Search

Your search keyword '"Stein, Deborah M"' showing total 1,076 results
Start Over Author "Stein, Deborah M"
1,076 results on '"Stein, Deborah M"'

4. Establishing a core outcome set for blunt cerebrovascular injury: an EAST modified Delphi method consensus study.

Author

Ziesmann, Markus, Byerly, Saskya, Yeh, Daniel Dante, Boltz, Melissa, Gelbard, Rondi, Haut, Elliott R, Smith, Jason W, Stein, Deborah M, Zarzaur, Ben L, Bensard, Denis D, Biffl, Walter L, Boyd, April, Brommeland, Tor, Cothren Burlew, Clay, Fabian, Timothy, Lauerman, Margaret, Leichtle, Stefan, Moore, Ernest E, Timmons, Shelly, Vogt, Kelly, and Nahmias, Jeffry

Subjects
Brain Injuries, Traumatic, Multiple Trauma, Vascular System Injuries, stroke, Clinical Research, Brain Disorders, Stroke, Brain Injuries, Traumatic
Abstract

ObjectivesOur understanding of blunt cerebrovascular injury (BCVI) has changed significantly in recent decades, resulting in a heterogeneous description of diagnosis, treatment, and outcomes in the literature which is not suitable for data pooling. Therefore, we endeavored to develop a core outcome set (COS) to help guide future BCVI research and overcome the challenge of heterogeneous outcomes reporting.MethodsAfter a review of landmark BCVI publications, content experts were invited to participate in a modified Delphi study. For round 1, participants submitted a list of proposed core outcomes. In subsequent rounds, panelists used a 9-point Likert scale to score the proposed outcomes for importance. Core outcomes consensus was defined as >70% of scores receiving 7 to 9 and

Published
2023

5. Main versus segmental hepatic artery angioembolization in patients with traumatic liver injuries: A Western Trauma Association multicenter study

Author

Nguyen, Peter D., Nahmias, Jeffry, Aryan, Negaar, Samuels, Jason M., Cripps, Michael, Carmichael, Heather, McIntyre, Robert, Jr., Urban, Shane, Burlew, Clay Cothren, Velopulos, Catherine, Ballow, Shana, Dirks, Rachel C., Spalding, Marchall Chance, LaRiccia, Aimee, Farrell, Michael S., Stein, Deborah M., Truitt, Michael S., Grossman Verner, Heather M., Mentzer, Caleb J., Mack, T.J., Ball, Chad G., Mukherjee, Kaushik, Mladenov, Georgi, Haase, Daniel J., Abdou, Hossam, Schroeppel, Thomas J., Rodriquez, Jennifer, Bala, Miklosh, Keric, Natasha, Crigger, Morgan, Dhillon, Navpreet K., Ley, Eric J., Egodage, Tanya, Williamson, John, Cardenas, Tatiana C.P., Eugene, Vadine, Patel, Kumash, Costello, Kristen, Bonne, Stephanie, Elgammal, Fatima S., Dorlac, Warren, Pederson, Claire, Werner, Nicole L., Haan, James M., Lightwine, Kelly, Semon, Gregory, Spoor, Kristen, Harmon, Laura A., and Grigorian, Areg

Published
2025
Full Text
View/download PDF

6. The implications of poor nutritional status on outcomes of geriatric trauma patients

Author

Amos, Joseph D., Teichman, Amanda, Whitmill, Melissa L., Burruss, Sigrid K., Dunn, Julie A., Najafi, Kaveh, Godat, Laura N., Enniss, Toby M., Shoultz, Thomas H., Egodage, Tanya, Bongiovanni, Tasce, Hazelton, Joshua P., Colling, Kristin P., Costantini, Todd W., Stein, Deborah M., Schroeppel, Thomas J., Nahmias, Jeffry, El-Qawaqzeh, Khaled, Choron, Rachel L., Comish, Paul B., Leneweaver, Kyle, Palmer, Brandi, Truitt, Michael S., Farrell, Mike, Laufenberg, Lacee J., Lasso-Tay, Erica, Stillman, Zachery, Hass, Daniel T., Grossman, Heather M., Gordon, Darnell, Krause, Cassandra, Thomas, Jonathan, Hosseinpour, Hamidreza, Anand, Tanya, Bhogadi, Sai Krishna, Nelson, Adam, Hejazi, Omar, Castanon, Lourdes, Ghaedi, Arshin, Khurshid, Muhammad Haris, Magnotti, Louis J., and Joseph, Bellal

Published
2024
Full Text
View/download PDF

7. High-grade liver injuries with contrast extravasation managed initially with interventional radiology versus observation: A secondary analysis of a WTA multicenter study

Author

Aryan, Negaar, Grigorian, Areg, Tay-Lasso, Erika, Cripps, Michael, Carmichael, Heather, McIntyre Jr., Robert, Urban, Shane, Velopulos, Catherine, Cothren Burlew, Clay, Ballow, Shana, Dirks, Rachel C., LaRiccia, Aimee, Farrell, Michael S., Stein, Deborah M., Truitt, Michael S., Grossman Verner, Heather M., Mentzer, Caleb J., Mack, T.J., Ball, Chad G., Mukherjee, Kaushik, Mladenov, Georgi, Haase, Daniel J., Abdou, Hossam, Schroeppel, Thomas J., Rodriquez, Jennifer, Bala, Miklosh, Keric, Natasha, Crigger, Morgan, Dhillon, Navpreet K., Ley, Eric J., Egodage, Tanya, Williamson, John, Cardenas, Tatiana CP., Eugene, Vadine, Patel, Kumash, Costello, Kristen, Bonne, Stephanie, Elgammal, Fatima S., Dorlac, Warren, Pederson, Claire, Werner, Nicole L., Haan, James M., Lightwine, Kelly, Semon, Gregory, Spoor, Kristen, Harmon, Laura A., Samuels, Jason M., Spalding, M.C., and Nahmias, Jeffry

Published
2024
Full Text
View/download PDF

9. Contributors

Author

Abelson, Jennifer, primary, Aboutanos, Michel B., additional, Abraham, Peter J., additional, Abualruz, Abdul Rahman, additional, Agarwal, Suresh, additional, Agrawal, Devendra K., additional, Alverdy, John C., additional, Aly, Ahmed, additional, Amato, Stas, additional, Anstadt, Michael J., additional, Asensio, Juan A., additional, Avery, Martin, additional, Bailey, Jeffrey A., additional, Barie, Philip S., additional, Becker, Tyson, additional, Beckerman, Daniel, additional, Bedrick, Edward J., additional, Benson, Jamie, additional, Berne, John D., additional, Berry, Cherisse, additional, Berry, Stepheny, additional, Bhat, Sneha G., additional, Bowie, Jason M., additional, Bowyer, Mark W., additional, Bozeman, Matthew C., additional, Bradley, Matthew, additional, Brakenridge, Scott, additional, Brandes, Steven B., additional, Brenner, Megan, additional, Britt, L.D., additional, Brown, Carlos V., additional, Brown, Ian E., additional, Brown, J. Christian, additional, Brown, Tommy, additional, Buckman, Robert F., additional, Burlew, Clay Cothren, additional, Byers, Patricia M., additional, Caban, Kim M., additional, Cancio, Leopoldo C., additional, Cannon, Jeremy W., additional, Cantlie, Shawn M., additional, Carroll, Eben A., additional, Champion, Howard R., additional, Childs, Ed W., additional, Chiu, William C., additional, Christmas, A. Britton, additional, Cioffi, William G., additional, Cocanour, Christine S., additional, Cohen, Mitchell J., additional, Coimbra, Raul, additional, Cook, Alan, additional, Cornell, David L., additional, Cotton, Bryan A., additional, Couture, Daniel E., additional, Cox, Thomas B., additional, Cristancho, Luis Alfonso Bustamante, additional, Croce, Martin A., additional, Croft, Chasen A., additional, Cubano, Miguel A., additional, Dabestani, Parinaz J., additional, Danton, Gary H., additional, Davis, Christopher S., additional, Davis, Kimberly, additional, de Moya, Marc A., additional, Desai, Urmen, additional, Destiné, Henson, additional, Diebel, Lawrence N., additional, Doucet, Jay J., additional, DuBose, Joseph J., additional, Dubov, Wayne E., additional, Duchesne, Juan C., additional, Durham, Rodney M., additional, Durso, Anthony M., additional, Eastridge, Brian, additional, Efron, David T., additional, Efron, Philip A., additional, Elster, Eric, additional, Esposito, Thomas J., additional, Fakhry, Samir M., additional, Feliciano, David V., additional, Fernandez, Carlos, additional, Fernandez-Moure, Joseph S., additional, Fernández, Luis G., additional, Fiorentino, Michele, additional, Firstenberg, Michael S., additional, Flint, Lewis M., additional, Fredericks, Charles J., additional, Fry, Donald E., additional, Galán, Ricardo, additional, Galante, Joseph M., additional, Galvagno, Samuel M., additional, Garcia, Ana Maria, additional, García, Erwin Rodriguez, additional, García-Núñez, Col Luis Manuel, additional, Gentilello, Larry M., additional, Ghanta, Ravi K., additional, Gigena, Alejandro, additional, Gilani, Ramyar, additional, Glance, Laurent G., additional, Goldman, Matthew, additional, Gonzalez, Ernest A., additional, Gonzalez, Richard P., additional, Grabo, Daniel, additional, Gross, Ronald I., additional, Gummadi, Sriharsha, additional, Guerrero, Whitney M., additional, Gunter, Oliver L., additional, Gurney, Jennifer M., additional, Gutiérrez, Jorge A., additional, Hall, Chad, additional, Hauser, Carl J., additional, Henry, Sharon, additional, Hirshberg, Ashen, additional, Holcomb, John B., additional, Hosmer, David, additional, Hoth, J. Jason, additional, Gomez, Tatiana Hoyos, additional, Hoyt, David B., additional, Humphries, Ashley, additional, Iyengar, Rahul, additional, Jawa, Randeep S., additional, Jessie, Elliot, additional, Johannigman, Jay, additional, Aquino Jose, Victor M., additional, Jurkovich, Gregory J., additional, Kalamchi, Louay, additional, Kapil, Aditi M., additional, Karmy-Jones, Riyad, additional, Kasotakis, George, additional, Kelley, Kathryn C., additional, Keskey, Robert, additional, Kessler, John J., additional, Kim, Dennis Y., additional, Kiraly, Laszlo, additional, Kirton, Orlando C., additional, Kotaru, Tharun R., additional, Kunac, Anastasia, additional, Kwolek, Kinga, additional, Lallemand, Michael S., additional, Ledgerwood, Anna M., additional, Lee, Amanda, additional, Leeper, Christine M., additional, Li, Zhongyu, additional, Libby, Matthew, additional, Lim, Robert B., additional, Liveris, Anna, additional, Livingston, David H., additional, Lobb, Jennifer, additional, Loftus, Tyler J., additional, Lucas, Charles E., additional, Luchette, Fred A., additional, Lundeberg, Megan R., additional, Mackersie, Robert C., additional, Mackey, Kevin E., additional, Magnotti, Louis J., additional, Mah, John W., additional, Maldonado, William Sánchez, additional, Malhotra, Ajai K., additional, Malone, Debra L., additional, Marini, Corrado P., additional, Martin, Matthew J., additional, Marttos, Antonio C., additional, Martyak, Michael T., additional, Mathew, Prakash J., additional, Mattox, Kenneth L., additional, Mayberry, John C., additional, Mazzini, Federico N., additional, McNelis, John, additional, Meallet, Mario A., additional, Meerkov, Meir B.L., additional, Meizoso, Jonathan P., additional, Meredith, J. Wayne, additional, Michetti, Christopher P., additional, Miljkovic, Stephanie S., additional, Miller, Keith R., additional, Miller, Preston R., additional, Minei, Joseph P., additional, Mitchell, Frank L., additional, Moas, Victor M., additional, Mohr, Alicia M., additional, Molnar, Joseph A., additional, Moore, Ernest E., additional, Moore, Frederick A., additional, Moutinho, Manuel, additional, Moysidis, Stavros, additional, Munera, Felipe, additional, Naiditch, Jessica A., additional, Napolitano, Lena M., additional, Narayan, Mayur, additional, Nash, Nicholas A., additional, Nicholson, Kristina J., additional, Nicholson, Susannah, additional, Norwood, Scott H., additional, Nunn, Andrew M., additional, O’Shea, Anne, additional, Osler, Turner M., additional, Pachter, H. Leon, additional, Paladino, Lorenzo, additional, Panthaki, Zubin Jal, additional, Parikh, Manish, additional, Pasquale, Michael D., additional, Patel, Purvi P., additional, Peitzman, Andrew B., additional, Peralta, Ruben, additional, Perez-Alonso, Alejandro J., additional, Pestana, Ivo A., additional, Petrone, Patrizio, additional, Pierre, Edgar J., additional, Pilson, Holly, additional, Polk, Travis, additional, Puyana, Juan Carlos, additional, Quintana, David, additional, Rai, Vikrant, additional, Rajasingh, Charlotte, additional, Ranney, Stephen, additional, Reisbig, Mark D., additional, Reiser, Bibiana Jin, additional, Remick, Kyle N., additional, Rhee, Peter, additional, Rich, Norman M., additional, Richardson, J. David, additional, Richart, Charles M., additional, Rivas, Luis A., additional, Robles, Anamaria J., additional, Rodriguez, Aurelio, additional, Rosengart, Matthew, additional, Rosenthal, Martin D., additional, Rotondo, Michael F., additional, Rowe, Vincent L., additional, Rubano, Jerry A., additional, Rubiano, Andrés M., additional, Ruggero, John M., additional, Rushing, Amy, additional, Salim, Ali, additional, Saillant, Noelle Nugent, additional, Sally, Mitchell B., additional, Salsamendi, Jason, additional, Sanford, Arthur P., additional, Savetamal, Alisa, additional, Scalea, Thomas M., additional, Schecter, William, additional, Schipper, Paul H., additional, Schreiber, Martin A., additional, Schroll, Rebecca W., additional, Schulingkamp, Danielle, additional, Schulman, Carl I., additional, Schulz, John T., additional, Shackelford, Stacy A., additional, Shadis, Ryan, additional, Shapiro, Marc J., additional, Shatz, David V., additional, Shiroff, Adam M., additional, Sicard, Gregorio, additional, Sifri, Ziad C., additional, Sing, Ronald F., additional, Sisley, Amy, additional, Smith, Brian P., additional, Smith, R. Stephen, additional, Singares, Eduardo Smith, additional, Sola, Richard, additional, Spain, David A., additional, Spencer, Audrey L., additional, Stavas, Joseph, additional, Stawicki, Stanislaw P., additional, Stein, Deborah M., additional, Stewart, Nakosi, additional, Stirparo, Joseph J., additional, Strong, Bethany L., additional, Sukumar, Mithran S., additional, Tadlock, Matthew D., additional, Taylor, John R., additional, Thaller, Seth R., additional, Thomas, Bradley W., additional, Thompson, Ashley M., additional, Tieu, Brandon H., additional, Tillou, Areti, additional, Tinkoff, Glen H., additional, Tisherman, Samuel A., additional, Todd, S. Rob, additional, Tominaga, Gail T., additional, Trammell, Amy Phillips, additional, Trunkey, Donald D., additional, Tuggle, David, additional, Upchurch, Gilbert R., additional, Van, Philbert, additional, VanDerHeyden, Nicole, additional, Vanzant, Erin L., additional, Wall, Matthew J., additional, Wenzl, Florian A., additional, Whitlow, Christopher T., additional, Wiegand, Lucas R., additional, Williams, Timothy K., additional, Wilson, Jonathan L., additional, Yeh, D. Dante, additional, Youngblood, Charles F., additional, and Zhang, Wei, additional

Published
2024
Full Text
View/download PDF

11. Effect of Aspirin Versus Low-Molecular-Weight Heparin Thromboprophylaxis on Medication Satisfaction and Out-of-Pocket Costs: A Secondary Analysis of a Randomized Clinical Trial

Author

O’Hara, Nathan N., Frey, Katherine P., Stein, Deborah M., Levy, Joseph F., Slobogean, Gerard P., Castillo, Renan, Firoozabadi, Reza, Karunakar, Madhav A., Gary, Joshua L., Obremskey, William T., Seymour, Rachel B., Cuschieri, Joseph, Mullins, C. Daniel, and O’Toole, Robert V.

Published
2024
Full Text
View/download PDF

12. A core outcome set for damage control laparotomy via modified Delphi method

Author

Byerly, Saskya, Nahmias, Jeffry, Stein, Deborah M, Haut, Elliott R, Smith, Jason W, Gelbard, Rondi, Ziesmann, Markus, Boltz, Melissa, Zarzaur, Ben L, Bala, Miklosh, Bernard, Andrew, Brakenridge, Scott, Brohi, Karim, Collier, Bryan, Burlew, Clay Cothren, Cripps, Michael, Crookes, Bruce, Diaz, Jose J, Duchesne, Juan, Harvin, John A, Inaba, Kenji, Ivatury, Rao, Kasten, Kevin, Kerby, Jeffrey D, Lauerman, Margaret, Loftus, Tyler, Miller, Preston R, Scalea, Thomas, and Yeh, D Dante

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Infectious Diseases, Oral and gastrointestinal, Good Health and Well Being, abdominal injuries, laparotomy, patient outcome assessment
Abstract

ObjectivesDamage control laparotomy (DCL) remains an important tool in the trauma surgeon's armamentarium. Inconsistency in reporting standards have hindered careful scrutiny of DCL outcomes. We sought to develop a core outcome set (COS) for DCL clinical studies to facilitate future pooling of data via meta-analysis and Bayesian statistics while minimizing reporting bias.MethodsA modified Delphi study was performed using DCL content experts identified through Eastern Association for the Surgery of Trauma (EAST) 'landmark' DCL papers and EAST ad hoc COS task force consensus.ResultsOf 28 content experts identified, 20 (71%) participated in round 1, 20/20 (100%) in round 2, and 19/20 (95%) in round 3. Round 1 identified 36 potential COS. Round 2 achieved consensus on 10 core outcomes: mortality, 30-day mortality, fascial closure, days to fascial closure, abdominal complications, major complications requiring reoperation or unplanned re-exploration following closure, gastrointestinal anastomotic leak, secondary intra-abdominal sepsis (including anastomotic leak), enterocutaneous fistula, and 12-month functional outcome. Despite feedback provided between rounds, round 3 achieved no further consensus.ConclusionsThrough an electronic survey-based consensus method, content experts agreed on a core outcome set for damage control laparotomy, which is recommended for future trials in DCL clinical research. Further work is necessary to delineate specific tools and methods for measuring specific outcomes.Level of evidenceV, criteria.

Published
2022

13. The Impact of Obesity on Renal Trauma Outcome: An Analysis of the National Trauma Data Bank from 2013 to 2016

Author

Hakam, Nizar, Nabavizadeh, Behnam, Sadighian, Michael J, Holler, Jordan, Shibley, Patrick, Li, Kevin D, Low, Patrick, Amend, Gregory, Stein, Deborah M, and Breyer, Benjamin N

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Bioengineering, Prevention, Nutrition, Kidney Disease, Clinical Research, Physical Injury - Accidents and Adverse Effects, Obesity, Assistive Technology, Cardiovascular, Renal and urogenital, Good Health and Well Being, Adult, Body Mass Index, Humans, Injury Severity Score, Kidney, Length of Stay, Retrospective Studies, Surgery, Clinical sciences
Abstract

BackgroundThe obesity paradox has been recently demonstrated in trauma patients, where improved survival was associated with overweight and obese patients compared to patients with normal weight, despite increased morbidity. Little is known whether this effect is mediated by lower injury severity. We aim to explore the association between body mass index (BMI) and renal trauma injury grade, morbidity, and in-hospital mortality.MethodsA retrospective cohort of adults with renal trauma was conducted using 2013-2016 National Trauma Data Bank. Multiple regression analyses were used to assess outcomes of interest across BMI categories with normal weight as reference, while adjusting for relevant covariates including kidney injury grade.ResultsWe analyzed 15181 renal injuries. Increasing BMI above normal progressively decreased the risk of high-grade renal trauma (HGRT). Subgroup analysis showed that this relationship was maintained in blunt injury, but there was no association in penetrating injury. Overweight (OR 1.02, CI 0.83-1.25, p = 0.841), class I (OR 0.92, CI 0.71-1.19, p = 0.524), and class II (OR 1.38, CI 0.99-1.91, p = 0.053) obesity were not protective against mortality, whereas class III obesity (OR 1.46, CI 1.03-2.06, p = 0.034) increased mortality odds. Increasing BMI by category was associated with a stepwise increase in odds of acute kidney injury, cardiovascular events, total hospital length of stay (LOS), intensive care unit LOS, and ventilator days.ConclusionsIncreasing BMI was associated with decreased risk of HGRT in blunt trauma. Overweight and obesity were associated with increased morbidity but not with a protective effect on mortality. The obesity paradox does not exist in kidney trauma when injury grade is accounted for.

Published
2021

16. Biliary Tract

Author

Knight, Ariel W., Wang, Chia-Ching, Stein, Deborah M., Coccolini, Federico, Series Editor, Coimbra, Raul, Series Editor, Kirkpatrick, Andrew W., Series Editor, Di Saverio, Salomone, Series Editor, Ansaloni, Luca, Editorial Board Member, Balogh, Zsolt, Editorial Board Member, Biffl, Walt, Editorial Board Member, Catena, Fausto, Editorial Board Member, Davis, Kimberly, Editorial Board Member, Ferrada, Paula, Editorial Board Member, Fraga, Gustavo, Editorial Board Member, Ivatury, Rao, Editorial Board Member, Kluger, Yoram, Editorial Board Member, Leppaniemi, Ari, Editorial Board Member, Maier, Ron, Editorial Board Member, Moore, Ernest E., Editorial Board Member, Napolitano, Lena, Editorial Board Member, Peitzman, Andrew, Editorial Board Member, Reilly, Patrick, Editorial Board Member, Rizoli, Sandro, Editorial Board Member, Sakakushev, Boris E., Editorial Board Member, Sartelli, Massimo, Editorial Board Member, Scalea, Thomas, Editorial Board Member, Spain, David, Editorial Board Member, Stahel, Philip, Editorial Board Member, Sugrue, Michael, Editorial Board Member, Velmahos, George, Editorial Board Member, Weber, Dieter, Editorial Board Member, Tarasconi, Antonio, editor, Bui, Simona, editor, Chirica, Mircea, editor, Roth, Gaël, editor, and Nahmias, Jeffry, editor

Published
2023
Full Text
View/download PDF

17. Risk-stratified thromboprophylaxis effects of aspirin versus low-molecular-weight heparin in orthopedic trauma patients: A secondary analysis of the PREVENT CLOT trial

Author

OʼHara, Nathan N., OʼToole, Robert V., Frey, Katherine P., Castillo, Renan C., Cuschieri, Joseph, Haut, Elliott R., Slobogean, Gerard P., Firoozabadi, Reza, Christmas, A. Britton, Obremskey, William T., Carlini, Anthony R., Gaski, Greg E., Kutcher, Matthew E., Marvel, Debra, Stein, Deborah M., Levy, Joseph F., Wegener, Stephen T., Fowler, Brianna E., Taylor, Tara J., Weston-Farber, Elias, Herndon, Steven Craig, Jr., DeCoster, Thomas A., Jurkovich, Gregory J., Lee, Christopher, Malhotra, Ajai K., Riedel, Matthew D., Wells, Jeffrey L., Altman, Daniel T., Westrick, Edward R., Bosse, Michael J., Karunakar, Madhav A., Cunningham, Kyle W., Huynh, Toan, Jacobs, David G., Kempton, Laurence B., Phelps, Kevin D., Seymour, Rachel B., Sims, Stephen H., Churchill, Christine, Carroll, Eben A., Babcock, Sharon, Miller, Preston R., Pilson, Holly T., Goodman, James Brett, Weaver, Michael J., Esposito, John G., Goldhaber, Samuel Zachary, Heng, Marilyn, McGovern, Madeline M., Velmahos, George C., von Keudell, Arvind G., Rivera, Jessica C., Gitajn, Ida Leah, Schneider, Prism S., Buckley, Richard E., Johal, Herman S., Gallant, Jodi L., McKay, Paula, Kleweno, Conor P., Agel, Julie, Arif, Hikmatullah, McKinley, Todd O., Natoli, Roman M., Heincelman, Carrie L., Jang, Yohan, Lopas, Luke A., Mullis, Brian H., Richard, Raveesh D., Virkus, Walter, Hill, Lauren C., Hymes, Robert A., Holzman, Michael, Malekzadeh, A. Stephen, Panjshiri, Farhanaz, Schulman, Jeff E., Ramsey, Lolita, Ahn, James, Cuff, Jaslynn A. N., Gary, Joshua L., Warner, Stephen J., Cotton, Bryan A., Vallier, Heather A., Claridge, Jeffrey A., Breslin, Mary A., Cowley, R Adams, Connelly, Daniel, Eglseder, W. Andrew, Haac, Bryce E., Healey, Kathleen Marie, LeBrun, Christopher T., Manson, Theodore, McKibben, Natasha S., Mulliken, Alexandra, Nascone, Jason, Pensy, Raymond A., Pollak, Andrew N., Sciadini, Marcus F., Udogwu, Ugochukwu N., Zingas, Nicolas, Burke, Cynthia Elaine, DeLeon, Genaro A., Hannan, Zachary D., Howe, Andrea L., Marinos, Dimitrius P., McKegg, Phillip C., Evans, Andrew R., Askam, Brad M., Joseph, Bellal, Lowe, Jason, Weinlein, John C., Bergin, Patrick F., Bhanat, Eldrin L., Khanna, Rajinder, Morellato, John, Nehete, Priyanka V., Domes, Christopher, Whiting, Paul S., Goodspeed, David C., Kuhn, Gabrielle R., Guillamondegui, Oscar D., Moreno-Diaz, Andres Fidel, Stinner, Daniel J., Pritchett, Charles, Jr., and Trochez, Karen M.

Published
2024
Full Text
View/download PDF

19. Acute respiratory distress syndrome, acute kidney injury, and mortality after trauma are associated with increased circulation of syndecan-1, soluble thrombomodulin, and receptor for advanced glycation end products

Author

Dixon, Alexandra, Kenny, James E., Buzzard, Lydia, Holcomb, John, Bulger, Eileen, Wade, Charles, Fabian, Timothy, Schreiber, Martin, Holcomb, John B., Wade, Charles E., del Junco, Deborah J., Fox, Erin E., Matijevic, Nena, Podbielski, Jeanette M., Beeler, Angela M., Tilley, Barbara C., Baraniuk, Sarah, DeSantis, Stacia M., Zhu, Hongjian, Nixon, Joshua, Seay, Roann, Appana, Savitri N., Yang, Hui, Gonzalez, Michael O., Baer, Lisa, Wang, Yao-Wei Willa, Hula, Brittany S., Espino, Elena, Nguyen, An, Pawelczyk, Nicholas, Arora-Nutall, Kisha D., Sharma, Rishika, Cardenas, Jessica C., Rahbar, Elaheh, Burnett, Tyrone, Jr, Clark, David, van Belle, Gerald, May, Susanne, Leroux, Brian, Hoyt, David, Powell, Judy, Sheehan, Kellie, Hubbard, Alan, Arkin, Adam P., Hess, John R., Callum, Jeannie L., Pittet, Jean-Francois, Miller, Christopher N., Cotton, Bryan A., Vincent, Laura, Welch, Timothy, Poole, Tiffany, Pivalizza, Evan G., Gumbert, Sam D., Bai, Yu, McCarthy, James J., Noland, Amy, Hobbs, Rhonda, Bulger, Eileen M., Klotz, Patricia, Cattin, Lindsay, Warner, Keir J., Wilson, Angela, Boman, David, White, Nathan, Grabinsky, Andreas, Daniel-Johnson, Jennifer A., Cohen, Mitchell Jay, Callcut, Rachael A., Nelson, Mary, Redick, Brittney, Conroy, Amanda, Steurer, Marc P., Maxim, Preston C., Fiebig, Eberhard, Moore, Joanne, Mallari, Eireen, Muskat, Peter, Johannigman, Jay A., Robinson, Bryce R. H., Branson, Richard D., Gomaa, Dina, Barczak, Christopher, Bennett, Suzanne, Carey, Patricia M., Hancock, Helen, Rodriguez, Carolina, Inaba, Kenji, Zhu, Jay G., Wong, Monica D., Menchine, Michael, Katzberg, Kelly, Henderson, Sean O., McKeever, Rodney, Shulman, Ira A., Nelson, Janice M., Tuma, Christopher W., Matsushita, Cheryl Y., Scalea, Thomas M., Stein, Deborah M., Shaffer, Cynthia K., Wade, Christine, Herrera, Anthony V., Kallam, Seeta, Wade, Sarah E., Galvagno, Samuel M., Jr, Fontaine, Magali J., Hunt, Janice M., Cooke, Rhonda K., Fabian, Timothy C., Weinberg, Jordan A., Croce, Martin A., Wilson, Suzanne, Panzer-Baggett, Stephanie, Waddle-Smith, Lynda, Flax, Sherri, Brasel, Karen J., Walsh, Pamela, Milia, David, Nelson, Allia, Kaslow, Olga, Aufderheide, Tom P., Gottschall, Jerome L., Carpenter, Erica, OʼKeeffe, Terence, Rokowski, Laurel L., Denninghoff, Kurt R., Redford, Daniel T., Novak, Deborah J., Knoll, Susan, Kerby, Jeffrey D., Bosarge, Patrick L., Pierce, Albert T., Williams, Carolyn R., Stephens, Shannon W., Wang, Henry E., Marques, Marisa B., Schreiber, Martin A., Watters, Jennifer M., Underwood, Samantha J., Groat, Tahnee, Newgard, Craig, Merkel, Matthias, Scanlan, Richard M., Miller, Beth, Rizoli, Sandro, Tien, Homer, Nascimento, Barto, Trpcic, Sandy, Sobrian-Couroux, Skeeta, Reis, Marciano, Pérez, Adic, Belo, Susan E., Merkley, Lisa, and Colavecchia, Connie

Published
2024
Full Text
View/download PDF

22. The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic-An interrupted time-series analysis.

Author

Matthay, Zachary A, Kornblith, Aaron E, Matthay, Ellicott C, Sedaghati, Mahsa, Peterson, Sue, Boeck, Marissa, Bongiovanni, Tasce, Campbell, Andre, Chalwell, Lauren, Colwell, Christopher, Farrell, Michael S, Kim, Woon Cho, Knudson, M Margaret, Mackersie, Robert, Li, Lilian, Nunez-Garcia, Brenda, Langness, Simone, Plevin, Rebecca E, Sammann, Amanda, Tesoriero, Ronald, Stein, Deborah M, and Kornblith, Lucy Z

Subjects
Humans, Wounds and Injuries, Retrospective Studies, Adult, Child, Trauma Centers, San Francisco, Female, Male, Disease Transmission, Infectious, Interrupted Time Series Analysis, Physical Abuse, Correlation of Data, COVID-19, SARS-CoV-2, Physical Distancing, Trauma, epidemiology, violence, Biodefense, Prevention, Injury (total) Accidents/Adverse Effects, Pediatric, Emerging Infectious Diseases, Violence Research, Behavioral and Social Science, Vaccine Related, Injury - Childhood Injuries, Injuries and accidents, Emergency & Critical Care Medicine, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Nursing
Abstract

BackgroundThe large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses.MethodsA single-center interrupted time-series analysis was performed to identify associations of shelter-in-place with trauma volume, injury mechanisms, and patient demographics in San Francisco, California. To control for short-term trends in trauma epidemiology, weekly level data were analyzed 6 months before shelter-in-place. To control for long-term trends, monthly level data were analyzed 5 years before shelter-in-place.ResultsTrauma volume decreased by 50% in the week following shelter-in-place (p < 0.01), followed by a linear increase each successive week (p < 0.01). Despite this, trauma volume for each month (March-June 2020) remained lower compared with corresponding months for all previous 5 years (2015-2019). Pediatric trauma volume showed similar trends with initial decreases (p = 0.02) followed by steady increases (p = 0.05). Reductions in trauma volumes were due entirely to changes in nonviolent injury mechanisms, while violence-related injury mechanisms remained unchanged (p < 0.01).ConclusionAlthough the shelter-in-place order was associated with an overall decline in trauma volume, violence-related injuries persisted. Delineating and addressing underlying factors driving persistent violence-related injuries during shelter-in-place orders should be a focus of public health efforts in preparation for future pandemic responses.Level of evidenceEpidemiological study, level III.

Published
2021

23. PREVENTion of CLots in Orthopaedic Trauma (PREVENT CLOT): a randomised pragmatic trial protocol comparing aspirin versus low-molecular-weight heparin for blood clot prevention in orthopaedic trauma patients.

Author

O'Toole, Robert V, Stein, Deborah M, Frey, Katherine P, O'Hara, Nathan N, Scharfstein, Daniel O, Slobogean, Gerard P, Taylor, Tara J, Haac, Bryce E, Carlini, Anthony R, Manson, Theodore T, Sudini, Kuladeep, Mullins, C Daniel, Wegener, Stephen T, Firoozabadi, Reza, Haut, Elliott R, Bosse, Michael J, Seymour, Rachel B, Holden, Martha B, Gitajn, Ida Leah, Goldhaber, Samuel Z, Eastman, Alexander L, Jurkovich, Gregory J, Vallier, Heather A, Gary, Joshua L, Kleweno, Conor P, Cuschieri, Joseph, Marvel, Debra, Castillo, Renan C, and METRC

Subjects
METRC, orthopaedic & trauma surgery, thromboembolism, trauma management, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences
Abstract

IntroductionPatients who sustain orthopaedic trauma are at an increased risk of venous thromboembolism (VTE), including fatal pulmonary embolism (PE). Current guidelines recommend low-molecular-weight heparin (LMWH) for VTE prophylaxis in orthopaedic trauma patients. However, emerging literature in total joint arthroplasty patients suggests the potential clinical benefits of VTE prophylaxis with aspirin. The primary aim of this trial is to compare aspirin with LMWH as a thromboprophylaxis in fracture patients.Methods and analysisPREVENT CLOT is a multicentre, randomised, pragmatic trial that aims to enrol 12 200 adult patients admitted to 1 of 21 participating centres with an operative extremity fracture, or any pelvis or acetabular fracture. The primary outcome is all-cause mortality. We will evaluate non-inferiority by testing whether the intention-to-treat difference in the probability of dying within 90 days of randomisation between aspirin and LMWH is less than our non-inferiority margin of 0.75%. Secondary efficacy outcomes include cause-specific mortality, non-fatal PE and deep vein thrombosis. Safety outcomes include bleeding complications, wound complications and deep surgical site infections.Ethics and disseminationThe PREVENT CLOT trial has been approved by the ethics board at the coordinating centre (Johns Hopkins Bloomberg School of Public Health) and all participating sites. Recruitment began in April 2017 and will continue through 2021. As both study medications are currently in clinical use for VTE prophylaxis for orthopaedic trauma patients, the findings of this trial can be easily adopted into clinical practice. The results of this large, patient-centred pragmatic trial will help guide treatment choices to prevent VTE in fracture patients.Trial registration numberNCT02984384.

Published
2021

24. Describing the density of high-level trauma centers in the 15 largest US cities

Author

Stey, Anne M, Byskosh, Alexandria, Etkin, Caryn, Mackersie, Robert, Stein, Deborah M, Bilimoria, Karl Y, and Crandall, Marie L

Subjects
Public Health, Health Sciences, Human Society, Violence Research, Physical Injury - Accidents and Adverse Effects, systems analysis, violence
Abstract

BackgroundThere has been a proliferation of urban high-level trauma centers. The aim of this study was to describe the density of high-level adult trauma centers in the 15 largest cities in the USA and determine whether density was correlated with urban social determinants of health and violence rates.MethodsThe largest 15 US cities by population were identified. The American College of Surgeons' (ACS) and states' department of health websites were cross-referenced for designated high-level (levels 1 and 2) trauma centers in each city. Trauma centers and associated 20 min drive radius were mapped. High-level trauma centers per square mile and per population were calculated. The distance between high-level trauma centers was calculated. Publicly reported social determinants of health and violence data were tested for correlation with trauma center density.ResultsAmong the 15 largest cities, 14 cities had multiple high-level adult trauma centers. There was a median of one high-level trauma center per every 150 square kilometers with a range of one center per every 39 square kilometers in Philadelphia to one center per596 square kilometers in San Antonio. There was a median of one high-level trauma center per 285 034 people with a range of one center per 175 058 people in Columbus to one center per 870 044 people in San Francisco. The median minimum distance between high-level trauma centers in the 14 cities with multiple centers was 8 kilometers and ranged from 1 kilometer in Houston to 43 kilometers in San Antonio. Social determinants of health, specifically poverty rate and unemployment rate, were highly correlated with violence rates. However, there was no correlation between trauma center density and social determinants of health or violence rates.DiscussionHigh-level trauma centers density is not correlated with social determinants of health or violence rates.Level of evidenceVI.Study typeEconomic/decision.

Published
2020

25. Patient-centered outcomes research and the injured patient: a summary of application

Author

Godat, Laura N, Jensen, Aaron R, Stein, Deborah M, Arbabi, Saman, Bulger, Eileen, Cohen, Mitchell J, Costantini, Todd W, Crandall, Marie M, Dicker, Rochelle A, Haut, Elliott R, Joseph, Bellal, Kozar, Rosemary A, Malhotra, Ajai K, Nathens, Avery B, Nirula, Raminder, Price, Michelle A, Smith, Jason W, and Zarzaur, Ben L

Subjects
Health Services and Systems, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Patient Safety, Physical Injury - Accidents and Adverse Effects, Clinical Research, Health Services, 8.1 Organisation and delivery of services, Health and social care services research, Good Health and Well Being, Coalition for National Trauma Research Scientific Advisory Council
Abstract

As trauma surgeons, we focus on the immediate care and needs of the injured patient every day. Historically, trauma and injury research has focused on outcomes such as mortality, complications, and length of stay; and process metrics such as time to CT scan, resuscitation checklist frequencies, or venous thromboembolism prophylaxis rates. These outcomes are perceived by healthcare providers to be important, but patients likely have different perceptions of what outcomes are most important to measure and improve. True patient-centered outcomes research involves the healthcare providers, and the entire team of stakeholders including patients and the community. Understanding the process of stakeholder engagement and the barriers trauma researchers must overcome to effectively enter this field of research is important. This summary aims to inform the trauma research community on the basics of patient-centered outcomes research, priorities for funding from the Patient-Centered Outcomes Research Institute, resources for collaboration around patient-centered outcomes research, and a unique career development and training opportunity for early career trauma surgeons to develop a skill set in patient-centered outcomes research.

Published
2020

26. Building the future for national trauma research

Author

Price, Michelle A, Kozar, Rosemary A, Bulger, Eileen M, Jurkovich, Gregory J, Arbabi, Saman, Bulger, Eileen, Cohen, Mitchell J, Costantini, Todd W, Crandall, Marie M, Dicker, Rochelle A, Haut, Elliott R, Joseph, Bellal, Malhotra, Ajai K, Nathens, Avery B, Nirula, Raminder, Smith, Jason W, Stein, Deborah M, and Zarzaur, Ben L

Subjects
Commerce, Management, Tourism and Services, Marketing, Physical Injury - Accidents and Adverse Effects, Coalition for National Trauma Research Scientific Advisory Council
Abstract

This paper describes the current funding, infrastructure growth and future state of trauma research. It also introduces a group of review articles generated from The Future of Trauma Research: Innovations in Research Methodology conference hosted by the American College of Surgeons Committee on Trauma in July 2019.

Published
2020

31. Biliary Tract

Author

Knight, Ariel W., primary, Wang, Chia-Ching, additional, and Stein, Deborah M., additional

Published
2023
Full Text
View/download PDF

32. Restarting and timing of oral anticoagulation after traumatic intracranial hemorrhage: a review and summary of ongoing and planned prospective randomized clinical trials.

Author

King, Ben, Milling, Truman, Gajewski, Byron, Costantini, Todd W, Wick, Jo, Price, Michelle A, Mudaranthakam, Dinesh, Stein, Deborah M, Connolly, Stuart, Valadka, Alex, and Warach, Steven

Subjects
anticoagulants, brain injuries, hemorrhage, thromboembolism, traumatic, Hematology, Clinical Research, Patient Safety, Clinical Trials and Supportive Activities, 6.1 Pharmaceuticals, Cardiovascular
Abstract

Anticoagulant-associated traumatic intracranial hemorrhage (tICrH) is a devastating injury with high morbidity and mortality. For survivors, treating clinicians face the dilemma of restarting oral anticoagulation with scarce evidence to guide them. Thromboembolic risk is high from the bleeding event, patients' high baseline risks, that is, the pre-existing indication for anticoagulation, and the risk of immobility after the bleeding episode. This must be balanced with potentially devastating hematoma expansion or new hemorrhagic lesions. Retrospective evidence and expert opinion support restarting oral anticoagulants in most patients with tICrH, but timing is uncertain. Researchers have failed to make clear distinctions between tICrH and spontaneous intracranial hemorrhage (sICrH), which have differing natural histories. While both appear to benefit from restarting, sICrH has a higher rebleeding risk and similar or lower thrombotic risk. Clinical equipoise on restarting is also divergent. In sICrH, equipoise is centered on whether to restart. In tICrH, it is centered on when. Several prospective randomized clinical trials are ongoing or about to start to examine the risk-benefit of restarting. Most of them are restricted to patients with sICrH, with antiplatelet control groups. Most are also restricted to direct oral anticoagulants (DOACs), as they are associated with a lower overall risk of ICrH. There is some overlap with tICrH via subdural hematoma, and one trial is specific to restart timing with DOACs in only traumatic cases. This is a narrative review of the current evidence for restarting anticoagulation and restart timing after tICrH along with a summary of the ongoing and planned clinical trials.

Published
2020

34. 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
Full Text
View/download PDF

37. Observation-first versus angioembolization-first approach in stable patients with blunt liver trauma: A WTA multicenter study.

Author

Nguyen, Peter D., Nahmias, Jeffry, Aryan, Negaar, Samuels, Jason M., Cripps, Michael, Carmichael, Heather, McIntyre Jr, Robert, Urban, Shane, Cothren Burlew, Clay, Velopulos, Catherine, Ballow, Shana, Dirks, Rachel C., Spalding, M. C., LaRiccia, Aimee, Farrell, Michael S., Stein, Deborah M., Truitt, Michael S., Grossman Verner, Heather M., Mentzer, Caleb J., and Mack, T. J.

Published
2024
Full Text
View/download PDF

40. An observation-first strategy for liver injuries with “blush” on computed tomography is safe and effective

Author

Samuels, Jason M., Carmichael, Heather, McIntyre, Robert, Jr, Urban, Shane, Ballow, Shana, Dirks, Rachel C., Spalding, M.C., LaRiccia, Aimee, Farrell, Michael S., Stein, Deborah M., Truitt, Michael S., Grossman Verner, Heather M., Mentzer, Caleb J., Mack, T.J., Ball, Chad G., Mukherjee, Kaushik, Mladenov, Georgi, Haase, Daniel J., Abdou, Hossam, Schroeppel, Thomas J., Rodriquez, Jennifer, Nahmias, Jeffry, Tay, Erika, Bala, Miklosh, Keric, Natasha, Crigger, Morgan, Dhillon, Navpreet K., Ley, Eric J., Egodage, Tanya, Williamson, John, Cardenas, Tatiana CP., Eugene, Vadine, Patel, Kumash, Costello, Kristen, Bonne, Stephanie, Elgammal, Fatima S., Dorlac, Warren, Pederson, Claire, Burlew, Clay Cothren, Werner, Nicole L., Haan, James M., Lightwine, Kelly, Semon, Gregory, Spoor, Kristen, Velopulos, Catherine, and Harmon, Laura A.

Published
2023
Full Text
View/download PDF

43. Developing a National Trauma Research Action Plan (NTRAP): Results from the Neurotrauma Research Panel Delphi Survey

Author

Stein, Deborah M., Braverman, Maxwell A., Phuong, Jimmy, Shipper, Edward, Price, Michelle A., Bixby, Pamela J., Adelson, P. David, Ansel, Beth M., Cifu, David X., DeVine, John G., Galvagno, Samuel M., Gelb, Daniel E., Harris, Odette, Kang, Christopher S., Kitagawa, Ryan S., McQuillan, Karen A., Patel, Mayur B., Robertson, Claudia S., Salim, Ali, Shutter, Lori, Valadka, Alex B., Bulger, Eileen M., Adelson, P. David, Ansel, Beth M., Chesnut, Randall M., Cifu, David X., DeVine, John G., Galvagno, Samuel M., Gelb, Daniel E., Giacino, Joseph T., Harris, Odette, Hawryluk, Gregory, Kang, Christopher S., Kitagawa, Ryan S., Manley, Geoffrey T., McQuillan, Karen A., Merck, Lisa H., Okonkwo, David O., Patel, Mayur B., Robertson, Claudia S., Salim, Ali, Shackelford, Col. Stacy A., Sheth, Kevin N., Shutter, Lori, Stein, Deborah M., Valadka, Alex B., Wade, Charles E., and Whyte, John

Published
2022
Full Text
View/download PDF

44. Routine repeat head CT may not be necessary for patients with mild TBI.

Author

Rosen, Claire B, Luy, Diego D, Deane, Molly R, Scalea, Thomas M, and Stein, Deborah M

Subjects
ct, mild traumatic brain injury, routine
Abstract

Background:Routine repeat cranial CT (RHCT) is standard of care for CT-verified traumatic brain injury (TBI). Despite mixed evidence, those with mild TBI are subject to radiation and expense from serial CT scans. Thus, we investigated the necessity and utility of RHCT for patients with mild TBI. We hypothesized that repeat head CT in these patients would not alter patient care or outcomes. Methods:We retrospectively studied patients suffering from mild TBI (Glasgow Coma Scale (GCS) score 13-15) and treated at the R Adams Cowley Shock Trauma Center from November 2014 through January 2015. The primary outcome was the need for surgical intervention. Outcomes were compared using paired Student's t-test, and stratified by injury on initial CT, GCS change, demographics, and presenting vital signs (mean ± SD). Results:Eighty-five patients met inclusion criteria with an average initial GCS score=14.6±0.57. Our center sees about 2800 patients with TBI per year, or about 230 per month. This includes patients with concussions. This sample represents about 30% of patients with TBI seen during the study period. Ten patients required operation (four based on initial CT and others for worsening GCS, headaches, large unresolving injury). There was progression of injury on repeat CT scan in only two patients that required operation, and this accompanied clinical deterioration. The mean brain Abbreviated Injury Scale (AIS) score was 4.8±0.3 for surgical patients on initial CT scan compared with 3.4±0.6 (P

Published
2018

45. Onset of Coagulation Function Recovery Is Delayed in Severely Injured Trauma Patients with Venous Thromboembolism

Author

McCully, Belinda H, Connelly, Christopher R, Fair, Kelly A, Holcomb, John B, Fox, Erin E, Wade, Charles E, Bulger, Eileen M, Schreiber, Martin A, Group, PROPPR Study, del Junco, Deborah J, Matijevic, Nena, Podbielski, Jeanette, Beeler, Angela M, Tilley, Barbara C, Baraniuk, Sarah, Nixon, Joshua, Seay, Roann, Appana, Savitri N, Yang, Hui, Gonzalez, Michael O, Baer, Lisa, Wang, Yao-Wei Willa, Hula, Brittany S, Espino, Elena, Nguyen, An, Pawelczyk, Nicholas, Arora-Nutall, Kisha D, Sharma, Rishika, Cardenas, Jessica C, Rahbar, Elaheh, Burnett, Tyrone, Clark, David, van Belle, Gerald, May, Susanne, Leroux, Brian, Hoyt, David, Powell, Judy, Sheehan, Kellie, Hubbard, Alan, Arkin, Adam P, Hess, John R, Callum, Jeanne, Cotton, Bryan A, Vincent, Laura, Welch, Timothy, Poole, Tiffany, Pivalizza, Evan G, Gumbert, Sam D, Bai, Yu, McCarthy, James J, Noland, Amy, Hobbs, Rhonda, Klotz, Patricia, Cattin, Lindsay, Warner, Keir J, Wilson, Angela, Boman, David, White, Nathan, Grabinsky, Andreas, Daniel-Johnson, Jennifer A, Cohen, Mitchell Jay, Callcut, Rachael A, Nelson, Mary, Redick, Brittney, Conroy, Amanda, Steurer, Marc P, Maxim, Preston C, Fiebig, Eberhard, Moore, Joanne, Mallari, Eireen, Muskat, Peter, Johannigman, Jay A, Robinson, Bryce RH, Branson, Richard D, Gomaa, Dina, Barczak, Christopher, Bennett, Suzanne, Carey, Patricia M, Miller, Christopher N, Hancock, Helen, Rodriguez, Carolina, Inaba, Kenji, Zhu, Jay G, Wong, Monica D, Menchine, Michael, Katzberg, Kelly, Henderson, Sean O, McKeever, Rodney, Shulman, Ira A, Nelson, Janice M, Tuma, Christopher W, Matsushita, Cheryl Y, Scalea, Thomas M, Stein, Deborah M, Shaffer, Cynthia K, and Wade, Christine

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Physical Injury - Accidents and Adverse Effects, Hematology, Clinical Research, Cardiovascular, Adult, Anticoagulants, Blood Coagulation Disorders, Blood Coagulation Tests, Female, Humans, Injury Severity Score, Male, Middle Aged, Recovery of Function, Thrombelastography, Trauma Centers, Venous Thromboembolism, Wounds and Injuries, PROPPR Study Group, Surgery, Clinical sciences
Abstract

BackgroundAltered coagulation function after trauma can contribute to development of venous thromboembolism (VTE). Severe trauma impairs coagulation function, but the trajectory for recovery is not known. We hypothesized that enhanced, early recovery of coagulation function increases VTE risk in severely injured trauma patients.Study designSecondary analysis was performed on data from the Pragmatic Randomized Optimal Platelet and Plasma Ratio (PROPPR) trial, excluding patients who died within 24 hours or were on pre-injury anticoagulants. Patient characteristics, adverse outcomes, and parameters of platelet function and coagulation (thromboelastography) were compared from admission to 72 hours between VTE (n = 83) and non-VTE (n = 475) patients. A p value < 0.05 indicates significance.ResultsDespite similar patient demographics, VTE patients exhibited hypercoagulable thromboelastography parameters and enhanced platelet function at admission (p < 0.05). Both groups exhibited hypocoagulable thromboelastography parameters, platelet dysfunction, and suppressed clot lysis (low clot lysis at 30 minutes) 2 hours after admission (p < 0.05). The VTE patients exhibited delayed coagulation recovery (a significant change compared with 2 hours) of K-value (48 vs 24 hours), α-angle (no recovery), maximum amplitude (24 vs 12 hours), and clot lysis at 30 minutes (48 vs 12 hours). Platelet function recovery mediated by arachidonic acid (72 vs 4 hours), ADP (72 vs 12 hours), and collagen (48 vs 12 hours) was delayed in VTE patients. The VTE patients had lower mortality (4% vs 13%; p < 0.05), but fewer hospital-free days (0 days [interquartile range 0 to 8 days] vs 10 days [interquartile range 0 to 20 days]; p < 0.05) and higher complication rates (p < 0.05).ConclusionsRecovery from platelet dysfunction and coagulopathy after severe trauma were delayed in VTE patients. Suppressed clot lysis and compensatory mechanisms associated with altered coagulation that can potentiate VTE formation require additional investigation.

Published
2017

46. Outcomes Following Concomitant Traumatic Brain Injury and Hemorrhagic Shock: A Secondary Analysis from the PROPPR Trial.

Author

Galvagno, Samuel M, Fox, Erin E, Appana, Savitri N, Baraniuk, Sarah, Bosarge, Patrick L, Bulger, Eileen M, Callcut, Rachel A, Cotton, Bryan A, Goodman, Michael, Inaba, Kenji, O'Keeffe, Terence, Schreiber, Martin A, Wade, Charles E, Scalea, Thomas M, Holcomb, John B, and Stein, Deborah M

Subjects
Traumatic Head and Spine Injury, Neurosciences, Traumatic Brain Injury (TBI), Brain Disorders, Lung, Physical Injury - Accidents and Adverse Effects, Injuries and accidents, Good Health and Well Being, Abbreviated Injury Scale, Adult, Blood Coagulation Disorders, Blood Transfusion, Brain Injuries, Traumatic, Critical Care, Female, Humans, Incidence, Logistic Models, Male, Middle Aged, Shock, Hemorrhagic, Treatment Outcome, Injury - Traumatic brain injury, Injury - Trauma - (Head and Spine), Injury (total) Accidents/Adverse Effects, Traumatic brain injury, hemorrhagic shock, resuscitation, trauma, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Nursing, Emergency & Critical Care Medicine
Abstract

Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes following concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI+HS) had worse outcomes and required more intensive care compared to patients with only one of these injuries.This is a post-hoc analysis of the Pragmatic, Randomized Optimal Platelets and Plasma Ratios (PROPPR) trial. TBI was defined by a head abbreviated injury scale >2. HS was defined as a base excess ≤ -4 and/or shock index ≥ 0.9. The primary outcome for this analysis was mortality at 30 days. Logistic regression, using generalized estimating equations (GEE), was used to model categorical outcomes.670 patients were included. Patients with TBI+HS had significantly higher lactate (median 6.3; IQR 4.7,9.2) compared to the TBI group (median 3.3; IQR 2.3,4). TBI+HS patients had higher activated prothrombin times and lower platelet counts. Unadjusted mortality was higher in the TBI+HS (51.6%) and TBI (50%) groups compared to the HS (17.5%) and neither group (7.7%). Adjusted odds of death in the TBI and TBI+HS groups were 8.2 (95% CI, 3.4-19.5) and 10.6 (95% CI, 4.8-23.2) times higher, respectively. Ventilator, ICU- and hospital-free days were lower in the TBI and TBI+HS groups compared to the other groups. Patients with TBI+HS or TBI had significantly greater odds of developing a respiratory complication compared to the neither group.The addition of TBI to HS is associated with worse coagulopathy prior to resuscitation, and increased mortality. When conrolling for multiple known confounders, the diagnosis of TBI alone or TBI+HS was associated with significantly greater odds of developing respiratory complications.prognostic study LEVEL OF EVIDENCE: II.

Published
2017

48. EAST Evidence-Based Statement on “Stand Your Ground” Laws

Author

Kaufman, Elinore J., Zakrison, Tanya L., Hoofnagle, Mark H., Tatebe, Leah C., Rattan, Rishi, Murphy, Patrick B., Smith, Randi N., Joseph, D’Andrea K., Yeh, D. Dante, Haut, Elliott R., Como, John, Christmas, A. Britton, Claridge, Jeffrey A., Stein, Deborah M., and Jung, Hee Soo

Published
2022
Full Text
View/download PDF

49. National blood shortage: A call to action from the trauma community

Author

Stein, Deborah M., Upperman, Jeffrey S., Livingston, David H., Andrews, Jennifer, Bulger, Eileen M., Cohen, Mitchell Jay, Eastridge, Brian J., Fontaine, Magali J., Guillamondegui, Oscar, Hess, John R., Jenkins, Donald H., Kaups, Krista L., Nance, Michael L., Spinella, Philip C., Zarzaur, Ben L., Zonies, David, and Coimbra, Raul

Published
2022
Full Text
View/download PDF

50. Community of trauma care partnering with stakeholders to improve injury outcomes: focus group analysis

Author

Appelbaum, Rachel D, primary, Newcomb, Anna, additional, Joseph, Katherine, additional, Hennessy, Morgan, additional, Fortin, Princess, additional, Bixby, Pam J, additional, Prentiss, Sue, additional, McConnell-Hill, Alexandra, additional, Flayter, Rochelle, additional, Price, Michelle A, additional, Dicker, Rochelle, additional, Kozar, Rosemary, additional, Haut, Elliott R, additional, and Stein, Deborah M, additional

Published
2024
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results