31 results match your criteria: "H.M.A.K.); Massachusetts General Hospital; Harvard Medical School (A.A.[Affiliation]"
Differences in Cortical Morphology in People With and Without Migraine: A Registry for Migraine (REFORM) MRI Study.
Neurology
May 2024
From the Department of Neurology (R.H.C., H.A., H.M.A.-K., A.H.P., F.M.A., M.A.), Danish Headache Center, Copenhagen University Hospital-Rigshospitalet; Department of Clinical Medicine (R.H.C., H.A., H.M.A.-K., F.M.A., M.A.), Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Harvard Medical School (R.H.C., H.A., H.M.A-K.), Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine (R.H.C., H.A., H.M.A-K.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Brain and Spinal Cord Injury (H.A., F.M.A.), Copenhagen University Hospital-Rigshospitalet, Denmark; Department of Neurology (Y.Z.), The First Affiliated Hospital of Chongqing Medical University, China; Department of Radiology (D.T.), Rigshospitalet Glostrup, Denmark; Translational Imaging in Neurology (ThINk) Basel (A.C., C.G.), Department of Biomedical Engineering, University Hospital Basel, University of Basel; Neurologic Clinic and Policlinic (A.C., C.G.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel, University of Basel, Switzerland; Gillberg Neuropsychiatry Centre (N.H.), Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg, Sweden; Athinoula A. Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital, Boston; and Danish Knowledge Center on Headache Disorders (M.A.), Glostrup, Denmark.
Background And Objectives: Structural imaging can offer insights into the cortical morphometry of migraine, which might reflect adaptations to recurring nociceptive messaging. This study compares cortical morphometry between a large sample of people with migraine and healthy controls, as well as across migraine subtypes.
Methods: Adult participants with migraine and age-matched and sex-matched healthy controls attended a single MRI session with magnetization-prepared rapid acquisition gradient echo and fluid-attenuated inversion recovery sequences at 3T.
Artificial intelligence versus surgeon gestalt in predicting risk of emergency general surgery.
J Trauma Acute Care Surg
October 2023
From the Division of Trauma, Emergency Surgery, and Surgical Critical Care (M.E.M., A.G., L.R.M., L.N., M.E.H., K.B., A.D.-G., R.S., G.V., H.M.A.K.), Massachusetts General Hospital, Boston; and Massachusetts Institute of Technology (D.B.), Cambridge, Massachusetts.
Background: Artificial intelligence (AI) risk prediction algorithms such as the smartphone-available Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) for emergency general surgery (EGS) are superior to traditional risk calculators because they account for complex nonlinear interactions between variables, but how they compare to surgeons' gestalt remains unknown. Herein, we sought to: (1) compare POTTER to surgeons' surgical risk estimation and (2) assess how POTTER influences surgeons' risk estimation.
Study Design: A total of 150 patients who underwent EGS at a large quaternary care center between May 2018 and May 2019 were prospectively followed up for 30-day postoperative outcomes (mortality, septic shock, ventilator dependence, bleeding requiring transfusion, pneumonia), and clinical cases were systematically created representing their initial presentation.
Contemporary management and outcomes of penetrating colon injuries: Validation of the 2020 AAST Colon Organ Injury Scale.
J Trauma Acute Care Surg
August 2023
From the Department of Surgery (A.Z.), Howard University Hospital, Washington, DC; Department of Surgery (A.Z., N.K.D., R.A.K.), Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland; Department of Surgery (M.A., K.M.S.), Yale University, New Haven, Connecticut; Department of Surgery (G.J., B.M.), University of New Mexico Health Science Center, Albuquerque, New Mexico; Department of Surgery (M.C., A.C.S.), College of Medicine, University of Florida, Jacksonville, Florida; Department of Surgery (B.S.R., M.L.M.), University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Surgery (N.D.M., C.L.J.), University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery (D.L., K.K.), Community Regional Medical Center, UCSF Fresno, Fresno, California; Department of Surgery (C.R.H., N.L.W.), Denver Health, Denver, Colorado; Department of Surgery (J.A.P.-Z., H.M.A.K.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Department of Surgery (W.A.M., L.N.H.), University of California San Diego Health, San Diego; Department of Surgery (G.T.T., K.B.S.), Scripps Memorial Hospital, La Jolla; and Department of Surgery (K.L.S.), Stanford University, Stanford, California.
Introduction: The American Association for the Surgery of Trauma Colon Organ Injury Scale (OIS) was updated in 2020 to include a separate OIS for penetrating colon injuries and included imaging criteria. In this multicenter study, we describe the contemporary management and outcomes of penetrating colon injuries and hypothesize that the 2020 OIS system correlates with operative management, complications, and outcomes.
Methods: This was a retrospective study of patients presenting to 12 Level 1 trauma centers between 2016 and 2020 with penetrating colon injuries and Abbreviated Injury Scale score of <3 in other body regions.
Is perioperative COVID-19 really associated with worse surgical outcomes? A nationwide COVIDSurg propensity-matched analysis.
J Trauma Acute Care Surg
April 2023
From the Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery (D.A., A.D.-G., M.E., A.G., J.A.P.-Z., M.B., A.M.R., H.M.A.K.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; NIHR Global Health Research Unit on Global Surgery, University of Birmingham (D.N., A.B.), Birmingham, United Kingdom.
Article Synopsis
- Patients undergoing surgery with perioperative COVID-19 had worse postoperative outcomes compared to those without COVID-19, indicating the potential severity of the virus in surgical settings.
- A study matched 1,054 patients with perioperative COVID-19 to 96,882 patients without it, focusing on demographics and health conditions to ensure comparable results.
- After matching, COVID-19 patients experienced higher mortality (12% vs. 8.1%), longer hospital stays, and more complications such as renal failure and sepsis, while having lower rates of bleeding compared to non-COVID patients.
Do not forget the platelets: The independent impact of red blood cell to platelet ratio on mortality in massively transfused trauma patients.
J Trauma Acute Care Surg
July 2022
From the Division of Trauma, Emergency Surgery, and Surgical Critical Care (A.D.G., L.N., A. Gaitanidis, A. Gebran, J.J.P., J.O.H., J.F., A.E.M., N.N.S., P.J.F., G.C.V., H.M.A.K.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and Leiden University Medical Center, Leiden, Netherlands (C.J.N.).
Background: Balanced blood component administration during massive transfusion is standard of care. Most literature focuses on the impact of red blood cell (RBC)/fresh frozen plasma (FFP) ratio, while the value of balanced RBC:platelet (PLT) administration is less established. The aim of this study was to evaluate and quantify the independent impact of RBC:PLT on 24-hour mortality in trauma patients receiving massive transfusion.
View Article and Find Full Text PDFPatient-reported outcomes 6 to 12 months after isolated rib fractures: A nontrivial injury pattern.
J Trauma Acute Care Surg
February 2022
From the Division of Trauma, Burn and Surgical Critical Care, Department of Surgery (P.H., A.O., M.E.M., A.S.), and Center for Surgery and Public Health (P.H., A.O., M.E.M., J.S.-G., S.G., A.H., N.P., J.H.E., A.S., D.N.), Brigham and Women's Hospital, Harvard Medical School; Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery (S.S.), Boston University School of Medicine, Boston, Massachusetts; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (H.M.A.K.), Massachusetts General Hospital, Harvard Medical School; and Division of Trauma, Burn and Critical Care Surgery, Department of Surgery (D.N.), University of Washington Medical Center, Seattle, Washington.
Article Synopsis
- A study on patients with rib fractures resulting from blunt chest trauma showed that long-term outcomes, such as chronic pain and activity limitations, are common even 6 to 12 months post-injury.
- Among 279 patients studied, a significant number experienced new daily pain, with 43% of those without preexisting pain disorders reporting it.
- Factors like older age, the number of rib fractures, and ICU admission increased the likelihood of patients receiving regional anesthesia for pain management.
Development of a field artificial intelligence triage tool: Confidence in the prediction of shock, transfusion, and definitive surgical therapy in patients with truncal gunshot wounds.
J Trauma Acute Care Surg
June 2021
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (TESSC) (C.J.N., A.K.M., O.A., J.A.F., J.J.P., A.E.M., P.J.F., H.M.A.K., D.R.K., G.C.V., N.S.), Massachusetts General Hospital (MGH), Boston, Massachusetts; Department of Trauma Surgery (C.J.N.), Leiden University Medical Center, Leiden, The Netherlands; Lincoln Laboratory (T.T., J.R., M.C.), Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts; and Center for Outcomes and Patient Safety in Surgery (H.M.A.K), Massachusetts General Hospital (MGH), Boston, Massachusetts.
Background: In-field triage tools for trauma patients are limited by availability of information, linear risk classification, and a lack of confidence reporting. We therefore set out to develop and test a machine learning algorithm that can overcome these limitations by accurately and confidently making predictions to support in-field triage in the first hours after traumatic injury.
Methods: Using an American College of Surgeons Trauma Quality Improvement Program-derived database of truncal and junctional gunshot wound (GSW) patients (aged 16-60 years), we trained an information-aware Dirichlet deep neural network (field artificial intelligence triage).
Implications of the national Stop the Bleed campaign: The swinging pendulum of prehospital tourniquet application in civilian limb trauma.
J Trauma Acute Care Surg
August 2021
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (S.M., A.K.M., C.M.L., K.A.B., B.L., H.M.A.K., G.V., A.E.M., N.S.), Massachusetts General Hospital, Boston, Harvard Medical School, Boston, Massachusetts; and Department of Trauma Surgery (S.M., F.W.B.), Amsterdam UMC, Amsterdam, the Netherlands.
Background: Prehospital tourniquet (PHT) utilization has increased in response to mass casualty events. We aimed to describe the incidence, therapeutic effectiveness, and morbidity associated with tourniquet placement in all patients treated with PHT application.
Methods: A retrospective observational cohort study was performed to evaluate all adults with a PHT who presented at two Level I trauma centers between January 2015 and December 2019.
Multisystem outcomes and predictors of mortality in critically ill patients with COVID-19: Demographics and disease acuity matter more than comorbidities or treatment modalities.
J Trauma Acute Care Surg
May 2021
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (O.A., A.M., L.N., K.L., K.A.B., M.E.M., C.K., A.G., M.A.C., L.R.M., H.M., B.B.-K., J.P., J.F., N.S., A.M., C.P., P.F., D.K., J.L., G.C.V., H.M.A.K.), and Division of Pulmonary Critical Care (M.R.F.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Background: We sought to describe characteristics, multisystem outcomes, and predictors of mortality of the critically ill COVID-19 patients in the largest hospital in Massachusetts.
Methods: This is a prospective cohort study. All patients admitted to the intensive care unit (ICU) with reverse-transcriptase-polymerase chain reaction-confirmed severe acute respiratory syndrome coronavirus 2 infection between March 14, 2020, and April 28, 2020, were included; hospital and multisystem outcomes were evaluated.
Trauma outcome predictor: An artificial intelligence interactive smartphone tool to predict outcomes in trauma patients.
J Trauma Acute Care Surg
July 2021
From the Department of Surgery (L.R.M.), Massachusetts General Hospital, Boston; Massachusetts Institute of Technology (D.B., H.T.B., K.G.), Cambridge; Interpretable AI (D.B., D.Z., J.D.); and Division of Trauma, Emergency Surgery, and Surgical Critical Care (M.E.H., M.E.M., G.C.V., H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts.
Background: Classic risk assessment tools often treat patients' risk factors as linear and additive. Clinical reality suggests that the presence of certain risk factors can alter the impact of other factors; in other words, risk modeling is not linear. We aimed to use artificial intelligence (AI) technology to design and validate a nonlinear risk calculator for trauma patients.
View Article and Find Full Text PDFThe Emergency Surgery Score accurately predicts the need for postdischarge respiratory and renal support after emergent laparotomies: A prospective EAST multicenter study.
J Trauma Acute Care Surg
March 2021
From the Division of Trauma, Emergency Surgery & Surgical Critical Care (M.E.H., N.K., L.N., H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts; Division of Acute Care and Ambulatory Surgery (N.K.), Siriraj Hospital, Mahidol University, Bangkok, Thailand; R Adams Cowley Shock Trauma Center (B.A., J.D., L.O.), University of Maryland Medical Center, Baltimore, Maryland; Department of Surgery, UCHealth Memorial Hospital Central Trauma Center (C.D., J.R., T.S.), Colorado Springs, Colorado; The Dewitt Daughtry Family Department of Surgery Ryder Trauma Center/Jackson Memorial Hospital (R.R., G.V., D.D.Y.), Miami, Florida; Department of Surgery, Loma Linda University Medical Center (U.S., D.T.), Department of Surgery, Loma Linda, California; Marshfield Clinic (D.C., C.E.), Marshfield, Wisconsin; University of Utah (M.C., N.W.), Salt Lake City, Utah; Department of Surgery, Cooper University Hospital (J.B., A.G.-S.), Camden, New Jersey; Department of Surgery, University of Colorado Anschutz Medical Campus (H.C., C.V.), Aurora, Colorado; Division of Acute Care Surgery, Department of Surgery, The Johns Hopkins University School of Medicine (R.C., J.S.), Baltimore, Maryland; Department of Surgery, Eastern Maine Medical Center (K.B.), Bangor, Maine; Department of Surgery, University of Texas Southwestern Medical Center and Parkland Hospital (G.B., T.S.), Dallas, Texas; Department of Surgery, Staten Island University Hospital, Northwell Health (Z.C., V.S.), Staten Island, New York; Department of Surgery, University of Florida College of Medicine-Jacksonville (F.M., D.S.), Jacksonville, Florida; Mayo Clinic (M.C., M.Z.), Rochester, Minnesota; Miami Valley Hospital (C.H., M.W.), Dayton, Ohio; New York University School of Medicine (M.K., S.R.), New York, New York; Department of Surgery, Papageorgiou General Hospital/Aristotle University School of Medicine (V.P., G.T.), Greece; and Department of Surgery, Hackensack University Medical Center (J.P.), Hackensack, New Jersey.
Background: The Emergency Surgery Score (ESS) was recently validated as an accurate mortality risk calculator for emergency general surgery. We sought to prospectively evaluate whether ESS can predict the need for respiratory and/or renal support (RRS) at discharge after emergent laparotomies (EL).
Methods: This is a post hoc analysis of a 19-center prospective observational study.
Long-term outcomes of psychoactive drug use in trauma patients: A multicenter patient-reported outcomes study.
J Trauma Acute Care Surg
February 2021
From the Division of Trauma, Emergency Surgery, and Surgical Critical Care (M.E.M., K.B., G.V., H.M.A.K.), Massachusetts General Hospital; Department of Surgery (J.P.H.-E., A.S.), Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School; Center for Surgery and Public Health (J.P.H.-E., C.O., A.N.H., A.S.), Brigham and Women's Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health; Department of Psychiatry (N.C.L.-C.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Trauma, Burn and Critical Care Surgery (D.N.), Harborview Medical Center, University of Washington, Seattle, Washington; Division of Trauma, Acute Care Surgery and Surgical Critical Care (S.E.S.), Boston University School of Medicine, Boston, Massachusetts.
Article Synopsis
- Psychoactive drug use (PDU) affects up to 40% of trauma patients and is linked to higher in-hospital complications, but its long-term impact is not well understood.
- A study evaluated trauma patients 6 to 12 months after injury to assess the long-term effects of PDU on functional, mental, and psychosocial outcomes, using a structured phone interview.
- Results from 571 patients showed that those with PDU were generally younger, had more severe injuries, lower educational attainment, and were more prone to chronic pain and mental health disorders post-injury.
Colorectal resection in emergency general surgery: An EAST multicenter trial.
J Trauma Acute Care Surg
December 2020
From the R Adams Cowley Shock Trauma Center, Department of Surgery, University of Maryland Medical Center (B.O.A., L.O.M., J.K., B.B.R.), Baltimore, Maryland; Department of Surgery, Mayo Clinic (M.C.H., M.D.Z.), Rochester, Minnesota; Department of Surgery, Southside Hospital, Northwell Health (A.B.R., M.D.G.), Bay Shore, NY; Department of Surgery, UCHealth Memorial Hospital Central Trauma Center (T.J.S., H.H.), Colorado Springs, Colorado; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital (N.K., H.M.A.K.), Boston, Massachusetts; Department of Surgery, West Virginia University Medicine (A.W., D.G.), Morgantown, West Virginia; Department of Surgery, Robert Wood Johnson University Hospital (M.S., G.P.), New Brunswick, NJ; Department of Surgery, University of Southern California (G.C., K.M.), Los Angeles, California; Department of Surgery, Marshfield Clinic (D.C.C., L.M.C.), Marshfield, Wisconsin; Department of Surgery, Northwestern Memorial Hospital (B.S., J.P.), Chicago, Illinois; Department of Surgery, Loma Linda University Medical Center (U.J.S., R.D.C.), Loma Linda, CA; Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital (G.V., D.D.Y.), Miami, Florida; Department of Surgery, Methodist Dallas Medical Center (V.A., M.S.T.) Dallas, Texas; Department of Surgery, University of Texas Southwestern Medical Center and Parkland Hospital (M.P., L.D.), Dallas, Texas; Department of Surgery, Reading Hospital (A.M., A.W.O.), West Reading, Pennsylvania; Cooper University Health Care (J.L.S.R., N.B.), Camden, NJ; Department of Surgery, University of Colorado (O.F., C.G.V.), Denver, Colorado; George Washington University (C.H., J.M.E), Washington, District of Columbia; Department of Surgery, University of California, Irvine (S.G., J.N.), Irvine, California; Department of Surgery, Tufts University (K.J., N.B), Boston, Massachusetts; and Department of Surgery, Medical City Plano (V. P., M.M.C.), Plano, Texas.
Objective: Evidence comparing stoma creation (STM) versus anastomosis after urgent or emergent colorectal resection is limited. This study examined outcomes after colorectal resection in emergency general surgery patients.
Methods: This was an Eastern Association for the Surgery of Trauma-sponsored prospective observational multicenter study of patients undergoing urgent/emergent colorectal resection.
The Geriatric Nutritional Risk Index is a powerful predictor of adverse outcome in the elderly emergency surgery patient.
J Trauma Acute Care Surg
August 2020
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (Z.J., M.E.M., A.N., J.M.L., K.M., N.K., K.H., M.W.E.H., A.M., D.K., P.F., N.S., M.R., G.V., H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts; and Department of General Surgery(Z.J.), Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China.
Background: The degree to which malnutrition impacts perioperative outcomes in the elderly emergency surgery (ES) patient remains unknown. We aimed to study the relationship between malnutrition, as measured by the Geriatric Nutritional Risk Index (GNRI), and postoperative outcomes in elderly patients undergoing ES.
Methods: Using the 2007 to 2016 American College of Surgeons National Surgical Quality Improvement Program database, all patients 65 years or older undergoing ES were included in our study.
No news is good news? Three-year postdischarge mortality of octogenarian and nonagenarian patients following emergency general surgery.
J Trauma Acute Care Surg
July 2020
From the Division of Trauma, Emergency Surgery, and Surgical Critical Care (N.N., J.H., M.K., J.M.L., N.K., G.V., D.K., P.F., N.S., A.M., M.R., H.M.A.K.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery (N.N.), and Department of Anesthesiology (M.K.), Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand; and Center for Outcomes and Patient Safety in Surgery (H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts.
Background: Outcome data on the very elderly patients undergoing emergency general surgery (EGS) are sparse. We sought to examine short- and long-term mortality in the 80 plus years population following EGS.
Methods: Using our institutional 2008-2018 EGS Database, all the 80 plus years patients undergoing EGS were identified.
Prospective validation of the Emergency Surgery Score in emergency general surgery: An Eastern Association for the Surgery of Trauma multicenter study.
J Trauma Acute Care Surg
July 2020
From the Division of Trauma (H.M.A.K., N.K., G.C.V.), Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School (H.M.A.K.), Boston, Maryland; Division of Acute Care and Ambulatory Surgery (N.K.), Siriraj Hospital, Mahidol University, Bangkok, Thailand; R Adams Cowley Shock Trauma Center, Department of Surgery, (B.O.A., J.J.D.Jr., L.B.O.), University of Maryland Medical Center, Baltimore, Maryland; Department of Surgery, UCHealth Memorial Hospital Central Trauma Center (C.D., J.R., T.S.), Colorado Springs, Colorado; Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center/Jackson Memorial Hospital (R.R., G.V., D.D.Y.), Miami, Florida; Loma Linda University Medical Center (U.J.S., D.T.), Department of Surgery, Loma Linda, California; Department of Surgery, Marshfield Clinic (D.C.C., C.B.E.), Marshfield, Wisconsin; Department of Surgery, University of Utah (M.L.M., N.W.), Salt Lake City, Utah; Department of Surgery, Cooper University Hospital (J.B., A.G-S), Camden, New Jersey; Department of Surgery, University of Colorado Anschutz Medical Campus (H.C., C.V.), Aurora, Colorado; Division of Acute Care Surgery, Department of Surgery, Johns Hopkins University School of Medicine (R.C., J.V.S.), Baltimore, Maryland; Department of Surgery, Eastern Maine Medical Center (K.B.), Bangor, Maine; Department of Surgery, University of Texas Southwestern Medical Center and Parkland Hospital (G.B., T.S.), Dallas, Texas; Department of Surgery, Staten Island University Hospital (Z.C., V.S.), Northwell Health, Staten Island, New York; Department of Surgery, University of Florida College of Medicine-Jacksonville (F.M., D.S.), Jacksonville, Florida; Department of Surgery, Mayo Clinic (M.C., M.D.Z.), Rochester, Minnesota; Department of Surgery, Miami Valley Hospital (C.H., M.W.), Dayton, Ohio; Department of Surgery, New York University School of Medicine (M.K., S.R.), New York, New York; Papageorgiou General Hospital, Aristotle University School of Medicine (V.N.P., G.T.), Thessaloniki Greece; Department of Surgery, Hackensack University Medical Center (J.M.P.), Hackensack, New Jersey.
Background: The Emergency Surgery Score (ESS) was recently developed and retrospectively validated as an accurate mortality risk calculator for emergency general surgery. We sought to prospectively validate ESS, specifically in the high-risk nontrauma emergency laparotomy (EL) patient.
Methods: This is an Eastern Association for the Surgery of Trauma multicenter prospective observational study.
Identification of a new genetic variant associated with cholecystitis: A multicenter genome-wide association study.
J Trauma Acute Care Surg
July 2020
From the Division of Trauma (A.B., A.G., K.B., M.E.H., C.N., M.C., N.K., A.M., G.V., H.M.A.K.), Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts; Department of Anesthesia (A.B., M.C., M.S.), Center of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Biomedical Informatics (M.R.F.), Harvard Medical School; and Pulmonary and Critical Care Medicine (M.R.F.), Massachusetts General Hospital, Boston, Massachusetts.
Background: The genomic landscape of gallbladder disease remains poorly understood. We sought to examine the association between genetic variants and the development of cholecystitis.
Methods: The Biobank of a large multi-institutional health care system was used.
The dose-dependent relationship between blood transfusions and infections after trauma: A population-based study.
J Trauma Acute Care Surg
July 2020
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (C.J.N., M.E.H., J.P., J.F., A.E.M., N.S., D.R.K., P.J.F., G.C.V., H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts; Department of Trauma Surgery (C.J.N.), Leiden University Medical Center, Leiden, The Netherlands; Harvard Medical School (J.P., J.F., A.E.M., N.S., D.R.K., P.J.F., G.C.V., H.M.A.K.), Cambridge; and Center for Outcomes and Patient Safety in Surgery (COMPASS) (H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts.
Objective: The relationship between total transfusion volume and infection in the trauma patient remains unclear, especially at lower volumes of transfusion. We sought to quantify the cumulative, independent impact of transfusion within 24 hours of admission on the risk of infection in trauma patients.
Methods: Using the Trauma Quality Improvement Program 2013 to 2016 database, we included all patients who received blood transfusions in the first 4 hours.
Case 39-2019: A 57-Year-Old Woman with Hypotension and Trauma after a Motorcycle Accident.
N Engl J Med
December 2019
From the Departments of Surgery (D.R.K., H.M.A.K.), Anesthesia (J.C.C.), and Radiology (N.E.F.), Massachusetts General Hospital, and the Departments of Surgery (D.R.K., H.M.A.K.), Anesthesia (J.C.C.), and Radiology (N.E.F.), Harvard Medical School - both in Boston.
Obesity as protective against, rather than a risk factor for, postoperative Clostridium difficile infection: A nationwide retrospective analysis of 1,426,807 surgical patients.
J Trauma Acute Care Surg
June 2019
From the Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery (K.M., A.T.N., A.I.E., N.K., J.M.L., M.K., K.R.H., N.K., A.E.M., N.S., D.R.K., G.C.V., H.M.A.K.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, Department of Trauma Surgery (K.M.), Leiden University Medical Center, Leiden University, The Netherlands; and Department of Anaesthesia (A.T.N.), Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Denmark.
Background: Recent studies suggest that obesity is a risk factor for Clostridium difficile infection, possibly due to disruptions in the intestinal microbiome composition. We hypothesized that body mass index (BMI) is associated with increased incidence of C. difficile infection in surgical patients.
View Article and Find Full Text PDFMost of the variation in length of stay in emergency general surgery is not related to clinical factors of patient care.
J Trauma Acute Care Surg
August 2019
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (A.A., A.N., N.K., K.H., A.M., N.S., M.R., P.F., G.V., H.M.A.K.); Massachusetts General Hospital; Harvard Medical School (A.A., A.N., N.K., K.H., A.M., N.S., M.R., P.F., G.V., H.M.A.K.), Boston, Massachusetts.
Background: Hospital length of stay (LOS) is currently recognized as a key quality indicator. We sought to investigate how much of the LOS variation in the high-risk group of patients undergoing Emergency general surgery could be explained by clinical versus nonclinical factors.
Methods: Using the 2007 to 2015 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, we included all patients who underwent an emergency appendectomy, cholecystectomy, colectomy, small intestine resection, enterolysis, or hernia repair.
Life after 90: Predictors of mortality and performance of the ACS-NSQIP risk calculator in 4,724 nonagenarian patients undergoing emergency general surgery.
J Trauma Acute Care Surg
May 2019
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (M.K., K.C., J.M.L., A.I.E., N.K., K.H., A.T.N., D.K., N.S., A.E.M., G.V., H.M.A.K.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; and Department of Anesthesiology, Faculty of Medicine (M.K.), Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Background: The decision to emergently operate on nonagenarian patients (NONAs) can be complex due to the uncertainty about outcomes and goals of care at this advanced age. We sought to study: (1) the outcomes and predictors of mortality for NONAs undergoing emergency general surgery (EGS) and (2) the accuracy of ACS-NSQIP mortality risk calculator in this special population.
Methods: Using the 2007 to 2015 ACS-NSQIP database, we included all patients older than 90 years of age who underwent an emergent operation with a Current Procedural Terminology (CPT) code for "digestive system.
Interrupted versus continuous fascial closure in patients undergoing emergent laparotomy: A randomized controlled trial.
J Trauma Acute Care Surg
September 2018
From the Department of Surgery (T.P., J.D.B., S.M., E.F., G.M.vdW., A.M., H.A., H.M.A.K., P.J.F., D.R.K., D.D.Y., G.C.V., M.A.dM.), Massachusetts General Hospital, Boston, MA.
Background: The optimal method of fascial closure, interrupted fascial closure (IFC) versus continuous fascial closure (CFC) has never been studied exclusively in the setting of emergency surgery. We hypothesized that IFC decreases postoperative incisional hernia development following emergent laparotomies.
Methods: Between August 2008 and September 2015, patients undergoing emergent laparotomies were consented and randomly assigned to either IFC or CFC.
Elevated admission N-terminal pro-brain natriuretic peptide level predicts the development of atrial fibrillation in general surgical intensive care unit patients.
J Trauma Acute Care Surg
September 2017
From the Department of Anesthesiology, King Chulalongkorn Memorial Hospital (N.C.), Thai Red Cross Society (N.C.), Department of Anesthesiology (N.C.), Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Trauma, Emergency Surgery and Surgical Critical Care (N.C., D.D.Y., L.A.O., H.M.A.K., P.F., D.R.K., M.D., K.B., J.L., G.V.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, Department of Medicine (Y.C.), Massachusetts General Hospital and Harvard Medical School; Division of Cardiology (J.L.J.), Massachusetts General Hospital and Cardiometabolic Trials, Harvard Clinical Research Institute; Department of Pathology (E.L., K.L.), Massachusetts General Hospital; and Harvard Medical School (E.L., K.L.), Boston, Massachusetts.
Background: New onset atrial fibrillation (AF) in critically ill surgical patients is associated with significant morbidity and increased mortality. N-terminal pro-B type natriuretic peptide (NT-proBNP) is released by cardiomyocytes in response to stress and may predict AF development after surgery. We hypothesized that elevated NT-proBNP level at surgical intensive care unit (ICU) admission predicts AF development in a general surgical and trauma population.
View Article and Find Full Text PDFThe Emergency Surgery Score (ESS) accurately predicts the occurrence of postoperative complications in emergency surgery patients.
J Trauma Acute Care Surg
July 2017
From the Division of Trauma, Emergency Surgery and Surgical Critical Care (A.R.N., J.D.B., N.F.S., T.P., K.H., D.D.Y., J.L., M.D.M., G.C.V., D.C.C., H.M.A.K.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; and Codman Center for Clinical Effectiveness in Surgery (D.C.C., H.M.A.K.), Massachusetts General Hospital, Boston, Massachusetts.
Background: The Emergency Surgery Score (ESS) was recently validated as a scoring system to predict mortality in emergency surgery (ES) patients. We sought to examine the ability of ESS to predict the occurrence of 30-day postoperative complications in ES.
Methods: The 2011-2012 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was screened for all surgical operations classified as "emergent.