Trauma Commons^™

Decreased Frequency Of Splenectomy For High-Grade Splenic Injuries Following The Implementation Of An Interventional Radiology Alert Protocol., Maura Kopchak, John Bach, William B Devoe, Brian Dusseau, Katherine A Graham, John Dillis, Thomas Glusich, Jeff Hubartt

OhioHealth Research Institute Articles

Background A vascular interventional radiology (VIR) protocol was initiated at a mature level 2 trauma center on 3/1/2023 to reduce time to vessel puncture to < 60 minutes as per American College of Surgeons (ACS) guidelines. The average time to vessel puncture in the two years prior to protocol initiation was 102 minutes. Following initiation, time to vessel puncture was reduced to 48.2 minutes (p < 0.001). A statistically significant increase in the number of splenic embolizations was noted in the post-protocol group. The primary outcome of the current study was to evaluate if the initiation of a VIR protocol correlated with a statistically significant decrease in splenectomies for high-grade splenic injuries (American Association for the Surgery of Trauma (AAST) grade 3 or higher) in favor of splenic embolization. The secondary outcomes of the study were to assess whether the initiation of the VIR alert protocol improved our rate of splenic salvage, defined as preserved splenic immune function, and if there was a decreased rate of splenectomies across all injury grades. Methods The trauma registry database was queried for all splenic injuries from 1/1/2021 to 9/1/2024. Admission CT scans were used to grade injuries using the AAST Organ Injury Scale. Demographic and clinical characteristics, including severity of illness (ISS), admission INR, age, blood product required pre- and post-intervention, mortality, sex, length of stay, anticoagulant (AC)/antiplatelet (AP) use, mechanism of injury, and need for REBOA (resuscitative endovascular balloon occlusion of the aorta) placement, were collected for all patients. Patients were further broken down into those requiring splenectomy, embolization, or no intervention. Data were analyzed using chi-square and Mann-Whitney U with Jamovi Version 2.3.26.0 (The Jamovi Project, 2023). Results No statistically significant difference was found for clinical or demographic characteristics between groups. Fewer splenectomies and more splenic embolizations were performed in the post-protocol group for high-grade splenic injuries (grade 3), which was statistically significant (p< 0.001). This was also true when all grade splenic injuries were compared (p< 0.001). Conclusion Following the establishment of an institutional VIR alert protocol for active hemorrhage control in trauma patients, more frequent utilization of angioembolization for high-grade splenic injuries was found with a subsequent decrease in splenectomy rate. Implementation of the VIR alert protocol directly correlated with a shift in practice pattern reflecting attempts at splenic salvage for all injury grades.

Impact Of Pre-Existing Psychiatric Conditions On Trauma Outcomes: A National Analysis, Kelly Mckenney, Marie Ugo, Sindhura Kompella, Clara Alvarez, Ilko Luque

HCA Healthcare Journal of Medicine

Background

Understanding the impact of psychiatric pre-existing conditions (PsyPECs) on trauma outcomes is crucial, as trauma is the leading cause of mortality for Americans aged 1-45. Although previous regional studies have shown higher mortality rates and longer hospital length of stay (H-LOS) for injured patients with PsyPECs, this has not been studied at the national level. The purpose of this study is to identify the PsyPECs associated with mechanism of injury and other outcomes in adult patients admitted for trauma in the United States’ trauma centers.

Methods

Data were extracted from the National Trauma Data Bank (NTDB). There were 5301 …

Substance Use And Childhood Environment In Adolescent Head Injury: Examining The Effects Of Race, Jessica A. Phelps

Department of Sociology: Dissertations, Theses, and Student Research

Adolescents participating in sports are at an increased risk of concussion, which is particularly important given the difficulties with cognitive function, emotion regulation, and impulsivity that may occur as a result of this brain injury. These symptoms can predispose adolescents to subsequent concussions, leading to further damage during a critical time in neurodevelopment which can result in mental health disorder development in adulthood. It is crucial to understand what factors may predispose youth to increased rates of concussion for these reasons. As such, this paper explored whether race/ethnicity, gender, grade in school, childhood environment, and risk-taking behaviors were associated with …

Preclinical Animal Modeling To Investigate Redox-Mediated Molecular Dysfunction In Traumatic Brain Injury, Brandon Z. Mcdonald

Department of Agricultural and Biological Systems Engineering: Dissertations, Theses, and Student Research

Impacts associated with traumatic brain injury (TBI) induce a multitude of neurological morbidities mediated by a spread of biochemical dysfunction. Redox stress is a significant contributor to TBI pathophysiology and several redox stress markers have substantial evidence to support their role in diagnosing preclinical and clinical TBI. However, there is a critical need to verify their translational utility through correlations with behavioral, imaging, and molecular modalities. In chapter two, we examined the therapeutic efficacy of an antioxidant treatment (NPC3) using a controlled cortical impact (CCI) mouse model of TBI. NPC3 alleviated glial expression and reactivity while influencing the expression of …

Acute Compartment Syndrome Following Lower Leg Vascular Injury: A Big-Data Approach To Estimating Incidence And Risk Factors, Harry Moroz, Edward J. Harvey, Yasser C. Bouklouch

Journal of Shock and Hemodynamics

Acute Compartment Syndrome (ACS) is a limb- and life-threatening complication of lower leg fractures. Rapid recognition and fasciotomy can prevent irreversible ischemic injury, but ACS is often under-recognized. Vascular injury may increase the risk of ACS by impairing perfusion and exacerbating swelling. This study aimed to determine the incidence, risk factors, and outcomes of ACS in patients with lower leg fractures, with particular emphasis on the impact of vascular injury. This retrospective cohort study used data from the 2017 American College of Surgeons Trauma Quality Programs database to perform a multicenter analysis of patients with lower leg fractures. Patients were …

Selective Retention Of Birdshot Pellets In The Rearfoot: A Case Demonstrating Tissue Preservation And Functional Recovery, Yasim Zafar, Steven Bolton, Alexandria Armstrong, Hooman Mir

School of Podiatric Medicine - Student Research

Level of Evidence: III (Case Study)

Statement of Purpose: Gunshot wounds to the foot pose a unique surgical dilemma—whether to pursue aggressive foreign body removal or to preserve soft tissue integrity. This case highlights the management of a birdshot injury to the rearfoot where selective non-removal of pellets near the neurovascular bundle led to complete healing and full functional recovery. The purpose is to emphasize tissue preservation over aggressive exploration in complex ballistic foot injuries.

Case Study: A 26-year-old female sustained a birdshot gunshot wound to the right rearfoot. Multiple small entry wounds were noted on the posterior and plantar …

Predicting Trauma Admission In Anticoagulated Geriatric Patients Presenting With A Ground Level Fall, Y-Nhi H. Bui Ms, Trevor Glad Bmus, Dylan Jack Bs, Michael Martyak

Knowledge and Creativity Expo

Our study undertook a rigorous investigation into an expanding trauma patient population, tackling some of the significant challenges with this patient population in trauma triage. Our research has not only addressed key questions, but has also paved the way for future inquiries by offering innovative perspectives. This presentation is particularly important given the current advancements and interests in geriatric trauma. We hope that our findings will influence ongoing projects and spark collaborations among diverse research communities.

Extracorporeal Membrane Oxygenation In Trauma Before And After Covid-19: Associations Of Utilization, Timing, And Outcomes, Ryan Mancoll, William Rice, Theodore Chin, Grayson Mast M.D, Samantha Olafson M.D.

Knowledge and Creativity Expo

Objectives:

The COVID-19 pandemic expanded and altered general ECMO utilization and provider experience; however, any impact on trauma-specific ECMO practice following this shift remains unclear. We hypothesize that trauma ECMO utilization patterns, timing of initiation, and outcomes have differed following COVID-19.

Methods:

We conducted a retrospective cohort study of trauma patients receiving ECMO (2017-2024) using the American College of Surgeons Trauma Quality Improvement Program (TQIP) Participant Use Files. The primary exposure was the COVID era (2017-2019 vs. 2021-2024). Primary outcomes included ECMO utilization, time to initiation, and in-hospital mortality; secondary outcomes included discharge disposition, major complications, and length of stay …

Cemented Femoral Fixation In A High-Risk Periprosthetic Fracture Cohort – A Case Series, John Spak, Philip C. Aurigemma, Yaser C. Rahim

The Lahey Journal

Introduction:
Periprosthetic femur fractures (PPFx) are a major cause of early revision after total hip arthroplasty (THA), accounting for nearly 20% of early failures. Cementless fixation, though widely used, has been associated with an increased risk of early PPFx, particularly in elderly or osteoporotic patients. Cemented femoral fixation may reduce this risk in high-risk populations.

Case Presentation:
We performed a retrospective review of 430 consecutive primary THAs conducted between July 2022 and July 2025 at a single institution. Cementless fixation was used in 390 patients and cemented fixation in 40 high-risk patients (mean age 81.7 vs. 65.9 years; BMI 24.5 …

Exploring The Effects Of Traumatic Brain Injuries On Cranial Nerve Injury, Caitlin J. Mcpartland, Michael J. Pienkos, Sarah E. Johnson, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Background

Traumatic brain injuries (TBI) are a significant and growing health issue, leading to over 200 000 hospitalizations annually in the United States. Cranial nerve (CN) injuries accompanying TBI can severely impact patients’ quality of life. This review aims to address the gap in research regarding the severity, mechanisms of injury, and associated intracranial injuries, emphasizing the importance of early detection and intervention.

Methods

A comprehensive literature search was conducted across databases such as PubMed and Ovid using key terms, including “cranial nerve injury,” “cranial nerve palsy,” “traumatic brain injury,” and “Glasgow Coma Scale.” Inclusion criteria encompassed studies reporting CN …

How Does Pattern Of Bone Healing Affect The Strain Of Plate Implant Via Frequency Detection? A Biomechanical Cadaveric Study, Chavarin Amarase, Chanyaphan Virulsri, Pairat Tangpornprasert, Pisitpong Chancharoen, Saran Tantavisut

Chulalongkorn Medical Journal

Background: Detecting bone union is a crucial process in treating bone fractures to prevent complications, including implant failure and bone nonunion. Nowadays, there are many methods and new innovative devices for detecting bone union through strain measurements, such as strain gauges, fluid level displacement, contrast media, and frequency changes. There is also a trend toward increasing these methods in the future. However, the patterns of bone healing studied with these methods still do not provide a standard for determining the true bone healing process. The aim of this study is to identify the most appropriate bone healing pattern for …

Comparing Educational Pathways For Denturists To Become Maxillofacial Prosthetic Specialists In The Us And The Uk, Minseok Kim

Oral Health

Abstract

In the absence of formal training, licensure, and professionalism, this scientific literature review will seek to include denturists in the American maxillofacial prosthetics industry. Denturists are oral health professionals who perform oral examination, design, manufacture, and place removable oral prostheses. In other regions of the world, they are also known as clinical dental technologists and dental prosthetists. This practice is not widespread in the US. The review can also be assessed on the model mediated by PRISMA, which is concentrated on the experiences of international education in the United Kingdom, Canada, and Australia, where the concentration further revolves around …

Implementing Daily Spontaneous Awakening And Breathing Trials In The Trauma Intensive Care Unit: A Quality Improvement Initiative, Bradley Vaughn, Lina V. Mata-Mcmurry, Eric Shaw, James Dunne

South Atlantic Division GME Research Days 2026

No abstract provided.

Interpersonal Violent Blunt Head Trauma As A Cause Of Acute Ischemic Stroke: A Case Report, Gabriella A. Rivas, Sirin Khajaviyan, Sahil N. Parikh, Dmitri Zbarsky

South Atlantic Division GME Research Days 2026

No abstract provided.

Changing Practice: Optimizing Head Ct-Imaging In Pediatric Trauma Patients At A Community Level Ii Pediatric Trauma Center - A Quality Improvement Initiative, Matthew Daniel, Aaron Worthley, Sarah Johnson, Daniel Saad, Antonio Pepe, Eleah Porter

South Atlantic Division GME Research Days 2026

No abstract provided.

Traumatic Left Diaphragmatic Rupture With Visceral Herniation And Volvulus: Successful Robotic-Assisted Laparoscopic Repair, Eleah Porter, Zachery Hensel

South Atlantic Division GME Research Days 2026

No abstract provided.

Maternal Child Maltreatment And Intimate Partner Violence: Effects On Perceptions Of Infant Temperment And The Mediating Role Of Emotion Regulation And Responsiveness, Jewelian N. Fairchild, G. Anne Bogat, Amy K. Nuttall, Alytia A. Levendosky, Joseph S. Lonstein, Maria Muzik

Psychology Faculty Publications

Purpose

Maternal adverse experiences, such as maltreatment in childhood and later intimate partner violence (IPV) during pregnancy, can disrupt the mother-child relationship and influence maternal perceptions of infant temperament. The present study explored how these adversities influence mothers’ views of their infants’ temperaments and examined the role of maternal emotion regulation and responsiveness to their infants as mediators of these relationships.

Methods

Using data from a longitudinal study of highly stressed, vulnerable women, 355 mothers retrospectively reported on their own childhood maltreatment, as well as their experiences of IPV and emotion regulation during pregnancy. Maternal responsiveness was coded using mother-infant …

The Effects Of A Stepped-Care Mental Health Program On Trauma Recidivism At A Level I Trauma Center, Gabriella Rivas, Juliette Gammel, Kola George, Kenneth Ruggiero, Tatiana Davidson, Hannah Espeleta, Langdon Hartsock, Kristoff Reid

South Atlantic Division GME Research Days 2026

No abstract provided.

Improving Trauma Resuscitation Through Video Review: A Quality Improvement-Oriented Literature Review, Joshua Smith, Leena Iqbal

North Texas GME Research Forum 2026

Background Trauma resuscitation is a high-acuity, time-critical environment characterized by diagnostic uncertainty, simultaneous interventions, and complex team dynamics. Despite the widespread adoption of standardized trauma frameworks such as Advanced Trauma Life Support (ATLS), deviations from best practice and process variability remain common. Trauma video review (TVR) has emerged as a method to objectively evaluate resuscitation performance beyond traditional documentation.

Methods A narrative literature review was conducted of English-language publications examining the use of video recording and structured video review in trauma resuscitation. Peer-reviewed articles and relevant gray literature were identified through database and citation searches. Included works evaluated TVR for …

Patient Safety: Paramedic To Nurse Patient Handover Quality And Its Influence On Clinical Deterioration In The Emergency Department, Madison P. Penick

Nursing | Student Research Posters

No abstract provided.

Migration Of Copper Bullet Fragment Through The Orbit And Conjunctiva, Maxwell A. Levi, Mehron G. Kouhestani, Giovanni Disandro, Peter A. Netland

Department of Ophthalmology Faculty Publications

This is a case report of a 31-year-old female who sustained a gunshot wound to the left orbit, resulting in a ruptured globe and retained bullet fragments extending into the frontal lobe. The patient underwent enucleation without orbital implant, and no metallic fragments were recovered intraoperatively. Three months later, she returned with bloody conjunctival discharge. Examination revealed a 1.25-cm copper-colored metallic bullet jacket fragment spontaneously protruding through the conjunctiva. Serial CT imaging confirmed anterior and inferior migration of the bullet fragment over time, with a total migration distance of 32.9 mm through the orbit. The shrapnel was removed in clinic …

Exploring The Impact Of Age On Traumatic Brain Injury Cause And Recovery In Arkansas: A Retrospective Review, Abby Jones, Steven Wheeler, Jessica Danley

2026 Honors Symposium

Traumatic brain injuries (TBIs) remain a major public health concern, and increasing evidence goes to show the significance of the effect of age in quality of care, diagnosis, and recovery outcomes. In rural states, such as Arkansas, where research has shown a lack of resources and higher fatality rates among TBI patients, healthcare professionals can become better informed and equipped as a result of research efforts to uncover the effects of age on cause and recovery for inpatient TBI individuals in the early stages (Daugherty et al., 2022). Current research and prior evidence suggests that older individuals are more likely …

Patient Safety: Paramedic To Nurse Patient Handover Quality And Its Influence On Clinical Deterioration In The Emergency Department, Madison P. Penick

Nursing | Senior Theses

Background: Quality patient handoff from Emergency Medical Services to the Emergency Department is a crucial transition of care that directly impacts patient safety, medical intervention, and patient outcomes. If concise, effective communication is not achieved, critical details can be left out resulting in medical errors, delayed intervention times, and lack of identification of clinical deterioration.

Aim: This study aims to understand how paramedic to nurse handoff quality impacts a nurse’s early identification of clinical deterioration.

Proposal:

Methodology: A quasi-experimental study of mixed-method research.

Recruitment strategy: A fire department in Marin County, CA and ED nurses from the base trauma center …

Positive Efast—Not So Fast, Barry J. Knapp, Mitchell Vallone, Megan Duggins, Matt Jones, Jacob Knapp, Lily Kauffman, Alexander Dornstauder

Department of Emergency Medicine Faculty Publications

[Patient presentation] A 68-year-old man presented via emergency medical services (EMS) with right hip pain following a traumatic fall from his bicycle. On arrival at the emergency department, he was alert and oriented. Physical examination revealed only tenderness over the greater trochanter of the left femur, with no significant pain on passive range of motion of the left hip. Plain radiography demonstrated a left acetabular fracture (Fig 1).

Time To Safe Chest Tube Removal After Water-Seal Trial, Rahul Pawa, Joshua Gazzetta, Leo A. Benedict, Sean Nix, Phillip Jones, Yoon Cho, Alyssa Fesmire

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Lost Fractures: Prevalence And Risk Factors For Missed Costosternal And Costal Cartilage Fractures Among Patients With Radiologic Chest Wall Injury., Joseph D Forrester, Mohamad Abou Chaar, Andrew T Barnes, Zachary M Bauman, Samy Bendjemil, Nizama N Betts, Benjamin Christie, Raaga Dasari, Devoe Wb, Michelle J Earley, Bradley Faliks, Tracy J Johns, Connie Johnson, Michelle S Junker, Brian D Kim, Jonathan M King, Ariel Whitney Knight, Alexis A Schweibinz, Daniel Stephens, Mary Stuever, Simeng Wang

Trauma and Acute Care Articles

BACKGROUND: Costosternal cartilages and the costal margin, collectively termed costal cartilage, are hyaline cartilage connecting ribs to the sternum and to adjacent ribs, respectively. Presence of intact costal cartilage is essential for elasticity of the chest wall. Anecdotally, costal cartilage injuries are underdiagnosed on trauma CT scan in patients with rib fractures. Our aim was to determine a baseline frequency of acute costal cartilage injury among patients presenting with rib fractures.

METHODS: We performed a retrospective cohort study of injured adult patients admitted to Level I/II trauma centers with rib fractures from January 2020 to July 2024. CT images obtained …

The Moderating Role Of Social And Emotional Support In The Association Between Adverse Childhood Experiences And Adult Mental Health Across Racial Groups: The Need For Investing In Social Capital, Syeda S. Jesmin, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

The sustained impact of Adverse Childhood Experiences (ACE) on mental health outcomes in adulthood is well documented in the literature. ACE survivors may be especially vulnerable to poor mental health outcomes if they have limited or no social support. This study examined the moderating role of social support on the association of ACEs and mental health across different racial groups.

Methods

Data were obtained from the 2022 Behavioral Risk Factor Surveillance System (n = 14,327). The nine ACE questions about traumatic events in childhood were used to create ACE scores. Chi-square tests were used for bivariate comparisons. Both stratified …

Gender Differences In The Association Between Adverse Childhood Experiences And Drug Use: Findings From A Community-Based Survey In China, Hongyun Fu, Elizabeth Monk-Turner, Xiushi Yang

Department of Pediatrics Faculty Publications

Background

While adverse childhood experiences (ACEs) are widely recognized risk factors for behavioral health problems, including drug use, prior research has largely been conducted in Western countries, focused primarily on males, and relied on convenience samples without comparison groups of nonusers. Limited work has examined the impact of ACEs on drug use in non-Western contexts. This study examines gender differences in the relationship between ACEs and drug use in China, using data from a population-based probability sample survey.

Methods:

Cross-sectional data were collected in 2019 from one city in Yunnan Province in Southwest China and one city in Guangdong Province …

A Comprehensive Review Of Bone Remodeling After Trauma And Operative Treatment In Orthopedic Surgery, Sarah E. Rabin, Ian P. Marshall, Benjamin A. Nelson, Justine N. Li, Madison M. Baldauf, Ashley B. Bozzay, Benjamin W. Hoyt

Department of Medicine Faculty Publications

Bone remodeling is a dynamic process involving bone resorption and formation that is regulated on a cellular level and impacted by mechanical stress. A variety of Orthopedic surgery treatment strategies can affect bone remodeling, which can in turn may have long-term impacts on skeletal stress tolerance and function. This review provides a comprehensive overview of bone remodeling involved in Orthopedic surgery. Materials related to bone remodeling principles across Orthopedic surgery domains were selected and compiled using databases including PubMed, MEDLINE, AccessMedicine, and CINAHL; case studies were not included. Relevant literature was summarized for a general review of bone remodeling and …

Intimate Partner Violence And Brain Injury In Women: Understanding Prevalence, Symptomatology, And Consequences, Jacob T. Perez

Undergraduate Research Symposium

Intimate partner violence (IPV) refers to physical, sexual, or psychological harm caused by a current or former partner. While IPV can affect anyone, women are particularly vulnerable and disproportionately affected. Physical IPV often includes experiences of repeated trauma to the head, face, and neck, including strangulation. These injuries can result in a range of consequences, including comorbid conditions such as depression, PTSD, anxiety, and cognitive impairments, along with neurological effects like reduced brain connectivity and white matter integrity. Common brain injuries associated with IPV include traumatic brain injury (TBI), which results from blunt force trauma; subconcussive/repetitive blows, caused by head …