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Trauma & Acute Care Surgery

Trauma & Acute Care Surgery > Peer-Reviewed Publications 2015

Research


Lancaster General Hospital’s Trauma Service has a very active clinical research program. We have a Clinical Research Coordinator who organizes and sets up monthly research meetings with timelines for presentations at national meetings.

We are also supported by the Research Institute at Lancaster General Hospital, which provides strong statistical support for the numerous projects that we are involved with. At any one time, we have a number of ongoing projects, many of which have been presented for both podium and poster presentations at naional trauma meetings, inlcuding the American Assoication for the Surgery of Trauma, Society of Critical Care Medicine, American College of Surgeons, etc.

The participants in our research program include the trauma surgeons, nurses and advanced practioners, who work in Trauma Service, as well as several of our liasons from other specialties. This activity has been supported through the administratiom of Lancaster Genreal Hospital. Trauma Service has received numerous accolades for some of the research projects that we have accomplished.


Summaries of Peer-Reviewed Publications of 2015

Click on summary titles for the corresponding PDF full reports. 

Hyponatremia as a fall predictor in a geriatric trauma population
Approximately one in three older adults fall each year, resulting in a significant proportion of geriatric traumatic injuries. The purpose of this study was to characterize the impact of hyponatremia on falls in the geriatric population. Results suggest hyponatremic patients are significantly more likely to be admitted for a fall compared to non-hyponatremic patients.

The Golden Hour in Trauma: Dogma or Medical Folklore?
This editorial details the efficacy of the "golden hour" for today's trauma patients.

An Analysis of Geriatric Recidivism in the era of Accountable Care Organizations
To date, there are almost 500 accountable care organizations across the United States emphasizing cost-effective care. As readmissions largely impact health care cost, this study sought to determine factors associated with geriatric trauma readmissions (recidivism) within our institution. Multivariate modeling found female sex, admission Glasgow Coma Scale score of 15, history of head trauma, and preexisting pulmonary disease to be significant predictors of recidivism. 

An Analysis of Brain Trauma Foundation Traumatic Brain Injury Guideline Compliance and Patient Outcome
Evidence-based guidelines for the care of severe traumatic brain injury (TBI) have been available from the Brain Trauma Foundation (BTF) since 1995. Although each individual guideline has been validated in isolation, to date, little resarch has examined the guidelines in composite. This study aimed to examine the relationship between compliance with the BTF guidelines and mortality. Results suggest full compliance with all guidelines is difficult to achieve and may not be necessary to optimally care for TBI patients.

The ACT Alert: Preliminary Results of a Novel Protocol to Assess Geriatric Head Trauma Patients on Anticoagulation
In busy emergency departments (ED), elderly patients on anticoagulation (AC) sustaining minor injuries who are triaged to a lower priority for evaluation are at risk for potentially serious consequences. This study sought to analyze the impact of a novel Anticoagulation and Trauma (ACT) Alert protocol on improving outcomes in this population. Results of this investigation showed the ACT Alert improved ED throughput and reduced hospital length of stay.

An Innovative Approach for Decreasing Fall Trauma Admissions from Geriatric Living Facilities: Preliminary Investigation
Geriatric living facilities have been associated with a high rate of falls. This study detailed a novel intervention approach targeting geriatric living facilities designed to reduce geriatric fall admissions to our level II trauma center. Results of this intervention found a significant decrease in geriatric fall admissions following the implementation of this protocol.

Under Fire: Gun Violence is not just an Urban Problem
Gun violence continues to be a source of trauma patient morbidity and mortality annuall in the United States. This study sought to characterize gun violence in Lancaster County, Pennsylvania. A low-level pattern of gun violence was identified in Lancaster over time with no change in mortality observed for those afflicted by gunshot wounds.

Do Magnet Hospitals Attract Better Outcomes for Pediatric Traumatic Brain Injury Patients
Research suggests hospitals attaining Magnet recognition have improved outcomes compared to non-Magnet centers for adult patients. This study sought to determine whether decreased mortality for pediatric patients would also be found at Magnet centers. Results suggest equal outcomes for pediatric trauma patients managed at Magnet and non-Magnet centers.

A Reduction in Antipsychotic Medications is associated with a Decrease in Geriatric Fall Trauma
Research suggests medications, such as antipsychotics, with extensive side-effects may contribute to the high fall rate in older adults. This study sought to determine whether a resident-specific antipsychotic reduction initiative at a local extended care facility would decrease falls. Results found a significant decrease in falls following the implentation of this intervention.

Do Intracranial Pressure Monitors Improve Survival in Pediatric Traumatic Brain Injury Patients?
Intracranial pressure (ICP) monitoring in pediatric traumatic brain injury (TBI) patients is controversial. This study sought to characterize the risk-adjusted impact of ICP monitor placement on mortality for severe head injured pediatric trauma patients. Results found no survival advantage for pediatric patients manged with ICP monitors.  



 
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