A Civilian/Military Trauma Institute: National Trauma Coordinating Center

AbstractIntroduction:Injury patterns are closely related to changes in behavior. Pandemics and measures undertaken against them may cause changes in behavior; therefore, changes in injury patterns during the coronavirus disease 2019 (COVID-19) outbreak can be expected when compared to the parallel period in previous years.Study Objective:The aim of this study was to compare injury-related hospitalization patterns during the overall national lockdown period with parallel periods of previous years.Methods:A retrospective study was completed of all patients hospitalized from March 15 through April 30, for years 2016-2020. Data were obtained from 21 hospitals included in the national trauma registry during the study years. Clinical, demographic, and circumstantial parameters were compared amongst the years of the study.Results:The overall volume of injured patients significantly decreased during the lockdown period of the COVID-19 outbreak, with the greatest decrease registered for road traffic collisions (RTCs). Patients’ sex and ethnic compositions did not change, but a smaller proportion of children were hospitalized during the outbreak. Many more injuries were sustained at home during the outbreak, with proportions of injuries in all other localities significantly decreased. Injuries sustained during the COVID-19 outbreak were more severe, specifically due to an increase in severe injuries in RTCs and falls. The proportion of intensive care unit (ICU) hospitalizations did not change, however more surgeries were performed; patients stayed less days in hospital.Conclusions:The lockdown period of the COVID-19 outbreak led to a significant decrease in number of patients hospitalized due to trauma as compared to parallel periods of previous years. Nevertheless, trauma remains a major health care concern even during periods of high-impact disease outbreaks, in particular due to increased proportion of severe injuries and surgeries.

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Abstract No. 54 Utilization and efficacy of prophylactic inferior vena cava filter placement in severely injured trauma patients at high thromboembolic event risk: a National Trauma Data Bank Study

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2021.03.473 ◽

2021 ◽

Vol 32 (5) ◽

pp. S24

Author(s):

S. Lee ◽

S. Fan ◽

R. Duszak ◽

J. Gichoya ◽

B. Majdalany ◽

...

Keyword(s):

Inferior Vena Cava Filter ◽

Thromboembolic Event ◽

Inferior Vena ◽

Vena Cava ◽

Data Bank ◽

Trauma Patients ◽

Filter Placement ◽

National Trauma ◽

Event Risk ◽

National Trauma Data Bank

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Can military trauma promote psychological growth in combat veterans? Results from the National Health and Resilience in Veterans Study

Journal of Affective Disorders ◽

10.1016/j.jad.2020.12.077 ◽

2020 ◽

Author(s):

Jared Greenberg ◽

Jack Tsai ◽

Steven M. Southwick ◽

Robert H. Pietrzak

Keyword(s):

National Health ◽

Combat Veterans ◽

Psychological Growth ◽

Military Trauma

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5. The Child and Japanese National Trauma

The Uncanny Child in Transnational Cinema ◽

10.1515/9789048537792-008 ◽

2018 ◽

pp. 155-184

Keyword(s):

National Trauma

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Hypocalcemia in Military Casualties From Point of Injury to Surgical Teams in Afghanistan

Military Medicine ◽

10.1093/milmed/usaa267 ◽

2021 ◽

Vol 186 (Supplement_1) ◽

pp. 300-304

Author(s):

Jeffrey R Conner ◽

Linda C Benavides ◽

Stacy A Shackelford ◽

Jennifer M Gurney ◽

Edward F Burke ◽

...

Keyword(s):

Blood Product ◽

Calcium Supplementation ◽

Cohort Analysis ◽

Blood Product Transfusion ◽

Blood Products ◽

Military Trauma ◽

Retrospective Cohort Analysis ◽

Increased Risk ◽

Surgical Teams ◽

Patterns Of Injury

ABSTRACT Introduction Hypocalcemia is a known sequela of citrated blood product transfusion. Civilian data suggest hypocalcemia on hospital admission is associated with worse outcomes. Initial calcium levels in military casualties have not previously been analyzed. The objective of this retrospective review aimed to assess the initial calcium levels in military trauma casualties at different Forward Surgical Teams (FST) locations in Afghanistan and describe the effects of prehospital blood product administration on arrival calcium levels. Materials and Methods This is a retrospective cohort analysis of military casualties arriving from point of injury to one of two FSTs in Afghanistan from August 2018 to February 2019 split into four locations. The primary outcome was incidence of hypocalcemia (ionized calcium < 1.20 mmol/L). Results There were 101 patients included; 55 (54.5%) experienced hypocalcemia on arrival to the FST with a mean calcium of 1.16 mmol/L (95% confidence interval [CI], 1.14 to 1.18). The predominant mechanism of injury consisted of blast patterns, 46 (45.5%), which conferred an increased risk of hypocalcemia compared to all other patterns of injury (odds ratio = 2.42, P = .042). Thirty-eight (37.6%) patients required blood product transfusion. Thirty-three (86.8%) of the patients requiring blood product transfusion were hypocalcemic on arrival. Mean initial calcium of patients receiving blood product was 1.13 mmol/L (95% CI, 1.08 to 1.18), which was significantly lower than those who did not require transfusion (P = .01). Eight (7.9%) of the patients received blood products before arrival, with 6/8 (75%) presenting with hypocalcemia. Conclusions Hypocalcemia develops rapidly in military casualties and is prevalent on admission even before transfusion of citrated blood products. Blast injuries may confer an increased risk of developing hypocalcemia. This data support earlier use of calcium supplementation during resuscitation.

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