Integrating Geriatric Consults into Routine Care of Older Trauma Patients: One-Year Experience of a Level I Trauma Center.

Background: Although involvement of geriatricians in the care of older trauma patients is associated with changes in processes of care and improved outcomes, few geriatrician consultations were ordered on our service.

Study Design: Mandatory geriatric consults were initiated in September 2013 for all trauma patients 70 years and older admitted to our hospital. We prospectively collected data on patients admitted from October 2013 through September 2014 (postintervention) and compared their data with those of patients admitted from June 2011 through June 2012 (preintervention).

Racial disparities in emergency general surgery: Do differences in outcomes persist among universally insured military patients?

Background: Racial disparities in surgical care are well described. As many minority patients are also uninsured, increasing access to care is thought to be a viable solution to mitigate inequities. The objectives of this study were to determine whether racial disparities in 30-/90-/180- day outcomes exist within a universally insured population of military-/civilian-dependent emergency general surgery (EGS) patients and ascertain whether differences in outcomes differentially persist in care received at military versus civilian hospitals and among sponsors who are enlisted service members versus officers.

Postdischarge complications following nonoperative management of blunt splenic injury.

Background: Nonoperative management (NOM) is the standard of care in majority of blunt splenic injuries. However, little is known about the postdischarge complications.

Methods: Patients admitted for blunt splenic injury were identified in the California State Inpatient Database (2007 to 2011).

Whatever happens to trauma patients who leave against medical advice?

Background: Although trauma patients are frequently discharged against medical advice (AMA), the fate of these patients remains mostly unknown.

Methods: Patients with traumatic injuries were identified in the California State Inpatient Database, 2007 to 2011. Readmission characteristics of patients discharged AMA were compared with patients discharged home.

The truth about trauma readmissions.

Background: There is a paucity of data on the causes and associated patient factors for unplanned readmissions among trauma patients.

Methods: We examined patients admitted for traumatic injuries between 2007 and 2011 in the California State Inpatient Database. Using chi-square tests and multivariate logistic regression models, we determined rates, reasons, locations, and patient factors associated with 30-day readmissions.

Morbidity or mortality? Variations in trauma centres in the rescue of older injured patients.

Introduction: Prior analysis demonstrates improved survival for older trauma patients (age>64years) treated at trauma centres that manage a higher proportion of geriatric patients. We hypothesised that 'failure to rescue' (death after a complication during an in-hospital stay) may be responsible for part of this variation. The objective of the study was to determine if trauma centre failure to rescue rates are associated with the proportion of older trauma seen.

Inpatient Pediatric Tonsillectomy: Does Hospital Type Affect Cost and Outcomes of Care?

Objective: To ascertain whether hospital type is associated with differences in total cost and outcomes for inpatient tonsillectomy.

Study Design: Cross-sectional analysis of the 2006, 2009, and 2012 Kids' Inpatient Database (KID).

Subjects And Methods: Children ≤18 years of age undergoing tonsillectomy with/without adenoidectomy were included.

Evaluation of the Perceived Association Between Resident Turnover and the Outcomes of Patients Who Undergo Emergency General Surgery: Questioning the July Phenomenon.

Importance: The influx of new surgical residents and interns at the beginning of the academic year is assumed to be associated with poor outcomes. Referred to as the July phenomenon, this occurrence has been anecdotally associated with increases in the frequency of medical errors due to intern inexperience. Studies in various surgical specialties provide conflicting results.

The hazards of off-road motor sports: Are four wheels better than two?

Background: Off-road motorsports are an increasing popular activity, yet the relative safety profile of all-terrain vehicles (ATV) to off-road motorcycles (ORMC) has not been compared.

Study Design: A retrospective review of the 2002-2006 US National Trauma Data Bank of ATV and ORMC crash victims. Patients were described according to demographic (age, sex, race and ethnicity, insurance status) and injury characteristics (Injury Severity Score, hypotension, motor component of the Glasgow Coma Score, presence of a severe head or extremity injury) known to affect trauma outcomes.

Operative delay to laparoscopic cholecystectomy: Racking up the cost of health care.

Background: Health care providers are increasingly focused on cost containment. One potential target for cost containment is in-hospital management of acute cholecystitis. Ensuring cholecystectomy within 24 hours for cholecystitis could mitigate costs associated with longer hospitalizations.

The current status of the use of oral medication to prevent HIV transmission.

Purpose Of Review: This review was designed to evaluate the progress in studies of the use of oral and topical antiretroviral (ARV) medication for primary HIV prevention.

Recent Findings: Nonhuman primate data have suggested that the administration of ARV medication before or after retroviral exposure can protect against the establishment of chronic infection. Over the past two decades, observational studies have demonstrated the safety of ARV agents for postexposure prophylaxis and more recent efficacy studies have demonstrated that tenofovir with or without emtricitabine can protect against HIV when used as preexposure prophylaxis (PrEP).