Ronald Tesoriero

Angeles University Foundation

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Thomas M. Scalea

University of Maryland, Baltimore

Brandon R. Bruns

The University of Texas Southwestern Medical Center

Deborah M. Stein

University of Maryland, Baltimore

José J. Diaz

University of South Florida

Margaret H. Lauerman

University of Maryland, Baltimore

Mayur Narayan

Johnson University

Elena N. Klyushnenkova

University of Maryland, Baltimore

Anthony V. Herrera

University of Maryland, Baltimore

Joseph A. Kufera

University of Maryland, Baltimore

Clint W. Sliker

University of Maryland, Baltimore

Cooperative Institutions

University of Maryland, Baltimore

105

University of Maryland Medical Center

University of California, San Francisco

University of Baltimore

Johns Hopkins University

San Francisco General Hospital

American College of Surgeons

Angeles University Foundation

American Association for the Surgery of Trauma

University of Maryland Medical System

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Article title: Inhibiting CARD11 translation during BCR activation by targeting the eIF4A RNA helicase

James J. Steinhardt Raymond J. Peroutka Krystyna Mazan-Mamczarz Qing Chen Simone Houng

RNA Helicase A

breakpoint cluster region

Eukaryotic translation

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Citations (0)

Nontrauma open abdomens

Journal of Trauma and Acute Care Surgery (2016)

Brandon R. Bruns Sarwat A. Ahmad Lindsay O’Meara Ronald Tesoriero Margaret H. Lauerman

Damage-control surgery with open abdomen (OA) is described for trauma, but little exists regarding use in the emergency general surgery. This study aimed to better define the following: demographics, indications for surgery and OA, fascial and surgical site complications, and in-hospital/long-term mortality. We hypothesize that older patients will have increased mortality, patients will have protracted stays, they will require specialized postdischarge care, and the indications for OA will be varied.A prospective observational study of emergency general surgery OA patients from June 2013 to June 2014 was performed. Demographics, clinical/operative variables, comorbidities, indications for procedure and OA, wound/fascial complications, and disposition were collected. Patients were stratified into age groups (≤ 60, 61-79, and ≥ 80 years). Six-month and 1-year mortality was determined by query of the Social Security Death Index.A total of 338 laparotomies were performed, of which 96 (28%) were managed with an OA. Median age was 61 years (interquartile range [IQR], 0-68 years), and 51% were male. The median Charlson Comorbidity Index was 2 (IQR, 1.5-5.1), and the median hospital stay was 25 days (IQR, 15-50 days). The most common indications for operation were perforated viscus/free air (20%), mesenteric ischemia (17%), peritonitis (16%), and gastrointestinal hemorrhage (12%). The most common indication for OA was damage control (37%). In the 63 patients with fascial closure, there were 9 (14%) wound infections and 6 (10%) fascial dehiscences. A total of 30% of the patients died in the hospital, and an additional six patients died 6 months after discharge. Patients in the oldest age stratum were more likely to die at 6 months than those in the lower strata.Older patients were more likely to die by 6 months, the median hospital stay was 3 weeks, and there were multiple indications for OA management. With a 6-month mortality of 36% and 70% of survivors requiring postdischarge care, this population represents a critically ill population meriting additional study.Prognostic and epidemiologic study, level III.

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Demographics

Mesenteric Ischemia

Damage Control Surgery

10.1097/ta.0000000000000958

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The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis

Journal of Trauma and Acute Care Surgery (2020)

Zachary A. Matthay Aaron E. Kornblith Ellicott C. Matthay Mahsa Sedaghati Sue Peterson

BACKGROUND The large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses. METHODS A single-center interrupted time-series analysis was performed to identify associations of shelter-in-place with trauma volume, injury mechanisms, and patient demographics in San Francisco, California. To control for short-term trends in trauma epidemiology, weekly level data were analyzed 6 months before shelter-in-place. To control for long-term trends, monthly level data were analyzed 5 years before shelter-in-place. RESULTS Trauma volume decreased by 50% in the week following shelter-in-place ( p < 0.01), followed by a linear increase each successive week ( p < 0.01). Despite this, trauma volume for each month (March–June 2020) remained lower compared with corresponding months for all previous 5 years (2015–2019). Pediatric trauma volume showed similar trends with initial decreases ( p = 0.02) followed by steady increases ( p = 0.05). Reductions in trauma volumes were due entirely to changes in nonviolent injury mechanisms, while violence-related injury mechanisms remained unchanged ( p < 0.01). CONCLUSION Although the shelter-in-place order was associated with an overall decline in trauma volume, violence-related injuries persisted. Delineating and addressing underlying factors driving persistent violence-related injuries during shelter-in-place orders should be a focus of public health efforts in preparation for future pandemic responses. LEVEL OF EVIDENCE Epidemiological study, level III.

Trauma Center

Demographics

Social distance

Penetrating Trauma

Blunt trauma

10.1097/ta.0000000000003044

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Citations (37)

Repair of Cardiac Injuries

Springer eBooks (2022)

Ronald Tesoriero Jose Rubero

10.1007/978-3-030-85047-0_30

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Critical Care Management of Severe Acute Pancreatitis

Springer eBooks (2016)

Ronald Tesoriero José J. Diaz

Fulminant

Organ dysfunction

10.1007/978-3-319-33341-0_17

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Citations (3)

Outcomes of Venovenous Extracorporeal Membrane Oxygenation When Stratified by Age: How Old Is Too Old?

ASAIO Journal (2019)

Kristopher B. Deatrick Michael Mazzeffi Samuel M. Galvagno Ronald Tesoriero David J. Kaczoroswki

The purpose of this study was to evaluate survival to hospital discharge for patients on venovenous extracorporeal membrane oxygenation (VV ECMO) when stratified by age. We performed a retrospective study at single, academic, tertiary care center intensive care unit for VV ECMO. All patients, older than 17 years of age, on VV ECMO admitted to a specialized intensive care unit for the management of VV ECMO between August 2014 and May 2018 were included in the study. Trauma and bridge-to-lung transplant patients were excluded for this analysis. Demographics, pre-ECMO and ECMO data were collected. Primary outcome was survival to hospital discharge when stratified by age. Secondary outcomes included time on VV ECMO and hospital length of stay (HLOS). One hundred eighty-two patients were included. Median P/F ratio at time of cannulation was 69 [56-85], and respiratory ECMO survival prediction (RESP) score was 3 [1-5]. Median time on ECMO was 319 [180-567] hours. Overall survival to hospital discharge was 75.8%. Lowess and cubic spline curves demonstrated an inflection point associated with increased mortality at age >45 years. Kaplan-Meier analysis demonstrated significantly greater survival in patients <45 years of age (p = 0.0001). Survival to hospital discharge for those

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Hospital discharge

10.1097/mat.0000000000001076

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Citations (34)

Adult emergency resuscitative thoracotomy: A Western Trauma Association clinical decisions algorithm

Journal of Trauma and Acute Care Surgery (2024)

Ronald Tesoriero Raúl Coimbra Walter L. Biffl Clay Cothren Burlew Chasen A. Croft

Tesoriero, Ronald MD, FACS; Coimbra, Raul MD, PhD, FACS; Biffl, Walter L. MD, FACS; Burlew, Clay Cothren MD, FACS; Croft, Chasen A. MD; Fox, Charles MD, FACS; Hartwell, Jennifer L. MD; Keric, Natasha MD; Lorenzo, Manuel MD, MBA, FACS, FCCM; Martin, Matthew J. MD, FACS; Magee, Gregory A. MD, MSc; Moore, Laura J. MD, FACS; Privette, Alica R. MD, FACS; Schellenberg, Morgan MD, FACS; Schuster, Kevin M. MD, MPH, FACS; Weinberg, Jordan A. MD; Stein, Deborah M. MD, MPH, FACS, FCCM Author Information

Thoracotomy

Association (psychology)

10.1097/ta.0000000000004462

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Citations (1)

Evaluation and management of blunt traumatic aortic injury

Journal of Trauma and Acute Care Surgery (2015)

Nicole Fox Diane A. Schwartz Jose H. Salazar Elliott R. Haut Philipp Dahm

Blunt traumatic aortic injury (BTAI) is the second most common cause of death in trauma patients. Eighty percent of patients with BTAI will die before reaching a trauma center. The issues of how to diagnose, treat, and manage BTAI were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the practice management guidelines on this topic published in 2000. Since that time, there have been advances in the management of BTAI. As a result, the EAST guidelines committee decided to develop updated guidelines for this topic using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework recently adopted by EAST.A systematic review of the MEDLINE database using PubMed was performed. The search retrieved English language articles regarding BTAI from 1998 to 2013. Letters to the editor, case reports, book chapters, and review articles were excluded. Topics of investigation included imaging to diagnose BTAI, type of operative repair, and timing of operative repair.Sixty articles were identified. Of these, 51 articles were selected to construct the guidelines.There have been changes in practice since the publication of the previous guidelines in 2000. Computed tomography of the chest with intravenous contrast is strongly recommended to diagnose clinically significant BTAI. Endovascular repair is strongly recommended for patients without contraindications. Delayed repair of BTAI is suggested, with the stipulation that effective blood pressure control must be used in these patients.

Grading (engineering)

10.1097/ta.0000000000000470

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Citations (162)

Angiographic embolization for hemorrhage following pelvic fracture

Journal of Trauma and Acute Care Surgery (2016)

Ronald Tesoriero Brandon R. Bruns Mayur Narayan Joseph J. DuBose Sundeep Guliani

Major pelvic disruption with hemorrhage has a high rate of lethality. Angiographic embolization remains the mainstay of treatment. Delays to angiography have been shown to worsen outcomes in part because time spent awaiting mobilization of resources needed to perform angiography allows ongoing hemorrhage. Alternative techniques like pelvic preperitoneal packing and aortic balloon occlusion now exist. We hypothesized that time to angiographic embolization at our Level 1 trauma center would be longer than 90 minutes.A retrospective review was performed of patients with pelvic fracture who underwent pelvic angiography at our trauma center over a 10-year period. The trauma registry was queried for age, sex, injury severity score, hemodynamic instability (HI) on presentation, and transfusion requirements within 24 hours. Charts were reviewed for time to angiography, embolization, and mortality.A total of 4712 patients were admitted with pelvic fractures during the study period, 344 (7.3%) underwent pelvic angiography. Median injury severity score was 29. Median 24-hour transfusion requirements were five units of red blood cells and six units of fresh frozen plasma. One hundred fifty-one patients (43.9%) presented with HI and 104 (30%) received massive transfusion (MT). Median time to angiography was 286 minutes (interquartile range, 210-378). Times were significantly shorter when stratified for HI (HI, 264 vs stable 309 minutes; p = 0.003), and MT (MT, 230 vs non-MT, 317 minutes; p < 0.001), but still took nearly 4 hours. Overall mortality was 18%. Hemorrhage (35.5%) and sepsis/multiple-organ failure (43.5%) accounted for most deaths.Pelvic fracture hemorrhage remains a management challenge. In this series, the median time to embolization was more than 5 hours. Nearly 80% of deaths could be attributed to early uncontrolled hemorrhage and linked to delays in hemostasis. Earlier intervention by Acute Care Surgeons with techniques like preperitoneal packing, aortic balloon occlusion, and use of hybrid operative suites may improve outcomes.Therapeutic study, level V.

Pelvic fracture

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Trauma Center

Single Center

10.1097/ta.0000000000001259

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Citations (129)

Acute Care Surgery: Defining the Economic Burden of Emergency General Surgery

Journal of the American College of Surgeons (2016)

Mayur Narayan Ronald Tesoriero Brandon R. Bruns Elena N. Klyushnenkova Hegang Chen

Interquartile range

10.1016/j.jamcollsurg.2016.01.054

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Citations (33)