauma care. The relationship between trauma mechanism-subtype and outcomes has yet to be explored. We hypothesized that trauma centers with a high volume of penetrating trauma patients might be associated with a higher survival rate for penetrating trauma patients.

Morbid Obesity's Silver Lining: An Armor for Hollow Viscus in Blunt Abdominal Trauma.

Background: Morbid obesity is usually accompanied by both subcutaneous and visceral fat accumulation. Fat can mimic an air bag, absorbing the force of a collision. We hypothesized that morbid obesity is mechanically protective for hollow viscus organs in blunt abdominal trauma (BAT).

Placenta to the Rescue: Limb Salvage Using Dehydrated Human Amnion/Chorion Membrane.

Reconstruction of skin and soft tissue wounds can pose a unique surgical challenge. This is especially true for cases of exposed bone and tendon where soft tissue loss is extensive and opportunities for tissue advancement or rotation are limited. A clinical case is presented describing an experience with dehydrated human amnion/chorion membrane (dHACM, EpiFix®/AmnioFix®, MiMedx Group, Marietta, GA) graft to obtain granulation over an open fracture with desiccated bone.