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1. Impact of catastrophic brain injury guidelines on organ donation rates: Results of an EAST multicenter trial

Author

Nordham, Kristen D., Tatum, Danielle, Attia, Abdallah S., Patel, Mayur B., Paramesh, Anil, Duchesne, Juan C., Nahmias, Jeffry, Maiga, Amelia W., Peetz, Allan B., Udekwu, Pascal O., Stiles, Anquonette, Shell, Chloe, Stodghill, Joshua D., Maghsoudi, Taneen, Iacullo, Erin, McLafferty, Bryant, Coonan, Erin, Boudreau, Ryan M., Zimmerman, Steven A., Shammassian, Berje, Egodage, Tanya, Aramento, Isabella, Morris, Patrick, Metheny, Jacob, Farrell, Michael S., Painter, Matthew D., McCabe, Owen T., Spadafore, Philomene, Wong, David Tai-Wai, Serrano, Jan, Sciarretta, Jason D., Kim, Phillip, Hayton, Ryan, Gonzales, Danessa, Murry, Jason, Meadows, Katelyn, Jacobson, Lewis E., Williams, Jamie M., Bernard, Andrew C., Smith, Brennan, Morrissey, Shawna L., Patel, Nilesh, Tabello, Dina, Teicher, Erik, Chowdhury, Sharfuddin Mahmud, Ahmad, Fazal, Marcos, Basem S., West, Michaela A., Jacome, Tomas H., Davis, Greggory, Marks, Joshua A., Rattigan, Deviney, Haan, James M., Lightwine, Kelly, Matsushima, Kazuhide, Park, Stephen, Santos, Ariel, Shrestha, Kripa, Sawyer, Robert, VandenBerg, Sheri, Jean, Robert J., Hicks, R Chace, Lueckel, Stephanie, Bugaev, Nikolay, Abosena, Wael, Alvarez, Claudia, Lieser, Mark J., McDonald, Hannah, Dumas, Ryan P., Fitzgerald, Caitlin A., Terzian, William Thomas Hillman, Tian, Yuqian, Mousafeiris, Vasileios, Mulita, Francesk, Berne, John D., Mederos, Dalier R., Smith, Alison A., and Taghavi, Sharven

Published
2025
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2. A western trauma association multicenter comparison of mesh versus non-mesh repair of blunt traumatic abdominal wall hernias

Author

Harrell, Kevin N., Grimes, Arthur D., Gill, Harkanwar, Reynolds, Jessica K., Ueland, Walker R., Sciarretta, Jason D., Todd, Samual R., Trust, Marc D., Ngoue, Marielle, Thomas, Bradley W., Ayuso, Sullivan A., LaRiccia, Aimee, Spalding, M. Chance, Collins, Michael J., Collier, Bryan R., Karam, Basil S., de Moya, Marc A., Lieser, Mark J., Chipko, John M., Jr, Haan, James M., Lightwine, Kelly L., Cullinane, Daniel C., Falank, Carolyne R., Phillips, Ryan C., Kemp, Michael T., Alam, Hasan B., Udekwu, Pascal O., Sanin, Gloria D., Hildreth, Amy N., Biffl, Walter L., Schaffer, Kathryn B., Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L., and Maxwell, Robert A.

Published
2024
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3. Trauma and nontrauma damage-control laparotomy: The difference is delirium (data from the Eastern Association for the Surgery of Trauma SLEEP-TIME multicenter trial).

Author

McArthur, Kaitlin, Krause, Cassandra, Kwon, Eugenia, Luo-Owen, Xian, Cochran-Yu, Meghan, Swentek, Lourdes, Burruss, Sigrid, Turay, David, Krasnoff, Chloe, Grigorian, Areg, Nahmias, Jeffry, Butt, Ahsan, Gutierrez, Adam, LaRiccia, Aimee, Kincaid, Michelle, Fiorentino, Michele N, Glass, Nina, Toscano, Samantha, Ley, Eric, Lombardo, Sarah R, Guillamondegui, Oscar D, Bardes, James M, DeLa'O, Connie, Wydo, Salina M, Leneweaver, Kyle, Duletzke, Nicholas T, Nunez, Jade, Moradian, Simon, Posluszny, Joseph, Naar, Leon, Kaafarani, Haytham, Kemmer, Heidi, Lieser, Mark J, Dorricott, Alexa, Chang, Grace, Nemeth, Zoltan, and Mukherjee, Kaushik

Subjects
Humans, Delirium, Abdominal Injuries, Postoperative Complications, Analgesics, Opioid, Length of Stay, Laparotomy, Injury Severity Score, Incidence, Linear Models, Risk Factors, Retrospective Studies, Sleep, Adult, Middle Aged, Intensive Care Units, United States, Female, Male, Young Adult, Physical Injury - Accidents and Adverse Effects, Traumatic Head and Spine Injury, Infectious Diseases, Clinical Research, Patient Safety, Clinical Trials and Supportive Activities, Trauma, damage-control laparotomy, sedation, delirium, nontrauma, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Nursing, Emergency & Critical Care Medicine
Abstract

BackgroundDamage-control laparotomy (DCL) has been used for traumatic and nontraumatic indications. We studied factors associated with delirium and outcome in this population.MethodsWe reviewed DCL patients at 15 centers for 2 years, including demographics, Charlson Comorbidity Index (CCI), diagnosis, operations, and outcomes. We compared 30-day mortality; renal failure requiring dialysis; number of takebacks; hospital, ventilator, and intensive care unit (ICU) days; and delirium-free and coma-free proportion of the first 30 ICU days (DF/CF-ICU-30) between trauma (T) and nontrauma (NT) patients. We performed linear regression for DF/CF-ICU-30, including age, sex, CCI, achievement of primary fascial closure (PFC), small and large bowel resection, bowel discontinuity, abdominal vascular procedures, and trauma as covariates. We performed one-way analysis of variance for DF/CF-ICU-30 against traumatic brain injury severity as measured by Abbreviated Injury Scale for the head.ResultsAmong 554 DCL patients (25.8% NT), NT patients were older (58.9 ± 15.8 vs. 39.7 ± 17.0 years, p < 0.001), more female (45.5% vs. 22.1%, p < 0.001), and had higher CCI (4.7 ± 3.3 vs. 1.1 ± 2.2, p < 0.001). The number of takebacks (1.7 ± 2.6 vs. 1.5 ± 1.2), time to first takeback (32.0 hours), duration of bowel discontinuity (47.0 hours), and time to PFC were similar (63.2 hours, achieved in 73.5%). Nontrauma and T patients had similar ventilator, ICU, and hospital days and mortality (31.0% NT, 29.8% T). Nontrauma patients had higher rates of renal failure requiring dialysis (36.6% vs. 14.1%, p < 0.001) and postoperative abdominal sepsis (40.1% vs. 17.1%, p < 0.001). Trauma and NT patients had similar number of hours of sedative (89.9 vs. 65.5 hours, p = 0.064) and opioid infusions (106.9 vs. 96.7 hours, p = 0.514), but T had lower DF/CF-ICU-30 (51.1% vs. 73.7%, p = 0.029), indicating more delirium. Linear regression analysis indicated that T was associated with a 32.1% decrease (95% CI, 14.6%-49.5%; p < 0.001) in DF/CF-ICU-30, while achieving PFC was associated with a 25.1% increase (95% CI, 10.2%-40.1%; p = 0.001) in DF/CFICU-30. Increasing Abbreviated Injury Scale for the head was associated with decreased DF/CF-ICU-30 by analysis of variance (p < 0.001).ConclusionNontrauma patients had higher incidence of postoperative abdominal sepsis and need for dialysis, while T was independently associated with increased delirium, perhaps because of traumatic brain injury.Level of evidenceTherapeutic study, level IV.

Published
2021

4. An Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

Author

Taghavi, Sharven, Maher, Zoe, Goldberg, Amy J, Chang, Grace, Mendiola, Michelle, Anderson, Christofer, Ninokawa, Scott, Tatebe, Leah C, Maluso, Patrick, Raza, Shariq, Keating, Jane J, Burruss, Sigrid, Reeves, Matthew, Coleman, Lauren E, Shatz, David V, Goldenberg-Sandau, Anna, Bhupathi, Apoorva, Spalding, M Chance, LaRiccia, Aimee, Bird, Emily, Noorbakhsh, Matthew R, Babowice, James, Nelson, Marsha C, Jacobson, Lewis E, Williams, Jamie, Vella, Michael, Dellonte, Kate, Hayward, Thomas Z, Holler, Emma, Lieser, Mark J, Berne, John D, Mederos, Dalier R, Askari, Reza, Okafor, Barbara U, Haut, Elliott R, Etchill, Eric W, Fang, Raymond, Roche, Samantha L, Whittenburg, Laura, Bernard, Andrew C, Haan, James M, Lightwine, Kelly L, Norwood, Scott H, Murry, Jason, Gamber, Mark A, Carrick, Matthew M, Bugaev, Nikolay, Tatar, Antony, Duchesne, Juan, and Tatum, Danielle

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Physical Injury - Accidents and Adverse Effects, Good Health and Well Being, Adult, Emergency Medical Services, Female, Hospital Mortality, Humans, Injury Severity Score, Logistic Models, Male, Middle Aged, Prospective Studies, Trauma Centers, United States, Urban Health Services, Wounds, Gunshot, Wounds, Penetrating, Young Adult, Penetrating trauma, prehospital procedures, prehospital transport, outcomes, Clinical sciences, Nursing
Abstract

BackgroundPrehospital procedures (PHP) by emergency medical services (EMS) are performed regularly in penetrating trauma patients despite previous studies demonstrating no benefit. We sought to examine the influence of PHPs on outcomes in penetrating trauma patients in urban locations where transport to trauma center is not prolonged. We hypothesized that patients without PHPs would have better outcomes than those undergoing PHP.MethodsThis was an Eastern Association for the Surgery of Trauma-sponsored, multicenter, prospective, observational trial of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. The impact of PHPs and transport mechanism on in-hospital mortality were examined.ResultsOf 2,284 patients included, 1,386 (60.7%) underwent PHP. The patients were primarily Black (n = 1,527, 66.9%) males (n = 1,986, 87.5%) injured by gunshot wound (n = 1,510, 66.0%) with 34.1% (n = 726) having New Injury Severity Score of ≥16. A total of 1,427 patients (62.5%) were transported by Advanced Life Support EMS, 17.2% (n = 392) by private vehicle, 13.7% (n = 312) by police, and 6.7% (n = 153) by Basic Life Support EMS. Of the PHP patients, 69.1% received PHP on scene, 59.9% received PHP in route, and 29.0% received PHP both on scene and in route. Initial scene vitals differed between groups, but initial emergency department vitals did not. Receipt of ≥1 PHP increased mortality odds (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.01-1.83; p = 0.04). Logistic regression showed increased mortality with each PHP, whether on scene or during transport. Subset analysis of specific PHP revealed that intubation (OR, 10.76; 95% CI, 4.02-28.78; p < 0.001), C-spine immobilization (OR, 5.80; 95% CI, 1.85-18.26; p < 0.01), and pleural decompression (OR, 3.70; 95% CI, 1.33-10.28; p = 0.01) had the highest odds of mortality after adjusting for multiple variables.ConclusionPrehospital procedures in penetrating trauma patients impart no survival advantage and may be harmful in urban settings, even when performed during transport. Therefore, PHP should be forgone in lieu of immediate transport to improve patient outcomes.Level of evidencePrognostic, level III.

Published
2021

5. Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Author

Harrell, Kevin N., Grimes, Arthur D., Gill, Harkanwar, Reynolds, Jessica K., Ueland, Walker R., Sciarretta, Jason D., Todd, Samual R., Trust, Marc D., Ngoue, Marielle, Thomas, Bradley W., Ayuso, Sullivan A., LaRiccia, Aimee, Spalding, M Chance, Collins, Michael J., Collier, Bryan R., Karam, Basil S., de Moya, Marc A., Lieser, Mark J., Chipko, John M., Haan, James M., Lightwine, Kelly L., Cullinane, Daniel C., Falank, Carolyne R., Phillips, Ryan C., Kemp, Michael T., Alam, Hasan B., Udekwu, Pascal O., Sanin, Gloria D., Hildreth, Amy N., Biffl, Walter L., Schaffer, Kathryn B., Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L., and Maxwell, Robert A.

Published
2023
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6. Would you be surprised? Prospective multicenter study of the Surprise Question as a screening tool to predict mortality in trauma patients

Author

Hoffman, Melissa Red, Slivinski, Andrea, Shen, Yan, Watts, Dorraine D., Wyse, Ransom J., Garland, Jeneva M., Fakhry, Samir M., Tarbox, Vanessa, Kurek, Stanley J., Hoffman, Melissa, Slivinski, Andrea, Berg, Gina M., Shaddix, Jamie L., Dunne, James R., Eversley-Kelso, Tatiana R., Kerley, David, Nagy, Roger, Moreau, Shawn, Timmer, Jeremy, Evans, Alex, Gibson, Andrea, Lieser, Mark J., Chipko, John M., Carrick, Matthew, Rodkey, Kathy, Rembisz, Adam, and Kromer, Mark

Published
2024
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7. Findings on Repeat Posttraumatic Brain Computed Tomography Scans in Older Patients With Minimal Head Trauma and the Impact of Existing Antithrombotic Use

Author

Helmer, Kenneth S., Curcio, Gary J., Gilligan, Doreen, Taylor, Dallas A., Hughes, Frances, Barker, Ralph J., Bissinger, Carol M., Miller, Charles J., Harbour, Lori F., Duane, Therèse M., Carrick, Matthew M., Lieser, Mark J., Flaherty, Stephen, Blair, Valeria, Perez, Julia, Cervantes, Carli, Hogan, Christopher, Ruiz, Chris R., Tinti, Meredith, Romero, Cecilia A., Jones, Karla J., Neeley, Tara, Wright, Kimberly, Dunne, James, Eversley-Kelso, Tatiana, Harte, Melissa A., Kline, Richard A., Love, Joseph D., van Doorn, Erika, Brock, Christie M., Acuna, David L., Shaddix, Jamie L., Rhodes, Heather, Biswas, Saptarshi, Shillinglaw, William C., Slivinski, Andrea, Offner, Patrick J., Levine, Jeffrey H., Banton, Kaysie L., Katubig, Burt, Watts, Dorraine D., Wilson, Nina Y., Shen, Yan, Garland, Jeneva M., Wyse, Ransom J., Hunt, Darrell L., Gauny, Randy W., and Fakhry, Samir M.

Published
2023
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8. Does treatment delay for blunt cerebrovascular injury affect stroke rate?: An EAST multicenter study

Author

Appelbaum, Rachel D, Esposito, Emily, Spaulding, M Chance, Simpson, Joshua P, Dunn, Julie, Zier, Linda B, Burruss, Sigrid, Kim, Paul P, Jacobson, Lewis E, Williams, Jamie M, Nahmias, Jeffry, Grigorian, Areg, Harmon, Laura, Gergen, Anna K, Chatoor, Matthew, Rattan, Rishi, Young, Andrew J, Pascual, Jose L, Murry, Jason, Ong, Adrian W, Muller, Alison, Sandhu, Rovinder S, Bugaev, Nikolay, Tatar, Antony, Zreik, Khaled, Lieser, Mark J, Stein, Deborah M, Scalea, Thomas M, and Lauerman, Margaret H

Published
2022
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9. Dexmedetomidine and paralytic exposure after damage control laparotomy: risk factors for delirium? Results from the EAST SLEEP-TIME multicenter trial

Author

Krause, Cassandra, Kwon, Eugenia, Luo-Owen, Xian, McArthur, Kaitlin, Cochran-Yu, Meghan, Swentek, Lourdes, Burruss, Sigrid, Turay, David, Grigorian, Areg, Nahmias, Jeffry, Butt, Ahsan, Gutierrez, Adam, LaRiccia, Aimee, Kincaid, Michelle, Fiorentino, Michele N., Glass, Nina, Toscano, Samantha, Ley, Eric, Lombardo, Sarah R., Guillamondegui, Oscar D., Bardes, James M., DeLa’O, Connie, Wydo, Salina M., Leneweaver, Kyle, Duletzke, Nicholas T., Nunez, Jade, Moradian, Simon, Posluszny, Joseph, Naar, Leon, Kaafarani, Haytham, Kemmer, Heidi, Lieser, Mark J., Dorricott, Alexa, Chang, Grace, Nemeth, Zoltan, and Mukherjee, Kaushik

Published
2022
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10. Tranexamic Acid and Pulmonary Complications: A Secondary Analysis of an EAST Multicenter Trial

Author

Raza, Shariq S., Tatum, Danielle, Nordham, Kristen D., Broome, Jacob M., Keating, Jane, Maher, Zoe, Goldberg, Amy J., Chang, Grace, Mendiola Pla, Michelle, Haut, Elliott R., Tatebe, Leah, Toraih, Eman, Anderson, Christofer, Ninokawa, Scott, Maluso, Patrick, Burruss, Sigrid, Reeves, Matthew, Coleman, Lauren E., Shatz, David V., Goldenberg-Sandau, Anna, Bhupathi, Apoorva, Spalding, Chance, LaRiccia, Aimee, Bird, Emily, Noorbakhsh, Matthew R., Babowice, James, Nelson, Marsha C., Jacobson, Lewis E., Williams, Jamie, Vella, Michael, Dellonte, Kate, Hayward, Thomas Z., Holler, Emma, Lieser, Mark J., Berne, John D., Mederos, Dalier R., Askari, Reza, Okafor, Barbara, Etchill, Eric, Fang, Raymond, Roche, Samantha L., Whittenburg, Laura, Bernard, Andrew C., Haan, James M., Lightwine, Kelly L., Norwood, Scott H., Murry, Jason, Gamber, Mark A., Carrick, Matthew M., Bugaev, Nikolay, Tatar, Antony, Duchesne, Juan, and Taghavi, Sharven

Abstract

Background Anti-inflammatory effects of tranexamic acid (TXA) in reducing trauma endotheliopathy may protect from acute lung injury. Clinical data showing this benefit in trauma patients is lacking. We hypothesized that TXA administration mitigates pulmonary complications in penetrating trauma patients.Materials and Methods This is a post-hoc analysis of a multicenter, prospective, observational study of adults (18+ years) with penetrating torso and/or proximal extremity injury presenting at 25 urban trauma centers. Tranexamic acid administration in the prehospital setting or within three hours of admission was examined. Participants were propensity matched to compare similarly injured patients. The primary outcome was development of pulmonary complication (ARDS and/or pneumonia).Results A total of 2382 patients were included, and 206 (8.6%) received TXA. Of the 206, 93 (45%) received TXA prehospital and 113 (55%) received it within three hours of hospital admission. Age, sex, and incidence of massive transfusion did not differ. The TXA group was more severely injured, more frequently presented in shock (SBP < 90 mmHg), developed more pulmonary complications, and had lower survival (P< 0.01 for all). After propensity matching, 410 patients remained (205 in each cohort) with no difference in age, sex, or rate of shock. On logistic regression, increased emergency department heart rate was associated with pulmonary complications. Tranexamic acid was not associated with different rate of pulmonary complications or survival on logistic regression. Survival was not different between the groups on logistic regression or propensity score–matched analysis.Conclusions Tranexamic acid administration is not protective against pulmonary complications in penetrating trauma patients.

Published
2025
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12. Factors Associated with Stroke Formation in Blunt Cerebrovascular Injury: An EAST Multicenter Study

Author

Esposito, Emily, Kufera, Joseph A., Wolff, Timothy W., Spalding, M. Chance, Simpson, Joshua, Dunn, Julie A., Zier, Linda, Burruss, Sigrid, Kim, Paul, Jacobson, Lewis E., Williams, Jamie, Nahmias, Jeffry, Grigorian, Areg, Harmon, Laura, Gergen, Anna, Chatoor, Matthew, Rattan, Rishi, Young, Andrew J., Pascual, Jose L., Murry, Jason, Ong, Adrian W., Muller, Alison, Sandhu, Rovinder S., Appelbaum, Rachel, Bugaev, Nikolay, Tatar, Antony, Zreik, Khaled, Hustad, Leah, Lieser, Mark J., Stein, Deborah M., Scalea, Thomas M., and Lauerman, Margaret H.

Published
2021
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13. Bone Anchor Fixation in the Repair of Blunt Traumatic Abdominal Wall Hernias: A Western Trauma Association Multicenter Study

Author

Harrell, Kevin N, primary, Grimes, Arthur D, additional, Gill, Harkanwar, additional, Reynolds, Jessica K, additional, Ueland, Walker R, additional, Sciarretta, Jason D, additional, Todd, Samual R, additional, Trust, Marc D, additional, Ngoue, Marielle, additional, Thomas, Bradley W, additional, Ayuso, Sullivan A, additional, LaRiccia, Aimee, additional, Spalding, Chance M, additional, Collins, Michael J, additional, Collier, Bryan R, additional, Karam, Basil S, additional, de Moya, Marc A, additional, Lieser, Mark J, additional, Chipko, John M, additional, Haan, James M, additional, Lightwine, Kelly L, additional, Cullinane, Daniel C, additional, Falank, Carolyne R, additional, Phillips, Ryan C, additional, Kemp, Michael T, additional, Alam, Hasan B, additional, Udekwu, Pascal O, additional, Sanin, Gloria D, additional, Hildreth, Amy N, additional, Biffl, Walter L, additional, Schaffer, Kathryn B, additional, Marshall, Gary, additional, Muttalib, Omaer, additional, Nahmias, Jeffry, additional, Shahi, Niti, additional, Moulton, Steven L, additional, and Maxwell, Robert A, additional

Published
2024
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14. Management of blunt traumatic abdominal wall hernias: A Western Trauma Association multicenter study

Author

Harrell, Kevin N., Grimes, Arthur D., Albrecht, Roxie M., Reynolds, Jessica K., Ueland, Walker R., Sciarretta, Jason D., Todd, Samual R., Trust, Marc D., Ngoue, Marielle, Thomas, Bradley W., Ayuso, Sullivan A., LaRiccia, Aimee, Spalding, M. Chance, Collins, Michael J., Collier, Bryan R., Karam, Basil S., de Moya, Marc A., Lieser, Mark J., Chipko, John M., Jr, Haan, James M., Lightwine, Kelly L., Cullinane, Daniel C., Falank, Carolyne R., Phillips, Ryan C., Kemp, Michael T., Alam, Hasan B., Udekwu, Pascal O., Sanin, Gloria D., Hildreth, Amy N., Biffl, Walter L., Schaffer, Kathryn B., Marshall, Gary, Muttalib, Omaer, Nahmias, Jeffry, Shahi, Niti, Moulton, Steven L., and Maxwell, Robert A.

Published
2021
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15. A Western Trauma Association Multicenter Comparison of Mesh Versus Non-Mesh Repair of Blunt Traumatic Abdominal Wall Hernia

Author

Harrell, Kevin N, primary, Grimes, Arthur D, additional, Gill, Harkanwar, additional, Reynolds, Jessica K, additional, Ueland, Walker R, additional, Sciarretta, Jason D, additional, Todd, Samual R, additional, Trust, Marc D, additional, Ngoue, Marielle, additional, Thomas, Bradley W, additional, Ayuso, Sullivan A, additional, LaRiccia, Aimee, additional, Spalding, M Chance, additional, Collins, Michael J, additional, Collier, Bryan R, additional, Karam, Basil S, additional, de Moya, Marc A, additional, Lieser, Mark J, additional, Chipko, John M, additional, Haan, James M, additional, Lightwine, Kelly L, additional, Cullinane, Daniel C, additional, Falank, Carolyne R, additional, Phillips, Ryan C, additional, Kemp, Michael T, additional, Alam, Hasan B, additional, Udekwu, Pascal O, additional, Sanin, Gloria D, additional, Hildreth, Amy N, additional, Biffl, Walter L, additional, Schaffer, Kathryn B, additional, Marshall, Gary, additional, Muttalib, Omaer, additional, Nahmias, Jeffry, additional, Shahi, Niti, additional, Moulton, Steven L, additional, and Maxwell, Robert A, additional

Published
2023
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18. Findings on Repeat Posttraumatic Brain Computed Tomography Scans in Older Patients With Minimal Head Trauma and the Impact of Existing Antithrombotic Use

Author

Flaherty, Stephen, primary, Biswas, Saptarshi, additional, Watts, Dorraine D., additional, Wilson, Nina Y., additional, Shen, Yan, additional, Garland, Jeneva M., additional, Wyse, Ransom J., additional, Lieser, Mark J., additional, Duane, Therèse M., additional, Offner, Patrick J., additional, Love, Joseph D., additional, Shillinglaw, William C., additional, Hunt, Darrell L., additional, Gauny, Randy W., additional, Fakhry, Samir M., additional, Helmer, Kenneth S., additional, Curcio, Gary J., additional, Gilligan, Doreen, additional, Taylor, Dallas A., additional, Hughes, Frances, additional, Barker, Ralph J., additional, Bissinger, Carol M., additional, Miller, Charles J., additional, Harbour, Lori F., additional, Carrick, Matthew M., additional, Flaherty, Stephen, additional, Blair, Valeria, additional, Perez, Julia, additional, Cervantes, Carli, additional, Hogan, Christopher, additional, Ruiz, Chris R., additional, Tinti, Meredith, additional, Romero, Cecilia A., additional, Jones, Karla J., additional, Neeley, Tara, additional, Wright, Kimberly, additional, Dunne, James, additional, Eversley-Kelso, Tatiana, additional, Harte, Melissa A., additional, Kline, Richard A., additional, van Doorn, Erika, additional, Brock, Christie M., additional, Acuna, David L., additional, Shaddix, Jamie L., additional, Rhodes, Heather, additional, Slivinski, Andrea, additional, Levine, Jeffrey H., additional, Banton, Kaysie L., additional, and Katubig, Burt, additional

Published
2023
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19. Survey of Diagnostic and Management Practices in Small Bowel Obstruction: Individual and Generational Variation Despite Practice Guidelines

Author

Fakhry, Samir M., primary, Duane, Therèse M., additional, Garland, Jeneva M., additional, Dunne, James R., additional, Kurek, Stanley J., additional, Hunt, Darrell L., additional, Plurad, David S., additional, Shillinglaw, William C., additional, Carrick, Matthew M., additional, Lieser, Mark J., additional, Wyse, Ransom J., additional, Wilson, Nina Y., additional, and Watts, Dorraine D., additional

Published
2023
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20. Supplemental Material - Survey of Diagnostic and Management Practices in Small Bowel Obstruction: Individual and Generational Variation Despite Practice Guidelines

Author

Fakhry, Samir M., Duane, Therèse M., Garland, Jeneva M., Dunne, James R., Kurek, Stanley J., Hunt, Darrell L., Plurad, David S., Shillinglaw, William C., Carrick, Matthew M., Lieser, Mark J., Wyse, Ransom J., Wilson, Nina Y., and Watts, Dorraine D.

Subjects
FOS: Clinical medicine, 110323 Surgery
Abstract

Supplemental Material for Survey of Diagnostic and Management Practices in Small Bowel Obstruction: Individual and Generational Variation Despite Practice Guidelines by Samir M. Fakhry, Therèse M. Duane, Jeneva M. Garland, James R. Dunne, Stanley J. Kurek, Darrell L. Hunt, David S. Plurad, William C. Shillinglaw, Matthew M. Carrick, Mark J. Lieser, Ransom J. Wyse, Nina Y. Wilson, and Dorraine D. Watts in The American Surgeon.

Published
2023
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21. Risk factors for recurrence in blunt traumatic abdominal wall hernias: A secondary analysis of a Western Trauma association multicenter study

Author

Harrell, Kevin N., primary, Grimes, Arthur D., additional, Gill, Harkanwar, additional, Reynolds, Jessica K., additional, Ueland, Walker R., additional, Sciarretta, Jason D., additional, Todd, Samual R., additional, Trust, Marc D., additional, Ngoue, Marielle, additional, Thomas, Bradley W., additional, Ayuso, Sullivan A., additional, LaRiccia, Aimee, additional, Spalding, M Chance, additional, Collins, Michael J., additional, Collier, Bryan R., additional, Karam, Basil S., additional, de Moya, Marc A., additional, Lieser, Mark J., additional, Chipko, John M., additional, Haan, James M., additional, Lightwine, Kelly L., additional, Cullinane, Daniel C., additional, Falank, Carolyne R., additional, Phillips, Ryan C., additional, Kemp, Michael T., additional, Alam, Hasan B., additional, Udekwu, Pascal O., additional, Sanin, Gloria D., additional, Hildreth, Amy N., additional, Biffl, Walter L., additional, Schaffer, Kathryn B., additional, Marshall, Gary, additional, Muttalib, Omaer, additional, Nahmias, Jeffry, additional, Shahi, Niti, additional, Moulton, Steven L., additional, and Maxwell, Robert A., additional

Published
2022
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23. Low Prevalence but High Impact of COVID-19 Positive Status in Adult Trauma Patients: A Multi-institutional Analysis of 28 904 Patients

Author

Fakhry, Samir M., primary, Morse, Jennifer L., additional, Garland, Jeneva M., additional, Elkbuli, Adel, additional, Sheets, Nicholas W., additional, Slivinski, Andrea, additional, Berg, Gina M., additional, Wyse, Ransom J., additional, Shen, Yan, additional, Wilson, Nina Y., additional, Miller, Amanda L., additional, Carrick, Matthew M., additional, Fisher, Chris, additional, Shillinglaw, William C., additional, Banton, Kaysie L., additional, Lieser, Mark J., additional, Chipko, John M., additional, McBride, Katherine M., additional, Biswas, Saptarshi, additional, and Watts, Dorraine D., additional

Published
2022
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24. Bile Acid Toxicity

Author

Gores, Gregory J., Spivey, James R., Botla, Ravi, Park, Joong-Won, Lieser, Mark J., Lemasters, John J., editor, and Nieminen, Anna-Liisa, editor

Published
2002
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25. Grade 1 Internal Carotid Artery Blunt Cerebrovascular Injury Persistence Risks Stroke With Current Management: An EAST Multicenter Study

Author

Yang, Sarah, primary, Esposito, Emily, additional, Spalding, Chance, additional, Simpson, Joshua, additional, Dunn, Julie A., additional, Zier, Linda, additional, Burruss, Sigrid, additional, Kim, Paul, additional, Jacobson, Lewis E., additional, Williams, Jamie, additional, Nahmias, Jeffry, additional, Grigorian, Areg, additional, Harmon, Laura, additional, Gergen, Anna, additional, Chatoor, Matthew, additional, Rattan, Rishi, additional, Young, Andrew J., additional, Pascual, Jose L., additional, Murry, Jason, additional, Ong, Adrian W., additional, Muller, Alison, additional, Sandhu, Rovinder S., additional, Appelbaum, Rachel, additional, Bugaev, Nikolay, additional, Tatar, Antony, additional, Zreik, Khaled, additional, Lieser, Mark J., additional, Scalea, Thomas M., additional, Stein, Deborah M., additional, and Lauerman, Margaret, additional

Published
2022
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27. Endovascular Intervention in Internal Carotid Artery Blunt Cerebrovascular Injury: An EAST Multicenter Study

Author

Lauerman, Margaret, primary, Esposito, Emily, additional, Spalding, Chance, additional, Simpson, Joshua, additional, Dunn, Julie A., additional, Zier, Linda, additional, Burruss, Sigrid, additional, Kim, Paul, additional, Jacobson, Lewis E., additional, Williams, Jamie, additional, Nahmias, Jeffry, additional, Grigorian, Areg, additional, Harmon, Laura, additional, Gergen, Anna, additional, Chatoor, Matthew, additional, Rattan, Rishi, additional, Young, Andrew J., additional, Pascual, Jose L., additional, Murry, Jason, additional, Ong, Adrian W., additional, Muller, Alison, additional, Sandhu, Rovinder S., additional, Appelbaum, Rachel, additional, Bugaev, Nikolay, additional, Tatar, Antony, additional, Zreik, Khaled, additional, Lieser, Mark J., additional, Scalea, Thomas M., additional, and Stein, Deborah M., additional

Published
2022
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28. The public health burden of geriatric trauma: Analysis of 2,688,008 hospitalizations from Centers for Medicare and Medicaid Services inpatient claims

Author

Fakhry, Samir M., primary, Shen, Yan, additional, Biswas, Saptarshi, additional, Duane, Therese M., additional, McBride, Katherine M., additional, Elkbuli, Adel, additional, Wyse, Ransom J., additional, Wilson, Nina Y., additional, Garland, Jeneva M., additional, Kurek, Stanley J., additional, Plurad, David S., additional, Banton, Kaysie L., additional, Fisher, Chris, additional, Gage, Alexis, additional, Hunt, Diane L.S., additional, Lieser, Mark J., additional, Shillinglaw, William R.C., additional, and Watts, Dorraine D., additional

Published
2022
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29. sj-pdf-1-asu-10.1177_00031348221082277 – Supplemental Material for Grade 1 Internal Carotid Artery Blunt Cerebrovascular Injury Persistence Risks Stroke With Current Management: An EAST Multicenter Study

Author

Yang, Sarah, Esposito, Emily, Spalding, Chance, Simpson, Joshua, Dunn, Julie A., Zier, Linda, Burruss, Sigrid, Kim, Paul, Jacobson, Lewis E., Williams, Jamie, Nahmias, Jeffry, Grigorian, Areg, Harmon, Laura, Gergen, Anna, Chatoor, Matthew, Rattan, Rishi, Young, Andrew J., Pascual, Jose L., Murry, Jason, Ong, Adrian W., Muller, Alison, Sandhu, Rovinder S., Appelbaum, Rachel, Bugaev, Nikolay, Tatar, Antony, Zreik, Khaled, Lieser, Mark J., Scalea, Thomas M., Stein, Deborah M., and Lauerman, Margaret

Subjects
FOS: Clinical medicine, 110323 Surgery
Abstract

Supplemental Material, sj-pdf-1-asu-10.1177_00031348221082277 for Grade 1 Internal Carotid Artery Blunt Cerebrovascular Injury Persistence Risks Stroke With Current Management: An EAST Multicenter Study by Sarah Yang, Emily Esposito, Chance Spalding, Joshua Simpson, Julie A. Dunn, Linda Zier, Sigrid Burruss, Paul Kim, Lewis E. Jacobson, Jamie Williams, Jeffry Nahmias, Areg Grigorian, Laura Harmon, Anna Gergen, Matthew Chatoor, Rishi Rattan, Andrew J. Young, Jose L. Pascual, Jason Murry, Adrian W. Ong, Alison Muller, Rovinder S. Sandhu, Rachel Appelbaum, Nikolay Bugaev, Antony Tatar, Khaled Zreik, Mark J. Lieser, Thomas M. Scalea, Deborah M. Stein and Margaret Lauerman in The American Surgeon

Published
2022
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30. Supplemental Material - Low Prevalence but High Impact of COVID-19 Positive Status in Adult Trauma Patients: A Multi-institutional Analysis of 28 904 Patients

Author

Fakhry, Samir M., Morse, Jennifer L., Garland, Jeneva M., Elkbuli, Adel, Sheets, Nicholas W., Slivinski, Andrea, Berg, Gina M., Wyse, Ransom J., Shen, Yan, Wilson, Nina Y., Miller, Amanda L., Carrick, Matthew M., Fisher, Chris, Shillinglaw, William C., Banton, Kaysie L., Lieser, Mark J., Chipko, John M., McBride, Katherine M., Biswas, Saptarshi, and Watts, Dorraine D.

Subjects
FOS: Clinical medicine, 110323 Surgery
Abstract

Supplemental Material for Low Prevalence but High Impact of COVID-19 Positive Status in Adult Trauma Patients: A Multi-institutional Analysis of 28 904 Patients by Samir M. Fakhry, Jennifer L. Morse, Jeneva M. Garland, Adel Elkbuli, Nicholas W. Sheets, Andrea Slivinski, Gina M. Berg, Ransom J. Wyse, Yan Shen, Nina Y. Wilson, Amanda L. Miller, Matthew M. Carrick, Chris Fisher, William C. Shillinglaw, Kaysie L. Banton, Mark J. Lieser, John M. Chipko, Katherine M. McBride, Saptarshi Biswas, Dorraine D. Watts in The American Surgeon

Published
2022
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31. An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

Author

Taghavi, Sharven, primary, Maher, Zoe, additional, Goldberg, Amy J., additional, Haut, Elliott R., additional, Raza, Shariq, additional, Chang, Grace, additional, Tatebe, Leah C., additional, Toraih, Eman, additional, Mendiola, Michelle, additional, Anderson, Christofer, additional, Ninokawa, Scott, additional, Maluso, Patrick, additional, Keating, Jane, additional, Burruss, Sigrid, additional, Reeves, Matthew, additional, Coleman, Lauren E., additional, Shatz, David V., additional, Goldenberg-Sandau, Anna, additional, Bhupathi, Apoorva, additional, Spalding, M. Chance, additional, LaRiccia, Aimee, additional, Bird, Emily, additional, Noorbakhsh, Matthew R., additional, Babowice, James, additional, Nelson, Marsha C., additional, Jacobson, Lewis E., additional, Williams, Jamie, additional, Vella, Michael, additional, Dellonte, Kate, additional, Hayward, Thomas Z., additional, Holler, Emma, additional, Lieser, Mark J., additional, Berne, John D., additional, Mederos, Dalier R., additional, Askari, Reza, additional, Okafor, Barbara, additional, Etchill, Eric, additional, Fang, Raymond, additional, Roche, Samantha L., additional, Whittenburg, Laura, additional, Bernard, Andrew C., additional, Haan, James M., additional, Lightwine, Kelly L., additional, Norwood, Scott H., additional, Murry, Jason, additional, Gamber, Mark A., additional, Carrick, Matthew M., additional, Bugaev, Nikolay, additional, Tatar, Antony, additional, and Tatum, Danielle, additional

Published
2022
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32. Impact of time to surgery on mortality in hypotensive patients with noncompressible torso hemorrhage: An AAST multicenter, prospective study

Author

Duchesne, Juan, primary, Slaughter, Kevin, additional, Puente, Ivan, additional, Berne, John D., additional, Yorkgitis, Brian, additional, Mull, Jennifer, additional, Sperry, Jason, additional, Tessmer, Matthew, additional, Costantini, Todd, additional, Berndtson, Allison E., additional, Kai, Taylor, additional, Rokvic, Giannina, additional, Norwood, Scott, additional, Meadows, Katelyn, additional, Chang, Grace, additional, Lemon, Brittney M., additional, Jacome, Tomas, additional, Van Sant, Lauren, additional, Paul, Jasmeet, additional, Maher, Zoe, additional, Goldberg, Amy J., additional, Madayag, Robert M., additional, Pinson, Greg, additional, Lieser, Mark J., additional, Haan, James, additional, Marshall, Gary, additional, Carrick, Matthew, additional, and Tatum, Danielle, additional

Published
2022
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33. Dexmedetomidine and paralytic exposure after damage control laparotomy: risk factors for delirium? Results from the EAST SLEEP-TIME multicenter trial

Author

Krause, Cassandra, primary, Kwon, Eugenia, additional, Luo-Owen, Xian, additional, McArthur, Kaitlin, additional, Cochran-Yu, Meghan, additional, Swentek, Lourdes, additional, Burruss, Sigrid, additional, Turay, David, additional, Grigorian, Areg, additional, Nahmias, Jeffry, additional, Butt, Ahsan, additional, Gutierrez, Adam, additional, LaRiccia, Aimee, additional, Kincaid, Michelle, additional, Fiorentino, Michele N., additional, Glass, Nina, additional, Toscano, Samantha, additional, Ley, Eric, additional, Lombardo, Sarah R., additional, Guillamondegui, Oscar D., additional, Bardes, James M., additional, DeLa’O, Connie, additional, Wydo, Salina M., additional, Leneweaver, Kyle, additional, Duletzke, Nicholas T., additional, Nunez, Jade, additional, Moradian, Simon, additional, Posluszny, Joseph, additional, Naar, Leon, additional, Kaafarani, Haytham, additional, Kemmer, Heidi, additional, Lieser, Mark J., additional, Dorricott, Alexa, additional, Chang, Grace, additional, Nemeth, Zoltan, additional, and Mukherjee, Kaushik, additional

Published
2021
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34. Grade 1 Internal Carotid Artery Blunt Cerebrovascular Injury Persistence Risks Stroke With Current Management: An EAST Multicenter Study

Author

Yang, Sarah, Esposito, Emily, Spalding, Chance, Simpson, Joshua, Dunn, Julie A., Zier, Linda, Burruss, Sigrid, Kim, Paul, Jacobson, Lewis E., Williams, Jamie, Nahmias, Jeffry, Grigorian, Areg, Harmon, Laura, Gergen, Anna, Chatoor, Matthew, Rattan, Rishi, Young, Andrew J., Pascual, Jose L., Murry, Jason, Ong, Adrian W., Muller, Alison, Sandhu, Rovinder S., Appelbaum, Rachel, Bugaev, Nikolay, Tatar, Antony, Zreik, Khaled, Lieser, Mark J., Scalea, Thomas M., Stein, Deborah M., and Lauerman, Margaret

Abstract

Background Higher blunt cerebrovascular injury (BCVI) grade and lack of medical therapy are associated with stroke. Knowledge of stroke risk factors specific to individual grades may help tailor BCVI therapy to specific injury characteristics.Methods A post-hoc analysis of a 16 center, prospective, observational trial (2018-2020) was performed including grade 1 internal carotid artery (ICA) BCVI. Repeat imaging was considered the second imaging occurrence only.Results From 145 grade 1 ICA BCVI included, 8 (5.5%) suffered a stroke. Grade 1 ICA BCVI with stroke were more commonly treated with mixed anticoagulation and antiplatelet therapy (75.0% vs 9.6%, P <.001) and less commonly antiplatelet therapy (25.0% vs 82.5%, P = .001) compared to injuries without stroke. Of the 8 grade 1 ICA BCVI with stroke, 4 (50.0%) had stroke after medical therapy was started. In comparing injuries with resolution at repeat imaging to those without, stroke occurred in 7 (15.9%) injuries without resolution and 0 (0%) injuries with resolution (P = .005). At repeat imaging in grade 1 ICA BCVI with stroke, grade of injury was grade 1 in 2 injuries, grade 2 in 3 injuries, grade 3 in 1 injury, and grade 5 in one injury.Discussion While the stroke rate for grade 1 ICA BCVI is low overall, injury persistence appears to heighten stroke risk. Some strokes occurred despite initiation of medical therapy. Repeat imaging is needed in grade 1 ICA BCVI to evaluate for injury progression or resolution.

Published
2023
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35. Low Prevalence but High Impact of COVID-19 Positive Status in Adult Trauma Patients: A Multi-institutional Analysis of 28 904 Patients

Author

Fakhry, Samir M., Morse, Jennifer L., Garland, Jeneva M., Elkbuli, Adel, Sheets, Nicholas W., Slivinski, Andrea, Berg, Gina M., Wyse, Ransom J., Shen, Yan, Wilson, Nina Y., Miller, Amanda L., Carrick, Matthew M., Fisher, Chris, Shillinglaw, William C., Banton, Kaysie L., Lieser, Mark J., Chipko, John M., McBride, Katherine M., Biswas, Saptarshi, and Watts, Dorraine D.

Abstract

Background Few large investigations have addressed the prevalence of COVID-19 infection among trauma patients and impact on providers. The purpose of this study was to quantify the prevalence of COVID-19 infection among trauma patients by timing of diagnosis, assess nosocomial exposure risk, and evaluate the impact of COVID-19 positive status on morbidity and mortality.Methods Registry data from adults admitted 4/1/2020-10/31/2020 from 46 level I/II trauma centers were grouped by: timing of first positive status (Day 1, Day 2-6, or Day = 7); overall Positive/Negative status; or Unknown if test results were unavailable. Groups were compared on outcomes (Trauma Quality Improvement Program complications) and mortality using univariate analysis and adjusted logistic regression.Results There were 28 904 patients (60.7% male, mean age: 56.4, mean injury severity score: 10.5). Of 13 274 (46%) patients with known COVID-19 status, 266 (2%) were Positive Day 1, 119 (1%) Days 2-6, 33 (.2%) Day = 7, and 12 856 (97%) tested Negative. COVID-19 Positive patients had significantly worse outcomes compared to Negative; unadjusted comparisons showed longer hospital length of stay (10.98 vs 7.47;P< .05), higher rates of intensive care unit (57.7% vs 45.7%; P< .05) and ventilation use (22.5% vs 16.9%; P< .05). Adjusted comparisons showed higher rates of acute respiratory distress syndrome (1.7% vs .4%; P< .05) and death (8.1% vs 3.4%; P< .05).Conclusions This multicenter study conducted during the early pandemic period revealed few trauma patients tested COVID-19 positive, suggesting relatively low exposure risk to care providers. COVID-19 positive status was associated with significantly higher mortality and specific morbidity. Further analysis is needed with consideration for care guidelines specific to COVID-19 positive trauma patients as the pandemic continues.

Published
2023
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36. The Impact of Nursing on Trauma Patient Satisfaction: An Analysis of HCAHPS From 112,283 Patients

Author

Watts, Dorraine D., primary, Slivinski, Andrea, additional, Garland, Jeneva M., additional, Kerley, David R., additional, Wilson, Nina Y., additional, Cooper, Tabatha, additional, Howard, Kyle, additional, Dunne, James, additional, Lieser, Mark J., additional, Berg, Gina M., additional, Wyse, Ransom J., additional, Carrick, Matthew M., additional, and Fakhry, Samir M., additional

Published
2021
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39. Factors associated with stroke formation in blunt cerebrovascular injury: An EAST multicenter study

Author

Esposito, Emily C., Kufera, Joseph A., Wolff, Timothy W., Spalding, M. Chance, Simpson, Joshua, Dunn, Julie A., Zier, Linda, Burruss, Sigrid, Kim, Paul, Jacobson, Lewis E., Williams, Jamie, Nahmias, Jeffry, Grigorian, Areg, Harmon, Laura, Gergen, Anna, Chatoor, Matthew, Rattan, Rishi, Young, Andrew J., Pascual, Jose L., Murry, Jason, Ong, Adrian W., Muller, Alison, Sandhu, Rovinder S., Appelbaum, Rachel, Bugaev, Nikolay, Tatar, Antony, Zreik, Khaled, Hustad, Leah, Lieser, Mark J., Stein, Deborah M., Scalea, Thomas M., and Lauerman, Margaret H.

Published
2022
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41. Bile Acid Toxicity

Author

Gores, Gregory J., primary, Spivey, James R., additional, Botla, Ravi, additional, Park, Joong-Won, additional, and Lieser, Mark J., additional

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44. Interferon-... primes neutrophil-mediated gastric surface cell cytotoxicity.

Author

Lieser, Mark J. and Kozol, Robert A.

Subjects
*NEUTROPHILS, *INTERFERON inducers, *GASTRIC mucosa, *CYTOCHEMISTRY
Abstract

Investigates in vitro effects of interferon-gamma-induced oxidative priming of polymorphonuclear luekocytes (PMN) by examining the cytotoxic role of interferon-gamma-primed PMNs toward GSC. PMN-mediated cytotoxicity reduction; T lymphocyte derived interferon-gamma role in pathogenesis of PMN-mediated injury to gastric and gastrointestinal tract mucosa.

Published
1995

46. Oxidative priming of neutrophils by interferon‐y

Author

Tennenberg, Steven D., Fey, Debra E., and Lieser, Mark J.

Abstract

Priming of neutrophil (PMN) oxidative responses is an integral component of host defense and inflammation and may contribute to cell‐mediated tissue injury. The characteristics and mechanisms of interferon‐ γ (EFN‐γ)‐induced oxidative priming of PMNs were explored in vitro. Following pretreatment of human PMNs with recombinant IFN‐γ, superoxide anion release was selectively primed toward the receptor‐initiated stimulants f‐Met‐Leu‐Phe (fMLP) and C5a but not toward the transduction‐mediated stimulants phorbol myristate acetate and A23187, a calcium ionophore. IFN‐γ also induced priming toward the stimulant NaF, a direct activator of guanine nucleotide regulatory proteins. Priming was not associated with changes in fMLP surface receptor expression or degranulation. Priming was dependent on de novo mRNA and protein synthesis. The immuno‐ regulatory lymphokine IFN‐y primes PMN oxidative responses, apparently via production of proteins that are involved in the early postreceptor transductional pathways of oxidative metabolism.

Published
1993
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47. Stop the Bleed-Wait for the Ambulance or Get in the Car and Drive? A Post Hoc Analysis of an EAST Multicenter Trial.

Author

Simpson JT, Nordham KD, Tatum D, Haut ER, Ali A, Maher Z, Goldberg AJ, Tatebe LC, Chang G, Taghavi S, Raza S, Toraih E, Mendiola Plá M, Ninokawa S, Anderson C, Maluso P, Keating J, Burruss S, Reeves M, Craugh LE, Shatz DV, Bhupathi A, Spalding MC, LaRiccia A, Bird E, Noorbakhsh MR, Babowice J, Nelson MC, Jacobson LE, Williams J, Vella M, Dellonte K, Hayward TZ 3rd, Holler E, Lieser MJ, Berne JD, Mederos DR, Askari R, Okafor B, Etchill E, Fang R, Roche SL, Whittenburg L, Bernard AC, Haan JM MD, Lightwine KL, Norwood SH, Murry J, Gamber MA, Carrick MM, Bugaev N, and Tatar A

Abstract

Background: The Stop the Bleed campaign gives bystanders an active role in prehospital hemorrhage control. Whether extending bystanders' role to private vehicle transport (PVT) for urban penetrating trauma improves survival is unknown, but past research has found benefit to police and PVT. We hypothesized that for penetrating trauma in an urban environment, where prehospital procedures have been proven harmful, PVT improves outcomes compared to any EMS or advanced life support (ALS) transport. Methods: Post-hoc analysis of an EAST multicenter trial was performed on adult patients with penetrating torso/proximal extremity trauma at 25 urban trauma centers from 5/2019-5/2020. Patients were allocated to PVT and any EMS or ALS transport using nearest neighbor propensity score matching. Univariate analyses included Wilcoxon signed rank or McNemar's Test and logistic regression. Results: Of 1999 penetrating trauma patients in urban settings, 397 (19.9%) had PVT, 1433 (71.7%) ALS transport, and 169 (8.5%) basic life support (BLS) transport. Propensity matching yielded 778 patients, distributed equally into balanced groups. PVT patients were primarily male (90.5%), Black (71.2%), and sustained gunshot wounds (68.9%). ALS transport had significantly higher ED mortality (3.9% vs 1.9%, P = 0.03). There was no difference in in-hospital mortality rate, hospital LOS, or complications for all EMS or ALS only transport patients. Conclusion: Compared to PVT, ALS, which provides more prehospital procedures than BLS, provided no survival benefit for penetrating trauma patients in urban settings. Bystander education incorporating PVT for early arrival of penetrating trauma patients in urban settings to definitive care merits further investigation., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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48. Clinically relevant redifferentiation of fibroblast-like chondrocytes into functional chondrocytes by the low molecular weight fraction of human serum albumin.

Author

Hausburg MA, Frederick ED, McNair P, Schwappach J, Banton KL, Roshon M, Lieser MJ, Acuna DL, Banerjee RR, and Bar-Or D

Subjects
Aggrecans metabolism, Cells, Cultured, Chondrocytes metabolism, Chondrocytes pathology, Collagen Type II metabolism, Fibroblasts metabolism, Fibroblasts pathology, Glycosaminoglycans metabolism, Humans, Interleukin-6 metabolism, Molecular Weight, Osteoarthritis metabolism, Osteoarthritis pathology, Phenotype, SOX9 Transcription Factor metabolism, Cell Transdifferentiation drug effects, Chondrocytes drug effects, Chondrogenesis drug effects, Fibroblasts drug effects, Osteoarthritis drug therapy, Serum Albumin, Human pharmacology
Abstract

Objectives: Traumatic joint injury induces chondrocyte dysfunction and progressive breakdown of articular cartilage, leading to post-traumatic osteoarthritis (PTOA). In this condition, dysfunctional fibroblast-like chondrocytes (FLCs) no longer express proteins required for cartilage maintenance, such as SOX9 and collagen-type II (COL2). Interleukin-6 (IL-6) has been demonstrated to downregulate expression of these two critical proteins in chondrocytes, and increased IL-6 levels have been measured in patients with PTOA. The <5kDa fraction of human serum albumin (LMWF5A) has been suggested to modulate this pathway, as decreased levels of IL-6 are secreted by immunostimulated LMWF5A-treated macrophages. Our objective was to determine whether LMWF5A induces an in vitro model of FLCs to redifferentiate into functional chondrocytes., Methods: SOX9 and COL2 were monitored via western blot, and COL2 was detected with immunofluorescence. Aggrecan and IL-6 were quantified by ELISA. Glycosaminoglycan (GAG) levels were quantified with alcian blue., Results: We found that LMWF5A significantly increases the principal cartilage transcription factor SOX9 and the SOX9 target protein COL2 in monolayer-cultured FLCs. Multiple LMWF5A treatments of 3-D pellet FLC cultures over 2wks resulted in a significant decrease in IL-6 and significant increases in the major players of articular cartilage mechanics, aggrecan and highly-sulfated GAGs., Conclusions: These data support the hypothesis and clinical outcomes of two phase III clinical trials that LMWF5A-treatment induces chondrogenesis and supports functional cartilage. We propose that LMWF5A could maintain articular cartilage integrity in all joints following traumatic injury.

Published
2018

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