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Nearly 10% of pregnant women suffer traumatic injury. Clinical outcomes for pregnant trauma patients (PTPs) with severe injuries have not been well studied. We sought to describe outcomes for PTPs presenting with severe injuries, hypothesizing that PTPs with severe injuries will have higher rates of complications and mortality compared to less injured PTPs. A post-hoc analysis of a multi-institutional retrospective study at 12 Level-I/II trauma centers was performed. Patients were stratified into severely injured (injury severity score [ISS] > 15) and not severely injured (ISS < 15) and compared with bivariate analyses. From 950 patients, 32 (3.4%) had severe injuries. Compared to non-severely injured PTPs, severely injured PTPs were of similar maternal age but had younger gestational age (21 vs 26 weeks, p = 0.009). Penetrating trauma was more common in the severely injured cohort (15.6% vs 1.4%, p < 0.001). The severely injured cohort more often underwent an operation (68.8% vs 3.8%, p < 0.001), including a hysterectomy (6.3% vs 0.3%, p < 0.001). The severely injured group had higher rates of complications (34.4% vs 0.9%, p < 0.001), mortality (15.6% vs 0.1%, p < 0.001), a higher rate of fetal delivery (37.5% vs. 6.0%, p < 0.001) and resuscitative hysterotomy (9.4% vs. 0%, p < 0.001). Only approximately 3% of PTPs were severely injured. However, severely injured PTPs had a nearly 40% rate of fetal delivery as well as increased complications and mortality. This included a resuscitative hysterotomy rate of nearly 10%. Significant vigilance must remain when caring for this population., (© 2024. The Author(s).)

Background: Motocross-related injury patterns and outcomes are poorly understood. The purpose of this analysis was to characterize the epidemiology, injury patterns, and outcomes of motocross collisions. These parameters were compared with motorcycle collisions for context., Methods: The National Trauma Databank (NTDB) (2007-14) was used to identify and compare injured motorcycle and motocross riders. Variables extracted were demographics, Abbreviated Injury Scale for each body area, Injury Severity Score, and emergency department vital signs. Outcomes included mortality, ventilation days, intensive care unit length of stay, and hospital length of stay., Results: Of the 5,774,836 NTDB patients, 141,529 were involved in motocross or motorcycle collisions (31,252 motocross and 110,277 motorcycle). Overall, 94.4% were drivers and 87.4% were male. Motocross riders were younger (23 vs. 42, p < 0.001), more likely to use helmets (68.9% vs. 54.1%, p < 0.001), and less likely to have used alcohol (8.4% vs. 23.0%, p < 0.001). Head and chest injuries were less common in motocross patients (28.6% vs. 37.2%, p < 0.001; 25.5% vs. 37.7%, p < 0.001, respectively), as were Injury Severity Score of greater than 15 and Glasgow Coma Scale of less than or equal to 8 (18.2% vs. 28.1%, p < 0.001; 3.7% vs. 7.7%, p < 0.001, respectively). Overall mortality was significantly lower in the motocross group (0.3% vs. 1.4%, p < 0.001). Stepwise logistic regression analysis identified age of older than 60 years, Glasgow Coma Scale of less than or equal to 8, hypotension on admission, head Abbreviated Injury Scale of greater than or equal to 3, and riding a motorcycle, either as a driver or passenger, to be independent predictors of mortality. Subgroup analysis revealed being a motocross driver or passenger to be an independent predictor of improved survival (odds ratio [OR], 0.458; 95% confidence interval [CI], 0.359-0.585; p < 0.001 and OR, 0.127; CI 95%, 0.017-0.944; p = 0.044, respectively). Helmets were protective against mortality for all patients (OR, 0.866; 95% CI, 0.755-0.992; p = 0.039)., Conclusion: Motocross and motorcycle collisions are distinct mechanisms of injury. Motocross riders are younger, more likely to wear protective devices, and less likely to use alcohol. Motocross collisions are associated with better outcomes compared with motorcycle collisions. Wearing a helmet is associated with improved survival for all riders., Level of Evidence: Retrospective epidemiological study, level IV.

Objective: Offering undergraduate students research opportunities may enhance their interest in pursuing a surgical career and lead to increased academic productivity. We characterize the benefits of participating in the Trauma Research Associates Program., Design: A 19-point Web-based survey., Setting: Academic Level I Trauma Center., Participants: A total of 29 active and former members of the Trauma Research Associates Program., Main Outcome Measure(s): Academic activities and predictors associated with interest in a surgical career and research productivity., Results: Surveys were completed on 26 of 29 (90%) participants. Clinical experience was the most highly ranked motivation to join the program (65%), followed by pursuing a research experience (46%). During their involvement, 73% of participants observed surgical intensive care unit rounds, 65% observed acute care surgery rounds, and 35% observed a surgical procedure in the operating room. In addition, 46% submitted at least one abstract to a surgical meeting coauthored with the Division's faculty. Furthermore, 58% reported that they enrolled in a medical school, whereas 17% pursued a full-time research job. The program influenced the interest in a surgical career in 39% of all members, and 73% reported that they would incorporate research in their medical career. Observing a surgical procedure was independently associated with development of a high interest in a surgical career (adjusted odds ratio: 6.50; 95% CI: 1.09, 38.63; p = 0.04), whereas volunteering for more than 15 hours per week predicted submission of at least 1 abstract to a surgical conference by the participant (adjusted odds ratio: 13.00; 95% CI: 1.27, 133.29; p = 0.03)., Conclusions and Relevance: Development of a structured research program for undergraduate students is beneficial to both the participants and sponsoring institution. Undergraduate exposure to academic surgery enhances interest in pursuing a surgical specialty and leads to academic productivity., (Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)