Collin Stewart

Interests

Research

Rib fracturesResource utilization

Courses

No activities entered.

Scholarly Contributions

Chapters

• Stewart, C., & Tang, A. (2022). Esophagus, Stomach, and Duodenum. In Surgical Critical Care and Emergency Surgery: Clinical Questions and Answers. Wiley.
• Stewart, C., Chehab, M., & Joseph, B. (2022). Tracheal and Pulmonary Injury. In Management of Chest Trauma: A Practical Guide. Springer International Publishing. doi:10.1007/978-3-031-06959-8_17
  More info

  Chest injuries, both blunt and penetrating, are common and are responsible for at least a quarter of the mortalities seen in trauma patients. These injuries are diverse, encompassing the entirety of the respiratory tract from the trachea to the lungs. Tracheobronchial injuries most often lead to airway compromise and necessitate emergent surgical intervention to restore airway continuity. Although rare, tracheobronchial injuries are often fatal and even when timely managed are not uncommonly associated with anastomotic complications. The much more common pulmonary injuries include pneumothorax, hemothorax, and parenchymal injury. Although often managed nonoperatively, patients with pulmonary injuries may require surgical interventions to excise unsalvageable lung tissue, restore hemodynamic stability in cases of massive hemothorax, or evacuate retained blood clots. This chapter provides an overview of the common presentation and necessary diagnostic procedures for an accurate assessment of patients with tracheal and pulmonary injury. Furthermore, it describes the appropriate management for such patients and the complications that may arise.

Journals/Publications

• Al Ma'ani, M., Castillo Diaz, F., Hejazi, O., Khurshid, M. H., Kunac, A., Stewart, C., Colosimo, C., Nelson, A., Magnotti, L. J., & Joseph, B. (2025). The Alarming Surge of Driving Under the Influence-Related Motor Vehicle Crashes. Journal of Surgical Research, 314. doi:10.1016/j.jss.2025.07.020
  More info

  Introduction: The use of alcohol and illicit substances is increasing in the United States. However, it is not clear what proportion of motor vehicle crashes (MVCs) are related to driving under the influence (DUI) of alcohol or drugs. The aim of this study was to assess the prevalence and trends of positive drug and alcohol tests among drivers of MVCs admitted to trauma centers across the United States over the years. Methods: This is a retrospective analysis of the American College of Surgeons-Trauma Quality Improvement Program database over 4 years (2017-2020). Using International Classification of Diseases-10 diagnosis and E codes, we included patients presenting after an MVC as a driver of vehicles (cars, motorcycles, heavy transport vehicles, and three-wheeled motor vehicles). Trend analysis was performed for the rates of positive blood or urine toxicology results (alcohol, marijuana, cocaine, amphetamines, methamphetamines, and opiates) among these patients over the years. Results: Over 4 years, from a total of 683,184 MVC drivers with trauma were identified (adolescents [10-19 yr]: 7.6%; young adults [20-64 yr]: 77.1%; older adults [≥65 yr]: 15.3%). The mean (standard deviation) age was 43 (19), and 69% were male. The median (interquartile range) Injury Severity Score was 9 (4-14). The median Glasgow Coma Scale score was 15, and 20% had a Glasgow Coma Scale score of less than 15 on presentation. Overall, 65.8% of the victims were car drivers, followed by motorcyclists (25%), heavy transport vehicle drivers (8.6%), and three-wheeled motor vehicle riders (0.5%). The drug or alcohol screening test was positive in 28.8% of drivers, with 36.3% of them testing positive for more than one substance. Overall, alcohol was the most common substance found (47.1%), followed by marijuana (41.6%), and amphetamines (16.3%). Among those with positive screen tests, 52.9% tested positive for drugs other than alcohol, around two-thirds (59.2%) of which tested positive for marijuana. Trend analysis indicated that the incidence of substance abuse-related MVCs increased significantly from 27% in 2017 to 32% in 2020 (P < 0.001), with the most notable rise in cannabis-abuse-related MVCs (2017:10.2%; 2020:14.6%, P < 0.001). Subanalysis of different age groups demonstrated the same trend toward increasing DUI-related MVCs, with the most prominent rise in the prevalence of marijuana-positive MVC drivers among adolescents. Conclusions: Despite policies in place for the prevention of DUI, the prevalence of drug- or alcohol-related MVCs has been increasing over the years, with over one-third of MVC drivers having a positive drug screen on admission in 2020. This surge was even more prominent among adolescents with positive marijuana screen. These findings provide essential epidemiological data as to the prevalence of DUI, which will further inform policymakers to prevent DUI-related MVCs.
• Al Ma'ani, M., Castillo Diaz, F., Khurshid, M. H., Hejazi, O., Anand, T., Spencer, A. L., Stewart, C., Kunac, A., Magnotti, L. J., & Joseph, B. (2025). Silence of the Brittle: The Role of Frailty in Pain Perception and Management in Geriatric Trauma Patients. Journal of Surgical Research, 314. doi:10.1016/j.jss.2025.06.079
  More info

  Introduction: Pain management in geriatric trauma patients is linked to improved quality of life and better outcomes. However, the role of patient-related factors in pain perception and management is unknown. The aim of our study is to assess whether frailty is associated with differences in daily pain scores and analgesic use among geriatric trauma patients. Methods: We performed a 2-y (2021-2022) analysis of geriatric database at our level I trauma center. We included all geriatric (≥65 y) patients admitted to our trauma service with normal neurological exam and length of stay >48 h. Patients were stratified using the trauma-specific frailty index into frail (F) and nonfrail (NF) groups. Daily pain scores (10-point numeric scale), the highest reported pain score during the admission, regional and systemic analgesia received in the first 7 d, and overall analgesic requirements were recorded and compared. Analgesics were converted to morphine milligram equivalents. Descriptive statistics and multivariable linear regression analyses, adjusting for potential confounding factors were performed. Results: We identified a total of 275 geriatric trauma patients (NF 167, F 108). The mean age was 78 (8) y and 52% were male. The median injury severity score was 9 [4-10], with 93% sustaining blunt injuries. There were no significant differences in terms of patients’ demographic and injury characteristics between F and NF groups. On univariate analysis, the F group were less likely to report pain and had significantly lower opioid morphine milligram equivalent requirements in the first week of admission and overall. On linear regression analysis, frailty was independently associated with lower average pain scores in the first week (β = −1.81, 95% confidence interval [CI] [−3.51 to −0.11], P = 0.038), lower overall highest pain scores (β = −0.97, 95% CI [−1.64 to −0.302], P = 0.05), and received less opioids per day in the first week (β = −10.63, 95% CI [−16.55 to −4.71], P < 0.001) and overall (β = −15.02, 95% CI [−22.81 to −7.24], P < 0.001). Subanalysis of patients substratified by injury severity score showed similar trends. Conclusions: Frailty was associated with lower reported pain scores and reduced opioid use, regardless of injury severity. Whether these discrepancies are owing to differences in pain perception by patients or under-reporting it to health-care providers is yet to be understood. These findings lay the foundation for further research to explore the role of frailty on the pathophysiology of pain in geriatric trauma patients.
• Al Ma'ani, M., Castillo Diaz, F., Hejazi, O., Khurshid, M. H., Kunac, A., Stewart, C., Colosimo, C., Nelson, A., Magnotti, L. J., & Joseph, B. (2025). The Alarming Surge of Driving Under the Influence-Related Motor Vehicle Crashes. The Journal of surgical research, 314, 146-152.
  More info

  The use of alcohol and illicit substances is increasing in the United States. However, it is not clear what proportion of motor vehicle crashes (MVCs) are related to driving under the influence (DUI) of alcohol or drugs. The aim of this study was to assess the prevalence and trends of positive drug and alcohol tests among drivers of MVCs admitted to trauma centers across the United States over the years.
• Al Ma'ani, M., Castillo Diaz, F., Khurshid, M. H., Hejazi, O., Anand, T., Spencer, A. L., Stewart, C., Kunac, A., Magnotti, L. J., & Joseph, B. (2025). Silence of the Brittle: The Role of Frailty in Pain Perception and Management in Geriatric Trauma Patients. The Journal of surgical research, 314, 291-297.
  More info

  Pain management in geriatric trauma patients is linked to improved quality of life and better outcomes. However, the role of patient-related factors in pain perception and management is unknown. The aim of our study is to assess whether frailty is associated with differences in daily pain scores and analgesic use among geriatric trauma patients.
• Al Ma'ani, M., Hejazi, O., Sarani, B., Castillo Diaz, F., Khurshid, M. H., Nelson, A., Stewart, C., Anand, T., Magnotti, L. J., & Joseph, B. (2025). Outcomes of rib fixation versus nonoperative management in flail chest: Does body mass index change the equation?. The journal of trauma and acute care surgery.
  More info

  The aim of this study is to identify the relationship between body mass index (BMI) and outcomes of surgical stabilization of rib fractures (SSRF) versus nonoperative management.
• Colosimo, C., Mahankali, P., Hejazi, O., Bhogadi, S., Anand, T., Nelson, A., Stewart, C., Spencer, A., Ditillo, M., Magnotti, L., & Joseph, B. (2025). On the backseat: Analyzing motorcycle passenger injuries in children. American Journal of Surgery, 247. doi:10.1016/j.amjsurg.2025.116490
  More info

  Introduction: Despite the high risk of fatality from traveling in a motorcycle compared to motor vehicles, only five states have an age limit for motorcycle passengers. Literature is profoundly lacking on injury patterns of motorcycle passengers, particularly children. We studied injury patterns and helmet use for motorcycle passengers in children
• Hejazi, O., Colosimo, C., Khurshid, M. H., Stewart, C., Al Ma'ani, M., Anand, T., Castillo Diaz, F., Castanon, L., Magnotti, L. J., & Joseph, B. (2025). Does frailty predict readmission and mortality in diverticulitis? A nationwide analysis. The journal of trauma and acute care surgery, 99(4), 605-610.
  More info

  Diverticulitis is a major health concern in the United States affecting up to 25% of elderly population. It is unknown if frailty increases the risk of recurrent diverticulitis. The aim of our study is to identify the association between frailty and recurrence of diverticulitis.
• Hejazi, O., Stewart, C., Khurshid, M. H., Spencer, A. L., Castillo Diaz, F., Kunac, A., Al Ma'Ani, M., Okosun, S. E., Magnotti, L. J., & Joseph, B. (2025). Predictors of discharge against medical advice in pediatric trauma patients: A nationwide analysis. Journal of Trauma and Acute Care Surgery, 99(Issue 3). doi:10.1097/ta.0000000000004632
  More info

  BACKGROUND Discharge from hospital against medical advice (AMA) carries a significant risk of readmission and has increased rates of morbidity and mortality. Little is known about the characteristics of pediatric trauma patients discharged AMA. We aimed to identify predictors for discharge AMA in pediatric trauma patients. METHODS A 3-year retrospective cohort analysis of the 2017-2019 American College of Surgeons (ACS) Trauma Quality Improvement Program was performed. All pediatric (younger than 18 years) trauma patients were included. Patients with missing data on hospital discharge disposition were excluded. Two groups were compared: those discharged AMA and those who were not. Bivariate analysis using χ2 test was performed. A multivariable logistic regression analysis was performed to identify predictors for discharge AMA adjusting for age, sex, race, ethnicity, comorbidities, positive drug or alcohol screen, insurance status, injury severity, 4-hour packed red blood cells requirements, vitals, mechanisms of injury, and ACS Pediatric Trauma Center Verification Level. RESULTS A total of 259,363 pediatric trauma patients were identified; 436 (0.2%) were discharged AMA. Patients discharged AMA were older (mean age, 13 vs. 10 years; p < 0.001) and were more likely to be males (70% vs. 65%, p < 0.001), Black (31% vs. 18%, p < 0.001), and uninsured; to have a penetrating mechanism of injury (17% vs. 9%, p < 0.001); to be a victim of an assault; and to be treated at a non-pediatric-ACS-verified trauma center. Patients discharged AMA were more likely to test positive for alcohol or illicit drugs at time of admission. They were also more likely to undergo an abuse investigation and to be reported to Child Protective Services. CONCLUSION Discharge AMA is affected by different patient- and system-related factors. Understanding these factors could enable targeted interventions in clinical practice and policy. Our findings highlight the important role of pediatric trauma centers in addressing the needs of injured children. LEVEL OF EVIDENCE Therapeutic/Care Management; Level III.
• Hejazi, O., Stewart, C., Khurshid, M. H., Spencer, A. L., Castillo Diaz, F., Kunac, A., Al Ma'ani, M., Okosun, S. E., Magnotti, L. J., & Joseph, B. (2025). Predictors of discharge against medical advice in pediatric trauma patients: A nationwide analysis. The journal of trauma and acute care surgery, 99(3), 433-438.
  More info

  Discharge from hospital against medical advice (AMA) carries a significant risk of readmission and has increased rates of morbidity and mortality. Little is known about the characteristics of pediatric trauma patients discharged AMA. We aimed to identify predictors for discharge AMA in pediatric trauma patients.
• Huang, R., Hejazi, O., Khurshid, M. H., Nelson, A., Stewart, C., Anand, T., Matthews, M. R., Okosun, S. E., Magnotti, L. J., & Joseph, B. (2025). Diversity in crisis: The impact of race and ethnicity on failure to rescue among geriatric trauma patients over the years. Journal of Trauma and Acute Care Surgery, 99(Issue 2). doi:10.1097/ta.0000000000004514
  More info

  BACKGROUND Failure to rescue (FTR) is an indicator of the quality of care provided by trauma centers. The aim of this study was to examine the trends of FTR incidence in geriatric trauma patients over the years and to determine whether race, ethnicity, and sex impact the FTR incidence. METHODS This is a retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program database over 4 years (2017-2020). All geriatric (≥60 years) trauma patients were included. Patients who died within 24 hours of admission or whose length of stay was ≤1 day were excluded. Trend analysis was performed. Patients were stratified based on race, ethnicity, and sex, and multivariable regression analyses were performed. RESULTS Over the course of 4 years, 1,105,651 geriatric patients were identified, of whom 30,984 (2.8%) developed major complications and 10,684 (34.5% of those with complications) had FTR. The mean (SD) age was 75 (9) years, 46% were male, 86% were White, and 6% were Hispanic. The median (interquartile range) Injury Severity Score was 9 (4-10) with no change over the years (p = 0.364) and 96.8% sustained a blunt injury. Over the 4 years, the rate of FTR increased from 0.55% in 2017 to 1.04% in 2020 (p < 0.001). An analysis of trends in FTR patients revealed no significant difference in the proportion of males and females over the years (p = 0.482). However, there was a notable increase in the proportion of Black and Hispanic patients in comparison with White (p < 0.001) and non-Hispanic patients (p = 0.023), respectively. The odds of developing FTR have been increasing over the years, with Black race and Hispanic ethnicity identified as the independent risk factors for FTR. CONCLUSION The risk-adjusted odds of developing FTR have been increasing over the years, with one in every three patients who developed complications not surviving to discharge. Our findings demonstrate that racial and ethnic factors significantly impact the incidence of FTR.
• Khurshid, M. H., Castillo Diaz, F., Hejazi, O., Al Ma'ani, M., Stewart, C., Spencer, A. L., Anand, T., Kunac, A., Magnotti, L. J., & Joseph, B. (2025). Report Cards Are Out: Nine Years of Nonoperative Management for Blunt Abdominal Solid Organ Trauma. Journal of Surgical Research, 314. doi:10.1016/j.jss.2025.06.073
  More info

  Introduction: There has been a dramatic shift toward nonoperative management (NOM) of blunt abdominal solid organ injuries (ASOIs) with angioembolization (AE). However, there is a lack of evidence assessing temporal trends in AE use, timing of intervention, and how these trends relate to NOM failure and patient outcomes over time. The aim of this study was to assess the trends in time to AE, its association with failure of NOM, and outcomes of these patients across the United States. Materials and methods: We performed a retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program database over 9 y, ending in 2021. We included adult patients (age ≥ 18 y) with blunt ASOI (spleen, liver, and kidney) who underwent AE within 4 h of hospital arrival. Patients who underwent operative intervention before AE were excluded. The primary outcome measured was the failure of NOM. Secondary outcomes included major complications, 24-h mortality, and in-hospital mortality. Multivariable regression analyses were performed to identify the independent effect of every hour delay in time to AE on outcomes. Results: A total of 2203 patients with blunt ASOI who were managed nonoperatively with AE were identified. The mean age was 45, and 68% were male. On arrival, the mean systolic blood pressure was 105, and the median Glasgow coma scale was 15. The median Injury Severity Score and abdominal Abbreviated Injury Scale were 25 and 3, respectively. The median 4-h packed red blood cell, fresh frozen plasma, and platelet requirements were 2, 1, and 0, respectively. Overall, spleen was the most common angioembolized abdominal organ (57.3%), followed by the liver (28.9%) and kidney (13.8%). The median time to AE was 156 [114-195] min. Only 8% of patients underwent AE within the first 60 min of arrival. A significantly decreasing trend over the study period was observed in time to AE (2013:180 min versus 2021:105 min, P < 0.001). Among the study population, 19.7% experienced NOM failure, with a median [interquartile range] time to surgery of 5 [3-11] h. Over the years, there was a significant reduction in NOM failure rates (2013:26.2% versus 2021:8.7%, P < 0.001), major complications (2013:57.5% versus 2021:25.1%, P < 0.001), 24-h mortality (2013:6.8% versus 2021:1.3%, P = 0.006), and in-hospital mortality (2013:16.4% versus 2021:8.1%, P = 0.015). On multivariable regression analyses, every hour delay in time to AE was associated with higher odds of NOM failure (adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI] [1.02-1.16], P = 0.006), major complications (aOR: 1.12, 95% CI [1.02-1.23], P = 0.019), 24-h mortality (aOR: 1.19, 95% CI [1.09-1.52], P = 0.014), and in-hospital mortality (aOR: 1.17, 95% CI [1.01-1.35], P = 0.041). Conclusions: NOM of patients with blunt ASOI has improved over the past 9 y, with failure rates decreasing by approximately 30%, indicating enhanced effectiveness of AE over time. Timely AE was independently associated with lower complication rates and reduced 24-h and in-hospital mortality, likely due to earlier hemorrhage control and mitigation of secondary physiologic decline. Efforts should focus on improving timely access to AE through standardized trauma protocols, early identification of candidates, and streamlined interventional radiology activation.
• Khurshid, M. H., Castillo Diaz, F., Hejazi, O., Al Ma'ani, M., Stewart, C., Spencer, A. L., Anand, T., Kunac, A., Magnotti, L. J., & Joseph, B. (2025). Report Cards Are Out: Nine Years of Nonoperative Management for Blunt Abdominal Solid Organ Trauma. The Journal of surgical research, 314, 49-58.
  More info

  There has been a dramatic shift toward nonoperative management (NOM) of blunt abdominal solid organ injuries (ASOIs) with angioembolization (AE). However, there is a lack of evidence assessing temporal trends in AE use, timing of intervention, and how these trends relate to NOM failure and patient outcomes over time. The aim of this study was to assess the trends in time to AE, its association with failure of NOM, and outcomes of these patients across the United States.
• Khurshid, M. H., Hejazi, O., Spencer, A. L., Nelson, A., Stewart, C., Colosimo, C., Ditillo, M., Matthews, M. R., Magnotti, L. J., & Joseph, B. (2025). A little goes a long way: A comparison of enterolithotomy versus single-stage cholecystectomy in the management of gallstone ileus. Journal of Trauma and Acute Care Surgery, 98(Issue 4). doi:10.1097/ta.0000000000004497
  More info

  INTRODUCTION Gallstone ileus is an infrequent complication of cholelithiasis with no specific guidelines for its management. This study aims to compare the outcomes of patients with gallstone ileus managed with both enterolithotomy with cholecystectomy (EL-CCY) versus those managed with enterolithotomy (EL) only. METHODS In this retrospective analysis of 2011-2017 Nationwide Readmissions Database, all patients with an index admission diagnosis of gallstone ileus were included. Patients were stratified based on the type of intervention received for gallstone ileus into those who underwent EL-CCY and those who underwent EL alone and compared. Primary outcomes were in-hospital complications (surgical site infections, sepsis, pneumonia, cardiac arrest, deep vein thrombosis, intestinal obstruction) and mortality. Secondary outcomes were hospital length of stay, hospital costs, and readmissions rate and cause of readmissions. Multivariable logistic regression analysis was performed. RESULTS A total of 1,960 patients were identified. The mean age was 67 years and 67% were female. Two hundred eighty-nine patients (14.7%) were managed with EL-CCY, whereas 1,671 patients (85.3%) underwent EL only. Overall, the readmission rate was 4.8%, whereas mortality was 4.2%. There was no significant difference between groups in terms of index-admission complications (24.8% vs. 21.7%, p = 0.415), mortality (6.2% vs. 3.9%, p = 0.068), rates of readmission (3.5% vs. 5.1%, p = 0.22), and cause of readmission (p > 0.05). Enterolithotomy and cholecystectomy group had significantly longer hospital length of stay (10 vs. 8 days, p < 0.001) and median hospital costs ($70,959 vs. $52,147, p < 0.001). On multivariable logistic regression analysis, female sex was a predictor of undergoing EL-CCY, whereas increasing age and higher grade of all-patient redefined diagnosis-related groups risk of mortality were independently associated with lower odds of undergoing EL-CCY. CONCLUSION Our findings suggest no difference between EL compared with EL-CCY in terms of complications, readmissions, and mortality. However, patients managed with EL-CCY had a longer hospital stay and higher hospital costs compared with EL. Further prospective studies are needed to validate these findings and develop management protocols for gallstone ileus.
• Otaibi, B. W., Khurshid, M. H., Hejazi, O., Hage, K., Stewart, C., Colosimo, C., Spencer, A. L., Ditillo, M., Magnotti, L. J., & Joseph, B. (2025). The abdomen does not lie, but the labs might: Predictors of intra-abdominal injury on computed tomography imaging in pediatric blunt trauma patients. The journal of trauma and acute care surgery.
  More info

  Multiple studies have indicated that isolated abnormal laboratory results necessitate obtaining abdominal computed tomography (CT) for pediatric patients with blunt abdominal trauma (BAT), regardless of the normal abdominal examination. This study aims to identify the predictors of intra-abdominal injury (IAI) and the role of laboratory tests in CT imaging among pediatric BAT patients.
• Villarin Ayala, S., Hejazi, O., Al Ma'ani, M., Nelson, A., Khurshid, M. H., Stewart, C., Castillo Diaz, F., Spencer, A. L., Magnotti, L. J., & Joseph, B. (2025). Early Venous Thromboembolism Prophylaxis in Brain Injury Guidelines 1 and Brain Injury Guidelines 2 Traumatic Brain Injury Patients: A 5-Year Analysis. The journal of trauma and acute care surgery.
  More info

  Brain Injury Guidelines (BIG) was developed to reduce hospitalization of patients with mild traumatic brain injury (TBI). Limited data on venous thromboembolism (VTE) prophylaxis for patients were categorized as BIG 1 and BIG 2 hospitalized for non-TBI-related trauma. The aim of this study is to assess safety of early VTE prophylaxis among BIG 1 and BIG 2 patients. We hypothesize that early VTE prophylaxis is safe.
• Akl, M., Hejazi, O., Nelson, A., Khurshid, M. H., Stewart, C., Hosseinpour, H., Okosun, S., Magnotti, L. J., Bhogadi, S. K., & Joseph, B. (2024). From Procedure to Prognosis: The Association Between Obesity and Outcomes of Iliac Artery Injuries. The Journal of surgical research, 302, 621-627.
  More info

  The management of injuries to the iliac artery presents a challenging clinical scenario due to the impeded anatomical access. Obesity is a common comorbid condition known to affect the outcomes of trauma patients; however, there is a paucity of data on the association of obesity with the treatment and outcomes of iliac artery injuries. The aim of this study was to assess the association between body mass index (BMI) on the management and outcomes of patients with iliac artery injuries.
• Alexander, H. D., Bhogadi, S. K., Hejazi, O., Nelson, A., Khurshid, M. H., Stewart, C., Hosseinpour, H., Colosimo, C., Magnotti, L. J., & Joseph, B. (2024). The Synergy Factor: Trauma and Cancer. The Journal of surgical research, 302, 393-397.
  More info

  Trauma and cancer are the leading causes of death in the US. There is a paucity of data describing the impact of cancer on trauma patients. We aimed to determine the influence of cancer on outcomes of trauma patients.
• Bhogadi, S. K., Ditillo, M., Khurshid, M. H., Stewart, C., Hejazi, O., Spencer, A. L., Anand, T., Nelson, A., Magnotti, L. J., & Joseph, B. (2024). Development and Validation of Futility of Resuscitation Measure in Older Adult Trauma Patients. The Journal of surgical research, 301, 591-598.
  More info

  This study aimed to develop and validate Futility of Resuscitation Measure (FoRM) for predicting the futility of resuscitation among older adult trauma patients.
• Bhogadi, S. K., Hejazi, O., Nelson, A., Stewart, C., Hosseinpour, H., Spencer, A. L., Anand, T., Ditillo, M., Magnotti, L. J., & Joseph, B. (2024). Surgical stabilization of rib fractures: The impact of volume and the need for standardized indications. American journal of surgery, 234, 112-116.
  More info

  We aimed to examine impact of trauma center (TC) surgical stabilization of rib fracture (SSRF) volume on outcomes of patients undergoing SSRF.
• Bhogadi, S. K., Stewart, C., Hosseinpour, H., Nelson, A., Ditillo, M., Matthews, M. R., Magnotti, L. J., & Joseph, B. (2024). Outcomes of Patients With Traumatic Brain Injury Transferred to Trauma Centers. JAMA surgery, 159(11), 1282-1288.
  More info

  Wide variations exist in traumatic brain injury (TBI) management strategies and transfer guidelines across the country.
• Choron, R. L., Piplani, C., Kuzinar, J., Teichman, A. L., Bargoud, C., Sciarretta, J. D., Smith, R. N., Hanos, D., Afif, I. N., Beard, J. H., Dhillon, N. K., Zhang, A., Ghneim, M., Devasahayam, R., Gunter, O., Smith, A. A., Sun, B., Cao, C. S., Reynolds, J. K., , Hilt, L. A., et al. (2024). Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial. Trauma surgery & acute care open, 9(1), e001438.
  More info

  The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.
• Choron, R. L., Rallo, M., Piplani, C., Youssef, S., Teichman, A. L., Bargoud, C. G., Sciarretta, J. D., Smith, R. N., Hanos, D. S., Afif, I. N., Beard, J. H., Dhillon, N. K., Zhang, A., Ghneim, M., Devasahayam, R. J., Gunter, O. L., Smith, A. A., Sun, B. L., Cao, C., , Reynolds, J. K., et al. (2024). The impact of post-operative enteral nutrition on duodenal injury outcomes: A post hoc analysis of an EAST multicenter trial. The journal of trauma and acute care surgery.
  More info

  Leak following surgical repair of traumatic duodenal injuries results in prolonged hospitalization and oftentimes nil per os(NPO) treatment. Parenteral nutrition(PN) has known morbidity; however, duodenal leak(DL) patients often have complex injuries and hospital courses resulting in barriers to enteral nutrition(EN). We hypothesized EN alone would be associated with 1)shorter duration until leak closure and 2)less infectious complications and shorter hospital length of stay(HLOS) compared to PN.
• Colosimo, C., Bhogadi, S. K., Hejazi, O., Nelson, A., Hosseinpour, H., Stewart, C., Spencer, A. L., Ditillo, M., Magnotti, L. J., & Joseph, B. (2024). When Every Minute Counts: REBOA Before Surgery Is Independently Associated With a 15-Minute Delay in Time to Definitive Hemorrhage Control. Military medicine, 189(Suppl 3), 262-267.
  More info

  Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a temporizing hemorrhage control intervention, but its inevitable effect on time to operating room (OR) has not been assessed. The aim of our study is to assess the impact of undergoing REBOA before surgery (RBS) on time to definitive hemorrhage control surgery.
• Colosimo, C., Otaibi, B., Bhogadi, S. K., Nelson, A., Spencer, A. L., Anand, T., Stewart, C., Magnotti, L. J., & Joseph, B. (2024). Obesity is a predictor of abdominal computed tomography imaging in pediatric trauma patients. The journal of trauma and acute care surgery.
  More info

  Computed tomography (CT) has helped to reduce the morbidity due to missed injuries. However, CT imaging is associated with radiation exposure and thus has limited indications in pediatric patients. In this study, we aimed to identify the association between obesity and abdominal CT imaging in pediatric trauma patients.
• El-Qawaqzeh, K., Anand, T., Alizai, Q., Colosimo, C., Hosseinpour, H., Spencer, A., Ditillo, M., Magnotti, L. J., Stewart, C., & Joseph, B. (2024). Trauma in the Geriatric and the Super-Geriatric: Should They Be Treated the Same?. Journal of Surgical Research, 293. doi:10.1016/j.jss.2023.09.015
  More info

  Introduction: There is paucity of studies comparing the characteristics of trauma in geriatrics and super-geriatrics. We aimed to explore the injury characteristics and outcomes of older adult trauma patients on a nationwide scale. Methods: This is a retrospective analysis of 2017-2019 American College of Surgeons Trauma Quality Improvement Program. We included moderate to severely injured (Injury Severity Score >8) older adult (≥65 y) trauma patients. Patients were stratified into geriatric (65 y ≤ Age
• Hage, K., Nelson, A., Khurshid, M. H., Stewart, C., Hosseinpour, H., Okosun, S., Hejazi, O., Magnotti, L. J., Bhogadi, S. K., & Joseph, B. (2024). Diagnostic Laparoscopy in Trauma Patients: Do We Need to Open and See if We Can See Without Opening?. The Journal of surgical research, 303, 14-21.
  More info

  Diagnostic laparoscopy (DL) has been advocated to reduce the incidence of nontherapeutic laparotomies (NL) among stable trauma patients. This study aimed to compare the outcomes of hemodynamically stable trauma patients undergoing DL versus NL.
• Hejazi, O., Ghaedi, A., Stewart, C., Khurshid, M. H., Spencer, A. L., Hosseinpour, H., Nelson, A., Bhogadi, S. K., Magnotti, L. J., & Joseph, B. (2024). The Harsh Reality: Outcomes of Patients With Operatively Managed Lung Injuries. The Journal of surgical research, 302, 656-661.
  More info

  Most traumatic lung injuries are managed non-operatively. There is a paucity of recent data on the outcomes of operatively managed lung injuries. The aim of our study is to determine the survival rates of operatively managed traumatic lung injury patients on a nationwide scale.
• Hosseinpour, H., Magnotti, L. J., Huang, D. D., Weinberg, J. A., Tang, A., Hejazi, O., Stewart, C., Bhogadi, S. K., Anand, T., & Joseph, B. (2024). The role of number of affected vessels on radiologic and clinical outcomes of patients with blunt cerebrovascular injury. Journal of vascular surgery, 80(3), 685-692.
  More info

  There is a lack of data on the role of characteristics of injured vessels on the outcomes of patients with blunt cerebrovascular injuries (BCVIs). The aim of this study was to assess the effect of the number (single vs multiple) of injured vessels on outcomes.
• Hosseinpour, H., Stewart, C., Hejazi, O., Okosun, S. E., Khurshid, M. H., Nelson, A., Bhogadi, S. K., Ditillo, M., Magnotti, L. J., & Joseph, B. (2024). FINDING THE SWEET SPOT: THE ASSOCIATION BETWEEN WHOLE BLOOD TO RED BLOOD CELLS RATIO AND OUTCOMES OF HEMORRHAGING CIVILIAN TRAUMA PATIENTS. Shock (Augusta, Ga.), 62(3), 344-350.
  More info

  Purpose: To evaluate the dose-dependent effect of whole blood (WB) on the outcomes of civilian trauma patients with hemorrhagic shock. Methods: We performed a 2-year (2020-2021) retrospective analysis of the ACS-TQIP dataset. Adult (≥18) trauma patients with a shock index (SI) >1 who received at least 5 units of PRBC and one unit of WB within the first 4 h of admission were included. Primary outcomes were 6-h, 24-h, and in-hospital mortality. Secondary outcomes were major complications and hospital and intensive care unit length of stay. Results: A total of 830 trauma patients with a mean (SD) age of 38 (16) were identified. The median [IQR] 4-h WB and PRBC requirements were 2 [2-4] U and 10 [7-15] U, respectively, with a median WB:RBC ratio of 0.2 [0.1-0.3]. Every 0.1 increase in WB:RBC ratio was associated with decreased odds of 24-h mortality (aOR: 0.916, P = 0.035) and in-hospital mortality (aOR: 0.878, P < 0.001). Youden's index identified 0.25 (1 U of WB for every 4 U of PRBC) as the optimal WB:PRBC ratio to reduce 24-h mortality. High ratio (≥0.25) group had lower adjusted odds of 24-h mortality (aOR: 0.678, P = 0.021) and in-hospital mortality (aOR: 0.618, P < 0.001) compared to the low ratio group. Conclusions: A higher WB:PRBC ratio was associated with improved early and late mortality in trauma patients with hemorrhagic shock. Given the availability of WB in trauma centers across the United States, at least one unit of WB for every 4 units of packed red blood cells may be administered to improve the survival of hemorrhaging civilian trauma patients.
• Hosseinpour, H., Stewart, C., Hejazi, O., Okosun, S. E., Khurshid, M. H., Nelson, A., Bhogadi, S. K., Ditillo, M., Magnotti, L. J., & Joseph, B. (2024). FINDING THE SWEET SPOT: THE ASSOCIATION BETWEEN WHOLE BLOOD TO RED BLOOD CELLS RATIO AND OUTCOMES OF HEMORRHAGING CIVILIAN TRAUMA PATIENTS. Shock, 62(Issue 3). doi:10.1097/shk.0000000000002405
  More info

  Purpose: To evaluate the dose-dependent effect of whole blood (WB) on the outcomes of civilian trauma patients with hemorrhagic shock. Methods: We performed a 2-year (2020–2021) retrospective analysis of the ACS-TQIP dataset. Adult (≥18) trauma patients with a shock index (SI) >1 who received at least 5 units of PRBC and one unit of WB within the first 4 h of admission were included. Primary outcomes were 6-h, 24-h, and in-hospital mortality. Secondary outcomes were major complications and hospital and intensive care unit length of stay. Results: A total of 830 trauma patients with a mean (SD) age of 38 (16) were identified. The median [IQR] 4-h WB and PRBC requirements were 2 [2–4] U and 10 [7–15] U, respectively, with a median WB:RBC ratio of 0.2 [0.1–0.3]. Every 0.1 increase in WB:RBC ratio was associated with decreased odds of 24-h mortality (aOR: 0.916, P = 0.035) and in-hospital mortality (aOR: 0.878, P < 0.001). Youden’s index identified 0.25 (1 U of WB for every 4 U of PRBC) as the optimal WB:PRBC ratio to reduce 24-h mortality. High ratio (≥0.25) group had lower adjusted odds of 24-h mortality (aOR: 0.678, P = 0.021) and in-hospital mortality (aOR: 0.618, P < 0.001) compared to the low ratio group. Conclusions: A higher WB:PRBC ratio was associated with improved early and late mortality in trauma patients with hemorrhagic shock. Given the availability of WB in trauma centers across the United States, at least one unit of WB for every 4 units of packed red blood cells may be administered to improve the survival of hemorrhaging civilian trauma patients.
• Huang, R., Hejazi, O., Khurshid, M. H., Nelson, A., Stewart, C., Anand, T., Matthews, M. R., Okosun, S. E., Magnotti, L. J., & Joseph, B. (2024). Diversity in crisis: The impact of race and ethnicity on failure to rescue among geriatric trauma patients over the years. The journal of trauma and acute care surgery.
  More info

  Failure to rescue (FTR) is an indicator of the quality of care provided by trauma centers. The aim of this study was to examine the trends of FTR incidence in geriatric trauma patients over the years and to determine whether race, ethnicity, and sex impact the FTR incidence.
• Joseph, B., Hosseinpour, H., Sakran, J., Anand, T., Colosimo, C., Nelson, A., Stewart, C., Spencer, A. L., Zhang, B., & Magnotti, L. J. (2024). Defining the Problem: 53 Years of Firearm Violence Afflicting America’s Schools. Journal of the American College of Surgeons, 238(4), 671-678. doi:10.1097/xcs.0000000000000955
• Khurshid, M. H., Hejazi, O., Spencer, A. L., Nelson, A., Stewart, C., Colosimo, C., Ditillo, M., Matthews, M. R., Magnotti, L. J., & Joseph, B. (2024). A little goes a long way: A comparison of enterolithotomy versus single-stage cholecystectomy in the management of gallstone ileus. The journal of trauma and acute care surgery.
  More info

  Gallstone ileus is an infrequent complication of cholelithiasis with no specific guidelines for its management. This study aims to compare the outcomes of patients with gallstone ileus managed with both enterolithotomy with cholecystectomy (EL-CCY) versus those managed with enterolithotomy (EL) only.
• Litmanovich, B., Alizai, Q., Stewart, C., Hosseinpour, H., Nelson, A., Bhogadi, S., Colosimo, C., Spencer, A., Ditillo, M., & Joseph, B. (2024). Outcomes of Geriatric Burn Patients Presenting to the Trauma Service: How Does Frailty Factor in?. Journal of Surgical Research, 293. doi:10.1016/j.jss.2023.08.049
  More info

  Introduction: Frailty has been known to negatively affect the outcomes of geriatric trauma patients. However, there is a lack of data on the effect of frailty on the outcomes of geriatric trauma patients with concomitant burn injuries. The aim of our study was to compare the outcomes of frail versus nonfrail geriatric trauma patients with concomitant burn injuries. Methods: We performed a retrospective analysis of American College of Surgeons Trauma Quality Improvement Program (2018). We included geriatric (≥65 y) trauma patients who sustained a concomitant burn injury with ≥10% Total Body Surface Area affected. Patients with body region-specific AIS ≥4 were excluded. Patients were stratified into Frail and Nonfrail, using 5-factor modified Frailty Index. Primary outcomes measured were mortality. Secondary outcomes measured were complications, and hospital and intensive care unit (ICU) length of stay (LOS). Multivariable logistic regression was performed to identify independent predictors of mortality. Results: A total of 574 patients were identified, of which 172(30%) were Frail. Mean age was 74 ± 7 y and median [interquartile range] ISS was 3[1-10]. Overall, the rate of mortality was 23% and median hospital LOS was 14[3-31]. After controlling for potential confounding factors, frailty was not identified as an independent predictor of mortality (adjusted odds ratio:1.059, P = 0.93) and complications (adjusted odds ratio:1.10, P = 0.73). However, frail patients had longer hospital (β: 5.01, P = 0.002) and ICU LOS (β: 2.12, P < 0.001). Conclusions: Among geriatric trauma patients with concomitant burn injuries, frailty is associated with longer hospital and ICU LOS, and higher rates of thrombotic complications, but not higher mortality or overall complications. Future research should investigate the impact of early assessment of frailty as well as tailored interventions on outcomes in this population.
• Magnotti, L. J., Bhogadi, S. K., Anand, T., Stewart, C., Colosimo, C., Spencer, A. L., Nelson, A., & Joseph, B. (2024). Less Is More: Dissecting Trauma Centers by Procedural Volume. Annals of surgery, 280(4), 667-675.
  More info

  This study aims to examine the relationship between procedural volume and annual trauma volume (ATV) of ACS Level I trauma centers (TC).
• O'Connor, D., Hejazi, O., Colosimo, C., Stewart, C., Hosseinpour, H., Khurshid, M., Nelson, A. C., Joseph, B., Bhogadi, S. K., Anand, T., Spencer, A. L., & Magnotti, L. J. (2024). Role of endovascular management on outcomes in patients with traumatic inferior vena cava injuries. American journal of surgery, 238, 115836.
  More info

  The aim of this study was to examine the association between the injury mechanism and repair type with outcomes in patients with traumatic inferior vena cava injuries.
• Otaibi, B. W., Bhogadi, S. K., Khurshid, M. H., Stewart, C., Hosseinpour, H., Spencer, A. L., Hejazi, O., Nelson, A., Magnotti, L. J., & Joseph, B. (2024). Endovascular Versus Open Repair in Adolescent Patients With Difficult-to-Access Vascular Injuries. The Journal of surgical research, 302, 385-392.
  More info

  Management of subclavian artery injuries (SAI) and iliac artery injuries (IAI) in adolescent trauma patients poses a considerable challenge due to their complex anatomical locations. The aim of our study was to determine the association between the injury mechanism and type of repair with the outcomes of patients with traumatic SAI and IAI.
• Zambetti, B. R., Nelson, A. C., Hosseinpour, H., Anand, T., Colosimo, C., Spencer, A. L., Stewart, C., Bhogadi, S. K., Hejazi, O., Joseph, B., & Magnotti, L. J. (2024). The optimal management of blunt aortic injury in the young. American journal of surgery, 237, 115943.
  More info

  Blunt aortic injury (BAI) is relatively uncommon in the pediatric population. The goal of this study was to examine the management of BAI in both children and adolescents, using a large national dataset.
• Alizai, Q., Anand, T., Bhogadi, S. K., Nelson, A., Hosseinpour, H., Stewart, C., Spencer, A. L., Colosimo, C., Ditillo, M., & Joseph, B. (2023). From surveillance to surgery: The delayed implications of non-operative and operative management of pancreatic injuries. American journal of surgery, 226(5), 682-687.
  More info

  Our study compares the delayed outcomes of operative versus nonoperative management of pancreatic injuries.
• Alizai, Q., Colosimo, C., Hosseinpour, H., Stewart, C., Bhogadi, S. K., Nelson, A., Spencer, A. L., Ditillo, M., Magnotti, L. J., Joseph, B., & , A. F. (2023). It's Not All Black and White: The Effect of Increasing Severity of Frailty on Outcomes of Geriatric Trauma Patients. The journal of trauma and acute care surgery.
  More info

  Frailty is associated with poor outcomes in trauma patients. However, the spectrum of physiologic deficits, once a patient is identified as frail, is unknown. The aim of this study was to assess the dynamic association between increasing frailty and outcomes among frail geriatric trauma patients.
• Bhogadi, S. K., Alizai, Q., Colosimo, C., Spencer, A. L., Stewart, C., Nelson, A., Ditillo, M., Castanon, L., Magnotti, L. J., Joseph, B., , B. M., , A. A., Dultz, L., Black, G., Campbell, M., Berndtson, A. E., Costantini, T., Kerwin, A., Skarupa, D., , Burruss, S., et al. (2023). Not all traumatic brain injury patients on preinjury anticoagulation are the same. American journal of surgery.
  More info

  Prognostic significance of different anticoagulants in TBI patients remains unanswered. We aimed to compare effects of different anticoagulants on outcomes of TBI patients.
• Bhogadi, S. K., Stewart, C., El-Qawaqzeh, K., Colosimo, C., Hosseinpour, H., Nelson, A., Castanon, L., Spencer, A. L., Magnotti, L. J., & Joseph, B. (2023). Local Antibiotic Therapy for Open Long Bone Fractures: Appropriate Prophylaxis or Unnecessary Exposure for the Orthopedic Trauma Patient?. Military medicine, 188(Supplement_6), 407-411.
  More info

  Prophylactic local antibiotic therapy (LAbT) to prevent infection in open long bone fracture (OLBF) patients has been in use for many decades despite lack of definitive evidence confirming a beneficial effect. We aimed to evaluate the effect of LAbT on outcomes of OLBF patients on a nationwide scale.
• Choron, R. L., Teichman, A. L., Bargoud, C. G., Sciarretta, J. D., Smith, R. N., Hanos, D. S., Afif, I. N., Beard, J. H., Dhillon, N. K., Zhang, A., Ghneim, M., Devasahayam, R. J., Gunter, O. L., Smith, A. A., Sun, B. L., Cao, C. S., Reynolds, J. K., Hilt, L. A., Holena, D. N., , Chang, G., et al. (2023). Outcomes among trauma patients with duodenal leak following primary versus complex repair of duodenal injuries: An Eastern Association for the Surgery of Trauma multicenter trial. The journal of trauma and acute care surgery, 95(1), 151-159.
  More info

  Duodenal leak is a feared complication of repair, and innovative complex repairs with adjunctive measures (CRAM) were developed to decrease both leak occurrence and severity when leaks occur. Data on the association of CRAM and duodenal leak are sparse, and its impact on duodenal leak outcomes is nonexistent. We hypothesized that primary repair alone (PRA) would be associated with decreased duodenal leak rates; however, CRAM would be associated with improved recovery and outcomes when leaks do occur.
• Culbert, M., Nelson, A., Obaid, O., Castanon, L., Hosseinpour, H., Anand, T., El-Qawaqzeh, K., Stewart, C., Reina, R., & Joseph, B. (2023). Failure-to-rescue and mortality after emergent pediatric trauma laparotomy: How are the children doing? “Pediatric Emergent Trauma Laparotomy”. Journal of Pediatric Surgery, 58(3). doi:10.1016/j.jpedsurg.2022.08.017
  More info

  Introduction: Emergent trauma laparotomy is associated with mortality rates of up to 40%. There is a paucity of data on the outcomes of emergent trauma laparotomies performed in the pediatric population. The aim of our study was to describe the outcomes, including mortality and FTR, among pediatric trauma patients undergoing emergent laparotomy and identify factors associated with failure-to-rescue (FTR). Methods: We performed a one-year (2017) retrospective cohort analysis of the American College of Surgeons Trauma Quality Improvement Program dataset. All pediatric trauma patients (age
• El-Qawaqzeh, K., Anand, T., Alizai, Q., Colosimo, C., Hosseinpour, H., Spencer, A., Ditillo, M., Magnotti, L. J., Stewart, C., & Joseph, B. (2023). Trauma in the Geriatric and the Super-Geriatric: Should They Be Treated the Same?. The Journal of surgical research, 293, 316-326.
  More info

  There is paucity of studies comparing the characteristics of trauma in geriatrics and super-geriatrics. We aimed to explore the injury characteristics and outcomes of older adult trauma patients on a nationwide scale.
• El-Qawaqzeh, K., Hosseinpour, H., Gries, L., Magnotti, L. J., Bhogadi, S. K., Anand, T., Ditillo, M., Stewart, C., Cooper, Z., & Joseph, B. (2023). Dealing with the elder abuse epidemic: Disparities in interventions against elder abuse in trauma centers. Journal of the American Geriatrics Society.
  More info

  Elder abuse is a major cause of injury, morbidity, and death. We aimed to identify the factors associated with interventions against suspected physical abuse in older adults.
• Keller, B. A., Skubic, J., Betancourt-Garcia, M., Ignacio, R. C., Radowsky, J. S., Tyroch, A. H., Lascano, C. P., Joseph, B., Stewart, C., Moore, F. O., Costantini, T. W., Rizzo, J. A., Paul, J. S., Galindo, R. M., Silva, A., Coimbra, R., & Berndtson, A. E. (2023). Understanding the Burden of Traumatic Injuries at the United States-Mexico Border: A Scoping Review of the Literature. The journal of trauma and acute care surgery.
  More info

  The United States-Mexico border is the busiest land crossing in the world and faces continuously increasing numbers of undocumented border crossers. Significant barriers to crossing are present in many regions of the border, including walls, bridges, rivers, canals, and the desert, each with unique features that can cause traumatic injury. The number of patients injured attempting to cross the border is also increasing, but significant knowledge gaps regarding these injuries and their impacts remain. The purpose of this scoping literature review is to describe the current state of trauma related to the US-Mexico border to draw attention to the problem, identify knowledge gaps in the existing literature, and introduce the creation of a consortium made up of representatives from border trauma centers in the Southwestern United States, the Border Region Doing Research on Trauma (BRDR-T) Consortium. Consortium members will collaborate to produce multicenter, up-to-date data on the medical impact of the US-Mexico border, helping to elucidate the true magnitude of the problem and shed light on the impact cross-border trauma has on migrants, their families, and the United States healthcare system. Only once the problem is fully described can meaningful solutions be provided.
• Litmanovich, B., Alizai, Q., Stewart, C., Hosseinpour, H., Nelson, A., Bhogadi, S. K., Colosimo, C., Spencer, A. L., Ditillo, M., & Joseph, B. (2023). Outcomes of Geriatric Burn Patients Presenting to the Trauma Service: How Does Frailty Factor in?. The Journal of surgical research, 293, 327-334.
  More info

  Frailty has been known to negatively affect the outcomes of geriatric trauma patients. However, there is a lack of data on the effect of frailty on the outcomes of geriatric trauma patients with concomitant burn injuries. The aim of our study was to compare the outcomes of frail versus nonfrail geriatric trauma patients with concomitant burn injuries.
• Nelson, A. C., Bhogadi, S. K., Hosseinpour, H., Stewart, C., Anand, T., Spencer, A. L., Colosimo, C., Magnotti, L. J., & Joseph, B. (2023). There Is No Such Thing as Too Soon: Long-Term Outcomes of Early Cholecystectomy for Frail Geriatric Patients with Acute Biliary Pancreatitis. Journal of the American College of Surgeons, 237(5), 712-718.
  More info

  Early cholecystectomy (CCY) for acute biliary pancreatitis (ABP) is recommended but there is a paucity of data assessing this approach in frail geriatric patients. This study compares outcomes of frail geriatric ABP patients undergoing index admission CCY vs nonoperative management (NOM) with endoscopic retrograde cholangiopancreatography (ERCP).
• Zambetti, B. R., Patel, D. D., Stuber, J. D., Zickler, W. P., Hosseinpour, H., Anand, T., Nelson, A. C., Stewart, C., Joseph, B., & Magnotti, L. J. (2023). Role of Endovascular Stenting in Patients with Traumatic Iliac Artery Injury. Journal of the American College of Surgeons.
  More info

  Common and external iliac artery injuries (IAI) portend significant morbidity and mortality. The goal of this study was to examine the impact of mechanism of injury and type of repair on outcomes and identify the optimal repair for patients with traumatic IAI using a large, national dataset.
• Culbert, M. H., Nelson, A., Obaid, O., Castanon, L., Hosseinpour, H., Anand, T., El-Qawaqzeh, K., Stewart, C., Reina, R., & Joseph, B. (2022). Failure-to-rescue and mortality after emergent pediatric trauma laparotomy: How are the children doing?. Journal of pediatric surgery.
  More info

  Emergent trauma laparotomy is associated with mortality rates of up to 40%. There is a paucity of data on the outcomes of emergent trauma laparotomies performed in the pediatric population. The aim of our study was to describe the outcomes, including mortality and FTR, among pediatric trauma patients undergoing emergent laparotomy and identify factors associated with failure-to-rescue (FTR).
• El-Qawaqzeh, K., Reina Limon, R. F., Hosseinpour, H., Ditillo, M. F., Obaid, O., Anand, T., Stewart, C., Nelson, A. C., Nguyen, L., & Joseph, B. (2022). Geriatric Trauma, Frailty, and American College of Surgeons Trauma Center Verification Level: Are There Any Correlations with Outcomes?. Journal of the American College of Surgeons, 235(5), S281-S281. doi:10.1097/01.xcs.0000895216.99457.23
• Hosseinpour, H., El-Qawaqzeh, K., Stewart, C., Akl, M. N., Anand, T., Culbert, M. H., Nelson, A., Bhogadi, S. K., & Joseph, B. (2022). Emergency readmissions following geriatric ground-level falls: How does frailty factor in?. Injury.
  More info

  Ground-level falls (GLFs) in older adults are increasing as life expectancy increases, and more patients are being discharged to skilled nursing facilities (SNFs) for continuity of care. However, GLF patients are not a homogenous cohort, and the role of frailty remains to be assessed. Thus, the aim of this study is to examine the impact of frailty on the in-hospital and 30-day outcomes of GLF patients.
• Obaid, O., Anand, T., Nelson, A., Reina, R., Ditillo, M., Stewart, C., Douglas, M., Friese, R., Gries, L., & Joseph, B. (2022). Fibrinogen Supplementation for the Trauma Patient: Should You Choose Fibrinogen Concentrate Over Cryoprecipitate?. The journal of trauma and acute care surgery.
  More info

  Trauma-induced coagulopathy is frequently associated with hypofibrinogenemia. Cryoprecipitate (Cryo), and fibrinogen concentrate (FC) are both potential means of fibrinogen supplementation. The aim of this study was to compare the outcomes of traumatic hemorrhagic patients who received fibrinogen supplementation using FC versus Cryo.
• Reina, R., Anand, T., Bhogadi, S. K., Nelson, A., Hosseinpour, H., Ditillo, M., El-Qawaqzeh, K., Castanon, L., Stewart, C., & Joseph, B. (2022). Nonoperative management of blunt abdominal solid organ injury: Are we paying enough attention to patients on preinjury anticoagulation?. American journal of surgery.
  More info

  This study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM.
• Rodriguez, M., Stewart, C., Khan, O., & Citro, B. (2020). Robot-Assisted Laparoscopic Resection of a Transverse Colon Schwannoma. Case reports in surgery, 2020, 8057352.
• Pearcy, C., Almahmoud, K., Jackson, T., Hartline, C., Cahill, A., Spence, L., Kim, D., Olatubosun, O., Todd, S. R., Campion, E. M., Burlew, C. C., Regner, J., Frazee, R., Michaels, D., Dissanaike, S., Stewart, C., Foley, N., Nelson, P., Agrawal, V., & Truitt, M. S. (2017). Risky business? Investigating outcomes of patients undergoing urgent laparoscopic appendectomy on antithrombotic therapy. American journal of surgery, 214(6), 1012-1015.
  More info

  The literature regarding outcomes in patients on irreversible antithrombotic therapy (IAT) undergoing urgent laparoscopic appendectomy is limited. The aim of this multicenter retrospective study was to examine the impact of prehospital IAT on outcomes in this population.
• Bailey, S. H., Oni, G., Brown, S. A., Kashefi, N., Cheriyan, S., Maxted, M., Stewart, C., Jones, C., Maluso, P., Kenkel, A. M., Kenkel, M. M., Hoopman, J., Barton, F., & Kenkel, J. M. (2012). The use of non-invasive instruments in characterizing human facial and abdominal skin. Lasers in surgery and medicine, 44(2), 131-42.
  More info

  The skin is highly variable. This variation, although helpful for function, causes inconsistencies when assessed using subjective scales. The purpose of this study is to measure differences in skin on the face and abdomen using non-invasive, objective devices as a method to eliminate subjective error and help reduce intra- and inter-observer variability in clinical analysis.
• Rifkin, L. H., Stojadinovic, S., Stewart, C. H., Song, K. H., Maxted, M. C., Bell, M. H., Kashefi, N. S., Speiser, M. P., Saint-Cyr, M., Story, M. D., Rohrich, R. J., Brown, S. A., & Solberg, T. D. (2012). An athymic rat model of cutaneous radiation injury designed to study human tissue-based wound therapy. Radiation oncology (London, England), 7, 68.
  More info

  To describe a pilot study for a novel preclinical model used to test human tissue-based therapies in the setting of cutaneous radiation injury.