A multicenter study of post-traumatic stress disorder after injury: Mechanism matters more than injury severity.

Background: Traumatic injury is strongly associated with long-term mental health disorders, but the risk factors for developing these disorders are poorly understood. We report on a multi-institutional collaboration to collect long-term patient-centered outcomes after trauma, including screening for post-traumatic stress disorder. The objective of this study is to determine the prevalence of and risk factors for the development of post-traumatic stress disorder after traumatic injury.

Association of pain after trauma with long-term functional and mental health outcomes.

Background: Chronic pain after trauma is associated with serious clinical, social, and economic burden. Due to limitations in trauma registry data and previous studies, the current prevalence of chronic pain after trauma is unknown, and little is known about the association of pain with other long-term outcomes. We sought to describe the long-term burden of self-reported pain after injury and to determine its association with positive screen for posttraumatic stress disorder (PTSD), functional status, and return to work.

The Cost of Complications Following Major Resection of Malignant Neoplasia.

Background: Rising healthcare costs have led to increased focus on the need to achieve a higher "value of care." As value-maximization efforts expand to include more complex surgical patients, evidence to support meaningful implementation of complication-based initiatives is lacking. The objective of this study was to compare incremental costs of complications following major gastrointestinal (GI) resections for organ-specific malignant neoplasia using nationally representative data.

Disparate outcomes of global emergency surgery - A matched comparison of patients in developed and under-developed healthcare settings.

Introduction: Access to surgical care is an essential element of health-systems strengthening. This study aims to compare two diverse healthcare settings in South Asia and the United States (US).

Methods: Patients at the Aga Khan University Hospital (AKUH), Pakistan were matched to patients captured in the US Nationwide Inpatient Sample (US-NIS) from 2009 to 2011.

A meta-analysis of the incidence of complications associated with groin access after the use of resuscitative endovascular balloon occlusion of the aorta in trauma patients.

Background: Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients.

Methods: We identified articles in MEDLINE and EMBASE.

Intraoperative combination of resuscitative endovascular balloon occlusion of the aorta and a median sternotomy in hemodynamically unstable patients with penetrating chest trauma: Is this feasible?

Background: Recent evidence suggests that resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective life-saving intervention in patients with severe torso trauma. However, the deployment of REBOA in patients with isolated penetrating intrathoracic injuries remains controversial. We propose that a median sternotomy be performed in conjunction with REBOA as a feasible and effective means of hemorrhage control in patients suffering from penetrating chest trauma who present hemodynamically unstable.

Ethical Obligations Regarding Short-Term Global Health Clinical Experiences: An American College of Physicians Position Paper.

This American College of Physicians position paper aims to inform ethical decision making surrounding participation in short-term global health clinical care experiences. Although the positions are primarily intended for practicing physicians, they may apply to other health care professionals and should inform how institutions, organizations, and others structure short-term global health experiences. The primary goal of short-term global health clinical care experiences is to improve the health and well-being of the individuals and communities where they occur.

Pregnancy and Motherhood During Surgical Training.

Importance: Although family priorities influence specialty selection and resident attrition, few studies describe resident perspectives on pregnancy during surgical training.

Objective: To directly assess the resident experience of childbearing during training.

Design, Setting, And Participants: A self-administered 74-question survey was electronically distributed in January 2017 to members of the Association of Women Surgeons, to members of the Association of Program Directors in Surgery listserv, and through targeted social media platforms.

Hidden Curricula, Ethics, and Professionalism: Optimizing Clinical Learning Environments in Becoming and Being a Physician: A Position Paper of the American College of Physicians.

Much of what is formally taught in medicine is about the knowledge, skills, and behaviors required of a physician, including how to express compassion and respect for patients at the bedside. What is learned, however, includes not only admirable qualities but also behaviors and qualities that are inconsistent with ethics and professionalism. Positive role models may reinforce the character and values the profession seeks to cultivate; negative ones directly contradict classroom lessons and expectations of patients, society, and medical educators.

Preoperative Counseling in Salvage Total Laryngectomy: Content Analysis of Electronic Medical Records.

Objective To study preoperative counseling in patients undergoing salvage total laryngectomy (STL). Study Design Case series with chart review. Setting Tertiary care academic hospital.

Patterns of use and factors associated with early discontinuation of opioids following major trauma.

Background: Inappropriate use of prescription opioids is a growing public-health issue. We sought to estimate the proportion of traumatic injury patients using legal prescription opioids up to 1-year after hospitalization.

Methods: We used 2006-2014 claims data from TRICARE insurance to identify adults hospitalized secondary to trauma between 2007 and 2013.

Tympanostomy Tube Placement vs Medical Management for Recurrent Acute Otitis Media in TRICARE-Insured Children.

Objective To compare number of infections and health care utilization in children insured by TRICARE with recurrent acute otitis media (RAOM) managed surgically with tympanostomy tube (TT) placement compared with those managed medically. Study Design Retrospective matched cohort study. Setting TRICARE claims database from 2006 to 2010.

Routine inclusion of long-term functional and patient-reported outcomes into trauma registries: The FORTE project.

Background: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of postdischarge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries.

Examining the common aetiology of serous ovarian cancers and basal-like breast cancers using double primaries.

Background: The somatic molecular profiles of basal-like breast cancers and high-grade serous ovarian cancers share many similarities, leading to the hypothesis that they have similar aetiologies, in which case they should occur together in the same patient more often than expected.

Methods: We identified 545 women with double independent primary cancers of the breast and ovary reported to the California Cancer Registry from 1999 to 2013 and examined the coincidence of subtype combinations.

Results: For most subtype combinations the observed frequencies were similar to their expected frequencies, but in 103 observed cases vs 43.

Implementing Sexual Orientation and Gender Identity Data Collection in Emergency Departments: Patient and Staff Perspectives.

Purpose: To identify patient and provider perspectives concerning collection of sexual orientation and gender identity (SO&GI) information in emergency departments (EDs).

Methods: Semistructured interviews were conducted during the period of 2014-2015 with a diverse purposive sample of patients across the spectrum of sexual orientation and gender identities (n = 53) and ED nurses, physician assistants, physicians, and registrars (n = 38) in a major metropolitan area. Interviews were recorded, transcribed verbatim, and analyzed by multiple coders using constant comparative methods.

Preoperative assessment of surgical risk: creation of a scoring tool to estimate 1-year mortality after emergency abdominal surgery in the elderly patient.

Background: The risk of mortality after emergency general surgery (EGS) in elderly patients is prolonged beyond initial hospitalization. Our objective was to develop a preoperative scoring tool to quantify risk of 1-year mortality.

Methods: Three hundred ninety EGS patients aged 70 years or more were analyzed.

Inequalities in Specialist Hand Surgeon Distribution across the United States.

Background: Unequal access to hospital specialists for emergency care is an issue in the United States. The authors sought to describe the geographic distribution of specialist hand surgeons and associated factors in the United States.

Methods: Geographic distributions of surgeons holding a Subspecialty Certificate in Surgery of the Hand and hand surgery fellowship positions were identified from the American Board of Medical Specialties Database and the literature (2013), respectively.

Never giving up: outcomes and presentation of emergency general surgery in geriatric octogenarian and nonagenarian patients.

Background: Aging of the population necessitates consideration of the increasing number of older adults requiring emergency care. The objective of this study was to compare outcomes and presentation of octogenarian and/or nonagenarian emergency general surgery (EGS) patients with younger adults.

Methods: Based on a standardized definition of EGS, patients in the 2007 to 2011 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample were queried for primary EGS diagnoses.

How long should we fear? Long-term risk of venous thromboembolism in patients with traumatic brain injury.

Background: Although patients with traumatic brain injury (TBI) are known to be at high risk for venous thromboembolism (VTE), it is not clear how long this risk persists after injury. We aimed to determine the risk of VTE in patients with TBI during one year after injury and to identify associated factors.

Methods: Patients 18 years and older with International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses of isolated TBI (head Abbreviated Injury Scale [AIS] ≥3 and AIS <3 for all other body regions) were identified in the California State Inpatient Database (2007-2011).

Setting a National Agenda for Surgical Disparities Research: Recommendations From the National Institutes of Health and American College of Surgeons Summit.

Health care disparities (differential access, care, and outcomes owing to factors such as race/ethnicity) are widely established. Compared with other groups, African American individuals have an increased mortality risk across multiple surgical procedures. Gender, sexual orientation, age, and geographic disparities are also well documented.