In October Reports, Penn Trauma Proves a Vital Resource for Research & Practice

Each month, the faculty of Penn Trauma share their commitment to trauma practice and research in the nation’s leading trauma journals. In October, their focus turned to the influence of social media on violence, the costs of general emergency medicine, the influence of tranexamic acid administration, the value of primary care physicians in emergency care, and much else.

Featured This Month

Delayed TXA After TBI Impedes Learning, Memory; Early TXA is Favorable But not in Sham Animals

Culkin MC, Coons M, Bele P, Thaploo A, Georges AP, Anderson E, Browne KD, Jacovides C, Santos P, Kaplan LJ, Meaney DF, Smith DH, Pascual JL.

J Trauma Acute Care Surg. 2023 Oct 19. doi: 10.1097/TA.0000000000004155. Online ahead of print.

In a murine model, early tranexamic acid (TXA) following traumatic brain injury appears beneficial for cognitive and behavioral outcomes. However, administration 24 h post-injury consistently impairs cognitive recovery, and has the potential for adverse effects on cognition in uninjured (sham) animals.

Thromboembolic Complications Following Perioperative Tranexamic Acid Administration

Eisinger EC, Forsythe L, Joergensen S, Murali S, Cannon JW, Reilly PM, Kim PK, Kaufman EJ.

J Surg Res. 2023 Oct 13;293:676-684. doi: 10.1016/j.jss.2023.08.048. Online

Conducted at Penn Medicine, a comparative retrospective cohort study from Penn Trauma finds no difference in mortality following massive transfusion between patients receiving TXA versus those not receiving the agent, but significant differences in transfusion totals between the populations.

Costs of Care for Operative and Non-Operative Management of Emergency General Surgery Conditions

Kaufman EJ, Wirtalla CJ, Keele LJ, Neuman MD, Rosen CB, Syvyk S, Hatchimonji J, Ginzberg S, Friedman A, Roberts SE, Kelz RR.

Ann Surg. 2023 Oct 19. doi: 10.1097/SLA.0000000000006134. Online ahead of print.

A large (507,677 patients) retrospective comparative study of emergency general surgery (EGS) conditions finds higher or equivalent costs for operative management compared to non-operative management through 180 days.

New Research from Penn Trauma

• Red Blood Cell Transfusion: 2023 AABB International Guidelines.
  October 2023. JAMA.
• ECMO in Trauma Care: What You Need to Know.
  October 2023. Journal of Trauma and Acute Care Surgery.
• Analysis of Social Media Involvement in Violent Injury.
  Garcia Whitlock AE, Gill BP, Richardson JB, Patton DU, Strong B, Nwakanma CC, Kaufman EJ.
  October 2023. JAMA Surgery.
• Predictors of initial management failure in traumatic hemothorax: A prospective multicenter cohort analysis.
  October 2023. Surgery.
• Association of Established Primary Care Use With Postoperative Mortality Following Emergency General Surgery Procedures.
  October 2023. JAMA Surgery.
• Colleges and Crime-Comparing Homicide and Suicide Rates Among College Towns and Their Counterparts.
  October 2023. Journal of Surgical Research.
• National Cohort Study of Resource Utilization in Older Adults With Emergency General Surgery Conditions.
  October 2023. Journal of Surgical Research.
• Emergency Department Thoracotomy in Penetrating Chest Trauma Patients with No Signs of Life: A Worthwhile Endeavor.
  October 2023. World Journal of Surgery.
• Optimizing Mass Casualty Triage: Using Discrete Event Simulation to Minimize Time to Resuscitation.
  October 2023. Journal of the American College of Surgery.
• CT-based pleural effusion volume estimation formula demonstrates low accuracy and reproducibility for traumatic hemothorax.
  October 2023. Injury.
• The Conditional Effects of Multimorbidity on Operative Versus Nonoperative Management of Emergency General Surgery Conditions: A Retrospective Observational Study Using an Instrumental Variable Analysis.
  October 2023. Annals of Surgery.
• Implementation of Bedaquiline, Pretomanid, and Linezolid in the United States: Experience Using a Novel All-Oral Treatment Regimen for Treatment of Rifampin-Resistant or Rifampin-Intolerant Tuberculosis Disease.
  October 2023. Clinical infectious Diseases.
• Time to Transfer as a Quality Improvement Imperative: Implications of a Hub-and-Spoke Health System Model on the Timing of Emergency Procedures.
  Ginzberg SP, Roberson JL, Nehemiah A, Ballester JMS, Warshauer AK, Wachtel H, Erdman MS, Dlugosz KL, George LJ, Lynn JC, Martin ND, Myers JS.
  October 2023. Joint Commission Journal on Quality and Patient Safety.
• Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study.
  October 2023. Biological Psychiatry Global Open Science.
• The authors reply.
  Chang CWJ, Kaplan LJ.
  October 2023. Critical Care Medicine.