Tanya Anand

Interests

Research

Endotheliopathy of TraumaGeriatric TraumaHemorrhagic Shock and Resuscitation

Courses

Scholarly Contributions

Chapters

• Anand, T. (2020). Is it time for REBOA to replace emergent resuscitative thoracotomies?. In Difficult Decisions in Trauma Surgery.

Journals/Publications

• Ali Farhan, S., Hasnain, N., Moorpani, M., Sajid, E. U., Shahid, I., Anand, T., & Khosa, F. (2024). Gender Disparity in Academic Trauma Surgery: The Current State of Affairs. The American surgeon, 31348241256080.
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  Despite the increasing number of female surgeons in general surgery programs, women are still inadequately represented in leadership positions. This study aims to investigate the magnitude of gender bias in university-based trauma surgery fellowship programs and leadership positions in the United States of America.
• Anand, T., Hejazi, O., Conant, M., Joule, D., Lundy, M., Colosimo, C., Spencer, A., Nelson, A., Magnotti, L., & Joseph, B. (2024). Impact of resuscitation adjuncts on postintubation hypotension in patients with isolated traumatic brain injury. The journal of trauma and acute care surgery, 97(1), 112-118.
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  Postintubation hypotension (PIH) is a risk factor of endotracheal intubation (ETI) after injury. For those with traumatic brain injury (TBI), one episode of hypotension can potentiate that injury. This study aimed to identify the resuscitation adjuncts that may decrease the incidence of PIH in this patient population.
• Anand, T., Hejazi, O., Nelson, A., Litmanovich, B., Spencer, A. L., Khurshid, M. H., Ghaedi, A., Hosseinpour, H., Magnotti, L. J., & Joseph, B. (2024). Early Vasopressor Requirement Among Hypotensive Trauma Patients: Does It Cause More Harm Than Good?. The American surgeon, 31348241269425.
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  Optimal utilization of vasopressors during early post-injury resuscitation remains unclear. Our study aims to describe the relationship between the timing of vasopressor administration and outcomes among hypotensive trauma patients.
• Anand, T., Hosseinpour, H., Ditillo, M., Bhogadi, S. K., Akl, M. N., Collins, W. J., Magnotti, L. J., & Joseph, B. (2024). The Importance of Circulation in Airway Management: Preventing Post-Intubation Hypotension in The Trauma Bay. Annals of surgery.
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  To identify the modifiable and non-modifiable risk factors associated with post-intubation hypotension (PIH) among trauma patients who required endotracheal intubation (ETI) in the trauma bay.
• 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.
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  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., El-Qawaqzeh, K., Colosimo, C., Hosseinpour, H., Magnotti, L. J., Spencer, A. L., Anand, T., Ditillo, M., Alizai, Q., Nelson, A., & Joseph, B. (2024). Pediatric Acute Compartment Syndrome in Long Bone Fractures: Who is at Risk?. The Journal of surgical research, 298, 53-62.
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  There is a paucity of large-scale data on the factors that suggest an impending or underlying extremity pediatric acute compartment syndrome (ACS). In addition, literature regarding the timing of operative fixation and the risk of ACS is mixed. We aimed to describe the factors associated with pediatric ACS.
• 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.
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  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., Nelson, A., Hosseinpour, H., Anand, T., Hejazi, O., Colosimo, C., Spencer, A. L., Ditillo, M., Magnotti, L. J., & Joseph, B. (2024). Effect of PCC on outcomes of severe traumatic brain injury patients on preinjury anticoagulation. American journal of surgery, 232, 138-141.
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  This study aims to evaluate effect of 4-factor PCC on outcomes of severe TBI patients on preinjury anticoagulants undergoing craniotomy/craniectomy.
• 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.
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  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.
• Culbert, M. H., Bhogadi, S. K., Hosseinpour, H., Colosimo, C., Alizai, Q., Anand, T., Spencer, A. L., Ditillo, M., Magnotti, L. J., & Joseph, B. (2024). Predictors of Receiving Mental Health Services in Trauma Patients With Positive Drug Screen. The Journal of surgical research, 298, 7-13.
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  Initial interaction with health care system presents an important opportunity to provide substance use disorder (SUD) rehabilitation in the form of mental health services (MHSs). This study aims to identify predictors of receipt of MHSs among adult trauma patients with SUD and positive drug screen.
• Dhanasekara, C. S., Shrestha, K., Grossman, H., Garcia, L. M., Maqbool, B., Luppens, C., Dumas, R. P., Taveras Morales, L. R., Brahmbhatt, T. S., Haqqani, M., Lunevicius, R., Nzenwa, I. C., Griffiths, E., Almonib, A., Bradley, N. L., Lerner, E. P., Mohseni, S., Trivedi, D., Joseph, B. A., , Anand, T., et al. (2024). A comparison of outcomes including bile duct injury of subtotal cholecystectomy versus open total cholecystectomy as bailout procedures for severe cholecystitis: A multicenter real-world study. Surgery, 176(3), 605-613.
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  Dense inflammation obscuring the hepatocystic anatomy can hinder the ability to perform a safe standard laparoscopic cholecystectomy in severe cholecystitis, requiring use of a bailout procedure. We compared clinical outcomes of laparoscopic and open subtotal cholecystectomy against the traditional standard of open total cholecystectomy to identify the optimal bailout strategy for the difficult gallbladder.
• Hejazi, O., Spencer, A. L., Khurshid, M. H., Nelson, A., Hosseinpour, H., Anand, T., Bhogadi, S. K., Matthews, M. R., Magnotti, L. J., & Joseph, B. (2024). Failure to Rescue in Geriatric Ground-Level Falls: The Role of Frailty on Not-So-Minor Injuries. The Journal of surgical research, 302, 891-896.
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  The measure of mortality following a major complication (failure to rescue [FTR]) provides a quantifiable assessment of the level of care provided by trauma centers. However, there is a lack of data on the effects of patient-related factors on FTR incidence. The aim of this study was to identify the role of frailty on FTR incidence among geriatric trauma patients with ground-level falls (GLFs).
• Hosseinpour, H., Anand, T., Bhogadi, S. K., Nelson, A., Hejazi, O., Castanon, L., Ghaedi, A., Khurshid, M. H., Magnotti, L. J., Joseph, B., & , A. F. (2024). The implications of poor nutritional status on outcomes of geriatric trauma patients. Surgery, 176(4), 1281-1288.
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  Malnutrition is shown to be associated with worse outcomes among surgical patients, yet its postdischarge outcomes in trauma patients are not clear. This study aimed to evaluate both index admission and postdischarge outcomes of geriatric trauma patients who are at risk of poor nutritional status.
• Hosseinpour, H., Anand, T., Hejazi, O., Colosimo, C., Bhogadi, S. K., Spencer, A., Nelson, A., Ditillo, M., Magnotti, L. J., & Joseph, B. (2024). The Role of Whole Blood Hemostatic Resuscitation in Bleeding Geriatric Trauma Patients. The Journal of surgical research, 299, 26-33.
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  Whole blood (WB) has recently gained increased popularity as an adjunct to the resuscitation of hemorrhaging civilian trauma patients. We aimed to assess the nationwide outcomes of using WB as an adjunct to component therapy (CT) versus CT alone in resuscitating geriatric trauma patients.
• 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.
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  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., Nelson, A., Bhogadi, S. K., Magnotti, L. J., Alizai, Q., Colosimo, C., Hage, K., Ditillo, M., Anand, T., & Joseph, B. (2024). Should We Keep or Transfer Our Severely Injured Geriatric Patients to Higher Levels of Care?. The Journal of surgical research, 300, 15-24.
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  Interfacility transfer to higher levels of care is becoming increasingly common. This study aims to evaluate the association between transfer to higher levels of care and prolonged transfer times with outcomes of severely injured geriatric trauma patients compared to those who are managed definitively at lower-level trauma centers.
• 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.
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  Firearm violence and school shootings remain a significant public health problem. This study aimed to examine how publicly available data from all 50 states might improve our understanding of the situation, firearm type, and demographics surrounding school shootings.
• 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.
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  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.
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  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.
• Spencer, A. L., Hosseinpour, H., Nelson, A., Hejazi, O., Anand, T., Khurshid, M. H., Ghaedi, A., Bhogadi, S. K., Magnotti, L. J., & Joseph, B. (2024). Predicting the time of mortality among older adult trauma patients: Is frailty the answer?. American journal of surgery, 237, 115768.
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  This study aims to evaluate the temporal trends of mortality among frail versus non-frail older adult trauma patients during index hospitalization.
• 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.
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  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.
• 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.
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  There 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.
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  Our 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.
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  Adequate 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.
• Anand, T., & Joseph, B. (2023). Linguistic discordance: Factors go beyond language. American journal of surgery, 225(6), 946-947.
• Anand, T., Crawford, A. E., Sjoquist, M., Hashmi, Z. G., Richter, R. P., Joseph, B., & Richter, J. R. (2023). Decreased Glycocalyx Shedding on Presentation in Hemorrhaging Geriatric Trauma Patients. The Journal of surgical research, 293, 709-716.
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  Plasma levels of syndecan-1 (Sdc-1), a biomarker of endothelial glycocalyx (EG) damage, correlate with worse outcomes in trauma patients. However, EG injury is not well characterized in injured older adults (OA). The aims of this study were to characterize Sdc-1 shedding in OA trauma patients relative to younger adults (YA) and determine associations with putative regulators of EG sheddases.
• 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.
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  Management 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.
• Anand, T., Reyes, A. A., Sjoquist, M. C., Magnotti, L., & Joseph, B. (2023). Resuscitating the Endothelial Glycocalyx in Trauma and Hemorrhagic Shock. Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 4(3), e298.
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  The endothelium is lined by a protective mesh of proteins and carbohydrates called the endothelial glycocalyx (EG). This layer creates a negatively charged gel-like barrier between the vascular environment and the surface of the endothelial cell. When intact the EG serves multiple functions, including mechanotransduction, cell signaling, regulation of permeability and fluid exchange across the microvasculature, and management of cell-cell interactions. In trauma and/or hemorrhagic shock, the glycocalyx is broken down, resulting in the shedding of its individual components. The shedding of the EG is associated with increased systemic inflammation, microvascular permeability, and flow-induced vasodilation, leading to further physiologic derangements. Animal and human studies have shown that the greater the severity of the injury, the greater the degree of shedding, which is associated with poor patient outcomes. Additional studies have shown that prioritizing certain resuscitation fluids, such as plasma, cryoprecipitate, and whole blood over crystalloid shows improved outcomes in hemorrhaging patients, potentially through a decrease in EG shedding impacting downstream signaling. The purpose of the following paragraphs is to briefly describe the EG, review the impact of EG shedding and hemorrhagic shock, and begin entertaining the notion of directed resuscitation. Directed resuscitation emphasizes transitioning from macroscopic 1:1 resuscitation to efforts that focus on minimizing EG shedding and maximizing its reconstitution.
• 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.
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  Long-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., Magnotti, L. J., Hosseinpour, H., Anand, T., El-Qawaqzeh, K., Nelson, A., Colosimo, C., Spencer, A. L., Friese, R., & Joseph, B. (2023). The final decision among the injured elderly, to stop or to continue? Predictors of withdrawal of life supporting treatment. The journal of trauma and acute care surgery, 94(6), 778-783.
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  There is a paucity of data on factors that influence the decision regarding withdrawal of life supporting treatment (WLST) in geriatric trauma patients. We aimed to identify predictors of WLST in geriatric trauma 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.
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  Up 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.
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  Hospitalized 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.
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  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., 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.
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  Psychiatric 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.
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  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.
• 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.
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  It 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.
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  Multiple 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.
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  Healthcare 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.
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  Whole 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.
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  Interfacility 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.
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  We 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).
• 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.
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  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).
• Weaver, J. L., Cannada, L., Anand, T., Dream, S., Park, P. K., Altieri, M. S., Tasnim, S., Reyna, C., & , A. o. (2023). The importance of allyship in Academic Surgery. American journal of surgery, 225(4), 805-807.
• 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, 236(4), 753-759.
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  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.
• 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.
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  The 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.
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  Bladder 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.
• 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.
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  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).
• Ditillo, M., Tang, A., Saljuqi, T., Obaid, O., Nelson, A., Joseph, B., Hammad, A., Ditillo, M., Asmar, S., & Anand, T. (2022). Marijuana and thromboembolic events in geriatric trauma patients: The cannabinoids clots correlation!. American journal of surgery, 223(4), 798-803. doi:10.1016/j.amjsurg.2021.07.036
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  Tetrahydrocannabinol (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)..This is a 2017 analysis of the TQIP database including all GTP (age ≥65 years). Patients were stratified based on THC use. Propensity score matching (1:2 ratio) was performed..A total of 2,835 patients were matched (THC+: 945 and THC-: 1,890). Mean age was 70 ± 6 years, 94% sustained blunt injuries, and median ISS was 22[12-27]. Sixty-two percent of patients received thromboprophylaxis, with median time to initiation of 27 h from admission. Overall, the rate of TEC was 2.1% and mortality was 6.0%. THC + patients had significantly higher rates of TEC compared to THC- patients (3.0% vs. 1.7%; p = 0.01). Rates of DVT (2.2% vs 0.6%, p < 0.01) and PE (1.4% vs 0.4%, p < 0.01) were higher in the THC + group..THC exposure increases the risk of TEC in GTP. Incorporation of THC use into risk assessment protocols merits serious consideration in GTP.
• 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.
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  Several 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.
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  Blunt 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.
• 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, 53(11), 3723-3728.
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  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.
• 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.
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  Child 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.
• Joseph, B., Saljuqi, A. T., Amos, J. D., Teichman, A., Whitmill, M. L., Anand, T., Hosseinpour, H., Burruss, S. K., Dunn, J. A., Najafi, K., Godat, L. N., Enniss, T. M., Shoultz, T. H., Egodage, T., Bongiovanni, T., Hazelton, J. P., Colling, K. P., Costantini, T. W., Stein, D. M., , Schroeppel, T. J., et al. (2022). Prospective Validation and Application of the Trauma Specific Frailty Index (TSFI): Results of an AAST Multi-Institutional Observational Trial. The journal of trauma and acute care surgery.
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  The Frailty Index is a known predictor of adverse outcomes in geriatric patients. Trauma Specific Frailty Index (TSFI) was created and validated at a single center to accurately identify frailty and reliably predict worse outcomes among geriatric trauma patients. This study aims to prospectively validate the TSFI in a multi-institutional cohort of geriatric trauma patients.
• 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.
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  Routine 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.
• 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.
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  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.
• Obaid, O., Nelson, A., Kitts, D. J., Kapadia, M., Joseph, B., Hammad, A., Douglas, M., Ditillo, M., & Anand, T. (2022). Evaluation of Frailty Assessment Compliance in Acute Care Surgery: Changing Trends, Lessons Learned.. The Journal of surgical research, 270, 236-244. doi:10.1016/j.jss.2021.09.019
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  Routine 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..We performed a 7-y (2011-2017) analysis of our prospectively maintained frailty database. Frail patients were identified using the emergency general surgery and trauma specific frailty indices. Outcome measures were rates of compliance with frailty assessment, overall complications, discharge to skilled nursing facility (SNF)/rehab, and mortality over the study period. Multivariate logistic regression and Cochran-Armitage trend analyses were performed..We evaluated a total of 1045 geriatric patients (Trauma: 587, EGS: 458). Mean age was 74.5 ± 7.9 y, 74% were males, and 81% were white. Overall, 34% of the patients were frail. Compared to non-frail patients, frail patients had higher adjusted rates of complications (OR 2.4 [1.9-2.9]), mortality (OR 1.8 [1.4-2.3]), and rehab/SNF disposition (OR 3.7 [3.1-4.3]). The compliance rate of measuring frailty increased from 12% in 2011 to 78% in 2017, P < 0.001 (Figure). The complication rate decreased (33% versus 21%, P < 0.001), while the rate of discharge disposition to SNF/Rehab increased (41% versus 58%, P < 0.001). There was no difference in mortality (11% versus 9.8%, P = 0.48) over the study period..Adherence to frailty measurement increased over the study period. This was accompanied by a significant decline in overall in-hospital complications. Frailty indices can be utilized to identify high-risk patients and develop post-operative strategies to improve outcomes in acute care surgery.
• Pretorius, D., Richter, R. P., Anand, T., Cardenas, J. C., & Richter, J. R. (2022). Alterations in heparan sulfate proteoglycan synthesis and sulfation and the impact on vascular endothelial function. Matrix biology plus, 16, 100121.
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  The glycocalyx attached to the apical surface of vascular endothelial cells is a rich network of proteoglycans, glycosaminoglycans, and glycoproteins with instrumental roles in vascular homeostasis. Given their molecular complexity and ability to interact with the intra- and extracellular environment, heparan sulfate proteoglycans uniquely contribute to the glycocalyx's role in regulating endothelial permeability, mechanosignaling, and ligand recognition by cognate cell surface receptors. Much attention has recently been devoted to the enzymatic shedding of heparan sulfate proteoglycans from the endothelial glycocalyx and its impact on vascular function. However, other molecular modifications to heparan sulfate proteoglycans are possible and may have equal or complementary clinical significance. In this narrative review, we focus on putative mechanisms driving non-proteolytic changes in heparan sulfate proteoglycan expression and alterations in the sulfation of heparan sulfate side chains within the endothelial glycocalyx. We then discuss how these specific changes to the endothelial glycocalyx impact endothelial cell function and highlight therapeutic strategies to target or potentially reverse these pathologic changes.
• 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.
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  This study aims to assess the impact of pre-injury anticoagulant use on outcomes of isolated blunt abdominal SOI patients who underwent NOM.
• Reina, R., Obaid, O., Nelson, A., Joseph, B., Gries, L., Douglas, M., Ditillo, M., Castanon, L., Bible, L., & Anand, T. (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, Publish Ahead of Print. doi:10.1097/ta.0000000000003574
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  Several 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 is to examine the effect of these advancements on outcomes of blunt trauma patients undergoing emergency laparotomy..This is a 5-year (2013-2017) analysis of the Trauma Quality Improvement Program. Adult (age ≥ 18 years) blunt trauma patients with early (≤4 hours) PRBC and FFP transfusions and an emergency (≤4 hours) laparotomy for hemorrhage control were identified. Time-trend analysis of 24-hour mortality, PRBC/FFP ratio, and time to laparotomy was performed over the study period. The association between mortality and PRBC/FFP ratio, patient demographics, injury characteristics, transfusion volumes, and ACS verification level was examined by hierarchical regression analysis adjusting for inter-year variability..A total of 9,773 blunt trauma patients with emergency laparotomy were identified. Mean age was 44 ± 18 years, 67.5% were male, and median ISS was 34 [24-43]. Mean SBP at presentation was 73 ± 28 mm Hg, and median transfusion requirements were PRBC 9 [5-17] and FFP 6 [3-12]. During the 5-year analysis, time to laparotomy decreased from 1.87 hours to 1.37 hours (p < 0.001), PRBC/FFP ratio at 4 hours decreased from 1.93 to 1.71 (p < 0.001), and 24-hour mortality decreased from 23.0% to 19.3% (p = 0.014). (Figure) On multivariate analysis, decreased PRBC/FFP ratio was independently associated with decreased 24-hour mortality (OR 0.88; p < 0.001) and in-hospital mortality (OR 0.89; p < 0.001)..Resuscitation is becoming more balanced and time to emergency laparotomy shorter in blunt trauma patients, with a significant improvement in mortality. Future efforts should be directed towards incorporating transfusion practices and timely surgical interventions as markers of trauma center quality..Level III.
• Reina, R., Obaid, O., Northcutt, A., Nelson, A., Joseph, B., Gries, L., Ditillo, M., Castanon, L., Bible, L., & Anand, T. (2022). Prospective Validation of The Rib Injury Guidelines (RIG) For Traumatic Rib Fractures.. The journal of trauma and acute care surgery, Publish Ahead of Print. doi:10.1097/ta.0000000000003535
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  The Rib Injury Guidelines (RIG) were developed to guide triage of traumatic rib fracture patients to home, regular floor, or ICU and standardize care. The RIG score is based on patient history, physical examination, and imaging findings. The aim of this study is to evaluate triage effectiveness and healthcare resources utilization following RIG implementation..This is a prospective analysis at a Level I trauma center from October 2017 to January 2020. Adult (age ≥ 18 years) blunt trauma patients with a diagnosis of at least one rib fracture on CT imaging were included. Patients before (PRE) and after (POST) implementation of RIG were compared. In the POST group, patients were divided into RIG 1, RIG 2, and RIG 3 based on their RIG score. Outcomes were readmission for RIG 1 patients, unplanned ICU admission for RIG 2 patients, and overall ICU admission. Secondary outcomes were hospital length of stay (LOS) and mortality..A total of 1100 patients were identified (PRE: 754; POST: 346). Mean age was 56 ± 19 years, 788 (71.6%) were male, and median ISS was 14 [10-22]. The most common mechanism of injury was motor vehicle collision (554; 50.3%), 253 (22.9%) patients had ≥5 rib fractures, and 53 (4.8%) patients had a flail chest. In the POST group, 74 patients (21.1%) were RIG 1, 121 (35.2%) RIG 2, and 151 (43.7%) RIG 3. No patient in RIG 1 was readmitted following initial discharge, and 2 (1.6%) patients in RIG 2 had an unplanned ICU admission (both for alcohol withdrawal syndrome). POST patients had shorter hospital LOS (3 [1-6] vs. 4 [1-7] days; p = 0.019) and no difference in mortality (5.8% vs. 7.7%; p = 0.252). On multivariate analysis, RIG implementation was associated with decreased ICU admission (aOR 0.55 [0.36-0.82]; p = 0.004)..RIG is safe and effectively defines triage of rib fracture patients with an overall reduction in ICU admissions, shorter hospital LOS, and no readmissions..Level III.
• Sumra, H., Riner, A. N., Arjani, S., Tasnim, S., Zope, M., Reyna, C., & Anand, T. (2022). Minimizing implicit bias in search committees. American journal of surgery, 224(4), 1179-1181.
• Zope, M., Tasnim, S., Sumra, H., Riner, A. N., Reyna, C., Henry, M., Arjani, S., & Anand, T. (2022). It begins with the search committee: Promoting faculty diversity at the source.. American journal of surgery, 223(2), 432-435. doi:10.1016/j.amjsurg.2021.08.027
• 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.
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  Frailty 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.
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  Whole 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 is to examine the outcomes of WB transfusion as an adjunct to component therapy (CT) compared to CT only as early resuscitation for pediatric trauma patients.
• Arjani, S., Tasnim, S., Sumra, H., Zope, M., Riner, A. N., Reyna, C., Henry, M., & Anand, T. (2021). It begins with the search committee: Promoting faculty diversity at the source. American journal of surgery.
• 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.
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  Nonoperative 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., 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.
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  Tetrahydrocannabinol (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).
• Bible, L., Anand, T., Obaid, O., Kitts, D. J., Khurrum, M., Kapadia, M., Joseph, B., Hammad, A., Goh, M., Bible, L., & Anand, T. (2021). Pre-Hospital Administration of Opioids in Trauma Patients: Is Dose Associated With Outcomes?. The Journal of surgical research, 268, 634-642. doi:10.1016/j.jss.2021.08.001
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  Opioids are commonly used as an analgesic agent in the prehospital setting. Current efforts to prevent and control prescription opioid overuse are focused on the in-hospital and post-discharge phases. The aim of our study was to assess the associations between pre-hospital opioids use and in-hospital outcomes among trauma patients..We performed a 2 year (2016-2017) retrospective analysis of our Level-I trauma center database. We included all adult trauma patients (age > 18y) who received pre-hospital opioids (Fentanyl (F) or Morphine-Sulfate (MS)). Outcome measures were emergency-department (ED) hypotension (SPB < 90 mmHg), ED intubation, prescription opioid medication upon discharge, and mortality. Multivariate logistic regression was performed..In total, 709 patients were included in the analysis. Cutoff values of 200 mcg F and 15 mg MS were significantly associated with adverse outcomes. Overall, the ED hypotension rate was 14.4%, ED intubation rate was 6%, and ED mortality rate was 3.1%. On regression analysis, higher dosages of both pre-hospital F and pre-hospital MS were independently associated with increased odds of ED hypotension, ED intubation, and discharge on opioid medications, but not with ED mortality..Pre-hospital administration of high dose opioids is associated with increased odds of adverse outcomes. Collaborative efforts to standardize and control the overuse of opioids should target the pre-hospital setting to limit opioid associated adverse effects.
• Bible, L., Obaid, O., Khurrum, M., Goh, M., Hammad, A., Kitts, D. J., Anand, T., Kapadia, M., & Joseph, B. (2021). Pre-Hospital Administration of Opioids in Trauma Patients: Is Dose Associated With Outcomes?. The Journal of surgical research, 268, 634-642.
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  Opioids are commonly used as an analgesic agent in the prehospital setting. Current efforts to prevent and control prescription opioid overuse are focused on the in-hospital and post-discharge phases. The aim of our study was to assess the associations between pre-hospital opioids use and in-hospital outcomes among trauma patients.
• 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.
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  Never-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., 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.
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  The 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.
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  Minimally 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.
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  The 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.
• Anand, T., Ditillo, M., Kulvatunyou, N., Tang, A. L., Saljuqi, A. T., Northcutt, A., Kulvatunyou, N., Joseph, B., Hamidi, M. K., Haddadin, Z., Gries, L. M., Ditillo, M., & Anand, T. (2019). Association of Racial, Ethnic Disparities, and Frailty in Geriatric Trauma Patients. Journal of The American College of Surgeons, 229(4), S119. doi:10.1016/j.jamcollsurg.2019.08.265
• Anand, T., Roller, L. K., & Jurkovich, G. J. (2019). Vitamin C in surgical sepsis. Current opinion in critical care, 25(6), 712-716.
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  The current review discusses the supplemental use of vitamin C as an adjunct in the management of sepsis and septic shock.
• Anand, T., Tang, A., Joseph, B., & Anand, T. (2019). Penetrating Neck Trauma: a Review. Current Trauma Reports, 5(1), 12-18. doi:10.1007/s40719-019-0154-6
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  This review focuses on the management of penetrating neck trauma and its evolution over the last several decades. Our increased experience with high-resolution computed tomography has changed the management of penetrating neck trauma from an anatomically zone-based approach to a “no zone” approach. Physical signs and symptoms of vascular, airway, and digestive track injuries still guide the basis of further radiographic and surgical workup. With the advancement and greater availability of multi-detector computed tomography (MDCT) technology, assessment of injuries has become easier and far more accurate. The hemodynamically stable patient may now be approached in a “no-zone” manner, and in certain cases managed safely with conservative measures. Wartime experience and improved technology played major roles in the evolution of penetrating neck injury management. Aggressive surgical exploration had given way to selective management based on anatomical neck zones, to most currently a “no zone” approach.
• Anand, T., & Skinner, R. (2018). Vitamin C in burns, sepsis, and trauma. The journal of trauma and acute care surgery, 85(4), 782-787.
• Anand, T., Ponce, S., Pakula, A., Norville, C., Kallish, D., Martin, M., & Skinner, R. (2018). Results from a Quality Improvement Project to Decrease Infection-Related Ventilator Events in Trauma Patients at a Community Teaching Hospital. The American surgeon, 84(10), 1701-1704.
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  Ventilator-associated pneumonia (VAP) is linked to increased morbidity and mortality and clinical protocols (VAP bundles) have evolved to minimize VAP. In 2009, a quality improvement project was implemented at our institution to decrease VAP rates in adult trauma patients. A VAP prevention committee was developed, and formal evidence-based education for the nursing and physician staff was introduced. During the study period (2009-2016), 2380 patients required ICU admission to our Level II trauma center. The mean Injury Severity Score was 33 + 12, and there were 17 per cent penetrating and 83 per cent blunt injuries. The early compliance (2010) with the VAP bundle was 65 per cent. Within one year of the implementation of VAP prevention, the compliance increased to >90 per cent. Compliance has been carefully trended and has remained at 100 per cent. All of the aforementioned interventions have resulted in a sustained dramatic decline in VAP, from 12 per cent in 2009 to 0 per cent in 2016. Ongoing education and ICU policy development has become the mainstay of our trauma ICU program. The introduction of evidence-based care education imparted a culture of excellence resulting in favorable outcomes in high-risk trauma patients related to VAP prevention. Ongoing monitoring and education is required to sustain these promising outcomes.
• Anand, T., Ramnanan, R., Skinner, R., & Martin, M. (2016). Impact of Massive Transfusion and Aging Blood in Acute Trauma. The American surgeon, 82(10), 957-959.
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  Blood transfusions cause altered immunity and the duration of storage is contributory. In the era of massive transfusion protocols (MTPs) this impact is unclear, particularly as it relates to balanced transfusions. Trauma patients requiring our MTP after admission to our Level II trauma center were studied. The average age of blood transfused was calculated; old blood was a storage time of ≥14 days versus new blood 1:1. Infections, organ dysfunction multiorgan injury (MOI), and death were compared based on ratios and blood storage times. Of 2200 trauma admissions, 89 patients required MTP. Penetrating injuries were the majority, n = 53; and Injury Severity Score was 33 ± 14. Overall mortality was 31 per cent and sepsis was 28 per cent. Outcomes (storage time): Patients receiving old versus new blood had comparable age and Injury Severity Score. Sepsis rates, multiorgan injury and mortality were similar. Outcomes (packed red blood cells:fresh frozen plasma): Balanced transfusions (ratios of 1:1) demonstrated significant survival benefit and less infections compared with ratios >1:1. These data underscore the complexity of transfusion-related morbidity. In the modern era of MTP and balanced transfusions, the age of stored blood may not impact outcomes as demonstrated historically.
• Anand, T., vanSonnenberg, E., Gadani, K., & Skinner, R. (2016). A snapshot of circulation failure following acute traumatic injury: The expansion of computed tomography beyond injury diagnosis. Injury, 47(1), 50-2.
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  CT scans with a flat Inferior Vena Cava (IVC) suggest hypovolemia, and the presence of shock bowel implies hypoperfusion. The purpose of this study is to correlate injury severity, resuscitation needs, and clinical outcomes with CT indices of hypovolemia and hypoperfusion.
• Anand, T., Vansonnenberg, E., Gadani, K., & Skinner, R. (2013). 248: CT BEYOND TRAUMA DIAGNOSIS. Critical Care Medicine, 41, A56-A57. doi:10.1097/01.ccm.0000439395.65611.f8
• Anand, T., & Skinner, R. (2012). Arginine vasopressin: the future of pressure-support resuscitation in hemorrhagic shock. The Journal of surgical research, 178(1), 321-9.
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  Arginine vasopressin (AVP) is a key player in maintaining the intravascular volume and pressure during hemorrhagic shock. During the past 2 decades, animal studies, case reports, and reviews have documented the minimized blood loss and improved perfusion pressures in those receiving pressure support with AVP.

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).
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  Despite 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.

Others

• Anand, T. (2024, September). Pediatrics and Injury Prevention
  Poster Professor. AAST.