Has the trauma surgeon become house staff for the surgical subspecialist?
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ABSTRACT:
SUBMITTER: Ciesla DJ
PROVIDER: S-EPMC2276667 | biostudies-literature | 2006 Dec
REPOSITORIES: biostudies-literature
Publications
Has the trauma surgeon become house staff for the surgical subspecialist?
Ciesla David J DJ Moore Ernest E EE Cothren C Clay CC Johnson Jeffery L JL Burch Jon M JM
American journal of surgery 20061201 6
<h4>Background</h4>The role of the trauma surgeon is perceived to be mostly supportive of other procedure-oriented specialties. We designed this study to characterize the surgical and nonsurgical responsibilities of the contemporary trauma surgeon.<h4>Methods</h4>Trauma patients admitted to an urban academic level I trauma center were studied using trauma registry data for 2004.<h4>Results</h4>The large majority of patients admitted to trauma service has mild single-system injuries to 1 or 2 ana ...[more]
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Project description:BackgroundNo guidelines exist for management of hemodynamically stable children with suspected hollow viscus injury. We sought to determine factors contributing to surgeon management of these patients.MethodsSurgeon members of the Eastern Association for the Surgery of Trauma and American Pediatric Surgical Association completed a survey on 3 blunt abdominal injury scenarios: (1) isolated, (2) with multisystem injury, and (3) with traumatic brain injury (TBI), and a penetrating injury scenario. Multivariable logistic regression was used to determine factors associated with initial management of observation vs. operation for blunt injury and observation vs. local wound exploration versus laparoscopy for penetrating injury.ResultsOf 394 surgeons (response rate 22.3%), 50.3% were pediatric surgeons. For scenarios 1-3, 32.2%, 49.3%, and 60.7% of surgeons chose operation over observation, respectively. Compared to isolated blunt injury, surgeons were more likely to choose operation for patients with multisystem injury (aOR 2.20, 95%CI: 1.78-2.72) or TBI (aOR 3.60, 95%CI: 2.79-4.66). Pediatric surgeons were less likely to choose operation (aOR 0.32, 95%CI: 0.22-0.44). For penetrating injury, 39.1%, 29.5%, and 31.5% of surgeons chose observation, local wound exploration, and laparoscopy, respectively.ConclusionsLarge variation exists in management of hemodynamically stable children with suspected hollow viscus injury. Although patient injury characteristics account for some variation, surgeon factors such as type of surgeon also play a role. Evidence-based practice guidelines should be developed to standardize care.Type of studyCross-Sectional Survey.Level of evidenceN/A.
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2022-01-08 | PXD030167 | Pride
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