2024
Interactive Media-Based Approach for an Exception From Informed Consent Trial Involving Patients With Trauma
Stephens S, Carroll-Ledbetter C, Duckert S, Coffman T, Nelson M, Brown K, Rodgers J, Griffin R, Suen A, Casey J, Sloan S, Goldstein B, McClintock A, Goldkind S, Gelinas L, Higley A, Joseph B, Holcomb J, Jansen J, Afaneh A, Agarwal S, Anand T, Anderson J, Arbabi S, Ashley D, Bardes J, Benjamin E, Bjordahl P, Bochicchio G, Bugaev N, Butts C, Cannon J, Carlin M, Claridge J, Coimbra R, Cox D, Cross A, Dorlac W, Driver B, Dubose J, Gandhi R, George R, Goodman M, Hoth J, Hu C, Iyegha U, Jacobson L, Jenkins D, Kalkwarf K, Kepros J, Kutcher M, Leeper C, Lueckel S, Machado-Aranda D, Majercik S, Maung A, McKenzie K, Meizoso J, Nahmias J, O'Keeffe T, Rojavin Y, Ross S, Samra N, Schreiber M, Schroeppel T, Stevens T, Weinberg J, Wertin T, Wilson C, Wisler J, Zreik K. Interactive Media-Based Approach for an Exception From Informed Consent Trial Involving Patients With Trauma. JAMA Surgery 2024, 159 PMID: 38959020, PMCID: PMC11223059, DOI: 10.1001/jamasurg.2024.2147.Peer-Reviewed Original ResearchOpt-out requestsCommunity consultationCommunity forumsEmergency care researchOnline community forumsSurvey respondentsParticipating trauma centersSocial media advertisingCentral institutional review boardCare researchPublic disclosureSocial media campaignsInvolving patientsEFIC trialsMain OutcomesParticipant enrollmentAdministration of prothrombin complex concentrateTAP trialsMedia-based approachSocial media advertisementsMedia advertisingMedia campaignsEFIC studiesCommunity meetingsTrial sitesSplenic angioembolization: still an important tool in the toolbox
Ruangvoravat L, Maung A. Splenic angioembolization: still an important tool in the toolbox. Trauma Surgery & Acute Care Open 2024, 9: e001461. PMID: 38646617, PMCID: PMC11029377, DOI: 10.1136/tsaco-2024-001461.Peer-Reviewed Original ResearchWhole Blood Resuscitation for Injured Patients Requiring Transfusion: A Systematic Review, Meta-Analysis, and Practice Management Guideline from the Eastern Association for the Surgery of Trauma.
Meizoso J, Cotton B, Lawless R, Kodadek L, Lynde J, Russell N, Gaspich J, Maung A, Anderson C, Reynolds J, Haines K, Kasotakis G, Freeman J. Whole Blood Resuscitation for Injured Patients Requiring Transfusion: A Systematic Review, Meta-Analysis, and Practice Management Guideline from the Eastern Association for the Surgery of Trauma. Journal Of Trauma And Acute Care Surgery 2024 PMID: 38531812, DOI: 10.1097/ta.0000000000004327.Peer-Reviewed Original ResearchAdult civilian trauma patientsCivilian trauma patientsWhole blood resuscitationLength of stayICU length of stayMeta-analysisTrauma patientsSystematic reviewAssess quality of evidenceBlood transfusionInjured patientsBlood-based resuscitationBlood resuscitationEastern Association for the Surgery of TraumaInfectious complicationsQuality of evidenceRisk of biasEvidence-based recommendationsComponent therapyEnglish-language studiesAssociated with decreased mortalityHemorrhage control proceduresICU lengthWeb of ScienceCINAHL PlusTo close or not to close? Wound management in emergent colorectal surgery, an EAST multicenter prospective cohort study
Feather C, Rehrig S, Allen R, Barth N, Kugler E, Cullinane D, Falank C, Bhattacharya B, Maung A, Seng S, Ratnasekera A, Bass G, Butler D, Pascual J, Srikureja D, Winicki N, Lynde J, Nowak B, Azar F, Thompson L, Nahmias J, Manasa M, Tesoriero R, Kumar S, Collom M, Kincaid M, Sperwer K, Santos A, Klune J, Turcotte J. To close or not to close? Wound management in emergent colorectal surgery, an EAST multicenter prospective cohort study. Journal Of Trauma And Acute Care Surgery 2024, 97: 73-81. PMID: 38523130, DOI: 10.1097/ta.0000000000004321.Peer-Reviewed Original ResearchSurgical site infectionLength of stayHospital length of stayWound classColorectal surgeryICU admissionProcedural detailsMulticenter prospective cohort studyTraumatic colorectal injuriesIn-hospital mortality rateAssociated with increased risk of mortalityAssociated with increased riskMortality rateRates of in-hospital mortalityEmergency colorectal surgeryColorectal surgery patientsProspective observational studyIn-hospital mortalityProspective cohort studyWound closure techniquesAverage length of stayRisk of mortalityStatistically significant differenceVasopressor therapyASA score
2023
Routine post-operative labs and healthcare system burden in acute appendicitis
Sznol J, Becher R, Maung A, Bhattacharya B, Davis K, Schuster K. Routine post-operative labs and healthcare system burden in acute appendicitis. The American Journal Of Surgery 2023, 226: 571-577. PMID: 37291012, DOI: 10.1016/j.amjsurg.2023.06.005.Peer-Reviewed Original ResearchConceptsHealthcare system burdenSystem burdenHealth care costsAppendicitis managementIncreased LOSUncomplicated AAAcute appendicitisRetrospective cohortClinical courseClinical variablesPatient populationMinimal comorbiditiesMultivariable modelingHealthcare costsCare costsPatientsLaboratory utilizationNational Health Expenditure AccountsLab utilizationLaboratory testingBurdenLaboratory testsAppendicitisComorbiditiesCohortAlcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File
Jones T, Bhattacharya B, Schuster K, Becher R, Kodadek L, Davis K, Maung A. Alcohol withdrawal syndrome in trauma patients: a study using the Trauma Quality Program Participant User File. Trauma Surgery & Acute Care Open 2023, 8: e001047. PMID: 37188153, PMCID: PMC10175962, DOI: 10.1136/tsaco-2022-001047.Peer-Reviewed Original ResearchAlcohol withdrawal syndromeAlcohol use disorderPositive blood alcohol concentrationHistory of AUDBlood alcohol concentrationParticipant User FileAdult patientsTrauma patientsWithdrawal syndromeAbbreviated Injury Scale headHigh-risk patient populationInjury scale headAdult trauma patientsPositive toxicology screenMultivariable logistic regressionRetrospective reviewRetrospective studyToxicology screenPatient populationTricyclic antidepressantsMAIN OUTCOMEAmerican CollegePatientsUse disordersUncommon occurrence
2022
Occult traumatic pneumothorax: Is routine follow up chest X-ray necessary?
Bhattacharya B, O'Connor R, Becher R, Schuster K, Davis K, Maung A. Occult traumatic pneumothorax: Is routine follow up chest X-ray necessary? Surgery In Practice And Science 2022, 9: 100073. DOI: 10.1016/j.sipas.2022.100073.Peer-Reviewed Original ResearchChest X-rayRoutine chest X-rayInjury Severity ScoreClinical managementInitial trauma evaluationUrban trauma centerComputerized tomography scanPaucity of evidenceOccult pneumothoracesPneumothorax progressionAdult patientsTrauma centerClinical evolutionClinical symptomsInjury scoreMean ageTrauma evaluationSeverity scoreTomography scanPatientsInterventionPneumothoracesSymptomsAgeX-rayAcute Respiratory Failure and Mechanical Ventilation
Maung A, Kaplan L. Acute Respiratory Failure and Mechanical Ventilation. 2022, 77-84. DOI: 10.1002/9781119756781.ch8.Peer-Reviewed Original ResearchAcute respiratory failureRespiratory failureMechanical ventilationCritical careDifferent clinical scenariosAcute surgerySurgical interventionCare examinationClinical questionsClinical scenariosPatientsSurgical residentsMedical professionalsCareVentilationComplicationsSurgeryFailureMultiple-choice questionsEffect of Antibiotic Duration in Emergency General Surgery Patients with Intra-Abdominal Infection Managed with Open vs Closed Abdomen.
Diaz JJ, Zielinski MD, Chipman AM, O'Meara L, Schroeppel T, Cullinane D, Shoultz T, Barnes SL, May AK, Maung AA. Effect of Antibiotic Duration in Emergency General Surgery Patients with Intra-Abdominal Infection Managed with Open vs Closed Abdomen. Journal Of The American College Of Surgeons 2022, 234: 419-427. PMID: 35290260, DOI: 10.1097/xcs.0000000000000126.Peer-Reviewed Original ResearchConceptsIntra-abdominal infectionsOpen abdomenSecondary infectionAntibiotic durationClosed abdomenOA patientsExact testHigher Sequential Organ Failure AssessmentSequential Organ Failure AssessmentEmergency general surgery patientsChi-square/Fisher's exact testDuration of antibioticsAPACHE II scoreGeneral surgery patientsOrgan Failure AssessmentHigh rateAnesthesiologists physical statusFisher's exact testTwenty-one centersII scoreSurgery patientsOverall mortalityPrimary outcomeMean durationAntibiotic treatmentThe extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. The extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer. Journal Of Trauma And Acute Care Surgery 2022, 93: 686-694. PMID: 35293375, PMCID: PMC9470786, DOI: 10.1097/ta.0000000000003605.Peer-Reviewed Original ResearchConceptsNontrauma centersEmergency departmentMajor injuriesTrauma centerSignificant geographic variationInsurance-based differencesRisk-adjusted oddsLarge trauma centersNeighborhood socioeconomic disadvantageHierarchical logistic regressionInsured adultsTransfer patientsInsurance statusInterfacility transferStratified analysisED claimsUninsured adultsLevel IIISecondary objectiveTriage patternsDeprived populationsLogistic regressionInjurySocioeconomic disadvantageAdmission differencesAssessing the Race, Ethnicity, and Gender Inequities in Blood Alcohol Testing After Trauma
Jean RA, O'Neill KM, Johnson DC, Becher RD, Schuster KM, Davis KA, Maung AA. Assessing the Race, Ethnicity, and Gender Inequities in Blood Alcohol Testing After Trauma. Journal Of Surgical Research 2022, 273: 192-200. PMID: 35092878, DOI: 10.1016/j.jss.2021.12.032.Peer-Reviewed Original ResearchConceptsMultivariable logistic regressionWhite patientsOdds ratioInjury mechanismLogistic regressionParticipant User FileNon-Hispanic patientsSubstantial patient morbidityHealth care providersBlood alcohol testingPacific IslandersDemographic factorsHigh rateClinical factorsTrauma admissionsHispanic patientsScreening ratesPatient morbidityAlcohol screeningSerum alcoholInjury categoriesTrauma casesTraumatic injurySurgeons (ACS) verificationHigher odds
2021
Clinical significance of “positive” cervical spine MRI findings following a negative CT
Khurana B, Keraliya A, Velmahos G, Maung AA, Bono CM, Harris MB. Clinical significance of “positive” cervical spine MRI findings following a negative CT. Emergency Radiology 2021, 29: 307-316. PMID: 34850316, DOI: 10.1007/s10140-021-01992-5.Peer-Reviewed Original ResearchConceptsCareful retrospective reviewNeurological deficitsCervical spineTraumatic findingsClinical significanceUnevaluable patientsRetrospective reviewNegative CTCervical spine MRI findingsSub-cohort analysisAcute traumatic findingsPrevious multicenter studyNormal CTCStable injuriesSpine traumaMRI findingsMulticenter studyUnstable injuriesNegative CTCsEmergency radiologistsSignificant findingsPatientsSpine surgeonsSubtle findingsCervicalgiaIncreased mortality with resuscitative endovascular balloon occlusion of the aorta only mitigated by strong unmeasured confounding: An expanded analysis using the National Trauma Data Bank
Linderman GC, Lin W, Becher RD, Maung AA, Bhattacharya B, Davis KA, Schuster KM. Increased mortality with resuscitative endovascular balloon occlusion of the aorta only mitigated by strong unmeasured confounding: An expanded analysis using the National Trauma Data Bank. Journal Of Trauma And Acute Care Surgery 2021, 91: 790-797. PMID: 33951027, PMCID: PMC8547242, DOI: 10.1097/ta.0000000000003265.Peer-Reviewed Original ResearchConceptsAcute kidney injuryResuscitative endovascular balloon occlusionLower extremity amputationEndovascular balloon occlusionBalloon occlusionExtremity amputationTraumatic injuryTreatment weightingREBOA placementNational Trauma Data BankInverse probabilityPlacement of REBOATrauma Data BankSevere traumatic injuryMortality effectsUnmeasured confoundersNoncompressible torso hemorrhagePotent confounderTQIP dataTQIP databaseAortic injuryKidney injuryRetrospective studyInjury patternsBaseline variablesImproved outcomes using laparoscopy for emergency colectomy after mitigating bias by negative control exposure analysis
Linderman GC, Lin W, Sanghvi MR, Becher RD, Maung AA, Bhattacharya B, Davis KA, Schuster KM. Improved outcomes using laparoscopy for emergency colectomy after mitigating bias by negative control exposure analysis. Surgery 2021, 171: 305-311. PMID: 34332782, DOI: 10.1016/j.surg.2021.06.048.Peer-Reviewed Original ResearchConceptsOpen surgeryEmergency colectomyNational Surgical Quality Improvement Program dataQuality Improvement Program dataPostoperative septic shockLow-risk patientsSurgical site infectionPatients meeting criteriaColorectal emergenciesElective colectomyUnderwent laparoscopyHospital stayOverall morbidityNationwide registryAnastomotic leakColectomy casesConverted groupSeptic shockSite infectionPatient selectionBaseline variablesImproved outcomesLaparoscopic surgeryTreatment weightingColectomyMechanical Ventilation: Advanced Ventilation and Adjuncts
Maung A, Kaplan L. Mechanical Ventilation: Advanced Ventilation and Adjuncts. DeckerMed Surgery 2021 DOI: 10.2310/surg.2395.Peer-Reviewed Original ResearchMechanical Ventilation: Advanced Ventilation and Adjuncts
Maung A, Kaplan L. Mechanical Ventilation: Advanced Ventilation and Adjuncts. DeckerMed Critical Care Of The Surgical Patient 2021 DOI: 10.2310/7ccsp.2395.Peer-Reviewed Original ResearchAnticoagulation Is Associated with Increased Mortality in Splenic Injuries
Bhattacharya B, Becher RD, Schuster KM, Davis KA, Maung AA. Anticoagulation Is Associated with Increased Mortality in Splenic Injuries. Journal Of Surgical Research 2021, 266: 1-5. PMID: 33975026, DOI: 10.1016/j.jss.2021.04.002.Peer-Reviewed Original ResearchConceptsNon-ACS patientsSplenic injuryAC patientsMultivariable binary logistic regressionIndependent risk factorEffect of anticoagulationInjury Severity ScoreUnits of RBCsBinary logistic regressionHospital courseMedian LOSIncreased MortalitySeverity scoreRisk factorsWorse outcomesAnticoagulationSplenic surgeryAC groupPatientsHigh mortalityInjuryLogistic regressionMortalitySerious injuriesAngiographySex-based differences in helmet performance in bicycle trauma
Feler J, Maung AA, O'Connor R, Davis KA, Gerrard J. Sex-based differences in helmet performance in bicycle trauma. Journal Of Epidemiology & Community Health 2021, 75: 994-1000. PMID: 33827896, DOI: 10.1136/jech-2020-215544.Peer-Reviewed Original ResearchConceptsSex-based differencesBicycle traumaHead injuryHelmet useMultivariable logistic regression modelPatients 18 yearsRetrospective cohort studyNational Trauma DatabaseCervical spine fracturesSevere head injuryShort-term outcomesMotor vehicle collisionsSerious head injuryLogistic regression modelsAnticoagulant useCohort studyInjury overallIntracranial bleedingSpine fracturesTrauma databaseIntracranial hemorrhageCommon injuriesOdds reductionReduced oddsSkull fracture
2020
Choosing the Best Approach to Warfarin Reversal After Traumatic Intracranial Hemorrhage
Lumas SG, Hsiang W, Becher RD, Maung AA, Davis KA, Schuster KM. Choosing the Best Approach to Warfarin Reversal After Traumatic Intracranial Hemorrhage. Journal Of Surgical Research 2020, 260: 369-376. PMID: 33388533, DOI: 10.1016/j.jss.2020.12.004.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnticoagulantsBlood Coagulation FactorsCoagulantsConnecticutFemaleFollow-Up StudiesHospital CostsHumansIntracranial Hemorrhage, TraumaticLinear ModelsLogistic ModelsMaleMultivariate AnalysisPlasmaPractice Patterns, Physicians'Retrospective StudiesTomography, X-Ray ComputedTrauma CentersTreatment OutcomeWarfarinConceptsProthrombin complex concentrateFresh frozen plasmaTraumatic intracranial hemorrhageIntracranial hemorrhageWarfarin reversalReversal agentsUse of FFPAcademic level 1 trauma centerFollow-up computed tomography scanProgression of ICHFollow-up computed tomographyLevel 1 trauma centerComputed tomography scanTerms of mortalityElectronic medical recordsPreinjury warfarinElderly patientsHospital lengthInitial bleedICH progressionICH patientsMultivariable analysisRetrospective studyTrauma centerSurgical interventionSex-Based Differences in Bicycle Helmet Protection
Feler J, O’Connor R, Davis K, Gerrard J, Maung A. Sex-Based Differences in Bicycle Helmet Protection. Neurosurgery 2020, 67 DOI: 10.1093/neuros/nyaa447_427.Peer-Reviewed Original Research