2020
Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures.
Schuster KM, Sanghvi M, O'Connor R, Becher R, Maung AA, Davis KA. Spirometry not pain level predicts outcomes in geriatric patients with isolated rib fractures. Journal Of Trauma And Acute Care Surgery 2020, 89: 947-954. PMID: 32467465, DOI: 10.1097/ta.0000000000002795.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overEmergency Service, HospitalFemaleHand StrengthHospitals, RehabilitationHumansIntensive Care UnitsLength of StayMalePainPain ManagementPain MeasurementPatient DischargePatient TransferPredictive Value of TestsProspective StudiesRib FracturesSpirometryTrauma CentersTreatment OutcomeConceptsLength of stayIsolated rib fracturesNegative inspiratory forceUnplanned ICU admissionRib fracturesPain levelsDay 1ICU admissionInspiratory forceGrip strengthMedian LOSHospital day 1Expiratory volume 1Complete spirometryPain controlDischarge dispositionPulmonary functionEarly dischargeGeriatric patientsVital capacityMean ageSpirometry measuresPulmonary capacityLevel IVFEV1Closing the gap in care of blunt solid organ injury in children.
Yung N, Solomon D, Schuster K, Christison-Lagay E. Closing the gap in care of blunt solid organ injury in children. Journal Of Trauma And Acute Care Surgery 2020, 89: 894-899. PMID: 32345899, DOI: 10.1097/ta.0000000000002757.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildChild, PreschoolClinical Decision-MakingConsensusConservative TreatmentFemaleHospitals, PediatricHumansInfantInfant, NewbornInjury Severity ScoreLength of StayLiverMalePatient DischargePractice Guidelines as TopicProfessional Practice GapsRetrospective StudiesSpleenSurgical Procedures, OperativeTrauma CentersWounds, NonpenetratingYoung AdultConceptsAdult trauma centersPediatric trauma centerSolid organ injuryBlunt solid organ injuryOperative interventionOrgan injuryTrauma centerInjury gradeNonoperative managementLiver injuryPediatric blunt solid organ injuryPediatric solid organ injuryPhysiologic parametersNational Trauma Data BankTrauma center typeGrade of injuryTrauma Data BankBlunt spleenMean LOSHigher ORsConsensus guidelinesIsolated spleenOperative rateGrade ILevel IV
2018
Opioid dependency is independently associated with inferior clinical outcomes after trauma
Hsiang WR, McGeoch C, Lee S, Cheung W, Becher R, Davis KA, Schuster K. Opioid dependency is independently associated with inferior clinical outcomes after trauma. Injury 2018, 50: 192-196. PMID: 30342762, DOI: 10.1016/j.injury.2018.10.015.Peer-Reviewed Original ResearchConceptsNon-home dischargeOpioid-dependent patientsLength of stayInjury Severity ScoreOpioid dependencyVentilator daysMajor complicationsClinical outcomesPrescription abuseIllicit abuseLonger LOSChronic pain subgroupsMore ventilator daysOpioid-naïve patientsUse of opioidsAcademic Level IHigher readmission ratesInferior clinical outcomesChronic pain patientsOpioid subgroupsNaïve patientsAdult patientsPain subgroupsPatient demographicsReadmission ratesInsurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. Insurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer. Annals Of Surgery 2018, 268: 681-689. PMID: 30004929, DOI: 10.1097/sla.0000000000002954.Peer-Reviewed Original ResearchConceptsNTC patientsMajor injuriesOlder adult trauma patientsNationwide Emergency Department SampleOptimal trauma careAdult trauma patientsEmergency department admissionsEmergency Department SampleTrauma center careTransfer of patientsComplex traumatic injuriesMultilevel logistic regressionTrauma patientsDepartment admissionsHigh morbidityTC careDirect admissionInsurance statusInterfacility transferUninsured patientsTrauma careTraumatic injuryOutcome measuresTrauma systemCenter care
2016
Trauma patients on new oral anticoagulation agents have lower mortality than those on warfarin
Maung AA, Bhattacharya B, Schuster KM, Davis KA. Trauma patients on new oral anticoagulation agents have lower mortality than those on warfarin. Journal Of Trauma And Acute Care Surgery 2016, 81: 652-657. PMID: 27438683, DOI: 10.1097/ta.0000000000001189.Peer-Reviewed Original ResearchConceptsNew oral agentsNew oral anticoagulation agentsOral anticoagulation agentsAnticoagulation agentsControl groupLevel 1 trauma center databaseLower mortalityTrauma-related mortalityInjury Severity ScoreMechanism of injuryIntensive care unitMultivariable logistic regressionHigher overall mortalityTrauma center databaseTraumatic brain injuryElectronic medical recordsWarfarin groupHospital courseOral agentsControl patientsIndependent predictorsOverall mortalityTrauma patientsCare unitRetrospective reviewThe confusion continues: results from an American Association for the Surgery of Trauma survey on massive transfusion practices among United States trauma centers
Etchill E, Sperry J, Zuckerbraun B, Alarcon L, Brown J, Schuster K, Kaplan L, Piper G, Peitzman A, Neal MD. The confusion continues: results from an American Association for the Surgery of Trauma survey on massive transfusion practices among United States trauma centers. Transfusion 2016, 56: 2478-2486. PMID: 27515056, DOI: 10.1111/trf.13755.Peer-Reviewed Original ResearchConceptsMassive transfusion protocolMassive transfusion practiceMTP activationTransfusion practiceScoring systemTranexamic acidUnited States trauma centersPartial thromboplastin time (aPTT) testingTEG/ROTEMInternational normalized ratioStates trauma centersCare prothrombin timeOutcome-based studiesAmerican AssociationNontrauma patientsRed blood cellsTransfusion protocolTrauma centerHemostatic resuscitationMassive hemorrhageNormalized ratioRotational thromboelastometryProthrombin timeLevel INontrauma indicationsThe older they are the harder they fall: Injury patterns and outcomes by age after ground level falls
Bhattacharya B, Maung A, Schuster K, Davis KA. The older they are the harder they fall: Injury patterns and outcomes by age after ground level falls. Injury 2016, 47: 1955-1959. PMID: 27346422, DOI: 10.1016/j.injury.2016.06.019.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAgedAged, 80 and overAnticoagulantsAspirinComorbidityFemaleFollow-Up StudiesFractures, BoneGeriatric AssessmentHospitalizationHumansInjury Severity ScoreIntracranial HemorrhagesMaleMultiple TraumaPlatelet Aggregation InhibitorsRetrospective StudiesSurvival AnalysisTrauma CentersTreatment OutcomeUnited StatesConceptsGround-level fallInjury patternsAnticoagulation useAspirin useIntracranial bleedAnticoagulation agentsAbdominal solid organ injuriesCertain injury patternsAdult trauma patientsSolid organ injuryAntiplatelet useHome dischargePatient characteristicsLife expectancy increasesMean ISSOrgan injuryOverall mortalityRetrospective reviewTrauma patientsGeriatric patientsSignificant morbidityTrauma centerPatient populationPelvic fracturesCervical spine
2013
When the ICU is the operating room
Piper GL, Maerz LL, Schuster KM, Maung AA, Luckianow GM, Davis KA, Kaplan LJ. When the ICU is the operating room. Journal Of Trauma And Acute Care Surgery 2013, 74: 871-875. PMID: 23425750, DOI: 10.1097/ta.0b013e31827e9c52.Peer-Reviewed Original ResearchConceptsSurgical intensive care unitOperating roomOperative locationICU casesEmergency general surgery patientsGeneral surgery patientsTotal operative casesType of anesthesiaIntensive care unitMode of ventilationT-testStudent's t-testSurgery patientsCare unitNeuromuscular blockadeAdverse outcomesDeep sedationProcedure typeOperative procedureSurgical proceduresEpidemiologic studiesICU databaseCase volumeLevel ITotal cases
2012
Impact of adaptive statistical iterative reconstruction on radiation dose in evaluation of trauma patients
Maxfield MW, Schuster KM, McGillicuddy EA, Young CJ, Ghita M, Bokhari SA, Oliva IB, Brink JA, Davis KA. Impact of adaptive statistical iterative reconstruction on radiation dose in evaluation of trauma patients. Journal Of Trauma And Acute Care Surgery 2012, 73: 1406-1411. PMID: 23147183, PMCID: PMC3923265, DOI: 10.1097/ta.0b013e318270d2fb.Peer-Reviewed Original ResearchConceptsDose-length productCT scanTrauma patientsAdaptive statistical iterative reconstructionCervical spineLevel I trauma centerVolume CT dose indexI trauma centerRadiation doseStatistical iterative reconstructionCT dose indexBaseline demographicsTrauma centerTomographic scanPatient outcomesTrauma systemInclusion criteriaLevel IVTherapeutic studiesPatientsDose indexCT scanningRadiation exposureScansSubjective image qualityCompared to conventional ventilation, airway pressure release ventilation may increase ventilator days in trauma patients
Maung AA, Schuster KM, Kaplan LJ, Ditillo MF, Piper GL, Maerz LL, Lui FY, Johnson DC, Davis KA. Compared to conventional ventilation, airway pressure release ventilation may increase ventilator days in trauma patients. Journal Of Trauma And Acute Care Surgery 2012, 73: 507-510. PMID: 23019679, DOI: 10.1097/ta.0b013e31825ff653.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedContinuous Positive Airway PressureCritical CareDatabases, FactualFemaleFollow-Up StudiesHumansInjury Severity ScoreIntra-Abdominal HypertensionLength of StayLinear ModelsMaleMiddle AgedMultivariate AnalysisPulmonary Gas ExchangeRespiration, ArtificialRetrospective StudiesRisk AssessmentSurvival RateTime FactorsTrauma CentersTreatment OutcomeVentilator WeaningWounds and InjuriesConceptsAirway pressure release ventilationTotal ventilator daysVentilator daysHospital complicationsMechanical ventilationAIS scoreChest Abbreviated Injury Scale scoreAbbreviated Injury Scale scoreSpontaneous breathing trialAbdominal compartment syndromeAcute lung injuryAcute renal failureInjury Scale scoreStudy entry criteriaInjury Severity ScorePotential confounding factorsAPRV groupAPRV modeBreathing trialRescue therapyCompartment syndromeLung injuryRenal failureIndependent predictorsRetrospective review
2010
The status of massive transfusion protocols in United States trauma centers: massive transfusion or massive confusion?
Schuster KM, Davis KA, Lui FY, Maerz LL, Kaplan LJ. The status of massive transfusion protocols in United States trauma centers: massive transfusion or massive confusion? Transfusion 2010, 50: 1545-1551. PMID: 20158684, DOI: 10.1111/j.1537-2995.2010.02587.x.Peer-Reviewed Original ResearchConceptsFresh frozen plasmaRed blood cellsTrauma surgeonsRatio of FFPUnited States trauma centersMassive transfusion protocolStates trauma centersSurgery of TraumaTransfusion protocolMassive transfusionTrauma centerEmergency departmentMost centersEastern AssociationAnesthesia staffWeb-based surveyLogistic regressionRBC ratioBlood bankStudy designBlood cellsOperating roomSurgeonsSurgeryProtocol utilization
2008
Trauma Team Oversight Improves Efficiency of Care and Augments Clinical and Economic Outcomes
Davis KA, Cabbad NC, Schuster KM, Kaplan LJ, Carusone C, Leary T, Udelsman R. Trauma Team Oversight Improves Efficiency of Care and Augments Clinical and Economic Outcomes. Journal Of Trauma And Acute Care Surgery 2008, 65: 1236-1244. PMID: 19077607, DOI: 10.1097/ta.0b013e31818ba311.Peer-Reviewed Original ResearchMeSH KeywordsAbbreviated Injury ScaleConnecticutCost-Benefit AnalysisCross-Sectional StudiesEfficiency, OrganizationalFees, MedicalHospital CostsHumansInjury Severity ScoreLength of StayLinear ModelsMultiple TraumaOutcome and Process Assessment, Health CarePatient Care TeamPersonnel Administration, HospitalQuality Assurance, Health CareTrauma CentersUtilization ReviewConceptsInjury Severity ScoreEfficiency of careHospital lengthTrauma serviceFull-time trauma surgeonsMean Injury Severity ScoreMedian Injury Severity ScoreTrauma team activation criteriaLevel I trauma centerPercentage of patientsShorter hospital lengthI trauma centerLength of stayActual hospital costsMost patientsPatient demographicsTrauma activationsTrauma centerHospital contribution marginInjury patternsSeverity scoreHospital costsPatient managementTrauma surgeonsPatients