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Journal J Trauma Acute Care Surg

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Actin is associated with tissue injury in trauma patients and produces a hypercoagulable profile in vitro.

Julia R Coleman, Ernest E Moore, Kalev Freeman, Nicholas D Grubinger, Grant W Hennig, Mitchell J Cohen, Jason M Samuels, Kirk Hansen,

BACKGROUND:While tissue injury provokes fibrinolysis shutdown in trauma, the mechanism remains elusive. Cellular death causes release of structural proteins, including actin and myosin, which may interact with clot formation and structure. We hypothesized that tissue injury is associated with high circulating actin and that actin produces a hypercoagulable profile with ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):87-95]

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Featured Articles For CME Credit July 2020.

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):e7-e10]

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Timing and volume of crystalloid and blood products in pediatric trauma: An Eastern Association for the Surgery of Trauma multicenter prospective observational study.

Stephanie F Polites, Suzanne Moody, Regan F Williams, Mark L Kayton, Emily C Alberto, Randall S Burd, Thomas J Schroeppel, Joanne E Baerg, Amanda Munoz, William B Rothstein, Laura A Boomer, Eric M Campion, Caitlin Robinson, Rachel M Nygaard, Chad J Richardson, Denise I Garcia, Christian J Streck, Michaela Gaffley, John K Petty, Cynthia Greenwell, Samir Pandya, Alicia M Waters, Robert T Russell, Brian K Yorkgitis, Jennifer Mull, Jeffrey Pence, Matthew T Santore, Taleen MacArthur, Denise B Klinkner, Shawn D Safford, Tanya Trevilian, Adam M Vogel, Megan Cunningham, Christa Black, Jessica Rea, Ryan G Spurrier, Aaron R Jensen, Bethany J Farr, David P Mooney, Bavana Ketha, Melvin S Dassinger, Anna Goldenberg-Sandau, Janika San Roman, Todd M Jenkins, Richard A Falcone,

BACKGROUND:The purpose of this study was to determine the relationship between timing and volume of crystalloid before blood products and mortality, hypothesizing that earlier transfusion and decreased crystalloid before transfusion would be associated with improved outcomes. METHODS:A multi-institutional prospective observational study of pediatric trauma patients younger than 18 years, transported ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):36-42]

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Direct to operating room trauma resuscitation: Optimizing patient selection and time-critical outcomes when minutes count.

Amelia Johnson, Michael Rott, Andrea Kuchler, Emma Williams, Fredrick Cole, Ameen Ramzy, Ronald Barbosa, William Long, Matthew J Martin,

BACKGROUND:Although several trauma centers have developed direct to operating room (DOR) trauma resuscitation programs, there is little published data on optimal patient selection, practices, and outcomes. We sought to analyze triage criteria and interventions associated with optimal DOR outcomes and resource utilization. METHODS:Retrospective review of all adult DOR resuscitations for ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):160-166]

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Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients.

Jack Stupinski, Letitia Bible, Samer Asmar, Mohamad Chehab, Molly Douglas, Michael Ditillo, Lynn Gries, Muhammad Khurrum, Bellal Joseph,

BACKGROUND:Tetrahydrocannabinoids (THC) can modulate the coagulation cascade resulting in hypercoagulability. However, the clinical relevance of these findings has not been investigated. The aim of our study was to evaluate the impact of preinjury marijuana exposure on thromboembolic complications (TEC) in trauma patients. METHODS:We performed a 2-year (2015-2016) analysis of American ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):125-131]

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Duty.

Christina M Riojas, Susan L Evans,

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):18]

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Survivors of gun violence and the experience of recovery.

Kathleen M OʼNeill, Cecilio Vega, Sidney Saint-Hilaire, Leonard Jahad, Pina Violano, Marjorie S Rosenthal, Adrian A Maung, Robert D Becher, James Dodington,

BACKGROUND:Survivors of gun violence may develop significant mental health sequelae and are at higher risk for reinjury through repeat violence. Despite this, survivors of gun violence often return to the community where they were injured with suboptimal support for their mental health, emotional recovery, and well-being. The goal of this ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):29-35]

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Harnessing your passion and connecting to purpose.

Eileen M Bulger,

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):13-17]

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Risk assessment for intra-abdominal injury following blunt trauma in children: Derivation and validation of a machine learning model.

Christopher Pennell, Conner Polet, L Grier Arthur, Harsh Grewal, Stephen Aronoff,

BACKGROUND:Computed tomography is the criterion standard for diagnosing intra-abdominal injury (IAI) but is expensive and risks radiation exposure. The Pediatric Emergency Care Applied Research Network (PECARN) model identifies children at low risk of IAI requiring intervention (IAI-I) in whom computed tomography may be omitted but does not provide an individualized ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):153-159]

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Racial inequality in the trauma of women: A disproportionate decade.

Shawn N Izadi, Niral Patel, Demba Fofana, Anghela Z Paredes, Samuel K Snyder, Annelyn Torres-Reveron, Jeffrey J Skubic,

BACKGROUND:Historically, women have been largely underrepresented in the body of medical research. Given the paucity of data regarding race and trauma in women, we aimed to evaluate the most common types of traumas incurred by women and analyze temporal racial differences. METHODS:A 10-year review (2007-2016) of the National Trauma Data ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):254-262]

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Disparities in rural versus urban field triage: Risk and mitigating factors for undertriage.

Andrew-Paul Deeb, Heather M Phelos, Andrew B Peitzman, Timothy R Billiar, Jason L Sperry, Joshua B Brown,

BACKGROUND:There are well-known disparities for patients injured in rural setting versus urban setting. Many cite access to care; however, the mechanisms are not defined. One potential factor is differences in field triage. Our objective was to evaluate differences in prehospital undertriage (UT) in rural setting versus urban settings. METHODS:Adult patients ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):246-253]

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Dusk to Dawn: Evaluating the effect of a hospital-based youth violence prevention program on youths' perception of risk.

Katherine Brooke Snyder, Ashley Farrens, Ashley Raposo-Hadley, Melissa Tibbits, Jennifer Burt, Zachary M Bauman, Charity H Evans,

BACKGROUND:Historically, youth violence prevention strategies used deterrence-based programming with limited success. We developed a youth violence prevention program, Dusk to Dawn (D2D), intended to improve youths' recognition of high-risk situations and teach new skills in conflict resolution. The aim of this study was to evaluate the effect of D2D on ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):140-144]

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Feasibility of a trauma quality-of-life follow-up clinic.

Colleen Trevino, Timothy Geier, Sydney C Timmer-Murillo, Matthew Shawlin, David J Milia, Panna Codner, Terri deRoon-Cassini,

BACKGROUND:Little effort has been made to address long-term quality of life, chronic pain (CP), posttraumatic stress disorder (PTSD), and functional disability in trauma survivors. This quality initiative was developed to determine feasibility of a coordinated, comprehensive, patient-centered follow-up clinic for those at risk for poor long-term outcomes. METHODS:A convenience sample ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):226-229]

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Putting a halt to unnecessary transfers: Do patients with isolated subarachnoid hemorrhage and Glasgow Coma Scale of 13 to 15 need a trauma center?

Jyoti Sharma, Danielle Defoe, Jenna Gillen, Yen-Hong Kuo, Javier Perez, Setu Dalal, Saraswati Dayal, Elizabeth Kiselak, Kelly Rippey, Sanjeev Kaul, Stephen Cohn,

OBJECTIVES:Trauma patients with isolated subarachnoid hemorrhage (iSAH) presenting to nontrauma centers are typically transferred to an institution with neurosurgical availability. However, recent studies suggest that iSAH is a benign clinical entity with an excellent prognosis. This investigation aims to evaluate the neurosurgical outcomes of traumatic iSAH with Glasgow Coma Scale ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):222-225]

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Viscoelastic testing in combat resuscitation: Is it time for a new standard?

Daniel T Lammers, Christopher W Marenco, Kaitlin R Morte, Jason R Bingham, Matthew J Martin, Matthew J Eckert,

BACKGROUND:Traumatic hemorrhage and coagulopathy represent major sources of morbidity and mortality on the modern battlefield. Viscoelastic testing (VET) offers a potentially more personalized approach to resuscitation. We sought to evaluate outcomes of combat trauma patients who received VET-guided resuscitation compared with standard balanced blood product resuscitation. METHODS:Retrospective analysis of the ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):145-152]

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Predictors of mortality, limb loss, and discharge disposition at admission among patients with necrotizing skin and soft tissue infections.

Dara L Horn, Jolie Shen, Emma Roberts, Theresa N Wang, Kevin S Li, Grant E OʼKeefe, Joseph Cuschieri, Eileen M Bulger, Bryce R H Robinson,

BACKGROUND:Necrotizing soft tissue infections (NSTI) represent a heterogeneous group of rapidly progressive skin and soft tissue infections associated with significant morbidity and mortality. Efforts to identify factors associated with death have produced mixed results, and little or no data is available for other adverse outcomes. We sought to determine whether ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):186-191]

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Big colon surgery, little incisions: Minimally invasive techniques in emergent colon surgery.

Dominic Mario Forte, Rowan Sheldon, Eric Johnson, Scott R Steele, Matthew J Martin,

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):e1-e6]

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Heroes in crisis: Trauma centers should be screening for and intervening on posttraumatic stress in our emergency responders.

Leah C Tatebe, Nandini Rajaram Siva, Sydney Pekarek, Erik Liesen, Andrew Wheeler, Carol Reese, Victoria Schlanser, Matthew Kaminsky, Thomas Messer, Frederic Starr, Justin Mis, Faran Bokhari, Andrew Dennis,

BACKGROUND:Emergency responders face a crisis of rising suicide rates, and many resist seeking help due to the stigma surrounding mental health. We sought to evaluate the feasibility of an urban trauma center to screen for posttraumatic stress (PTS) among emergency responders and to provide mental health services. METHODS:Paramedics, firefighters, law ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):132-139]

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Diaphragm ultrasound: A novel approach to assessing pulmonary function in patients with traumatic rib fractures.

Danielle N OʼHara, Sean Randazzo, Sahar Ahmad, Erin Taub, Emily Huang, James A Vosswinkel, Randeep S Jawa,

BACKGROUND:Rib fractures following blunt trauma are a major cause of morbidity. Various factors have been used for risk stratification for complications. Ultrasound (US) measurements of diaphragm thickness (Tdi) and related measures such as thickening fraction (TF) have been verified for use in the evaluation of diaphragm function. In healthy individuals, ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):96-102]

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Eastern Association for the Surgery of Trauma (EAST) practice management guidelines and the perpetual quest for excellence.

Elliott R Haut,

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):1-10]

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Enterocutaneous fistula after emergency general surgery: Mortality, readmission, and financial burden.

Justin S Hatchimonji, Jesse Passman, Elinore J Kaufman, Catherine E Sharoky, Lucy W Ma, Dane Scantling, Ruiying Xiong, Daniel N Holena,

BACKGROUND:The burden of enterocutaneous fistula (ECF) after emergency general surgery (EGS) has not been rigorously characterized. We hypothesized that ECF would be associated with higher rates of postdischarge mortality and readmissions. METHODS:Using the 2016 National Readmission Database, we conducted a retrospective study of adults presenting for gastrointestinal (GI) surgery. Cases ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):167-172]

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Identifying participants for inclusion in hospital-based violence intervention: An analysis of 18 years of urban firearm recidivism.

Stephanie Bonne, Ann Tufariello, Zachary Coles, Bernadette Hohl, Michael Ostermann, Paul Boxer, Elizabeth Sloan-Power, Michael Gusmano, Nina E Glass, Anastasia Kunac, David Livingston,

BACKGROUND:Identifying individuals at highest risk maximizes efficacy of prevention programs in decreasing recidivist gunshot wound (GSW) injury. Characteristics of GSW recidivists may identify this population. Hospital-based violence intervention programs (HVIPs) are one effective strategy; however, programs are expensive, therefore, when possible, epidemiologic data should guide inclusion criteria. METHODS:Seventeen years of ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):68-73]

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No news is good news? Three-year postdischarge mortality of octogenarian and nonagenarian patients following emergency general surgery.

Natawat Narueponjirakul, John Hwabejire, Manasnun Kongwibulwut, Jae Moo Lee, Napaporn Kongkaewpaisan, George Velmahos, David King, Peter Fagenholz, Noelle Saillant, April Mendoza, Martin Rosenthal, Haytham M A Kaafarani,

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. The data were linked ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):230-237]

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Out of blood.

Mohanned M Mallah,

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):19]

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Treatment of blunt cerebrovascular injuries: Anticoagulants or antiplatelet agents?

Kamil Hanna, Molly Douglas, Samer Asmar, Muhammad Khurrum, Letitia Bible, Lourdes Castanon, Michael Ditillo, Narong Kulvatunyou, Bellal Joseph,

BACKGROUND:Blunt cerebrovascular injury (BCVI) is associated with cerebrovascular accidents (CVA). Early therapy with antiplatelet agents or anticoagulants is recommended. There are limited data comparing the effectiveness of these treatments. The aim of our study was to compare outcomes between BCVI patients who received anticoagulants versus those who received antiplatelet agents. ... Read more >>

J Trauma Acute Care Surg (The journal of trauma and acute care surgery)
[2020, 89(1):74-79]

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