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2. Minimal Clinically Important Difference (MCID) for the Short Musculoskeletal Function Assessment (SMFA) in Severe Lower Extremity Trauma: Pooled Data from 7 Multicenter, Prospective Clinical Trials

Author

Carlini, Anthony R., Agel, Julie, Bosse, Michael J., Frey, Katherine P., Staguhn, Elena D., Vallier, Heather A., Obremskey, William, Swiontkowski, Marc F., Cannada, Lisa K., Tornetta, Paul, III, MacKenzie, Ellen J., O’Toole, Robert V., Reider, Lisa, Allen, Lauren E., Collins, Susan C., and Castillo, Renan C.

Published
2024
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3. Effect of Severe Distal Tibia, Ankle, and Mid- to Hindfoot Trauma on Meeting Physical Activity Guidelines 18 Months After Injury

Author

McLaughlin, Kevin H, Mitchell, Stuart L, Archer, Kristin R, Master, Hiral, Morshed, Saam, Gary, Joshua L, Jones, Clifford B, MacKenzie, Ellen J, Reider, Lisa, and for the METRC

Subjects
Public Health, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Physical Injury - Accidents and Adverse Effects, Adult, Ankle, Exercise, Female, Humans, Odds Ratio, Tibia, Trauma Centers, United States, Depression, Fractures, Orthopedics, Rehabilitation, Wound and injuries, METRC, Risk factors, Human Movement and Sports Sciences, Public Health and Health Services, Clinical sciences, Allied health and rehabilitation science, Sports science and exercise
Abstract

ObjectiveTo examine the effect of severe lower extremity trauma on meeting Physical Activity Guidelines for Americans (PAGA) 18 months after injury and perform an exploratory analysis to identify demographic, clinical, and psychosocial factors associated with meeting PAGA.DesignSecondary analysis of observational cohort study.SettingA total of 34 United States trauma centers PARTICIPANTS: A total of 328 adults with severe distal tibia, ankle and mid- to hindfoot injuries treated with limb reconstruction (N=328).InterventionsNone.Main outcome measuresThe Paffenbarger Physical Activity Questionnaire was used to assess physical activity levels 18 months after injury. Meeting PAGA was defined as combined moderate- and vigorous-intensity activity ≥150 minutes per week or vigorous-intensity activity ≥75 minutes per week.ResultsFewer patients engaged in moderate- or vigorous-intensity activity after injury compared with before injury (moderate: 44% vs 66%, P

Published
2022

4. Do Transtibial Amputations Outperform Amputations of the Hind- and Midfoot Following Severe Limb Trauma?: A Secondary Analysis of the OUTLET Study

Author

Fram, Brianna R., Bosse, Michael J., Odum, Susan M., Reider, Lisa, Gary, Joshua L., Gordon, Wade T., Teague, David, Alkhoury, Dana, MacKenzie, Ellen J., Seymour, Rachel B., Karunakar, Madhav A., Fox, W. Everett, Hsu, Joseph R., Kempton, Laurence, Robinson, Katherine Sample, Sims, Stephen H., Churchill, Christine, Teasdall, Robert D., Carroll, Eben A., Scott, Aaron T., Halvorson, Jason J., Pilson, Holly, Goodman, James Brett, Holden, Martha B., McAndrew, Christopher M., Gardner, Michael J., Miller, Anna N., Hughes, Amanda Spraggs, Stinner, Daniel J., Rivera, Jessica C., Osborn, Patrick M., Nadeau, Jason T., Howes, Cameron, Schenker, Mara L., Mir, Hassan, Taylor, Benjamin C., Schmidt, Andrew H., Mullis, Brian H., Shively, Karl D., Sorkin, Anthony T., Virkus, Walter, Konda, Sanjit R., Choo, Andrew, Munz, John W., Boutte, Sterling, Breslin, Mary A., Toledano, James E., Langford, Joshua Robert, Horne, Andrea, O’Toole, Robert V., Boulton, Christina, Manson, Theodore, Nascone, Jason, Pollak, Andrew N., Sciadini, Marcus F., Degani, Yasmin, Howe, Andrea L., Zych, Gregory A., Cannada, Lisa K., Dawson, Sarah A., Jones, Clifford B., Sietsema, Debra L., Miclau, Theodore, Morshed, Saam, Wilken, Jason M., Bergin, Patrick F., Graves, Matt L., Spitler, Clay A., Jones, LaRita C., Ertl, William, Moloney, Gele B., Evans, Andrew R., Weiss, David B., Yarboro, Seth R., Lester-Ballard, Veronica, McVey, Eric D., Firoozabadi, Reza, Agel, Julie, Obremskey, William, Archer, Kristin R., Burgos, Eduardo J., Gajari, Vamshi, Rodriguez-Buitrago, Andres, Tummuru, Rajesh R., Trochez, Karen M., D’Alleyrand, Jean-Claude G., Castillo, Renan C., Allen, Lauren E., and Carlini, Anthony R.

Published
2024
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5. Inter-Rater Reliability of The Modified Radiographic Union Score for Diaphyseal Tibial (mRUST) Fractures with Bone Defects

Author

Mitchell, Stuart L, Obremskey, William T, Luly, Jason, Bosse, Michael J, Frey, Katherine P, Hsu, Joseph R, MacKenzie, Ellen J, Morshed, Saam, OʼToole, Robert V, Scharfstein, Daniel O, and Tornetta, Paul

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Adolescent, Adult, Aged, Bone Nails, Bone Plates, Child, Cohort Studies, Diaphyses, Female, Fracture Fixation, Intramedullary, Fractures, Open, Humans, Male, Middle Aged, Observer Variation, Radiography, Reproducibility of Results, Retrospective Studies, Tibial Fractures, radiographic union, bone defect, mRUST score, inter-rater reliability, tibia fracture, fracture healing, Major Extremity Trauma Rehabilitation Consortium, Orthopedics, Clinical sciences
Abstract

OBJECTIVES:To evaluate inter-rater reliability of the modified Radiographic Union Score for Tibial (mRUST) fractures among patients with open, diaphyseal tibia fractures with a bone defect treated with intramedullary nails (IMNs), plates, or definitive external fixation (ex-fix). DESIGN:Retrospective cohort study. SETTING:Fifteen-level one civilian trauma centers; 2 military treatment facilities. PATIENTS/PARTICIPANTS:Patients ≥18 years old with open, diaphyseal tibia fractures with a bone defect ≥1 cm surgically treated between 2007 and 2012. INTERVENTION:Three of 6 orthopedic traumatologists reviewed and applied mRUST scoring criteria to radiographs from the last clinical visit within 13 months of injury. MAIN OUTCOME MEASUREMENTS:Inter-rater reliability was assessed using Krippendorff's alpha (KA) statistic; intraclass correlation coefficient (ICC) is presented for comparison with previous publications. RESULTS:Two hundred thirteen patients met inclusion criteria including 115 IMNs, 24 plates, 29 ex-fixes, and 45 cases that no longer had instrumentation at evaluation. All reviewers agreed on the pattern of scoreable cortices for 90.4% of IMNs, 88.9% of those without instrumentation, 44.8% of rings, and 20.8% of plates. Thirty-one (15%) cases, primarily plates and ex-fixes, did not contribute to KA and ICC estimates because

Published
2019

6. Access to trauma center care: A statewide system-based approach

Author

Medrano, Nicolas W., Villarreal, Cynthia Lizette, Price, Michelle A., Bixby, Pamela J., Bulger, Eileen M., Eastridge, Brian J., Albrecht, Roxie M., Bailey, Jeffrey A., Benjamin, Elizabeth R., Bernard, Andrew C., Blackwell, Thomas H., Braithwaite, Sabina A., Brasel, Karen J., Brice, Jane H., Burlew, Clay C., Butler, Frank K., Callaway, David W., Cannon, Jeremy W., Champion, Howard R., Chang, Michael, Coimbra, Raul S., Davis, Gregory G., Demarest, Gerald B., Dorlac, Warren C., Drake, Stacy A., Eastman, Alex L., Elster, Eric A., Epley, Eric, Esposito, Thomas J., Ficke, James R., Fisher, Andrew D., Fowler, David R., Gaines, Barbara A., Gallagher, John M., Gary, Joshua L., Gestring, Mark L., Gill, James R., Goodloe, Jeffrey M., Gurney, Jennifer M., Harrell, Andrew J., Henry, Sharon M., Holcomb, John B., Jenkins, Donald H., Johannigman, Jay A., Kerby, Jeffrey D., Kharod, Chetan U., Kotwal, Russ S., Kozar, Rosemary A., Kuhls, Deborah A., Lathrop, Sarah L., Latimer, Andrew J., Levy, Michael, Mabry, Robert L., MacKenzie, Ellen J., Martin, Matthew J., Maxson, R. Todd, Mazuchowski, Edward L., Minei, Joseph P., Mitchell, Roger A., Jr, Moore, Ernest E., Moores, Leon E., Nashelsky, Marcus B., Nathens, Avery B., Nolte, Kurt B., OʼKeefe, Grant E., Phillips, Monica J., Robinson, James L., Sagraves, Scott G., Scalea, Thomas M., Schenarts, Paul J., Schreiber, Martin A., Shackelford, Stacy A., Sperry, Jason L., Stassen, Nicole A., Staudenmayer, Kristan L., Stewart, Ronald M., Stuke, Lance E., Valadka, Alex B., Winchell, Robert J., Zonies, David, and Yelon, Jay A.

Published
2023
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9. Modern External Ring Fixation Versus Internal Fixation for Treatment of Severe Open Tibial Fractures: A Randomized Clinical Trial (FIXIT Study)

Author

Franco, Kathy D., Harriott, Paula J., Boateng, Henry A., Ringenbach, Kathy, Norkey, Merryjessica, Tummuru, Rajesh, O’Toole, Robert V., Reider, Lisa, Gary, Joshua L., Quinnan, Stephen M., Hutson, James J., Jr., Scharfstein, Daniel O., Huang, Yanjie, McKinley, Todd O., Reid, J. Spence, Castillo, Renan C., Bosse, Michael J., MacKenzie, Ellen J., Stinner, Daniel J., Beltran, Michael J., Norton, Michelle M., Hsu, Joseph R., Karunakar, Madhav A., Seymour, Rachel B., Sims, Stephen H., Barrett, Caroline M., Churchill, Christine, Deans, Elizabeth C., Hurst, Kaitlyn, Sietsema, Debra L., Hak, David J., Mauffrey, Cyril, Henderson Trujillo, Corey, Mir, Hassan, Shah, Anjan R., Steverson, Barbara, Schmidt, Andrew H., Yoon, Patrick, Westberg, Jerald R., Gaski, Greg E., Hill, Lauren C., Achor, Timothy S., Brinker, Mark R., Choo, Andrew M., Munz, John W., Prasarn, Mark L., Warner, Stephen J., Galpin, Matthew C., Vallier, Heather A., Sontich, John K., Breslin, Mary Alice, Frisch, H. Michael, Kaufman, Adam M., Large, Thomas M., LeCroy, C. Michael, Langford, Joshua R, Horne, Andrea, Eglseder, W. Andrew, LeBrun, Christopher T., Nascone, Jason W., Pensy, Ray, Sciadini, Marcus F., Slobogean, Gerard, Degani, Yasmin, Amundson, Amanda, O’Hara, Nathan N., Zych, Gregory A., Watson, J. Tracy, Gardner, Michael J., Miclau, Theodore, Morshed, Saam, Kandemir, Utku, Belaye, Tigist, Marsh, J. Lawrence, Fruehling, Catherine, Bergin, Patrick F., Graves, Matt L., Spitler, Clay A., Maroto, Medardo, Kleweno, Conor P., Whiting, Paul S., Doro, Christopher, Goodspeed, David C., Lang, Gerald J., Simske, Natasha M., Siy, Alexander B., Obremskey, William, Burgos, Eduardo J., Jahangir, Alex, Sethi, Manish, Gajari, Vamshi, Teasdall, Robert D., Carroll, Eben A., Halvorson, Jason J., Miller, Anna N., Goodman, James Brett, Holden, Martha B., Gordon, Wade T., Allen, Lauren E., Ballreich, Jeromie M., Carlini, Anthony R., de Lissovoy, Gregory, Kirk, Rachel, Luly, Jason, and Remenapp, Craig M.

Published
2022
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10. The 1-Year Economic Impact of Work Productivity Loss Following Severe Lower Extremity Trauma

Author

Levy, Joseph F., Reider, Lisa, Scharfstein, Daniel O., Pollak, Andrew N., Morshed, Saam, Firoozabadi, Reza, Archer, Kristin R., Gary, Joshua L., O’Toole, Robert V., Castillo, Renan C., Quinnan, Stephen M., Kempton, Laurence B., Jones, Clifford B., Bosse, Michael J., MacKenzie, Ellen J., Altman, Gregory T., McAndrew, Christopher M., Reilly, Rachel M., Mullis, Brian H., Mir, Hassan R., Shah, Anjan R., Reisman, William M., Taylor, Benjamin C., Schmidt, Andrew H., McKinley, Todd O., Sorkin, Anthony, Virkus, Walter W., Gaski, Greg E., Konda, Sanjit R., Vallier, Heather A., Frisch, H. Michael, Sheu, Robert G., Toledano, James E., Cannada, Lisa K., Langford, Joshua, Zych, Gregory A., Hutson, James J., Jr., Osborn, Patrick M., Spitler, Clay A., Miclau, Theodore, Wilken, Jason M., Bergin, Patrick F., Teague, David, Moloney, Gele B., Sathy, Ashoke K., Obremskey, William, Carroll, Eben A., Potter, Benjamin K., Carlini, Anthony R., Keita, Maningbe, and Luly, Jason

Published
2022
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12. Early Advanced Weight-Bearing After Periarticular Fractures: A Randomized Trial Comparing Antigravity Treadmill Therapy Versus Standard of Care

Author

Stinner, Daniel J., Rivera, Jessica C., Smith, Christopher S., Weiss, David B., Hymes, Robert A., Matuszewski, Paul E., Gary, Joshua L., Morshed, Saam, Schmidt, Andrew H., Wilken, Jason M., Archer, Kristin R., Bailey, Lane, Kleihege, Jacquelyn, McLaughlin, Kevin H., Thompson, Richard E., Chung, Suna, Remenapp, Craig, MacKenzie, Ellen J., and Reider, Lisa

Published
2022
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20. Level-I Trauma Center Effects on Return-to-Work Outcomes

Author

Prada, Sergio I., Salkever, David, and MacKenzie, Ellen J.

Abstract

Background: Injury is the leading cause of death for persons aged 1-44 years in the United States. Injuries have a substantial economic cost. For that reason, regional systems of trauma care in which the more acutely injured patients are transported to Level-I (L-I) trauma centers (TCs) has been widely advocated. However, the cost of TC care is high, raising questions about the value of such an approach. Objectives: To study L-I TC effectiveness and study return-to-work (RTW) outcomes. Research Design: Using data from National Study on the Costs and Outcomes of Trauma, the authors address the issue of selection bias by comparing naive estimates to matching techniques, as well as to nonlinear instrumental variable models (2SRI) and bivariate probit estimators. Subjects: Individuals ages 18-64 who were mainly working before traumatic injury. Patients selected for the study were treated at 69 hospitals located in 12 states in the United States. N = 1790. Measures: Treatment is binary indicator on whether treated at L-I TC. Outcome is binary indicator on whether returned to work within 3 months after injury. Covariates include: demographics, pre-injury characteristics (job, health and insurance status), injury descriptors, other income sources, etc. Results: Across all models that control for unobserved factors, the authors find that L-I TC treatment is positively associated with RTW within 3 months after injury. The estimated average marginal effect of treatment on the probability of RTW ranges from 23 to 38 percentage points. Conclusions: Benefits of L-I TC care extend beyond mortality and morbidity. (Contains 6 tables, 2 graphs, and 20 notes.)

Published
2012
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29. Activation and On-Scene Intervals for Severe Trauma EMS Interventions: An Analysis of the NEMSIS Database.

Author

Medrano, Nicolas W., Villarreal, Cynthia Lizette, Mann, N. Clay, Price, Michelle A., Nolte, Kurt B., MacKenzie, Ellen J., Bixby, Pam, and Eastridge, Brian J.

Subjects
EVALUATION of medical care, HEALTH services accessibility, LIFE support systems in critical care, TIME, CRITICALLY ill, RURAL conditions, PATIENTS, MEDICAL care, RETROSPECTIVE studies, TRANSPORTATION of patients, T-test (Statistics), EMERGENCY medical services, DESCRIPTIVE statistics, RESEARCH funding, INFORMATION storage & retrieval systems, DATA analysis software, EMERGENCY medicine
Abstract

Objective: Time to care is a determinant of trauma patient outcomes, and timely delivery of trauma care to severely injured patients is critical in reducing mortality. Numerous studies have analyzed access to care using prehospital intervals from a Carr et al. meta-analysis of studies from 1975 to 2005. Carr et al.'s research sought to determine national mean activation and on-scene intervals for trauma patients using contemporary emergency medical services (EMS) records. Since the Carr et al. meta-analysis was published, the National Highway Traffic Safety Administration (NHTSA) created and refined the National Emergency Medical Services Information System (NEMSIS) database. We sought to perform a modern analysis of prehospital intervals to establish current standards and temporal patterns. Methods: We utilized NEMSIS to analyze EMS data of trauma patients from 2016 to 2019. The dataset comprises more than 94 million EMS records, which we filtered to select for severe trauma and stratified by type of transport and rurality to calculate mean activation and on-scene intervals. Furthermore, we explored the impact of basic life support (BLS) and advanced life support (ALS) of ground units on activation and on-scene time intervals. Results: Mean activation and on-scene intervals for ground transport were statistically different when stratified by rurality. Urban, suburban, and rural ground activation intervals were 2.60 ± 3.94, 2.88 ± 3.89, and 3.33 ± 4.58 minutes, respectively. On-scene intervals were 15.50 ± 10.46, 17.56 ± 11.27, and 18.07 ± 16.13 minutes, respectively. Mean helicopter transport activation time was 13.75 ± 7.44 minutes and on-scene time was 19.42 ± 16.09 minutes. This analysis provides an empirically defined mean for activation and on-scene times for trauma patients based on transport type and rurality. Results from this analysis proved to be significantly longer than the previous analysis, except for helicopter transport on-scene time. Shorter mean intervals were seen in ALS compared to BLS for activation intervals, however ALS on-scene intervals were marginally longer than BLS. Conclusions: With the increasing sophistication of geospatial technologies employed to analyze access to care, these intervals are the most accurate and up-to-date and should be included in access to care models. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Multisite investigation of traumatic brain injuries, posttraumatic stress disorder, and self-reported health and cognitive impairments

Author

Zatzick, Douglas F., Rivara, Frederick P., Jurkovich, Gregory J., Hoge, Charles W., Wang, Jin, Fan, Ming-Yu, Russo, Joan, Trusz, Sarah Geiss, Nathens, Avery, and Mackenzie, Ellen J.

Subjects
Post-traumatic stress disorder -- Risk factors, Post-traumatic stress disorder -- Demographic aspects, Post-traumatic stress disorder -- Research, Cognition disorders -- Risk factors, Cognition disorders -- Demographic aspects, Cognition disorders -- Research, Brain -- Injuries, Brain -- Patient outcomes, Brain -- Research, Health, Psychology and mental health
Published
2010

46. Family burden after traumatic brain injury in children

Author

Aitken, Mary E., McCarthy, Melissa L., Slomine, Beth S., Ding, Ru, Durbin, Dennis R., Jaffe, Kenneth M., Paidas, Charles N., Dorsch, Andrea M., Christensen, James R., and MacKenzie, Ellen J.

Subjects
Quality of life -- Health aspects, Quality of life -- Social aspects, Quality of life -- Research, Brain -- Injuries, Brain -- Demographic aspects, Brain -- Patient outcomes, Brain -- Research, Children -- Injuries, Children -- Social aspects, Children -- Patient outcomes, Children -- Research, Family -- Health aspects, Family -- Research
Published
2009

48. Managing the common problem of missing data in trauma studies

Author

Rue, Tessa, Thompson, Hilaire J., Rivara, Frederick P., Mackenzie, Ellen J., and Jurkovich, Gregory J.

Subjects
Medical research -- Reports, Medicine, Experimental -- Reports, Research bias -- Management, Missing observations (Statistics) -- Management, Wounds and injuries -- Research, Methodology -- Evaluation, Company business management, Health
Published
2008

49. A national evaluation of the effect of trauma-center care on morality

Author

MacKenzie, Ellen J., Rivara, Frederick P., Jurkovich, Gregory J., Nathens, Avery B., Frey, Katherine P., Egleston Brian L., Salkever, David S., and Scharfstein, Daniel

Subjects
Company financing, Trauma centers -- Evaluation, Trauma centers -- Finance, Medical care, Cost of -- Evaluation
Abstract

The difference in mortality between level 1 trauma centers and hospitals without a trauma center in justification of the expense of maintaining in trauma center is examined. The findings show that the risk of death is significantly lower when care is provided in the trauma center than in a non-trauma center and argue for continued efforts at regionalization.

Published
2006

50. Pain, Depression, and Posttraumatic Stress Disorder Following Major Extremity Trauma Among United States Military Serving in Iraq and Afghanistan: Results From the Military Extremity Trauma and Amputation/Limb Salvage Study

Author

Castillo, Renan C., primary, Carlini, Anthony R., additional, Doukas, William C., additional, Hayda, Roman A., additional, Frisch, Harold M., additional, Andersen, Romney C., additional, D'Alleyrand, Jean-Claude, additional, Mazurek, Michael T., additional, Ficke, James R., additional, Keeling, John J., additional, Pasquina, Paul F., additional, Wain, Harold J., additional, and MacKenzie, Ellen J., additional

Published
2021
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