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BACKGROUND: Trauma centers target injury prevention efforts based on trauma registry and local epidemiological data. Identifying geographic patterns of injury through geospatial mapping has emerged as a technology to help identify at-risk individuals. Yet, the feasibility of using spatial analysis to target injury prevention efforts remains unknown. OBJECTIVE: This study aims to demonstrate the use of geospatial mapping of older adult ground-level falls to target injury prevention efforts. METHODS: This retrospective cohort analysis of ground-level falls among older adults was conducted from 2017 to 2020 at a Level I trauma center and safety net hospital. Trauma admissions, U.S. census median income, Hispanic percentage, and population density by zip codes were combined to create choropleth and heat maps to identify injury hot spots to target fall prevention classes. RESULTS: A total of 5,629 patients were reviewed, of which 3,002 (53%) were fall cases. Low-level falls (<10 ft) accounted for 2,224 cases; 1,449 were among older adults centered around the study hospital. Ground-level falls accounted for 1,663 patients, of whom 1,182 were older adults clustering around senior housing, assisted living facilities, nursing homes, and rehabilitation centers. As a result, our fall prevention classes are now targeted at these newly identified locations. CONCLUSION: Geospatial analysis provided powerful visualization of fall injury locations to target our fall prevention efforts. Geospatial analysis is a feasible tool for trauma centers to guide injury prevention strategies that effectively target the populations most in need. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of preassigning a single bed in the surgical intensive care unit (SICU) for the next trauma admission. Background: Prolonged emergency department (ED) dwell time before admission to a critical care unit has an adverse effect on patient outcomes and is often due to the lack of an available bed in the intensive care unit (ICU). Methods: A "Bed Ahead" policy was instituted at an urban level 1 Trauma Public Safety Net Teaching Hospital to preassign 1 SICU bed for the next trauma patient who warrants a critical care admission. A retrospective review of all trauma patients admitted to the SICU before and after implementation of this policy was performed to assess the impact on ED dwell time, ICU and hospital lengths of stay, complications, and in-hospital mortality. Results: ED length of stay (ED-LOS); ICU length of stay (ICU-LOS); hospital length of stay (HLOS); complications; and in-hospital mortality were compared before (PRE) and after (POST)implementation of the Bed Ahead policy. Statistically significant improvements were seen in the POST period for ED-LOS, HLOS, complications, and in-hospital mortality. Conclusions: Preassigning 1 ICU for the yet to arrive next injured patient decreases ED dwell times, complications, HLOS, and in-hospital mortality. [ABSTRACT FROM AUTHOR]

In the past, injuries to the adrenal glands due to blunt trauma were considered rare, and were reported to be associated with high Injury Severity Scores (ISSs) and high mortality. Recent reports have reported a much high incidence associated with lower ISS and lower mortality. The purpose of this study was to assess the incidence of adrenal gland injuries due to blunt trauma in a large state trauma registry and determine whether these injuries are associated with a higher ISS and increased risk for mortality. A retrospective review was performed on the New York State Trauma Registry comparing blunt injured adults with adrenal injuries to those who did not. Concurrent organ injuries, ISS, and inhospital mortality were compared. Three hundred thirty-nine patients with adrenal gland injuries were identified. Concurrent liver and kidney injuries were more prevalent in the adrenal injured group, and concurrent injuries to the small and large intestine and spleen were more prevalent in the nonadrenal injured group. There was no difference in ISS or mortality between the adrenal injured and nonadrenal injured populations. The results of this study are consistent with recent smaller studies which identified incidence rates which were higher than previously reported and that ISS and mortality risk were unchanged by the presence of blunt adrenal gland injuries. Adrenal gland injuries due to blunt trauma are not uncommon, with an incidence rate of 0.61 per cent. Adrenal gland injuries are not associated with higher ISS or an increased risk of mortality. [ABSTRACT FROM AUTHOR]