Full Text Journal Articles by
Author C Clay Cothren

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Effect of blood products transfusion on the development of postinjury multiple organ failure.

Jeffrey L Johnson, Ernest E Moore, Jeffry L Kashuk, Anirban Banerjee, C Clay Cothren, Walter L Biffl, Angela Sauaia,

<h4>Hypothesis</h4>Transfusion of fresh frozen plasma (FFP) and platelets is independently associated with the development of multiple organ failure (MOF) in critically injured patients.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>Academic regional level I trauma center.<h4>Patients</h4>From 1992 to 2004, a total of 1440 critically injured patients were admitted to our surgical intensive care unit and survived ... Read more >>

Arch Surg (Archives of surgery (Chicago, Ill. : 1960))
[2010, 145(10):973-977]

Cited: 67 times

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Western Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries.

Walter L Biffl, C Clay Cothren, Ernest E Moore, Rosemary Kozar, Christine Cocanour, James W Davis, Robert C McIntyre, Michael A West, Frederick A Moore,

J Trauma (The Journal of trauma)
[2009, 67(6):1150-1153]

Cited: 83 times

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Postinjury coagulopathy management: goal directed resuscitation via POC thrombelastography.

Jeffry L Kashuk, Ernest E Moore, Michael Sawyer, Tuan Le, Jeffrey Johnson, Walter L Biffl, C Clay Cothren, Carlton Barnett, Philip Stahel, Christopher C Sillman, Angela Sauaia, Anirban Banerjee,

Progressive postinjury coagulopathy remains the fundamental rationale for damage control surgery, but the decision to abort operative intervention must occur before laboratory confirmation of coagulopathy. Current massive transfusion protocols have embraced pre-emptive resuscitation strategies emphasizing administration of packed red blood cells, fresh frozen plasma, and platelets in ratios approximating 1:1:1 ... Read more >>

Ann Surg (Annals of surgery)
[2010, 251(4):604-614]

Cited: 109 times

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Local wound exploration remains a valuable triage tool for the evaluation of anterior abdominal stab wounds.

C Clay Cothren, Ernest E Moore, Frank A Warren, Jeffry L Kashuk, Walter L Biffl, Jeffrey L Johnson,

<h4>Background</h4>Recent guidelines do not support local wound exploration (LWE) or diagnostic peritoneal lavage (DPL) in the evaluation of patients with anterior abdominal stab wounds (AASWs), favoring computed tomography scanning or serial examinations. In patients without immediate indications for laparotomy, we hypothesized that LWE/DPL would identify patients requiring surgery while limiting ... Read more >>

Am J Surg (American journal of surgery)
[2009, 198(2):223-226]

Cited: 15 times

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Rapid thrombelastography (r-TEG) identifies hypercoagulability and predicts thromboembolic events in surgical patients.

Jeffry L Kashuk, Ernest E Moore, Allison Sabel, Carlton Barnett, James Haenel, Tuan Le, Michael Pezold, Jerry Lawrence, Walter L Biffl, C Clay Cothren, Jeffrey L Johnson,

<h4>Background</h4>Despite routine prophylaxis, thromboembolic events (TEs) in surgical patients remain a substantial problem. Furthermore, the timing and incidence of hypercoagulability, which predisposes to these events is unknown, with institutional screening programs serving primarily to establish a diagnosis after an event has occurred. Emerging evidence suggests that point of care (POC) ... Read more >>

Surgery (Surgery)
[2009, 146(4):764-72; discussion 772-4]

Cited: 110 times

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Hemolysis, elevated liver enzymes, and low platelets syndrome: when is surgical help needed?

Ann M Kulungowski, Jeffry L Kashuk, Ernest E Moore, Haley G Hutting, Miral R Sadaria, C Clay Cothren, Jeffrey L Johnson, Angela Sauaia,

<h4>Background</h4>Life-threatening hemorrhage is a rare event in hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. Epidemiologic data are lacking to predict patients at risk for hemorrhage requiring surgical consultation. We sought to identify early clinical predictors of hemorrhagic complications in patients at risk for HELLP syndrome.<h4>Methods</h4>Patients at risk for ... Read more >>

Am J Surg (American journal of surgery)
[2009, 198(6):916-920]

Cited: 1 time

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Primary repair of civilian colon injuries is safe in the damage control scenario.

Jeffry L Kashuk, C Clay Cothren, Ernest E Moore, Jeffrey L Johnson, Walter L Biffl, Carlton C Barnett,

<h4>Background</h4>Although the safety of primary repair/anastomosis for civilian colon injuries after standard laparotomy (SL) has been established, recent civilian and military reports have questioned the advisability of this technique in the patient requiring damage control laparotomy (DL). We hypothesized that, even in the high-risk DL group, primary repair could be ... Read more >>

Surgery (Surgery)
[2009, 146(4):663-8; discussion 668-70]

Cited: 20 times

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Treatment for blunt cerebrovascular injuries: equivalence of anticoagulation and antiplatelet agents.

C Clay Cothren, Walter L Biffl, Ernest E Moore, Jeffry L Kashuk, Jeffrey L Johnson,

<h4>Hypothesis</h4>We hypothesize that the 2 antithrombotic treatment regimens, systemic heparin sodium vs antiplatelet agents, are equivalent for the treatment of blunt cerebrovascular injuries (BCVIs) to prevent devastating injury-related strokes.<h4>Design</h4>Retrospective review of a prospective database.<h4>Setting</h4>Level I trauma center.<h4>Patients</h4>Patients with BCVIs from January 1, 1997, to January 1, 2007.<h4>Main outcome measures</h4>Incidence of ... Read more >>

Arch Surg (Archives of surgery (Chicago, Ill. : 1960))
[2009, 144(7):685-690]

Cited: 87 times

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Diagnostic peritoneal lavage remains a valuable adjunct to modern imaging techniques.

John Y Cha, Jeffry L Kashuk, Eric L Sarin, C Clay Cothren, Jeffrey L Johnson, Walter L Biffl, Ernest E Moore,

<h4>Background</h4>Continuing improvements in computerized tomography scan technology and widespread acceptance of focused abdominal sonography for trauma (FAST) have prompted the suggestion that diagnostic peritoneal lavage (DPL) is obsolete. This sentiment, coupled with decreasing resident familiarity with DPL, has led to a poor understanding of the modern indications for DPL and ... Read more >>

J Trauma (The Journal of trauma)
[2009, 67(2):330-4; discussion 334-6]

Cited: 7 times

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Direct retroperitoneal pelvic packing versus pelvic angiography: A comparison of two management protocols for haemodynamically unstable pelvic fractures.

Patrick M Osborn, Wade R Smith, Ernest E Moore, C Clay Cothren, Steven J Morgan, Allison E Williams, Philip F Stahel,

<h4>Objective</h4>To evaluate the outcomes of haemodynamically unstable cases of pelvic ring injury treated with a protocol focused on either direct retroperitoneal pelvic packing or early pelvic angiography and embolisation.<h4>Methods</h4>A retrospective review of a prospectively collected database in an academic level I trauma centre, treating matched haemodynamically unstable cases of pelvic ... Read more >>

Injury (Injury)
[2009, 40(1):54-60]

Cited: 83 times

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An evaluation of multidetector computed tomography in detecting pancreatic injury: results of a multicenter AAST study.

Herb A Phelan, George C Velmahos, Gregory J Jurkovich, Randall S Friese, Joseph P Minei, Jay A Menaker, Allan Philp, Heather L Evans, Martin L Gunn, Alexander L Eastman, Susan E Rowell, Carrie E Allison, Ronald L Barbosa, Scott H Norwood, Malek Tabbara, Christopher J Dente, Matthew M Carrick, Matthew J Wall, Jim Feeney, Patrick J O'Neill, Gujjarappa Srinivas, Carlos V R Brown, Andrew C Reifsnyder, Moustafa O Hassan, Scott Albert, Jose L Pascual, Michelle Strong, Forrest O Moore, David A Spain, Mary-Anne Purtill, Byard Edwards, Jason Strauss, Rodney M Durham, Juan C Duchesne, Patrick Greiffenstein, C Clay Cothren,

<h4>Background</h4>Efforts to determine the suitability of low-grade pancreatic injuries for nonoperative management have been hindered by the inaccuracy of older computed tomography (CT) technology for detecting pancreatic injury (PI). This retrospective, multicenter American Association for the Surgery of Trauma-sponsored trial examined the sensitivity of newer 16- and 64-multidetector CT (MDCT) ... Read more >>

J Trauma (The Journal of trauma)
[2009, 66(3):641-6; discussion 646-7]

Cited: 36 times

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Management of patients with anterior abdominal stab wounds: a Western Trauma Association multicenter trial.

Walter L Biffl, Krista L Kaups, C Clay Cothren, Karen J Brasel, Rochelle A Dicker, M Kelley Bullard, James M Haan, Gregory J Jurkovich, Paul Harrison, Forrest O Moore, Martin Schreiber, M Margaret Knudson, Ernest E Moore,

<h4>Background</h4>The optimal management of hemodynamically stable, asymptomatic patients with anterior abdominal stab wounds (AASWs) remains controversial. The goal is to identify and treat injuries in a safe, cost-effective manner. Common evaluation strategies include local wound exploration (LWE)/diagnostic peritoneal lavage (DPL), serial clinical assessments (SCAs), and computed tomography (CT) imaging. The ... Read more >>

J Trauma (The Journal of trauma)
[2009, 66(5):1294-1301]

Cited: 44 times

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Occam's razor is a double-edged sword: concomitant pulmonary embolus and fat embolism syndrome.

C Clay Cothren, Ernest E Moore, Todd Vanderheiden, James B Haenel, Wade R Smith,

J Trauma (The Journal of trauma)
[2008, 65(6):1558-1560]

Cited: 1 time

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Postinjury life threatening coagulopathy: is 1:1 fresh frozen plasma:packed red blood cells the answer?

Jeffry L Kashuk, Ernest E Moore, Jeffrey L Johnson, James Haenel, Michael Wilson, John B Moore, C Clay Cothren, Walter L Biffl, Anirban Banerjee, Angela Sauaia,

<h4>Background</h4>Recent military experience suggests that immediate 1:1 fresh frozen plasma (FFP); red blood cells (RBC) for casualties requiring >10 units packed red blood cells (RBC) per 24 hours reduces mortality, but no clinical trials exist to address this issue. Consequently, we reviewed our massive transfusion practices during a 5-year period ... Read more >>

J Trauma (The Journal of trauma)
[2008, 65(2):261-70; discussion 270-1]

Cited: 203 times

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The U.S. trauma surgeon's current scope of practice: can we deliver acute care surgery?

C Clay Cothren, Ernest E Moore, David B Hoyt,

<h4>Background</h4>The evolving discipline of acute care surgery as an expansion of trauma surgery is undergoing intense critique. As we envision this new paradigm of surgical practice, an evaluation of our current status across the nation's trauma centers is an essential step. The purpose of this study is to determine the ... Read more >>

J Trauma (The Journal of trauma)
[2008, 64(4):955-65; discussion 965-8]

Cited: 25 times

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Blunt vertebral artery injury leading to cervical fracture diagnosis.

C Clay Cothren, Ernest E Moore, Rachel M Zent, Jon M Burch,

J Trauma (The Journal of trauma)
[2007, 62(1):262]

Cited: 0 times

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Outcomes in surgical versus medical patients with the secondary abdominal compartment syndrome.

C Clay Cothren, Ernest E Moore, Jeffrey L Johnson, John B Moore,

<h4>Background</h4>Secondary abdominal compartment syndrome (SACS) is a well-recognized sequelae of massive fluid resuscitation in surgical patients, but has only anecdotally been reported in the medical patient population. The purpose of this study was to compare the clinical scenarios, physiologic indices, and outcomes of patients with SACS due to medical versus ... Read more >>

Am J Surg (American journal of surgery)
[2007, 194(6):804-7; discussion 807-8]

Cited: 18 times

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Hepatic artery avulsion secondary to blunt abdominal trauma.

R Taylor Ripley, C Clay Cothren, Jeffrey L Johnson, Ernest E Moore,

J Trauma (The Journal of trauma)
[2006, 61(4):1022]

Cited: 1 time

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Traumatic ventricular septal defect.

C Clay Cothren, Ernest E Moore,

Surgery (Surgery)
[2007, 142(5):776-777]

Cited: 1 time

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Decreased progression of postinjury lung dysfunction to the acute respiratory distress syndrome and multiple organ failure.

David J Ciesla, Ernest E Moore, Jeffrey L Johnson, C Clay Cothren, Anirban Banerjee, Jon M Burch, Angela Sauaia,

<h4>Background</h4>Postinjury organ dysfunction is a result of unbridled systemic hyperinflammation. According to the two-event construct, patients are resuscitated into an early vulnerable window of systemic hyperinflammation (primed) in which a second otherwise innocuous event precipitates uncontrolled hyperinflammation, leading to secondary organ damage and dysfunction (activated). Recent efforts to decrease postinjury ... Read more >>

Surgery (Surgery)
[2006, 140(4):640-7; discussion 647-8]

Cited: 40 times

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Postinjury abdominal aortic graft infection: documentation and successful management.

Heather Y Wolford, C Clay Cothren, Ernest E Moore,

This case report illustrates that postinjury aortic grafts may become infected. A high index of suspicion should be maintained in the postoperative period to detect these infections as early as possible. Prevention and treatment strategies will continue to evolve. ... Read more >>

J Trauma (The Journal of trauma)
[2006, 61(5):1274-1276]

Cited: 0 times

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Image of the month: Schwannoma.

C Clay Cothren, Waleed L Lutfiyya, Fernando J Kim, David J Ciesla,

Arch Surg (Archives of surgery (Chicago, Ill. : 1960))
[2006, 141(9):941-942]

Cited: 1 time

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Cervical spine fracture patterns mandating screening to rule out blunt cerebrovascular injury.

C Clay Cothren, Ernest E Moore, Charles E Ray, Jeffrey L Johnson, John B Moore, Jon M Burch,

<h4>Background</h4>Aggressive screening for blunt cerebrovascular injury (BCVI) and prompt anticoagulation for documented injuries has resulted in a significant reduction in ischemic neurologic events. An association between vertebral artery injuries (VAIs) and specific cervical spine fracture patterns has been suggested; however, current screening guidelines would subject all patients with cervical spine ... Read more >>

Surgery (Surgery)
[2007, 141(1):76-82]

Cited: 65 times

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Preperitonal pelvic packing for hemodynamically unstable pelvic fractures: a paradigm shift.

C Clay Cothren, Patrick M Osborn, Ernest E Moore, Steven J Morgan, Jeffrey L Johnson, Wade R Smith,

<h4>Background</h4>The current management of pelvic fracture patients who are hemodynamically unstable in the United States consists of aggressive resuscitation, mechanical stabilization, and angioembolization. Despite this multidisciplinary approach, our recent analysis confirms an alarming 40% mortality in these high-risk patients. Therefore, we pursued alternate therapies to improve patient outcomes. European trauma ... Read more >>

J Trauma (The Journal of trauma)
[2007, 62(4):834-9; discussion 839-42]

Cited: 107 times

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Utility of once-daily dose of low-molecular-weight heparin to prevent venous thromboembolism in multisystem trauma patients.

C Clay Cothren, Wade R Smith, Ernest E Moore, Steven J Morgan,

<h4>Introduction</h4>Venous thromboembolism is a preventable cause of death in the severely injured patient. Low-molecular-weight heparins (LMWHs) have been recommended as effective, safe prophylactic agents. However, LMWH use remains controversial in patients at risk for bleeding, those with traumatic brain injury, and those undergoing multiple invasive or operative procedures. We hypothesized ... Read more >>

World J Surg (World journal of surgery)
[2007, 31(1):98-104]

Cited: 43 times

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