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1. Stop The Falls! A framework for injury prevention outreach for older adults presented by the American Association for the Surgery of Trauma Geriatric Trauma and Injury Prevention Committees

Author

Bellal Joseph, Vanessa P Ho, Molly P Jarman, Nasim Ahmed, D'Andrea Joseph, Tasce Bongiovanni, Kartik Prabhakaran, Thomas K Duncan, Asanthi Ratnasekera, Kristin P Colling, Sasha D Adams, Sigrid Burruss, Melissa Hornor, Jennifer Knight-Davis, Tanya Egodage, Elizabeth Gorman, Adin Tyler Putnam, and Caitlin Cohan

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

With the increasing age of the population in the USA, fall prevention events to target older patients are imperative. The American Association for the Surgery of Trauma hosted a fall prevention event at the host city of the 2023 Annual Meeting. We review the planning and implementation of this “Stop the Falls” event, in hopes that other institutions may benefit and sustainably effectuate fall prevention events for an increasingly geriatric population.

Published
2024
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2. Geriatric trauma triage: optimizing systems for older adults—a publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee

Author

Bellal Joseph, Vanessa P Ho, Nasim Ahmed, Tasce Bongiovanni, Kartik Prabhakaran, Asanthi Ratnasekera, Sasha D Adams, Joseph Posluszny, Jody Digiacomo, Milad Behbahaninia, Melissa Hornor, Jennifer Knight-Davis, Tanya Egodage, Elisabeth Swezey, Adin Tyler Putnam, and Caitlin Cohan

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Background Geriatric trauma patients are an increasing population of the United States (US), sustaining a high incidence of falls, and suffer greater morbidity and mortality to their younger counterparts. Significant variation and challenges exist to optimize outcomes for this cohort, while being mindful of available resources. This manuscript provides concise summary of locoregional and national practices, including relevant updates in the triage of geriatric trauma in an effort to synthesize the results and provide guidance for further investigation.Methods We conducted a review of geriatric triage in the United States (US) at multiple stages in the care of the older patient, evaluating existing literature and guidelines. Opportunities for improvement or standardization were identified.Results Opportunities for improved geriatric trauma triage exist in the pre-hospital setting, in the trauma bay, and continue after admission. They may include physiologic criteria, biochemical markers, radiologic criteria and even age. Recent Trauma Quality Improvement Program (TQIP) Best Practices Guidelines for Geriatric Trauma Management published in 2024 support these findings.Conclusion Trauma systems must adjust to provide optimal care for older adults. Further investigation is required to provide pertinent guidance.

Published
2024
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3. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Author

Gennaro Perrone, Mario Giuffrida, Fikri Abu-Zidan, Vitor F. Kruger, Marco Livrini, Gabriele Luciano Petracca, Giorgio Rossi, Antonio Tarasconi, Brian W. C. A. Tian, Elena Bonati, Ricardo Mentz, Federico N. Mazzini, Juan P. Campana, Elisabeth Gasser, Reinhold Kafka-Ritsch, Daniel M. Felsenreich, Christopher Dawoud, Stefan Riss, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonzaga, Cassio Alfred Brattig Canton, Bruno Monteiro Pereira, Gustavo P. Fraga, Leticia Gonçalves Zem, Vinicius Cordeiro-Fonseca, Renato de Mesquita Tauil, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, L. Juan José Meléndez, Ana Dimova, Stefan Dimov, Zdravko Zelić, Goran Augustin, Branko Bogdanić, Trpimir Morić, Elie Chouillard, Melinda Bajul, Belinda De Simone, Yves Panis, Francesco Esposito, Margherita Notarnicola, Lelde Lauka, Anna Fabbri, Hassen Hentati, Iskander Fnaiech, Venara Aurélien, Marie Bougard, Maxime Roulet, Zaza Demetrashvili, Irakli Pipia, Giorgi Merabishvili, Konstantinos Bouliaris, Georgios Koukoulis, Christos Doudakmanis, Sofia Xenaki, Emmanuel Chrysos, Stamatios Kokkinakis, Panteleimon Vassiliu, Nikolaos Michalopoulos, Ioannis Margaris, Aristotelis Kechagias, Konstantinos Avgerinos, Jevgeni Katunin, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Antonio Pujante, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Athanasios Marinis, Ioannis Siannis, Eirini Bourbouteli, Dimitrios K. Manatakis, Nikolaos Tasis, Vasileios Acheimastos, Sotiropoulou Maria, Kapiris Stylianos, Harilaos Kuzeridis, Dimitrios Korkolis, Evangelos Fradelos, George Kavalieratos, Thalia Petropoulou, Andreas Polydorou, Ioannis Papacostantinou, Tania Triantafyllou, Despina Kimpizi, Dimitrios Theodorou, Konstantinos Toutouzas, Alexandros Chamzin, Maximos Frountzas, Dimitrios Schizas, Ioannis Karavokyros, Athanasios Syllaios, Alexandros Charalabopoulos, Maria Boura, Efstratia Baili, Orestis Ioannidis, Lydia Loutzidou, Elissavet Anestiadou, Ioannis Tsouknidas, Georgios Petrakis, Eleni Polenta, Lovenish Bains, Rahul Gupta, Sudhir K. Singh, Archana Khanduri, Miklosh Bala, Asaf Kedar, Marcello Pisano, Mauro Podda, Adolfo Pisanu, Gennaro Martines, Giuseppe Trigiante, Giuliano Lantone, Antonino Agrusa, Giuseppe Di Buono, Salvatore Buscemi, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Luigi Oragano, Sandro Zonta, Federico Lovisetto, Carlo V. Feo, Antonio Pesce, Nicolò Fabbri, Giulio Lantone, Fabio Marino, Fabrizio Perrone, Leonardo Vincenti, Vincenzo Papagni, Arcangelo Picciariello, Stefano Rossi, Biagio Picardi, Simone Rossi Del Monte, Diego Visconti, Giulia Osella, Luca Petruzzelli, Giusto Pignata, Jacopo Andreuccetti, Rossella D’Alessio, Massimo Buonfantino, Eleonora Guaitoli, Stefano Spinelli, Gianluca Matteo Sampietro, Carlo Corbellini, Leonardo Lorusso, Alice Frontali, Isabella Pezzoli, Alessandro Bonomi, Andrea Chierici, Christian Cotsoglou, Giuseppe Manca, Antonella Delvecchio, Nicola Musa, Massimiliano Casati, Laface Letizia, Emmanuele Abate, Giorgio Ercolani, Fabrizio D’Acapito, Leonardo Solaini, Gianluca Guercioni, Simone Cicconi, Diego Sasia, Felice Borghi, Giorgio Giraudo, Giuseppe Sena, Pasquale Castaldo, Eugenia Cardamone, Giuseppe Portale, Matteo Zuin, Ylenia Spolverato, Marialusia Esposito, Roberta Maria Isernia, Maria Di Salvo, Romina Manunza, Giuseppe Esposito, Marcello Agus, Emanuele Luigi Giuseppe Asti, Daniele Tiziano Bernardi, Tommaso Panici Tonucci, Davide Luppi, Massimiliano Casadei, Stefano Bonilauri, Angela Pezzolla, Annunziata Panebianco, Rita Laforgia, Maurizio De Luca, Monica Zese, Dario Parini, Elio Jovine, Giuseppina De Sario, Raffaele Lombardi, Giovanni Aprea, Giuseppe Palomba, Marianna Capuano, Giulio Argenio, Gianluca Orio, Mariano Fortunato Armellino, Marina Troian, Martina Guerra, Carlo Nagliati, Alan Biloslavo, Paola Germani, Giada Aizza, Igor Monsellato, Ali Chaouki Chahrour, Gabriele Anania, Cristina Bombardini, Francesco Bagolini, Gabriele Sganga, Pietro Fransvea, Valentina Bianchi, Paolo Boati, Francesco Ferrara, Francesco Palmieri, Pasquale Cianci, Domenico Gattulli, Enrico Restini, Nicola Cillara, Alessandro Cannavera, Gabriela Elisa Nita, Jlenia Sarnari, Francesco Roscio, Federico Clerici, Ildo Scandroglio, Stefano Berti, Alessandro Cadeo, Alice Filippelli, Luigi Conti, Carmine Grassi, Gaetano Maria Cattaneo, Marina Pighin, Davide Papis, Giovanni Gambino, Vanessa Bertino, Domenico Schifano, Daniela Prando, Luisella Fogato, Fabio Cavallo, Luca Ansaloni, Roberto Picheo, Nicholas Pontarolo, Norma Depalma, Marcello Spampinato, Stefano D’Ugo, Luca Lepre, Michela Giulii Capponi, Rossella Domenica Campa, Giuliano Sarro, Vincenza Paola Dinuzzi, Stefano Olmi, Matteo Uccelli, Davide Ferrari, Marco Inama, Gianluigi Moretto, Michele Fontana, Francesco Favi, Erika Picariello, Alessia Rampini, Andrea Barberis, Antonio Azzinnaro, Alba Oliva, Luigi Totaro, Ilaria Benzoni, Valerio Ranieri, Gabriella Teresa Capolupo, Filippo Carannante, Marco Caricato, Maurizio Ronconi, Silvia Casiraghi, Giovanni Casole, Desire Pantalone, Giovanni Alemanno, Maximilian Scheiterle, Marco Ceresoli, Marco Cereda, Chiara Fumagalli, Federico Zanzi, Stefano Bolzon, Enrico Guerra, Francesca Lecchi, Paola Cellerino, Antonella Ardito, Rosa Scaramuzzo, Andrea Balla, Pasquale Lepiane, Nicola Tartaglia, Antonio Ambrosi, Giovanna Pavone, Gian Marco Palini, Simone Veneroni, Gianluca Garulli, Claudio Ricci, Beatrice Torre, Iris Shari Russo, Matteo Rottoli, Marta Tanzanu, Angela Belvedere, Marco Milone, Michele Manigrasso, Giovanni Domenico De Palma, Micaela Piccoli, Gianmaria Casoni Pattacini, Stefano Magnone, Paolo Bertoli, Michele Pisano, Paolo Massucco, Marco Palisi, Andrea-Pierre Luzzi, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Yoshiro Kobe, Takayuki Toma, Fumihiko Shimamura, Robert Parker, Sinkeet Ranketi, Mercy Mitei, Saulius Svagzdys, Henrikas Pauzas, Justas Zilinskas, Tomas Poskus, Marius Kryzauskas, Matas Jakubauskas, Andee Dzulkarnaen Zakaria, Zaidi Zakaria, Michael Pak-Kai Wong, Asri Che Jusoh, Muhammad Nazreen Zakaria, Daniel Rios Cruz, Aurea Barbara Rodriguez Elizalde, Alejandro Bañon Reynaud, Edgard Efren Lozada Hernandez, Jose maria Victor Palomo Monroy, Diego Hinojosa-Ugarte, Martha Quiodettis, María Esther Du Bois, José Latorraca, Piotr Major, Michał Pędziwiatr, Magdalena Pisarska-Adamczyk, Maciej Walędziak, Andrzej Kwiatkowski, Łukasz Czyżykowski, Silvia Dantas da Costa, Bela Pereira, Ana Rita Oliveira Ferreira, Filipe Almeida, Ricardo Rocha, Carla Carneiro, Diego Pita Perez, João Carvas, Catarina Rocha, Cátia Ferreira, Rita Marques, Urânia Fernandes, Pedro Leao, André Goulart, Rita Gonçalves Pereira, Sara Daniela Direito Patrocínio, Nuno Gonçalo Gonçalves de Mendonça, Maria Isabel Cerqueira Manso, Henrique Manuel Cardoso Morais, Paulo Sebastião Cardoso, Valentin Calu, Adrian Miron, Elena Adelina Toma, Mahir Gachabayov, Abakar Abdullaev, Andrey Litvin, Taras Nechay, Alexander Tyagunov, Anvar Yuldashev, Alison Bradley, Michael Wilson, Arpád Panyko, Zuzana Látečková, Vladimír Lacko, Dusan Lesko, Marek Soltes, Jozef Radonak, Victor Turrado-Rodriguez, Roser Termes-Serra, Xavier Morales-Sevillano, Pierfrancesco Lapolla, Andrea Mingoli, Gioia Brachini, Maurizio Degiuli, Silvia Sofia, Rossella Reddavid, Andrea de Manzoni Garberini, Angelica Buffone, Eduardo Perea del Pozo, Daniel Aparicio-Sánchez, Sandra Dos Barbeito, Mercedes Estaire-Gómez, Rebeca Vitón-Herrero, Mª de los Ángeles Gil Olarte-Marquez, José Gil-Martínez, Felipe Alconchel, Tatiana Nicolás-López, Aida Cristina Rahy-Martin, María Pelloni, Raquel Bañolas-Suarez, Fernando Mendoza-Moreno, Francisca García-Moreno Nisa, Manuel Díez-Alonso, María Elisa Valle Rodas, María Carmona Agundez, María Inmaculada Pérez Andrés, Claudia Cristina Lopes Moreira, Aintzane Lizarazu Perez, Iñigo Augusto Ponce, Ana María González-Castillo, Estela Membrilla-Fernández, Silvia Salvans, Mario Serradilla-Martín, Pablo Sancho Pardo, Daniel Rivera-Alonso, Jana Dziakova, Jose Mugüerza Huguet, Naila Pagès Valle, Enrique Colás Ruiz, Cristina Rey Valcárcel, Cristina Ruiz Moreno, Yeniffer Tatiana Moreno Salazar, Juan Jesús Rubio García, Silvia Sevila Micó, Joaquín Ruiz López, Silvia Pérez Farré, Maite Santamaria Gomez, Nuria Mestres Petit, Alberto Titos-García, Jose Manuel Aranda-Narváez, Laura Romacho-López, Luis Sánchez-Guillén, Veronica Aranaz-Ostariz, Marina Bosch-Ramírez, Aleix Martínez-Pérez, Elías Martínez-López, Juan Carlos Sebastián-Tomás, Granada Jimenez-Riera, Javier Jimenez-Vega, Jose Aurelio Navas Cuellar, Andrea Campos-Serra, Anna Muñoz-Campaña, Raquel Gràcia-Roman, Javier Martínez Alegre, Francisca Lima Pinto, Sara Nuñez O’Sullivan, Francisco Blanco Antona, Beatriz Muñoz Jiménez, Jaime López-Sánchez, Zahira Gómez Carmona, Rocio Torres Fernández, Isabel Blesa Sierra, Laura Román García de León, Verónica Polaino Moreno, Eva Iglesias, Paola Lora Cumplido, Altea Arango Bravo, Ignacio Rey Simó, Carlota López Domínguez, Aloia Guerreiro Caamaño, Rafael Calleja Lozano, Manuel Durán Martínez, Álvaro Naranjo Torres, Javier Tomas Morales Bernaldo de Quiros, Gianluca Pellino, Miriam Moratal Cloquell, Elsa García Moller, Sami Jalal-Eldin, Ahmed K. Abdoun, Hytham K. S. Hamid, Varut Lohsiriwat, Aitsariya Mongkhonsupphawan, Oussama Baraket, Karim Ayed, Imed Abbassi, Ali Ben Ali, Houssem Ammar, Ali Kchaou, Ahmed Tlili, Imen Zribi, Elif Colak, Suleyman Polat, Zehra Alan Koylu, Ali Guner, Mehmet Arif Usta, Murat Emre Reis, Baris Mantoglu, Emre Gonullu, Emrah Akin, Fatih Altintoprak, Zulfu Bayhan, Necattin Firat, Arda Isik, Ufuk Memis, Mehmet Bayrak, Yasemin Altıntaş, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Koray Das, Ahmet Seker, Nazmi Ozer, Semra Demirli Atici, Korhan Tuncer, Tayfun Kaya, Zeynep Ozkan, Onur Ilhan, Ibrahim Agackiran, Mustafa Yener Uzunoglu, Eren Demirbas, Yuksel Altinel, Serhat Meric, Nadir Adnan Hacım, Derya Salim Uymaz, Nail Omarov, Emre Balık, Giovanni D. Tebala, Hany Khalil, Mridul Rana, Mansoor Khan, Charlotte Florence, Christie Swaminathan, Cosimo Alex Leo, Lampros Liasis, Josef Watfah, Ivan Trostchansky, Edward Delgado, Marcelo Pontillo, Rifat Latifi, Raul Coimbra, Sara Edwards, Ana Lopez, George Velmahos, Ander Dorken, Anthony Gebran, Amanda Palmer, Jeffrey Oury, James M. Bardes, Sirivan Suon Seng, Lauren S. Coffua, Asanthi Ratnasekera, Tanya Egodage, Karla Echeverria-Rosario, Isabella Armento, Lena M. Napolitano, Naveen F. Sangji, Mark Hemmila, Jacob A. Quick, Tyler R. Austin, Theodore S. Hyman, William Curtiss, Amanda McClure, Nicholas Cairl, Walter L. Biffl, Hung P. Truong, Kathryn Schaffer, Summer Reames, Filippo Banchini, Patrizio Capelli, Federico Coccolini, Massimo Sartelli, Francesca Bravi, Carlo Vallicelli, Vanni Agnoletti, Gian Luca Baiocchi, and Fausto Catena

Subjects
Hartmann’s procedure, Ostomy, Emergency surgery, Resection, Primary anastomosis, Left side, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann’s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P

Published
2024
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10. Futility in acute care surgery: first do no harm

Author

Bellal Joseph, Rosemary A Kozar, Nasim Ahmed, Vanessa Ho, Jody C DiGiacomo, Tasce Bongiovanni, Bryan Morse, Michael W Cripps, Sasha D Adams, Uzer Khan, Alexandra Briggs, Thaddeus J Puzio, Milad Behbahaninia, Melissa Hornor, Allyson Cook Chapman, Jennifer Knight-Davis, Alicia Mangram, Kristin Pokorney Colling, John Hwabejire, Adam Campman Nelson, Tanya Egodage, Molly Price Jarman, D’Andrea Joseph, Ryan Landis, Ida Molavi, Tyler Putnam, and Elizabeth Gorman

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

The consequences of the delivery of futile or potentially ineffective medical care and interventions are devastating on the healthcare system, our patients and their families, and healthcare providers. In emergency situations in particular, determining if escalating invasive interventions will benefit a frail and/or severely critically ill patient can be exceedingly difficult. In this review, our objective is to define the problem of potentially ineffective care within the specialty of acute care surgery and describe strategies for improving the care of our patients in these difficult situations.

Published
2023
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11. Prospective validation and application of the Trauma-Specific Frailty Index: Results of an American Association for the Surgery of Trauma multi-institutional observational trial

Author

Bellal, Joseph, Abdul Tawab, Saljuqi, Joseph D, Amos, Amanda, Teichman, Melissa L, Whitmill, Tanya, Anand, Hamidreza, Hosseinpour, Sigrid K, Burruss, Julie A, Dunn, Kaveh, Najafi, Laura N, Godat, Toby M, Enniss, Thomas H, Shoultz, Tanya, Egodage, Tasce, Bongiovanni, Joshua P, Hazelton, Kristin P, Colling, Todd W, Costantini, Deborah M, Stein, Thomas J, Schroeppel, Jeffry, Nahmias, and Jonathan, Thomas

Subjects
Aged, 80 and over, Frailty, Frail Elderly, Humans, Aftercare, Surgery, Prospective Studies, Critical Care and Intensive Care Medicine, Geriatric Assessment, Patient Discharge, Aged
Abstract

The frailty index is a known predictor of adverse outcomes in geriatric patients. Trauma-Specific Frailty Index (TSFI) was created and validated at a single center to accurately identify frailty and reliably predict worse outcomes among geriatric trauma patients. This study aims to prospectively validate the TSFI in a multi-institutional cohort of geriatric trauma patients.This is a prospective, observational, multi-institutional trial across 17 American College of Surgeons Levels I, II, and III trauma centers. All geriatric trauma patients (65 years and older) presenting during a 3-year period were included. Frailty status was measured within 24 hours of admission using the TSFI (15 variables), and patients were stratified into nonfrail (TSFI, ≤0.12), prefrail (TSFI, 0.13-0.25), and frail (TSFI,0.25) groups. Outcome measures included index admission mortality, discharge to rehabilitation centers or skilled nursing facilities (rehab/SNFs), and 3-month postdischarge readmissions, fall recurrences, complications, and mortality among survivors of index admission.A total of 1,321 geriatric trauma patients were identified and enrolled for validation of TSFI (nonfrail, 435 [33%]; prefrail, 392 [30%]; frail, 494 [37%]). The mean ± SD age was 77 ± 8 years; the median (interquartile range) Injury Severity Score was 9 (5-13). Overall, 179 patients (14%) had a major complication, 554 (42%) were discharged to rehab/SNFs, and 63 (5%) died during the index admission. Compared with nonfrail patients, frail patients had significantly higher odds of mortality (adjusted odds ratio [aOR], 1.93; p = 0.018), major complications (aOR, 3.55; p0.001), and discharge to rehab/SNFs (aOR, 1.98; p0.001). In addition, frailty was significantly associated with higher adjusted odds of mortality, major complications, readmissions, and fall recurrence at 3 months postdischarge ( p0.05).External applicability of the TSFI (15 variables) was evident at a multicenter cohort of 17 American College of Surgeons trauma centers in geriatric trauma patients. The TSFI emerged as an independent predictor of worse outcomes, both in the short-term and 3-month postdischarge.Prognostic and Epidemiological; Level III.

Published
2022
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12. An observation-first strategy for liver injuries with 'blush' on computed tomography is safe and effective

Author

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

Subjects
Surgery, Critical Care and Intensive Care Medicine
Published
2022
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13. Early VTE Prophylaxis in Severe Traumatic Brain Injury: A Propensity Score Weighted EAST Multi-Center Study

Author

Asanthi M. Ratnasekera, Daniel Kim, Sirivan S. Seng, Christina Jacovides, Elinore J. Kaufman, Hannah M. Sadek, Lindsey L. Perea, Christina Monaco, Ilya Shnaydman, Alexandra Jeongyoon Lee, Victoria Sharp, Angela Miciura, Eric Trevizo, Martin Rosenthal, Lawrence Lottenberg, William Zhao, Alicia Keininger, Michele Hunt, John Cull, Chassidy Balentine, Tanya Egodage, Aleem Mohamed, Michelle Kincaid, Stephanie Doris, Robert Cotterman, Sara Seegert, Lewis E. Jacobson, Jamie Williams, Melissa Whitmill, Brandi Palmer, Caleb Mentzer, Nichole Tackett, Tjasa Hranjec, Thomas Dougherty, Shawna Morrissey, Lauren Donatelli-Seyler, Amy Rushing, Leah C. Tatebe, Tiffany J. Nevill, Michel B. Aboutanos, David Hamilton, Diane Redmond, Daniel C. Cullinane, Carolyne Falank, Mark McMellen, Christ Duran, Jennifer Daniels, Shana Ballow, Kevin Schuster, and Paula Ferrada

Subjects
Surgery, Critical Care and Intensive Care Medicine
Published
2023
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14. Trauma Incidence During the New Jersey COVID-19 Stay-At-Home Order: A Multicenter Study

Author

Jeremy M. Badach, Rebecca Platoff, Deviney Rattigan, Christopher A. Butts, Lisa Shea, John P. Gaughan, Krystal Hunter, Ziad Sifri, John Porter, and Tanya Egodage

Subjects
Surgery
Abstract

Given the early surge of COVID-19 in New Jersey (NJ), a statewide executive order (EO) to stay-at-home was instituted on March 22, 2020. We hypothesized that the EO would result in a decreased number of trauma admissions, length of stay, and resources utilized in trauma patients at NJ trauma centers.In an institutional review board-approved, retrospective, multicenter study, trauma registries at three level one trauma centers in NJ were queried from March 22 to June 14 in 2020 and compared to the same timeframe the year prior. Epidemiological and clinical data were obtained including demographics, select preexisting conditions, mechanism of injury, injury severity score, resources utilized, and outcomes.1859 trauma patients were evaluated during the EO versus 2201 the year prior. During the EO, trauma patients were less likely to be transferred from another hospital (21% versus 29% P 0.05), more likely to have a penetrating mechanism (16% versus 12% P 0.05), were equally likely to require a procedure (P = 0.44) and had similar injury severity score (5 [interquartile range [IQR] 1-9] versus 5 [IQR 1-9], P = 0.73). There was no significant difference in ventilator days (0 [IQR 0-1] versus 0 [IQR 0-2] P = 0.08), intensive care unit days (2 [IQR 0-4] versus 2 [IQR 0-3] P = 0.99), or length of stay (2 [IQR 1-5] versus 2 [IQR 1-6] P = 0.73). Patients were more likely to be sent home than to rehabilitation or long-term acute care hospital during the EO (81% versus 78%, P = 0.02).The 2020 COVID-19 EO was associated with a significantly different epidemiology with a higher rate of penetrating injury during the EO, and similar volume of injured patients evaluated.

Published
2022

15. Multicenter and prospective trial of anti-epileptics for early seizure prevention in mild traumatic brain injury with a positive computed tomography scan

Author

Matthew, Pease, Mazen, Zaher, Alejandro J, Lopez, Siyuan, Yu, Tanya, Egodage, Suzan, Semroc, Dooman, Arefan, and Brian, Jankowitz

Subjects
Surgery, Neurology (clinical)
Abstract

Background: Posttraumatic seizures (PTSs) are a major source of disability after traumatic brain injury (TBI). The Brain Trauma Foundation Guidelines recommend prophylactic anti-epileptics (AEDs) for early PTS in severe TBI, but high-quality evidence is lacking in mild TBI. Methods: To determine the benefit of administering prophylactic AEDs, we performed a prospective and multicenter study evaluating consecutive patients who presented to a Level 1 trauma center from January 2017 to December 2020. We included all patients with mild TBI defined as Glasgow Coma Scale (GCS) 13–15 and a positive head computed tomography (CT). Patients were excluded for previous seizure history, current AED use, or a neurosurgical procedure. Patients were given a prophylactic 7-day course of AEDs on a week-on versus week-off basis and followed with in-person clinic visits, in-hospital evaluation, or a validated phone questionnaire. Results: Four hundred and ninety patients were enrolled, 349 (71.2%) had follow-up, and 139 (39.8%) were given prophylactic AEDs. There was no difference between seizure rates for the prophylactic AED group (0.7%) and those without (2.9%; P = 0.25). Patients who had a PTS were on average older (81.4 years) than patients without a seizure (64.8 years; P = 0.02). Seizure rate increased linearly by age groups: 80 years old (4.6%). Conclusion: Prophylactic AEDs did not provide a benefit for PTS reduction in mild TBI patients with a positive CT head scan.

Published
2022
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