Outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) utilization in trauma patients with and without traumatic brain injuries: A national analysis of the American College of Surgeons Trauma Quality Improvement Program data set

Background Trauma patient care begins on-scene as field triage and mode of transportation are determinants of patient outcomes. This study evaluates the US national patterns of dead on arrival (DOA) among the trauma population. Methods A cross-sectional review of the American College of Surgeons (ACS) Trauma Quality Program Participant Use File (TQP-PUF) data set (2013-2017) was performed. Trauma patients reported as DOA were stratified by ISS into low (<15), intermediate (15-24), or high (≥25) severity. Each group was then subdivided by patient demographics, mechanism, type of injury, and mode of transportation. Results Of the 4 336 816 injury cases in the TQP-PUF data set, 33 199 were DOA (.77%). 77.1% (25 604/33 199) of DOAs were male. In the low-ISS group, .36% (13 272/3 639 811) were DOA; in the intermediate-ISS group, 1.2% (4868/421 994) were DOA; and in the high-ISS group, 5.5% (15 059/275 011) were DOA. Motor vehicle collisions (MVCs) (11 262) and firearms (8894) were the most common injury types, equating to 60.7% of DOAs. Falls accounted for 9.1% of all DOAs. The most common DOA age-group was 18-64 years, followed by ≥65 years. Conclusion DOA trauma patients are predominately adult men suffering fatal blunt force injuries most frequently via MVC. DOAs are caused by all ranges of injury severity. We recommend further development of prevention programs thereby reducing the prevalence of common traumatic injuries, notably MVC, falls, and firearms to improve survival. Future studies should also investigate the access to and distribution of trauma centers and the role of helicopter, ground, and police transport modalities and transport time on and reducing DOAs and improving trauma patient outcomes.

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Association of resuscitative endovascular balloon occlusion of the aorta (REBOA) and mortality in penetrating trauma patients

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-020-01370-9 ◽

2020 ◽

Cited By ~ 3

Author(s):

Alberto F. García ◽

Ramiro Manzano-Nunez ◽

Claudia P. Orlas ◽

Juan Ruiz-Yucuma ◽

Alejandra Londoño ◽

...

Keyword(s):

Penetrating Trauma ◽

Balloon Occlusion ◽

Trauma Patients ◽

Endovascular Balloon Occlusion

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Assessing Surgical Quality Using Administrative and Clinical Data Sets: A Direct Comparison of the University HealthSystem Consortium Clinical Database and the National Surgical Quality Improvement Program Data Set

American Journal of Medical Quality ◽

10.1177/1062860609339936 ◽

2009 ◽

Vol 24 (5) ◽

pp. 395-402 ◽

Cited By ~ 92

Author(s):

Daniel L. Davenport ◽

Clyde W. Holsapple ◽

Joseph Conigliaro

Keyword(s):

Quality Improvement ◽

Clinical Data ◽

Quality Improvement Program ◽

Data Sets ◽

Clinical Database ◽

Improvement Program ◽

Data Set ◽

Surgical Quality ◽

The University ◽

Program Data

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The Association Between Early Versus Late Physical Therapy Initiation and Outcomes of Trauma Patients With and Without Traumatic Brain Injuries

Journal of Surgical Research ◽

10.1016/j.jss.2021.11.011 ◽

2022 ◽

Vol 273 ◽

pp. 34-43

Author(s):

Adel Elkbuli ◽

Dino Fanfan ◽

Mason Sutherland ◽

Kevin Newsome ◽

Jennifer Morse ◽

...

Keyword(s):

Physical Therapy ◽

Brain Injuries ◽

Traumatic Brain Injuries ◽

Trauma Patients ◽

Therapy Initiation

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Assessing the need for resuscitative endovascular balloon occlusion of the aorta (REBOA) for management of non-compressible hemorrhage at a Canadian urban trauma centre

10.21203/rs.3.rs-198760/v1 ◽

2021 ◽

Author(s):

Elizabeth Purssell ◽

Sean Patrick ◽

Joseph Haegert ◽

Vesna Ivkov ◽

John Taylor

Keyword(s):

Injury Severity ◽

Retrospective Chart Review ◽

Balloon Occlusion ◽

Trauma Centre ◽

Trauma Patients ◽

Potential Candidate ◽

Study Objective ◽

Resuscitative Thoracotomy ◽

Less Invasive ◽

Endovascular Balloon Occlusion

Abstract Introduction Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a less invasive alternative to resuscitative thoracotomy (RT) for life threatening, infra-diaphragmatic, non-compressible hemorrhage from trauma. Existing evidence surrounding the efficacy of REBOA is conflicting; nevertheless, expert consensus suggests that REBOA should be considered in select trauma patients. There has been a paucity of studies that evaluate the potential utility of REBOA in the Canadian setting. The study objective was to evaluate the percentage of trauma patients presenting to a Level 1 Canadian trauma centre that would have met criteria for REBOA. Methods We conducted a retrospective chart review of patients recorded in the British Columbia Trauma Registry who warranted a trauma team activation (TTA) at our institution. We identified REBOA candidates using pre-defined criteria based on published guidelines. Each TTA case was screened by a reviewer, and then each Potential Candidate was reviewed by a panel of trauma physicians for determination of final candidacy. Results Fourteen patients were classified as Likely REBOA Candidates (2.2% of TTAs, median age 46.1 years, 64.3% female). These patients had a median Injury Severity Score of 31.5 (IQR 26.8). The main sources of hemorrhage in these patients were from abdominal injuries (71.4%) and pelvic fractures (42.9%). Conclusion The percentage of patients who met criteria for REBOA is similar to that of RTs performed at our Canadian institution. While REBOA would be performed infrequently, it is a less-invasive alternative to RT, which could be a potentially life-saving procedure in a small group of the most severely injured trauma patients.

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Complications after craniosynostosis surgery: comparison of the 2012 Kids’ Inpatient Database and Pediatric NSQIP Database

Neurosurgical FOCUS ◽

10.3171/2015.9.focus15383 ◽

2015 ◽

Vol 39 (6) ◽

pp. E11 ◽

Cited By ~ 34

Author(s):

Yimo Lin ◽

I-Wen Pan ◽

Rory R. Mayer ◽

Sandi Lam

Keyword(s):

Quality Improvement ◽

Blood Transfusion ◽

Retrospective Chart Review ◽

Administrative Claims ◽

Data Sets ◽

Cardiac Events ◽

Improvement Program ◽

Data Set ◽

American College Of Surgeons ◽

Inpatient Database

OBJECT Research conducted using large administrative data sets has increased in recent decades, but reports on the fidelity and reliability of such data have been mixed. The goal of this project was to compare data from a large, administrative claims data set with a quality improvement registry in order to ascertain similarities and differences in content. METHODS Data on children younger than 12 months with nonsyndromic craniosynostosis who underwent surgery in 2012 were queried in both the Kids’ Inpatient Database (KID) and the American College of Surgeons Pediatric National Surgical Quality Improvement Program (Peds NSQIP). Data from published clinical craniosynostosis surgery series are reported for comparison. RESULTS Among patients younger than 12 months of age, a total of 1765 admissions were identified in KID and 391 in Peds NSQIP in 2012. Only nonsyndromic patients were included. The mean length of stay was 3.2 days in KID and 4 days in Peds NSQIP. The rates of cardiac events (0.5% in KID, 0.3% in Peds NSQIP, and 0.4%-2.2% in the literature), stroke/intracranial bleeds (0.4% in KID, 0.5% in Peds NSQIP, and 0.3%-1.2% in the literature), infection (0.2% in KID, 0.8% in Peds NSQIP, and 0%-8% in the literature), wound disruption (0.2% in KID, 0.5% in Peds NSQIP, 0%-4% in the literature), and seizures (0.7% in KID, 0.8% in Peds NSQIP, 0%-0.8% in the literature) were low and similar between the 2 data sets. The reported rates of blood transfusion (36% in KID, 64% in Peds NSQIP, and 1.7%-100% in the literature) varied between the 2 data sets. CONCLUSIONS Both the KID and Peds NSQIP databases provide large samples of surgical patients, with more cases reported in KID. The rates of complications studied were similar between the 2 data sets, with the exception of blood transfusion events where the retrospective chart review process of Peds NSQIP captured almost double the rate reported in KID.

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