Michael Ditillo
- Associate Clinical Professor, Surgery - (Clinical Series Track)
- (520) 626-2408
- AHSC, Rm. 5334
- mfditillo@arizona.edu
Biography
Michael Ditillo, DO, FACS, is a clinical assistant professor of surgery with the Department of Surgery, Division of Trauma, Critical Care, Burns and Emergency Surgery. He is also the director of Geriatric Trauma, Acute Care, and Surgical Critical Care at Banner University Medical Center – Tucson.
Dr. Ditillo earned his undergraduate degree from Long Island University and his medical degree from the New York College of Osteopathic Medicine. He completed his residency in general surgery at the Brookdale University Hospital and Medical Center in Brooklyn, New York, and was fellowship-trained in trauma and surgical critical care at The R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center in Baltimore.
After finishing his fellowship, Dr. Ditillo served as assistant professor of surgery at the Yale School of Medicine/Yale New Haven Hospital for five years before moving to Pittsburgh. In Pittsburgh, he served as an assistant professor of surgery at Allegheny General Hospital in the Division of Trauma, Acute Care Surgery, and Surgical Critical Care. He was also the director of the Trauma Critical Care Unit, the associate director of the critical care fellowship program, and the assistant residency director of the general surgery fellowship program. At the University of Arizona School of Medicine, Dr. Ditillo has served clinically as the Director of Geriatric Trauma and Assistant director of the Trauma/Surgical ICU as well as as the General Surgery Clerkship Director, Fellowship Director of the Surgical Critical Care/Acute Care Surgery Fellowship, Co-Director, Faculty Instructional Development and the General Surgery Residency Program Director.
Dr. Ditillo’s clinical interests are in geriatric trauma, post-cardiac arrest hypothermia, coagulopathy in trauma, and hemostatic resuscitation.
Degrees
- D.O.
- New York College of Osteopathic Medicine, New York, United States
- B.S. Biology
- Long Island University, Long Island, New York, United States
Work Experience
- Surgical Critical Care Fellowship Allegheny General Hospital (2017 - 2019)
- Allegheny General Hospital (2015 - 2019)
- Allegheny General Hospital Bloodless Medicine Program (2015 - 2019)
- Allegheny General Hospital (2014 - 2019)
- Allegheny General Hospital (2014 - 2019)
- Yale University School of Medicine, New Haven, Connecticut (2009 - 2014)
- West Haven Campus-VA Cnnecticut Healthcare System (2009 - 2014)
- The R Adamd Cowley Shock Trauma Center-University of Maryland Medical Center (2008 - 2009)
- Brookdale University Hospital and Medical Center (2002 - 2008)
- Brookdale University Hospital and Medical Center Brooklyn (2002 - 2003)
- Brookdale University Hospital and Medical Center (2002 - 2003)
Awards
- 2022 College of Medicine Faculty Mentoring Award
- University of Arizona-College of Medicine, Summer 2022
- Summa Cum Laude
- Long Island University, Spring 2022
- 2021 Vernon and Virginia Furrow Excellence in Clinical Science Teaching Award
- University of Arizona COM-T, Summer 2021
- College of Medicine, Department of Surgery 41st Annual Faculty Teaching Awards - Outstanding Clinical Education Instructor in a Clerkship
- Summer 2021
Licensure & Certification
- Course Instructor Certification, Advanced Trauma Operative Management (2011)
- Course Certification, Advanced Trauma Operative Management (2010)
- Course Director Certification, ATLS (2012)
- Instructor Certification, Trauma Evaluation and Management (2008)
- Certified, Disaster and Emergency Management and Preparedness Course - ACS (2013)
- Medical License, Arizona State License (2019)
- Medical License, Pennsylvania State License (2014)
- Medical License, Connecticut State License (2009)
- Certified in Surgical Critical Care (2011)
- Instructor Certification, ATLS (2009)
- Provider Certification, ATLS (2002)
- Provider Certification, PALS (2003)
- Provider Certification, ACLS (2003)
- Board Certified in General Surgery, American Board of Surgery (2011)
Interests
Research
Frailty and geriatric trauma outcomes, post-cardiac arrest hypothermia in surgical/trauma patients, reversal of coagulopathy in trauma, and delirium in trauma and surgical patients.
Teaching
Dr. Ditillo’s clinical interests are in geriatric trauma, post-cardiac arrest hypothermia, coagulopathy in trauma, and hemostatic resuscitation.
Courses
2021-22 Courses
-
Independent Study
SURG 899 (Fall 2021)
2020-21 Courses
-
Surgery Clerkship
SURG 813C (Spring 2021) -
Surgery Clerkship Clinical
SURG 813C2 (Spring 2021) -
Independent Study
SURG 899 (Fall 2020) -
Surgery Clerkship
SURG 813C (Fall 2020)
2019-20 Courses
-
Surgery Clerkship
SURG 813C (Spring 2020) -
Surgery Clerkship Clinical
SURG 813C2 (Spring 2020) -
Surgery Clerkship Didactic
SURG 813C1 (Spring 2020)
Scholarly Contributions
Chapters
- Ditillo, M. (2014). Appendicitis. In Geriatric Trauma and Emergency Care. New York: Springer Publishing.
- Ditillo, M. (2012). Capillary Leak and Fluid Resuscitation. In Intra-abdominal Hypertension: Core Critical Care Topics. New York: Cambridge Univiersity Press.
- Ditillo, M. (2012). Nutritional Management of Gastro-Enterocutaneous Fistulae. In Surgery of Complex Abdominal Wall Defects. New York: Spring Publishing.
Journals/Publications
- Akl, M. N., El-Qawaqzeh, K., Anand, T., Hosseinpour, H., Colosimo, C., Nelson, A., Alizai, Q., Ditillo, M., Magnotti, L. J., & Joseph, B. (2023). Trauma Laparotomy for the Cirrhotic Patient: An Outcome-Based Analysis. The Journal of surgical research, 294, 128-136.More infoThere is a lack of large-scale data on outcomes of cirrhotic patients undergoing trauma laparotomy. We aimed to compare outcomes of cirrhotic versus noncirrhotic trauma patients undergoing laparotomy.
- 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 infoOur study compares the delayed outcomes of operative versus nonoperative management of pancreatic injuries.
- Alizai, Q., Arif, M. S., Colosimo, C., Hosseinpour, H., Spencer, A. L., Bhogadi, S. K., Nelson, A., Anand, T., Ditillo, M., & Joseph, B. (2023). Beyond the short-term relief: Outcomes of geriatric rib fracture patients receiving paravertebral nerve blocks and epidural analgesia. Injury, 111184.More infoAdequate pain control is a critical component of rib fracture management. Our study aimed to evaluate the in-hospital and post-discharge outcomes of geriatric rib fracture patients who received paravertebral nerve block (PVNB) versus epidural analgesia (EA) on a national level.
- 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 infoFrailty 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.
- Anand, T., Bhogadi, S. K., Cooper, Z., Ditillo, M., El-Qawaqzeh, K., Gries, L., Hosseinpour, H., Joseph, B., Magnotti, L. J., & Stewart, C. (2023).
Dealing with the elder abuse epidemic: Disparities in interventions against elder abuse in trauma centers
. Journal of the American Geriatrics Society. doi:10.1111/jgs.18286More infoBackground 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. Methods Analysis of the 2017–2018 ACS TQIP. All trauma patients ≥60 years with an abuse report for suspected physical abuse were included. Patients with missing information on abuse interventions were excluded. Outcomes were rates of abuse investigation initiation following an abuse report and change of caregiver at discharge among survivors with an abuse investigation initiated. Multivariable regression analyses were performed. Results Of 727,975 patients, 1405 (0.2%) had an abuse report. Patients with an abuse report were younger (mean, 72 vs 75, p < 0.001), and more likely to be females (57% vs 53%, p = 0.007), Hispanic (11% vs 6%, p < 0.001), Black (15% vs 7%, p < 0.001), suffer from dementia (18% vs 11%, p < 0.001), functional disability (19% vs 15%, p < 0.001), have a positive admission drug screen (9% vs 5%, p < 0.001) and had a higher ISS (median [IQR], 9 [4–16] vs 6 [3–10], p < 0.001). Perpetrators were members of the immediate/step/extended family in 91% of cases. Among patients with an abuse report, 1060 (75%) had abuse investigations initiated. Of these, 227 (23%) resulted in a change of caregiver at discharge. On multivariate analysis for abuse investigation initiation, male gender, private insurance, and management at non-level I trauma centers were associated with lower adjusted odds (p < 0.05), while Hispanic ethnicity, positive admission drug screen, and penetrating injury were associated with higher adjusted odds (p < 0.05). On multivariate analysis for change of caregiver, male gender, and private insurance were associated with lower adjusted odds (p < 0.05), while functional disability and dementia were associated with higher adjusted odds (p < 0.05). Conclusions Significant gender, ethnic, and socioeconomic disparities exist in the management of physical abuse of older adults. Further studies are warranted to expand on and address the contributing factors underlying these disparities. Level of Evidence III. Study Type Therapeutic/Care Management. - Anand, T., El-Qawaqzeh, K., Nelson, A., Hosseinpour, H., Ditillo, M., Gries, L., Castanon, L., & Joseph, B. (2023). Association Between Hemorrhage Control Interventions and Mortality in US Trauma Patients With Hemodynamically Unstable Pelvic Fractures. JAMA surgery, 158(1), 63-71.More infoManagement of hemodynamically unstable pelvic fractures remains a challenge. Hemostatic interventions are used alone or in combination. There is a paucity of data on the association between the pattern of hemorrhage control interventions and outcomes after a severe pelvic fracture.
- Avila, M., Bhogadi, S. K., Nelson, A., Hosseinpour, H., Ditillo, M., Akl, M., Anand, T., Spencer, A. L., Magnotti, L. J., & Joseph, B. (2023). The long-term risks of venous thromboembolism among non-operatively managed spinal fracture patients: A nationwide analysis. American journal of surgery, 225(6), 1086-1090.More infoLong-term readmission data for venous thromboembolism (VTE) after spinal fractures is limited. We aimed to evaluate the 1-month and 6-month VTE readmission rates in non-operatively managed traumatic spinal fractures.
- 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 infoPrognostic 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., Nelson, A., El-Qawaqzeh, K., Spencer, A. L., Hosseinpour, H., Castanon, L., Anand, T., Ditillo, M., Magnotti, L. J., & Joseph, B. (2023). Does preinjury anticoagulation worsen outcomes among traumatic hemothorax patients? A nationwide retrospective analysis. Injury, 54(9), 110850.More infoUp to a quarter of all traumatic deaths are due to thoracic injuries. Current guidelines recommend consideration of evacuation of all hemothoraces with tube thoracostomy. The aim of our study was to determine the impact of pre-injury anticoagulation on outcomes of traumatic hemothorax patients.
- Castanon, L., Bhogadi, S. K., Anand, T., Hosseinpour, H., Nelson, A., Colosimo, C., Spencer, A. L., Gries, L., Ditillo, M., & Joseph, B. (2023). The Association Between the Timing of Initiation of Pharmacologic Venous Thromboembolism Prophylaxis with Outcomes in Burns Patients. Journal of burn care & research : official publication of the American Burn Association, 44(6), 1311-1315.More infoHospitalized burn patients are at increased risk for venous thromboembolism (VTE). Guidelines regarding thromboprophylaxis in burn patients are unclear. This study aims to compare the outcomes of early versus late thromboprophylaxis initiation in burn patients. In this 3-year analysis of 2017-2019 ACS-TQIP, adult(18-64years) burn patients were identified after applying inclusion/exclusion criteria and stratified based on timing of initiation of VTE prophylaxis: Early(24 hours). Outcomes were deep venous thrombosis(DVT), pulmonary embolism(PE), unplanned return to operating room (OR), unplanned intensive care unit (ICU) admission, post-prophylaxis packed red blood cells (PRBC) transfusion, and mortality. Nine thousand two hundred and seventy-two patients were identified. Overall, median age was 41years, 71.5% were male, and median[IQR] injury severity score was 3[1-8]. 53% had second-degree burns, and 80% had less than 40% of total body surface area affected. Median time to thromboprophylaxis initiation was 11[6-20.6]hours. Overall VTE rate was 0.9% (DVT-0.7%, PE-0.2%). On univariable analysis, early prophylaxis group had lower rates of DVT(0.6% vs 1.1%, P = .025), and PE(0.1% vs 0.6%, P < .001). On multivariable regression, late prophylaxis was associated with 1.8 times higher odds of DVT (aOR = 1.8, 95% CI = 1.04-3.11, P = .03), 4.8 times higher odds of PE(aOR = 4.8, 95% CI = 1.9-11.9, P
- 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 infoThere 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., Colosimo, C., Bhogadi, S. K., Magnotti, L. J., Hosseinpour, H., Castanon, L., Nelson, A., Ditillo, M., Anand, T., & Joseph, B. (2023). Unequal Treatment? Confronting Racial, Ethnic, and Socioeconomic Disparity in Management of Survivors of Violent Suicide Attempt. Journal of the American College of Surgeons, 237(1), 68-78.More infoPsychiatric inpatient hospitalization is nearly always indicated for patients with recent suicidal behavior. We aimed to assess the factors associated with receiving mental health services during hospitalization or on discharge among survivors of suicide attempts in trauma centers.
- 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, 71(6), 1735-1748.More infoElder 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.
- El-Qawaqzeh, K., Magnotti, L. J., Hosseinpour, H., Nelson, A., Spencer, A. L., Anand, T., Bhogadi, S. K., Alizai, Q., Ditillo, M., & Joseph, B. (2023). Geriatric trauma, frailty, and ACS trauma center verification level: Are there any correlations with outcomes?. Injury, 110972.More infoIt remains unclear whether geriatrics benefit from care at higher-level trauma centers (TCs). We aimed to assess the impact of the TC verification level on frail geriatric trauma patients' outcomes. We hypothesized that frail patients cared for at higher-level TCs would have improved outcomes.
- Hosseinpour, H., Anand, T., Bhogadi, S. K., Colosimo, C., El-Qawaqzeh, K., Spencer, A. L., Castanon, L., Ditillo, M., Magnotti, L. J., & Joseph, B. (2023). Emergency Department Shock Index Outperforms Prehospital and Delta Shock Indices in Predicting Outcomes of Trauma Patients. The Journal of surgical research, 291, 204-212.More infoMultiple shock indices (SIs), including prehospital, emergency department (ED), and delta (ED SI - Prehospital SI) have been developed to predict outcomes among trauma patients. This study aims to compare the predictive abilities of these SIs for outcomes of polytrauma patients on a national level.
- Hosseinpour, H., El-Qawaqzeh, K., Magnotti, L. J., Bhogadi, S. K., Ghneim, M., Nelson, A., Spencer, A. L., Colosimo, C., Anand, T., Ditillo, M., & Joseph, B. (2023). The unexpected paradox of geriatric traumatic brain injury outcomes: Uncovering racial and ethnic disparities. American journal of surgery, 226(2), 271-277.More infoHealthcare disparities have always challenged surgical care in the US. We aimed to assess the influence of disparities on cerebral monitor placement and outcomes of geriatric TBI patients.
- Hosseinpour, H., Magnotti, L. J., Bhogadi, S. K., Anand, T., El-Qawaqzeh, K., Ditillo, M., Colosimo, C., Spencer, A., Nelson, A., & Joseph, B. (2023). Time to Whole Blood Transfusion in Hemorrhaging Civilian Trauma Patients: There Is Always Room for Improvement. Journal of the American College of Surgeons, 237(1), 24-34.More infoWhole blood (WB) is becoming the preferred product for the resuscitation of hemorrhaging trauma patients. However, there is a lack of data on the optimum timing of receiving WB. We aimed to assess the effect of time to WB transfusion on the outcomes of trauma patients.
- Hosseinpour, H., Magnotti, L. J., Bhogadi, S. K., Colosimo, C., El-Qawaqzeh, K., Spencer, A. L., Anand, T., Ditillo, M., Nelson, A., & Joseph, B. (2023). Interfacility transfer of pediatric trauma patients to higher levels of care: The effect of transfer time and level of receiving trauma center. The journal of trauma and acute care surgery, 95(3), 383-390.More infoInterfacility transfer of pediatric trauma patients to pediatric trauma centers (PTCs) after evaluation in nontertiary centers is associated with improved outcomes. We aimed to assess the outcomes of transferred pediatric patients based on their severity of the injury, transfer time, and level of receiving PTCs.
- Hosseinpour, H., Nelson, A., Bhogadi, S. K., Spencer, A. L., Alizai, Q., Colosimo, C., Anand, T., Ditillo, M., Magnotti, L. J., & Joseph, B. (2023). Delayed versus early hepatic resection among patients with severe traumatic liver injuries undergoing damage control laparotomy. American journal of surgery.More infoWe aimed to assess the effect of time to hepatic resection on the outcomes of patients with high-grade liver injuries who underwent damage control laparotomy (DCL).
- 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 infoFrailty 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.
- Akl, M., Anand, T., Reina, R., El-Qawaqzeh, K., Ditillo, M., Hosseinpour, H., Nelson, A., Obaid, O., Friese, R., & Joseph, B. (2022). Balanced hemostatic resuscitation for bleeding pediatric trauma patients: A nationwide quantitative analysis of outcomes. Journal of pediatric surgery.More infoThe administration of balanced component therapy has been associated with improvements in outcomes in adult trauma. There is little to no specific data to guide transfusion ratios in children. The aim of our study is to compare outcomes among different transfusion strategies in pediatric trauma patients.
- Collins, W. J., El-Qawaqzeh, K., Ditillo, M., Hosseinpour, H., Nelson, A., Bhogadi, S. K., Castanon, L., Gries, L., Anand, T., & Joseph, B. (2022). Minimally Invasive Surgery for Genitourinary Trauma: A Nationwide Outcomes-Based Analysis. The Journal of surgical research, 282, 129-136.More infoBladder and ureteral injuries are uncommon in trauma patients but are associated with increased morbidity and mortality. Patients presenting with such injuries may undergo either open surgical repair or laparoscopic repair. We aimed to compare outcomes of open surgical approach and laparoscopy in trauma patients with isolated bladder and ureteral injury. We hypothesized that laparoscopy is associated with improved outcomes.
- Douglas, M., Obaid, O., Castanon, L., Reina, R., Ditillo, M., Nelson, A., Bible, L., Anand, T., Gries, L., & Joseph, B. (2022). After 9,000 laparotomies for blunt trauma, resuscitation is becoming more balanced and time to intervention shorter: Evidence in action. The journal of trauma and acute care surgery, 93(3), 307-315.More infoSeveral advancements in hemorrhage control have been advocated for in the past decade, including balanced transfusions and earlier times to intervention. The aim of this study was to examine the effect of these advancements on outcomes of blunt trauma patients undergoing emergency laparotomy.
- El-Qawaqzeh, K., Anand, T., Richards, J., Hosseinpour, H., Nelson, A., Akl, M. N., Obaid, O., Ditillo, M., Friese, R., & Joseph, B. (2022). Predictors of Mortality in Blunt Cardiac Injury: A Nationwide Analysis. The Journal of surgical research, 281, 22-32.More infoBlunt thoracic injury (BTI) is one of the most common causes of trauma admission in the United States and is uncommonly associated with cardiac injuries. Blunt cardiac injury (BCI) after blunt thoracic trauma is infrequent but carries a substantial risk of morbidity and sudden mortality. Our study aims to identify predictors of concomitant cardiac contusion among BTI patients and the predictors of mortality among patients presenting with BCI on a national level.
- Joseph, B., Sakran, J. V., Obaid, O., Hosseinpour, H., Ditillo, M., Anand, T., & Zakrison, T. L. (2022). Nationwide Management of Trauma in Child Abuse: Exploring the Racial, Ethnic, and Socioeconomic Disparities. Annals of surgery, 276(3), 500-510.More infoChild abuse is a major cause of childhood injury, morbidity, and death. There is a paucity of data on the practice of abuse interventions among this vulnerable population. The aim of our study was to identify the factors associated with interventions for child abuse on a national scale.
- Kapadia, M., Obaid, O., Nelson, A., Hammad, A., Kitts, D. J., Anand, T., Ditillo, M., Douglas, M., & Joseph, B. (2022). Evaluation of Frailty Assessment Compliance in Acute Care Surgery: Changing Trends, Lessons Learned. The Journal of surgical research, 270, 236-244.More infoRoutine frailty assessment has emerged recently in the surgical literature and is an important prognostication and risk stratification tool. The aim of our study was to review our 7-y experience with two frailty assessment tools and changing trends in their use.
- Nelson, A., Reina, R., Northcutt, A., Obaid, O., Castanon, L., Ditillo, M., Gries, L., Bible, L., Anand, T., & Joseph, B. (2022). Prospective validation of the Rib Injury Guidelines for traumatic rib fractures. The journal of trauma and acute care surgery, 92(6), 967-973.More infoThe Rib Injury Guidelines (RIG) were developed to guide triage of traumatic rib fracture patients to home, regular floor, or intensive care unit (ICU) and standardize care. The RIG score is based on patient history, physical examination, and imaging findings. The aim of this study was to evaluate triage effectiveness and health care resources utilization following RIG implementation.
- 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, 93(4), 453-460.More infoTrauma-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 infoThis study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM.
- Anand, T., Khurrum, M., Chehab, M., Bible, L., Asmar, S., Douglas, M., Ditillo, M., Gries, L., & Joseph, B. (2021). Racial and Ethnic Disparities in Frail Geriatric Trauma Patients. World journal of surgery, 45(5), 1330-1339.More infoFrailty in geriatric trauma patients is commonly associated with adverse outcomes. Racial disparities in geriatric trauma patients are previously described in the literature. We aimed to assess whether race and ethnicity influence outcomes in frail geriatric trauma patients.
- Anand, T., Obaid, O., Nelson, A., Chehab, M., Ditillo, M., Hammad, A., Douglas, M., Bible, L., & Joseph, B. (2021). Whole blood hemostatic resuscitation in pediatric trauma: A nationwide propensity-matched analysis. The journal of trauma and acute care surgery, 91(4), 573-578.More infoWhole blood (WB) has shown promise in pediatric trauma resuscitation following its prominent role in the resuscitation of adult trauma patients. Although WB in children has been shown to be feasible, its effectiveness has yet to be explored. The aim of this study was to examine the outcomes of WB transfusion as an adjunct to component therapy (CT) compared with CT only as early resuscitation for pediatric trauma patients.
- Asmar, S., Bible, L., Chehab, M., Obaid, O., Castanon, L., Yaghi, M., Ditillo, M., & Joseph, B. (2021). Traumatic Femoral Artery Injuries and Predictors of Compartment Syndrome: A Nationwide Analysis. The Journal of surgical research, 265, 159-167.More infoThe femoral artery is commonly injured following lower extremity trauma. If not identified early and addressed properly, it can lead to compartment syndrome (CS) and limb amputation. The aim of this study is to examine traumatic femoral artery injuries and identify risk factors for the development of lower extremity CS.
- Asmar, S., Bible, L., Obaid, O., Anand, T., Chehab, M., Ditillo, M., Castanon, L., Nelson, A., & Joseph, B. (2021). Frail geriatric patients with acute calculous cholecystitis: Operative versus nonoperative management?. The journal of trauma and acute care surgery, 91(1), 219-225.More infoNonoperative management of acute calculous cholecystitis (ACC) in the frail geriatric population is underexplored. The aim of our study was to examine long-term outcomes of frail geriatric patients with ACC treated with cholecystectomy compared with initial nonoperative management.
- Asmar, S., Bible, L., Obaid, O., Tang, A., Khurrum, M., Castanon, L., Ditillo, M., & Joseph, B. (2021). Open vs Endovascular Treatment of Traumatic Peripheral Arterial Injury: Propensity Matched Analysis. Journal of the American College of Surgeons, 233(1), 131-138.e4.More infoArterial injuries occur in the setting of blunt and penetrating trauma. Despite increasing use, there remains a paucity of data comparing long-term outcomes of endovascular vs open repair management of these injuries. The aim of our study was to compare outcomes and readmission rates of open vs endovascular repair of traumatic arterial injuries.
- Asmar, S., Bible, L., Vartanyan, P., Castanon, L., Masjedi, A., Richards, J., Ditillo, M., Tang, A., & Joseph, B. (2021). Firearm-Related Injuries: A Single Center Experience. The Journal of surgical research, 265, 289-296.More infoFirearm-related injuries (FRI) are an important public health crisis in the US. There is relatively less city level data examining the injury-related trends in Tucson, Arizona. Our study aims to examine FRI, in Southern Arizona's only Level I trauma center.
- Asmar, S., Nelson, A., Anand, T., Hammad, A., Obaid, O., Ditillo, M., Saljuqi, T., Tang, A., & Joseph, B. (2021). Marijuana and thromboembolic events in geriatric trauma patients: The cannabinoids clots correlation!. American journal of surgery.More infoTetrahydrocannabinol (THC) can alter the coagulation cascade resulting in hypercoagulability. The aim of our study is to evaluate the impact of THC use on thromboembolic complications (TEC) in geriatric trauma patients (GTP).
- Calabrese, E. C., Asmar, S., Bible, L., Khurrum, M., Chehab, M., Tang, A., Castanon, L., Ditillo, M., & Joseph, B. (2021). Prospective Evaluation of Health Literacy and Its Impact on Outcomes in Emergency General Surgery. The Journal of surgical research, 261, 343-350.More infoHealth literacy (HL) is an important component of national health policy. The aim of our study was to assess the prevalence of low HL (LHL) and determine its impact on outcomes after emergency general surgery (EGS).
- Chehab, M., Ditillo, M., Khurrum, M., Gries, L., Asmar, S., Douglas, M., Bible, L., Kulvatunyou, N., & Joseph, B. (2021). Managing acute uncomplicated appendicitis in frail geriatric patients: A second hit may be too much. The journal of trauma and acute care surgery, 90(3), 501-506.More infoStudies have proposed the use of antibiotics only in cases of acute uncomplicated appendicitis (AUA). However, there remains a paucity of data evaluating this nonoperative approach in the vulnerable frail geriatric population. The aim of this study was to examine long-term outcomes of frail geriatric patients with AUA treated with appendectomy compared with initial nonoperative management (NOP).
- Chehab, M., Ditillo, M., Obaid, O., Nelson, A., Poppe, B., Douglas, M., Anand, T., Bible, L., & Joseph, B. (2021). Never-frozen liquid plasma transfusion in civilian trauma: a nationwide propensity-matched analysis. The journal of trauma and acute care surgery, 91(1), 200-205.More infoNever-frozen liquid plasma (LQP) was found to reduce component waste, decrease health care expenses, and have a superior hemostatic profile compared with fresh frozen plasma (FFP). Although transfusing LQP in hemorrhaging patients has become more common, its clinical effectiveness remains to be explored. This study aims to examine outcomes of trauma patients transfused with LQP compared with thawed FFP.
- Khurrum, M., Chehab, M., Ditillo, M., Richards, J., Douglas, M., Bible, L., Spece, L., & Joseph, B. (2021). Trends in Geriatric Ground-Level Falls: Report from the National Trauma Data Bank. The Journal of surgical research, 266, 261-268.More infoGround-level falls (GLF) are typically reported as a minor mechanism of injury; however, they represent a significant portion of hospitalized geriatric trauma patients as they can result in multisystem injury in this subset of the population. Our study aimed to analyze trends in geriatric trauma falls on the national level.
- Khurrum, M., Ditillo, M., Obaid, O., Anand, T., Nelson, A., Chehab, M., Kitts, D. J., Douglas, M., Bible, L., & Joseph, B. (2021). Four-factor prothrombin complex concentrate in adjunct to whole blood in trauma-related hemorrhage: Does whole blood replace the need for factors?. The journal of trauma and acute care surgery, 91(1), 34-39.More infoThe use of whole blood (WB) for the treatment of hemorrhagic shock and coagulopathy is increasing in civilian trauma patients. Four-factor prothrombin complex concentrate (4-PCC) in adjunct to component therapy showed improved outcomes in trauma patients. Our study aims to evaluate the outcomes of trauma patients who received 4-PCC and WB (4-PCC-WB) compared with WB alone.
- Obaid, O., Hammad, A., Bible, L., Ditillo, M., Castanon, L., Douglas, M., Anand, T., Nelson, A., & Joseph, B. (2021). Open Versus Laparoscopic Repair of Traumatic Diaphragmatic Injury: A Nationwide Propensity-Matched Analysis. The Journal of surgical research, 268, 452-458.More infoMinimally invasive surgical techniques have become routinely applied in the evaluation and treatment of patients with isolated traumatic diaphragmatic injuries (TDI). However, there remains a paucity of data that compares the laparoscopic repair to the open repair approach. The aim of our study is to examine patient outcomes between TDI patients managed laparoscopically versus those managed using open repair.
- Anand, T., Hanna, K., Kulvatunyou, N., Zeeshan, M., Ditillo, M., Castanon, L., Tang, A., Gries, L., & Joseph, B. (2020). Time to tracheostomy impacts overall outcomes in patients with cervical spinal cord injury. The journal of trauma and acute care surgery, 89(2), 358-364.More infoThe morbidity associated with cervical spine injury increases in the setting of concomitant cervical spinal cord injury (CSCI). A significant proportion of these patients require placement of a tracheostomy. However, it remains unclear if timing to tracheostomy following traumatic CSCI can impact outcomes. The aim of our study was to characterize outcomes associated with tracheostomy timing following traumatic CSCI.
- Asmar, S., Chehab, M., Bible, L., Khurrum, M., Castanon, L., Ditillo, M., & Joseph, B. (2020). The ED Systolic Blood Pressure Relationship After Traumatic Brain Injury. The Journal of surgical research, 257, 493-500.More infoBlood pressure alterations in patients with traumatic brain injury (TBI) have been shown to be associated with increased mortality. However, there is paucity of data describing the optimal emergency department (ED) systolic blood pressure (SBP) target during the initial evaluation. The aim of our study was to assess the association between SBP on presentation and mortality in patients with TBI.
- Asmar, S., Lokhandwala, A., Richards, J., Bible, L., Avila, M., Castanon, L., Ditillo, M., Douglas, M., & Joseph, B. (2020). The neuroprotective effect of quetiapine in critically ill traumatic brain injury patients. The journal of trauma and acute care surgery, 89(4), 775-782.More infoQuetiapine is an atypical antipsychotic commonly used in critical care. Cellular and animal models demonstrated its novel anti-inflammatory properties in traumatic brain injury (TBI). Our study aimed to assess the effect of quetiapine on outcomes in critically ill TBI patients. We hypothesize that quetiapine improves neurological outcomes.
- Astarabadi, M., Khurrum, M., Asmar, S., Bible, L., Chehab, M., Castanon, L., Ditillo, M., Douglas, M., & Joseph, B. (2020). The impact of non-neurological organ dysfunction on outcomes in severe isolated traumatic brain injury. The journal of trauma and acute care surgery, 89(2), 405-410.More infoOrgan dysfunction following traumatic brain injury (TBI) is common and has been associated with unpredictable outcomes. The aim of our study is to describe the incidence of non-neurological organ dysfunction (NNOD) and its impact on outcomes in patients with severe TBI admitted to our intensive care unit (ICU).
- Castanon, L., Asmar, S., Bible, L., Chehab, M., Ditillo, M., Khurrum, M., Hanna, K., Douglas, M., & Joseph, B. (2020). Early Enteral Nutrition in Geriatric Burn Patients: Is There a Benefit?. Journal of burn care & research : official publication of the American Burn Association, 41(5), 986-991.More infoNutrition is a critical component of acute burn care and wound healing. There is no consensus over the appropriate timing of initiating enteral nutrition in geriatric burn patients. This study aimed to assess the impact of early enteral nutrition on outcomes in this patient population. We performed a 1-year (2017) analysis of the American College of Surgeons Trauma Quality Improvement Program and included all older adult (age ≥65 years) isolated thermal burn patients who were admitted for more than 24 hr and received enteral nutrition. Patients were stratified into two groups based on the timing of initiation of feeding: early (≤24 hr) vs late (>24 hr). Multivariate logistic regression was performed to control for potential confounding factors. Outcome measures were hospital and intensive care unit lengths of stay, in-hospital complications, and mortality. A total of 1,004,440 trauma patients were analyzed, of which 324 patients were included (early: 90 vs late: 234). The mean age was 73.9 years and mean TBSA burnt was 31%. Patients in the early enteral nutrition group had significantly lower rates of in-hospital complications and mortality (15.6% vs 26.1%; P = 0.044), and a shorter hospital length of stay (17 [11,23] days vs 20 [14,24] days; P = 0.042) and intensive care unit length of stay (13 [8,15] days vs 17 [9,21] days; P = 0.042). In our regression model of geriatric burn patients, early enteral nutrition was associated with improved outcomes. The cumulative benefits observed may warrant incorporating early enteral nutrition as part of intensive care protocols.
- Chehab, M., Afaneh, A., Bible, L., Castanon, L., Hanna, K., Ditillo, M., Khurrum, M., Asmar, S., & Joseph, B. (2020). Angioembolization in intra-abdominal solid organ injury: Does delay in angioembolization affect outcomes?. The journal of trauma and acute care surgery, 89(4), 723-729.More infoAngioembolization (AE) is an integral component in multidisciplinary algorithms for achieving hemostasis in patients with trauma. The American College of Surgeons Committee on Trauma recommends that interventional radiologists be available within 30 minutes to perform emergent AE. However, the impact of the timing of AE on patient outcomes is still not well known. We hypothesized that a delay in AE would be associated with increased mortality and higher blood transfusion requirements in patients with blunt intra-abdominal solid organ injury.
- Cragun, B. N., Noorbakhsh, M. R., Hite Philp, F., Suydam, E. R., Ditillo, M. F., Philp, A. S., & Murdock, A. D. (2020). Traumatic Parafalcine Subdural Hematoma: A Clinically Benign Finding. The Journal of surgical research, 249, 99-103.More infoGuidelines for management of intracranial hemorrhage do not account for bleed location. We hypothesize that parafalcine subdural hematoma (SDH), as compared to convexity SDH, is a distinct clinical entity and these patients do not benefit from critical care monitoring or repeat imaging.
- Ditillo, M., Hanna, K., Castanon, L., Zeeshan, M., Kulvatunyou, N., Tang, A., Sakran, J., Gries, L., & Joseph, B. (2020). The role of cryoprecipitate in massively transfused patients: Results from the Trauma Quality Improvement Program database may change your mind. The journal of trauma and acute care surgery, 89(2), 336-343.More infoCryoprecipitate was developed for the treatment of inherited and acquired coagulopathies. The role of cryoprecipitate in hemorrhaging trauma patients is still speculative. The aim of our study was to assess the role of cryoprecipitate as an adjunct to transfusion in trauma patients.
- Hamidi, M., Asmar, S., Bible, L., Hanna, K., Castanon, L., Avila, M., Ditillo, M., & Joseph, B. (2020). Early Thromboprophylaxis in Operative Spinal Trauma Does Not Increase Risk of Bleeding Complications. The Journal of surgical research, 258, 119-124.More infoThromboprophylaxis in patients with spinal trauma is often delayed due to the risk of bleeding and expansion of the intraspinal hematoma (ISH). Our study aimed to assess the safety of early initiation of thromboprophylaxis in patients with operative spinal trauma (OST).
- Hanna, K., Asmar, S., Ditillo, M., Chehab, M., Khurrum, M., Bible, L., Douglas, M., & Joseph, B. (2020). Readmission With Major Abdominal Complications After Penetrating Abdominal Trauma. The Journal of surgical research, 257, 69-78.More infoDespite improvements in operative techniques, major abdominal complications (MACs) continue to occur after penetrating abdominal trauma (PAT). This study aimed to evaluate the burden of MAC after PAT.
- Hanna, K., Bible, L., Chehab, M., Asmar, S., Douglas, M., Ditillo, M., Castanon, L., Tang, A., & Joseph, B. (2020). Nationwide analysis of whole blood hemostatic resuscitation in civilian trauma. The journal of trauma and acute care surgery, 89(2), 329-335.More infoRenewed interest in whole blood (WB) resuscitation in civilians has emerged following its military use. There is a paucity of data on its role in civilians where balanced component therapy (CT) resuscitation is the standard of care. The aim of this study was to assess nationwide outcomes of using WB as an adjunct to CT versus CT alone in resuscitating civilian trauma patients.
- Hanna, K., Chehab, M., Bible, L., Asmar, S., Ditillo, M., Castanon, L., Tang, A., & Joseph, B. (2020). Failure to Rescue in Emergency General Surgery: Impact of Fragmentation of Care. Annals of surgery.More infoCompare emergency general surgery (EGS) patient outcomes following index and non-index hospital readmissions, and explore predictive factors for non-index readmission.
- Hanna, K., Chehab, M., Bible, L., Castanon, L., Douglas, M., Asmar, S., Ditillo, M., Tang, A., & Joseph, B. (2020). Nationwide analysis of cryopreserved packed red blood cell transfusion in civilian trauma. The journal of trauma and acute care surgery, 89(5), 861-866.More infoLiquid packed red blood cells (LPRBCs) have a limited shelf life and worsening quality with age. Cryopreserved packed red blood cells (CPRBCs) can be stored up to 10 years with no quality deterioration. The effect of CPRBCs on outcomes in civilian trauma is less explored. This study aims to evaluate the safety and efficacy of CPRBCs in civilian trauma patients.
- Hanna, K., Douglas, M., Asmar, S., Khurrum, M., Bible, L., Castanon, L., Ditillo, M., Kulvatunyou, N., & Joseph, B. (2020). Treatment of blunt cerebrovascular injuries: Anticoagulants or antiplatelet agents?. The journal of trauma and acute care surgery, 89(1), 74-79.More infoBlunt cerebrovascular injury (BCVI) is associated with cerebrovascular accidents (CVA). Early therapy with antiplatelet agents or anticoagulants is recommended. There are limited data comparing the effectiveness of these treatments. The aim of our study was to compare outcomes between BCVI patients who received anticoagulants versus those who received antiplatelet agents.
- Hanna, K., Khan, M., Ditillo, M., Hamidi, M., Tang, A., Zeeshan, M., Saljuqi, A. T., & Joseph, B. (2020). Prospective evaluation of preoperative cognitive impairment and postoperative morbidity in geriatric patients undergoing emergency general surgery. American journal of surgery, 220(4), 1064-1070.More infoCognitive impairment (CI) is common in geriatric patients. We aimed to evaluate the prevalence and impact of CI on outcomes in geriatric patients undergoing emergency general surgery (EGS).
- Khurrum, M., Asmar, S., Henry, M., Ditillo, M., Chehab, M., Tang, A., Bible, L., Gries, L., & Joseph, B. (2020). The survival benefit of low molecular weight heparin over unfractionated heparin in pediatric trauma patients. Journal of pediatric surgery.More infoVenous thromboembolism (VTE) prophylaxis in pediatric patients is controversial and is mainly dependent on protocols derived from adult practices. Our study aimed to compare outcomes among pediatric trauma patients who received low molecular weight heparin (LMWH) compared to those who received unfractionated heparin (UFH).
- Lokhandwala, A. M., Asmar, S., Khurrum, M., Chehab, M., Bible, L., Castanon, L., Ditillo, M., & Joseph, B. (2020). Platelet Transfusion After Traumatic Intracranial Hemorrhage in Patients on Antiplatelet Agents. The Journal of surgical research, 257, 239-245.More infoWith an aging population, the number of patients on antiplatelet medications and traumatic brain injury (TBI) is increasing. Our study aimed to evaluate the role of platelet transfusion on outcomes after traumatic intracranial bleeding (IB) in these patients.
- Masjedi, A., Asmar, S., Bible, L., Khurrum, M., Chehab, M., Castanon, L., Ditillo, M., & Joseph, B. (2020). The Evolution of Nonoperative Management of Abdominal Gunshot Wounds in the United States. The Journal of surgical research, 253, 224-231.More infoSurgical exploration for gunshot wounds to the abdomen has been a surgical standard for the greater part of the past century. Recently, nonoperative management (NOM) has been deemed as a safe option for abdominal gunshot wounds (AGWs). The aim of this analysis was to review the utilization of NOM and mortality after AGWs.
- Saljuqi, A. T., Hanna, K., Asmar, S., Tang, A., Zeeshan, M., Gries, L., Ditillo, M., Kulvatunyou, N., Castanon, L., & Joseph, B. (2020). Prospective Evaluation of Delirium in Geriatric Patients Undergoing Emergency General Surgery. Journal of the American College of Surgeons, 230(5), 758-765.More infoThe prevalence of delirium and its impact on outcomes after emergency general surgery (EGS) remain unexplored. The aims of our study were to assess the impact of frailty on delirium and the impact of delirium on outcomes in geriatric EGS patients.
- Stupinski, J., Bible, L., Asmar, S., Chehab, M., Douglas, M., Ditillo, M., Gries, L., Khurrum, M., & Joseph, B. (2020). Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients. The journal of trauma and acute care surgery, 89(1), 125-131.More infoTetrahydrocannabinoids (THC) can modulate the coagulation cascade resulting in hypercoagulability. However, the clinical relevance of these findings has not been investigated. The aim of our study was to evaluate the impact of preinjury marijuana exposure on thromboembolic complications (TEC) in trauma patients.
- Tang, A., Chehab, M., Ditillo, M., Asmar, S., Khurrum, M., Douglas, M., Bible, L., Kulvatunyou, N., & Joseph, B. (2020). Regionalization of Trauma Care by Operative Experience: Does the Volume of Emergent Laparotomy Matter?. The journal of trauma and acute care surgery.More infoThe volume-outcome relationship led to the regionalization of trauma care. The relationship between trauma centers' injury-specific laparotomy volume and outcomes has not been explored. The aim of our study was to examine the relationship between a trauma center's injury-specific laparotomy volume and outcomes in blunt and penetrating trauma patients.
- Vartan, P., Asmar, S., Bible, L., Chehab, M., Khurrum, M., Castanon, L., Ditillo, M., & Joseph, B. (2020). Alcohol Use Disorder Is Bad for Broken Ribs: A Nationwide Analysis of 19,638 Patients With Rib Fractures. The Journal of surgical research, 255, 556-564.More infoAlcohol use disorder (AUD) has deleterious effects on many organ systems. The aim of our study was to assess the impact of AUD on outcomes in patients with rib fractures. We hypothesized that AUD is associated with increased risk adverse outcomes.
- Hanna, K., Ditillo, M., & Joseph, B. (2019). The role of frailty and prehabilitation in surgery. Current opinion in critical care, 25(6), 717-722.More infoThe aging surgical population constitutes a unique challenge to clinicians across the spectrum of care. Frailty is a valuable tool for preoperative risk stratification and may guide targeted interventions, such as prehabilitation. The aim of this review is to revise the recent literature on the role of frailty and prehabilitation to optimize geriatric patients undergoing surgery.
- Hanna, K., Hamidi, M., Anderson, K. T., Ditillo, M., Zeeshan, M., Tang, A., Henry, M., Kulvatunyou, N., & Joseph, B. (2019). Pediatric resuscitation: Weight-based packed red blood cell volume is a reliable predictor of mortality. The journal of trauma and acute care surgery, 87(2), 356-363.More infoThe definition of massive transfusion (MT) in civilian pediatric trauma patients is not established. In combat-injured pediatric patients, the definition of MT is based on the volume of total blood products transfused. The aim of this study is to define MT in civilian pediatric trauma patients based on a packed red blood cell (PRBC) volume threshold and compare its predictive power to a total blood products volume threshold.
- Lokhandwala, A., Hanna, K., Gries, L., Zeeshan, M., Ditillo, M., Tang, A., Hamidi, M., & Joseph, B. (2019). Preinjury Statins Are Associated With Improved Survival in Patients With Traumatic Brain Injury. The Journal of surgical research, 245, 367-372.More infoStatins have been shown to improve outcomes in traumatic brain injury (TBI) in animal models. The aim of our study was to determine the effect of preinjury statins on outcomes in TBI patients.
- Hammad, A. Y., Ditillo, M., & Castanon, L. (2018). Pancreatitis. The Surgical clinics of North America, 98(5), 895-913.More infoAcute pancreatitis is an inflammation of the glandular parenchyma of the retroperitoneal organ that leads to injury with or without subsequent destruction of the pancreatic acini. This inflammatory process can either result in a self-limited disease or involve life-threatening multiorgan complications. Chronic pancreatitis consists of endocrine and exocrine gland dysfunction that develops secondary to progressive inflammation and chronic fibrosis of the pancreatic acini with permanent structural damage. Recurrent attacks of acute pancreatitis can result in chronic pancreatitis; acute and chronic pancreatitis are different diseases with separate morphologic patterns. Acute pancreatitis has an increasing incidence but a decreasing mortality.
- Zeeshan, M., Khan, M., O'Keeffe, T., Pollack, N., Hamidi, M., Kulvatunyou, N., Sakran, J. V., Gries, L., & Joseph, B. (2018). Optimal timing of initiation of thromboprophylaxis in spine trauma managed operatively: A nationwide propensity-matched analysis of trauma quality improvement program. The journal of trauma and acute care surgery, 85(2), 387-392.More infoPatients with spinal trauma are at high risk for venous thromboembolic events (VTE). Guidelines recommend prophylactic anticoagulation but they are unclear on timing of initiation of thromboprophylaxis. The aim of our study was to assess the impact of early versus late initiation of venous thromboprophylaxis in patients with spinal trauma who underwent operative intervention.
- Galvagno, S. M., Smith, C. E., Varon, A. J., Hasenboehler, E. A., Sultan, S., Shaefer, G., To, K. B., Fox, A. D., Alley, D. E., Ditillo, M., Joseph, B. A., Robinson, B. R., & Haut, E. R. (2016). Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society. The journal of trauma and acute care surgery, 81(5), 936-951.More infoThoracic trauma is the second most prevalent nonintentional injury in the United States and is associated with significant morbidity. Analgesia for blunt thoracic trauma was first addressed by the Eastern Association for the Surgery of Trauma (EAST) with a practice management guideline published in 2005. Since that time, it was hypothesized that there have been advances in the analgesic management for blunt thoracic trauma. As a result, updated guidelines for this topic using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework recently adopted by EAST are presented.
- Asmar, S., Bible, L., Chehab, M., Tang, A., Khurrum, M., Castanon, L., Ditillo, M., Douglas, M., & Joseph, B. (2021). Traumatic brain injury induced temperature dysregulation: What is the role of β blockers?. The journal of trauma and acute care surgery, 90(1), 177-184.More infoTraumatic brain injury (TBI) is associated with sympathetic discharge that leads to posttraumatic hyperthermia (PTH). Beta blockers (ββ) are known to counteract overactive sympathetic discharge. The aim of our study was to evaluate the effect of ββ on PTH in critically-ill TBI patients.
- Cragun, B. N., Hite Philp, F., O'Neill, J., Noorbakhsh, M. R., Tindall, R. P., Philp, A. S., & Ditillo, M. F. (2018). Therapeutic Hypothermia and Targeted Temperature Management for Traumatic Arrest and Surgical Patients. Therapeutic hypothermia and temperature management, 9(2), 156-158.More infoTherapeutic hypothermia (TH) and targeted temperature management (TTM) have been shown to improve outcomes in survivors of cardiac arrest, but prior research has excluded trauma and postoperative patients. We sought to determine whether TH/TTM is safe in trauma and surgical patients. A retrospective cohort study was conducted at a single level I trauma center reviewing adults presenting as a traumatic arrest or cardiac arrest in the postoperative period with a Glasgow Coma Scale
- Joseph, B., Hadeed, S., Haider, A. A., Ditillo, M., Joseph, A., Pandit, V., Kulvatunyou, N., Tang, A., Latifi, R., & Rhee, P. (2017). Obesity and trauma mortality: Sizing up the risks in motor vehicle crashes. Obesity research & clinical practice, 11(1), 72-78.More infoProtective effects of safety devices in obese motorists in motor vehicle collisions (MVC) remain unclear. Aim of our study is to assess the association between morbid obesity and mortality in MVC, and to determine the efficacy of protective devices. We hypothesised that patients with morbid obesity will be at greater risk of death after MVC.
- Patel, A., Fusi, S., Okanlami, O. O., Ditillo, M., & Sawh-Martinez, R. F. (2015). Blogging to bolster your plastic surgery career. Plastic and reconstructive surgery, 135(3), 658e-659e.
- Ditillo, M., Pandit, V., Rhee, P., Aziz, H., Hadeed, S., Bhattacharya, B., Friese, R. S., Davis, K., & Joseph, B. (2014). Morbid obesity predisposes trauma patients to worse outcomes: a National Trauma Data Bank analysis. The journal of trauma and acute care surgery, 76(1), 176-9.More infoOne third of US adults are obese. The impact of obesity on outcomes after blunt traumatic injury has been studied with discrepant results. The aim of our study was to evaluate outcomes in morbidly obese patients after blunt trauma. We hypothesized that morbidly obese patients have adverse outcomes as compared with nonobese patients after blunt traumatic injury.
- Joseph, B., Ditillo, M., Pandit, V., Aziz, H., Sadoun, M., Hays, D., Davis, K., Friese, R., & Rhee, P. (2014). Dabigatran therapy: minor trauma injuries are no longer minor. The American surgeon, 80(4), E116-8.
- Maung, A. A., Schuster, K. M., Kaplan, L. J., Ditillo, M. F., Piper, G. L., Maerz, L. L., Lui, F. Y., Johnson, D. C., & Davis, K. A. (2012). Compared to conventional ventilation, airway pressure release ventilation may increase ventilator days in trauma patients. The journal of trauma and acute care surgery, 73(2), 507-10.More infoAirway pressure release ventilation (APRV) is used both as a rescue therapy for patients with acute lung injury and as a primary mode of ventilation. Unlike assist-control volume (ACV) ventilation that uses spontaneous breathing trials, APRV weaning consists of gradual decreases in supporting pressure. We hypothesized that the APRV weaning process increases total ventilator days compared with those of spontaneous breathing trials-based weaning.
- Sixta, S., Moore, F. O., Ditillo, M. F., Fox, A. D., Garcia, A. J., Holena, D., Joseph, B., Tyrie, L., & Cotton, B. (2012). Screening for thoracolumbar spinal injuries in blunt trauma: an Eastern Association for the Surgery of Trauma practice management guideline. The journal of trauma and acute care surgery, 73(5 Suppl 4), S326-32.More infoThoracolumbar spine (TLS) injuries have an incidence rate of 5% in blunt trauma patients. The Eastern Association for the Surgery of Trauma published Practice Management Guidelines for the Screening of Thoracolumbar Spine Fracture in 2007. The Practice Management Guidelines Committee was assembled to reevaluate the literature.
- O'Connor, J., Ditillo, M., & Scalea, T. (2009). Penetrating cardiac injury. Journal of the Royal Army Medical Corps, 155(3), 185-90.More infoIt is understood that penetrating cardiac trauma is a highly lethal injury and those surviving to hospital have an overall mortality approaching 80%. Reported mortality figures vary widely and are extremely dependent on mechanism of wounding, cardiac chambers involved and possibly the presence of cardiac tamponade. Despite significant advances in prehospital care, operative techniques, and intensive care management, the mortality has not changed over several decades. This article will review the anatomic regions of concern for a cardiac injury, clinical presentation, and physical findings. The need for an expeditious evaluation and modalities available including, plain radiographs, sub-xiphoid window, and echocardiography will be considered. Options for surgical exposure, technical details of repairing cardiac injuries, and special circumstances such as injury adjacent to a coronary artery and intra-cardiac shunts are discussed in detail. Outcome data and future directions in managing this challenging injury are also examined.
- Ditillo, M. F., Dziura, J. D., & Rabinovici, R. (2006). Is it safe to delay appendectomy in adults with acute appendicitis?. Annals of surgery, 244(5), 656-60.More infoTo examine whether delayed surgical intervention in adult patients with acute appendicitis is safe by correlating the interval from onset of symptoms to operation (total interval) with the degree of pathology and incidence of postoperative complications.
Presentations
- Meka, J., Ditillo, M., Horak, H. A., & Corral, J. (2021, April). Workplace-Based Assessment in Clinical Education: An Adoption Cycle of Experience. AAMC GEA 2021. Virtual: AAMC.
- Ditillo, M. (2018, January). Traumatic Parafalcine Subdural Hematoma: A Clinically Benign Finding. Academic Surgical Congress. Jacksonville, FL.
- Ditillo, M. (2018, October). Desmopressin Reverses Platelet Inhibition In The ADP Pathway In Patients With Blunt Traumatic Brain Injuries. SABM Annual Meeting. Brooklyn, NY.
- Ditillo, M. (2017, August). Therapeutic Hypothermia: TO Chill or Not to Chill. PASCCM 22st Annual Challenges in Critical Care. Hershey, PA.
- Ditillo, M. (2017, December). Hemorrhage Control: From the Field to the ICU. Armstrong EMS Conference. Armstrong, PA.
- Ditillo, M. (2017, January). Targeted Temperature Management for Trauma and Surgical Patients. SCCM 46th Critical Care Congress. Honolulu, HI.
- Ditillo, M. (2017, July). Treatment of Blunt Thoracic Trauma. Allegheny General Hospital Nursing Trauma Symposium. Pittsburgh, PA.
- Ditillo, M. (2017, Ocotber). Targeted Temperature Management for Traumatic Arrest. American College of Surgeons Clinical Congress 2017. San Diego, CA.
- Ditillo, M. (2017, September). Damage Control Resuscitation. 65th AOCA Annual Convention. Miami Beach, FL.
- Ditillo, M. (2016, August). Damage Control Resuscitation: Blood is Thicker than Water. PASCCM 21st Annual Challenges in Critical Care. Hershey, PA.
- Ditillo, M. (2016, February). Adjuncts to Hemostasis. Grove City EMS Conference. Grove City, PA.
- Ditillo, M. (2016, July). Approach To Mass Casualty Event: The Hartford Consensus and Beyond. Allegheny General Hospital Nursing Trauma Symposium. Pittsburgh, PA.
- Ditillo, M. (2016, June). Damage Control Resucitation: Blood is Thicker Than Water. Audio-Digest Anesthesiology Volume 58, Issue 23.
- Ditillo, M. (2016, March). Damage Control Resuscitation: Blood is Thicker Than Water. Seventh Annual Allegheny Health System Anesthesia Update, New Approaches to Familiar Topics. Pittsburgh, PA.
- Ditillo, M. (2016, March). The Geriatric Trauma Patient. Pennsylvania EMS Update 2016. Pittsburgh, PA.
- Ditillo, M. (2016, October). Functional Recovery in Elderly after Trauma: The Impact of Frailty. American College of Surgeons Clinical Congress 2016. Washington, DC.
- Ditillo, M. (2015, July). Critical Care Alphabet Soup: Implementation of the ABCDEF Bundle in the ICU. Allegheny General Hospital Nursing Trauma Symposium. Pittsburgh, PA.
- Ditillo, M. (2015, July). The Mangled Extremity, An Evidence Based Approach. Allegheny General Hospital Nursing Trauma Symposium. Pittsburgh, PA.
- Ditillo, M. (2015, June). Damage Control Resucitation an Evidence Based Approach. Allegheny Health Network Anesthesia Grand Rounds. Pittsburgh, PA.
- Ditillo, M. (2015, March). All Bleeding Stops…One Way or Another. Pennsylvania EMS Update 2015. Pittsburgh, PA.
- Ditillo, M. (2015, November). Hemorrhage Control: From the Field to the ICU. Clarion EMS Conference. Clarion, PA.
- Ditillo, M. (2015, September). “Down But Not Out: Rib Fractures In The Super-Elderly. 74th Annual Meeting of the AAST and Clinical Congress of Acute Care Surgery. Las Vegas, NV.
- Ditillo, M. (2014, October). Morbidly Obese Patients and Motor Vehicle Collisions: Are Protective Devices Really Protective?. American College of Surgeons Clinical Congress 2014. San Francisco, CA.
- Ditillo, M. (2014, September). Fraility and Surgery. Allegheny General Hospital General Surgery Grand Rounds. Pittsburgh, PA.
- Ditillo, M. (2013, April). Approach to the Geriatric Trauma Patient. 15th Annual Connecticut Trauma Conference. Ledyard, CT.
- Ditillo, M. (2013, January). Pain Management in Blunt Thoracic Trauma. 26th Annual Meeting of the Eastern Association for the Surgery of Trauma. Scottsdale, AZ.
- Ditillo, M. (2013, October). Obesity Predisposes Trauma Patients to Worse Outcomes: A National Trauma Data Bank Analysis. American College of Surgeons Clinical Congress 2013. Washington, DC.
- Ditillo, M. (2013, September). Obesity Predisposes Trauma Patients to Worse Outcomes: A National Trauma Data Bank Analysis. 72nd Annual Meeting of the AAST and Clinical Congress of Acute Care Surgery. San Francisco.
- Ditillo, M. (2012, April). Does a Liberalized Fluid Protocol Improve Tissue Perfusion in Lung Resection Surgery without increasing Lung Water?. Association of VA Surgeons Annual Meeting. Miami, FL.
- Ditillo, M. (2012, February). Therapeutic Hypothermia: Past Present and Future. Surgical Grand Rounds. Brookdale University Hospital and Medical Center Brooklyn, NY.
- Ditillo, M. (2012, January). Practice Management Guidelines for the Screening of Thoracolumbar Spinal Injury in Blunt Trauma Eastern Association for the Surgery of Trauma Practice Management Guideline Committee. 25th Annual Meeting of the Eastern Association for the Surgery of Trauma. Naples, FL.
- Ditillo, M. (2012, March). The Mangled Extremity, An Evidence Based Approach. Yale School of Medicine Plastic Surgery Grand Rounds. New Haven, CT.
- Ditillo, M. (2012, May). Liberalized Fluid Protocol and Tissue Perfusion Biomarkers in Lung Resection Surgery. International Anesthesia Research Society. Boston, MA.
- Ditillo, M. (2012, May). “Does A Liberalized Fluid Protocol Increase Lung Water Post Lung Resection Surgery?. International Anesthesia Research Society. Boston, MA.
- Ditillo, M. (2011, January). Brief episodes of intracranial hypertension and cerebral hypoperfusion are associated with poor functional outcomes following severe traumatic brain injury. 24th Annual Meeting of the Eastern Association for the Surgery of Trauma. Naples, FL.
- Ditillo, M. (2011, June). Damage Control Resucitation: Blood is Thicker Than Water. Surgical Grand Rounds. St. Mary’s Medical Center Waterbury, CT.
- Ditillo, M. (2010, April). To Chill or Not to Chill-Therapeutic Hypothermia After Cardiac Arrest. Yale School of Medicine Surgical Grand Rounds. New Haven, CT.
- Ditillo, M. (2010, January). Therapeutic Hypothermia Post Cardiac Arrest: An Evidence Based Approach. Surgical Grand Rounds. Bridgeport Hospital-Yale New Haven Health System Bridgeport, CT.
- Ditillo, M. (2010, November). When the ICU is the OR. Connecticut Chapter of the American College of Surgeons Professional Association. Waterbury, CT.
- Ditillo, M. (2010, September). Outcomes of alcohol use in elderly trauma patients. 69th Annual Meeting of the American Association for the Surgery of Trauma. Boston, Massachusetts.
- Ditillo, M. (2009, October). Outcomes of alcohol use in elderly trauma patients. Connecticut Chapter of the American College of Surgeons Professional Association. Waterbury, CT.
Poster Presentations
- Ditillo, M. (2021). Does Thromboelastography Predict Preinjury Anticoagulation In Traumatic Brain Injury?. American Association for the Surgery of Trauma 80th Annual and Clinical Congress.
- Ditillo, M. (2018). Desmopressin Reverses Platelet Inhibition In The ADP Pathway In Patients With Blunt Traumatic Brain Injuries. SABM Annual Meeting.
- Ditillo, M. (2017, September). Targeted Temperature Management for Trauma Arrest. American Association for the Surgery of Trauma 76th Annual and Clinical Congress. Baltimore, MD.
- Ditillo, M. (2010). Outcomes of alcohol use in elderly trauma patients. 69th Annual Meeting of the American Association for the Surgery of Trauma.
- Ditillo, M. (2007, April). Not Just a Routine Hernia Operation. American Hernia Society.
- Ditillo, M. (2007, November). Cocaine: Effects on Developing Brains.” Poster Presentation. New York Academy Of Sciences. New York.
- Ditillo, M. (1997, October). Perinatal AZT (Zidovudine): neurobehavioral effects in a rat model. Neurobehavior and Teratology.
Reviews
- Bhogadi, S. K., Colosimo, C., Hosseinpour, H., Nelson, A., Rose, M. I., Calvillo, A. R., Anand, T., Ditillo, M., Magnotti, L. J., & Joseph, B. (2023. The undisclosed disclosures: The dollar-outcome relationship in resuscitative endovascular balloon occlusion of the aorta(pp 726-730).More infoDespite its rapid evolution, resuscitative endovascular balloon occlusion of the aorta (REBOA) remains a controversial intervention that continues to generate active research. Proper conflict of interest (COI) disclosure helps to ensure that research is conducted objectively, without bias. We aimed to identify the accuracy of COI disclosures in REBOA research.