This study sought to define and analyze rates of futile trauma transfers (FTTs) after the consolidation of two rural level 1 trauma centers into one. Data was extracted from the regional trauma registry for a period of 5 years (2017-2022) for all trauma patients transferred into our level 1 trauma center (n = 3369). An FTT was defined as a transfer that (1) received no major interventions and (2) died or was discharged to a hospice facility within 72 hours. Out of the 3369 transfer patients analyzed during the 33-month pre-consolidation and 33-month post-consolidation periods, 34 patients met the criteria of an FTT within the transfer-to-discharge window. The pre-consolidation category contained 12, and the post-consolidation category contained 22. Chi-square analysis indicated no significant difference in FTT rate between categories. Furthermore, the post-consolidation FTT rate of 1.1% remained consistent with the estimated national average of 1.5%.
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http://dx.doi.org/10.1177/00031348241241719 | DOI Listing |
Neurocrit Care
January 2025
Department of Neurosurgery, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Background: Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in the older adult population, and palliative care consultation can assist in goals-of-care discussions. However, patterns of hospital care delivered before consultation are understudied for older adult patients with TBI. The objective of this study was to identify demographic and clinical drivers of preconsultation care intensity in this population.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Duke University Medical Center, Durham, North Carolina.
Background: Direct mechanical ventricular actuation (DMVA) with the Anstadt cup is effective for non-blood-contacting biventricular support. Pneumatic regulation of a silicone device augments ventricular pump function. Vacuum attachment facilitates diastolic augmentation critical for biventricular support.
View Article and Find Full Text PDFJ Trauma Acute Care Surg
January 2025
From the Department of Surgery (J.-M.V., T.W.C., B.A.C.), McGovern Medical School, University of Texas Health Science Center, Houston, Texas; Department of Epidemiology (B.L.R.-R., S.R.W.) and Department of Surgery (J.W.C.), University of Pennsylvania, Philadelphia, Pennsylvania; Donald D. Trunkey Center for Civilian and Combat Casualty Care (M.A.S.), Oregon Health & Science University, Portland, Oregon; Department of Surgery, Ernest E. Moore Shock Trauma Center at Denver Health (E.E.M.), University of Colorado Health Sciences Center, Denver, Colorado; Department of Surgery (N.N.), University of Miami/Jackson Memorial Hospital, Miami, Florida; and Department of Surgery (J.L.S.), Trauma and Transfusion Medicine Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.
View Article and Find Full Text PDFEur J Public Health
December 2024
Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases in Zabrze, Medical University of Silesia, Zabrze, Poland.
The discontinuation of futile therapy is increasingly discussed in Polish clinical practice. Given the need to ensure patient well-being, it is essential to consider whether all clinical options resulting from medical progress should be used for every patient and on what grounds decisions to limit therapy should be based. The aim of our study was to determine the opinions of Polish medical doctors on this topic.
View Article and Find Full Text PDFJ Craniofac Surg
December 2024
Department of Plastic Surgery, Armed Forces Capital Hospital, Bundang-gu, Seongnam-City, Gyeonggi-do.
The aim of this study was to analyze "The House of the Sleeping Beauties" (れる) by Yasunari Kawabata from the perspectives of plastic surgery, and psychiatry/psychology. The central theme of the novel focuses on aging, desire, and the human connection to beauty and mortality. The protagonist, Eguchi, frequents a brothel where elderly men lie next to young women who are drugged and remain unconscious.
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