A5042163401- Trauma and Emergency Care Studies
- Emergency and Acute Care Studies
- Advanced Radiotherapy Techniques
- Clinical Nutrition and Gastroenterology
- Pharmaceutical Practices and Patient Outcomes
- Esophageal and GI Pathology
- Trauma Management and Diagnosis
- Abdominal Surgery and Complications
- Venous Thromboembolism Diagnosis and Management
- Injury Epidemiology and Prevention
- Radiation Dose and Imaging
- Prostate Cancer Diagnosis and Treatment
- Sepsis Diagnosis and Treatment
- Nutrition and Health in Aging
- Abdominal Trauma and Injuries
- Cardiac Arrest and Resuscitation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Congenital Diaphragmatic Hernia Studies
- Disaster Response and Management
- Hospital Admissions and Outcomes
- Lung Cancer Diagnosis and Treatment
- Frailty in Older Adults
- Healthcare Operations and Scheduling Optimization
- Transplantation: Methods and Outcomes
- Facial Trauma and Fracture Management
Carilion Clinic
2016-2023
Virginia Tech
2016-2023
ORCID
2023
Carilion Roanoke Memorial Hospital
2016-2020
Cancer Treatment Centers of America
2007-2015
University of Colorado Denver
2015
Denver Health Medical Center
2015
Trauma is a major risk factor for the development of venous thromboembolism (VTE). After observing higher than expected VTE rates within our center's Quality Improvement Program data, we instituted change in prophylaxis protocol, moving to enoxaparin dosing titrated by anti-Xa levels. We hypothesized that this intervention would lower symptomatic rates.Adult trauma patients at single institution meeting National Data Standard criteria from April 2015 September 2019 were examined with regards...
Geriatric trauma patients with low-level falls often have multiple comorbidities and limited physiologic reserve. Our aim was to investigate postdischarge mortality in this population. We hypothesized that five-year would be higher relative other blunt mechanisms. The registry of our Level 1 center queried for evaluated between July 2008 December 2012. Adult identified were matched data from 2013 the National Death Index. Low-level by E Codes; types based on classification. Patients...
The Beers Criteria for Potentially Inappropriate Medication (PIM) use is a list of medications with multiple risks in older patients. Approximately 24 per cent rate reported prior studies. Our objective was to determine the local PIM and subsequent fall risk geriatric trauma We conducted retrospective analysis all patients evaluated at our Level 1 center between 2014 2017. Patients were identified from database. Pre-admission medication determined through reconciliation electronic medical...
BACKGROUND This study aims to compare and externally validate the previously developed Revised Intensity Battle Score (RIBS) against other proposed scores for predicting poor outcomes after rib fractures. METHODS An external validation set was assembled retrospectively, comprising 1,493 adult patients with one or more fractures admitted a Level 1 trauma center between 2019 2022. The following fracture were calculated each patient: RIBS, Injury Severity Score, Rib Fracture Chest Trauma score....
To reduce the risk of catheter-associated urinary tract infection (CAUTI), limiting use indwelling catheters is encouraged with alternative collection methods and early removal. Adverse effects associated such practices have not been described. We also determined if CAUTI preventative measures increase catheter-related complications. hypothesized that there are complications removal catheters. described catheterization intermittent catheterization, compared complication rates before after...
Critically ill patients experience interruptions in enteral nutrition (EN). For ventilated who undergo percutaneous endoscopic gastrostomy (PEG) tube placement, postprocedure fasting times vary from 1 to 24 h depending on the surgeon's preference. There is no evidence support delayed feeding (DF) after PEG placement. This study's purpose was determine if there an increased complication rate associated with early (EF) PEG.150 adult trauma and surgical intensive care unit (TSICU) at a level I...
It has been well established that many classes of medications on the Beers list Potentially Inappropriate Medications (PIMs) are associated with falls and injuries in geriatric population, but little work performed to understand if similar relationships exist among nongeriatric adult population.A retrospective chart review 32 months trauma encounters at our Level I center was adults aged 18 years 64 years. Encounters were reviewed by mechanism injury intake medication reconciliation. The...
Choice of empiric antibiotic(s) for early ventilator associated pneumonia (VAP) involves weighing the risks potential infection with multi-drug resistant (MDR) pathogens against those over-exposure to broad-spectrum agents. Although VAP is believed be rarely caused by MDR pathogens, overall incidence all methicillin Staphylococcus aureus (MRSA) infections increasing. We questioned if MRSA becoming more common and these were occurring earlier in patient's hospital course. hypothesized that 1)...
Trauma recidivists are a high-risk patient population. The effects of recidivism on Geriatric trauma mortality have not been investigated. Our hypothesis is that associated with high postdischarge after the initial index admission in both geriatric and adult populations. registry our Level I center was queried for patients evaluated between 2008 2012. Patients were stratified (18-64) (≥65) groups matched data from National Death Index. Unique identified flagged. Statistical analysis...
Hospital-acquired infections (HAI) in trauma patients increase inpatient morbidity and mortality. However, their impact on long-term mortality is not well understood.A retrospective registry analysis of all admitted to an academic level I center between July 1, 2008 December 31, 2012 was performed. Patients included survived discharge were 18 years age or older. Age, gender, Injury Severity Score (ISS), ventilator use, history chronic obstructive pulmonary disease (COPD), HAI reviewed. Name,...
Decreasing hospital lengths of stay increases the burden on trauma patients after discharge. Our hypothesis was that a discharge callback protocol would decrease readmission rates. A retrospective quality improvement study evaluated all admitted from 2012 to 2016 at Level I center. postdischarge implemented in 2014, with mature place 2015. The precall and groups were compared regarding demographics, injury severity, readmission. Callback data included length call, unsolicited patient...
We investigated the patterns of injury associated with major midface trauma. Our hypothesis is that injuries are a decrease in certain traumatic brain as well torso injuries. The registry our Level I trauma center was queried for all adult patients treated over 25 years from 1989 to 2013. Patients fractures were identified based on ICD-9 code. Associated defined both individual codes Barell Injury Matrix. etiology e-codes. Univariate analysis performed using chi-squared test, Fisher's exact...
BACKGROUND Hyperparathyroidism is common in critical illness. Intact parathyroid hormone has a half-life of 3 minutes to 5 due rapid clearance by the liver, kidneys, and bone. In hemorrhagic shock, decreased may occur, thus making potential early marker for hypoperfusion. We hypothesized that hyperparathyroidism predicts mortality transfusion trauma patients. METHODS A prospective observational study was performed at Level I center consecutive adult patients receiving highest level team...
Purpose: Best fitting Tomotherapy treatment planning parameters for nine different lesion sites. Method and Materials: delivery depends on that are not necessarily familiar to a radiotherapy physicist. It is important planners familiarize themselves with these their impact the time required delivery: 51 Prostate plans, 268 lungs, 197 Brain, 21Liver, 38 Head & Neck, 46 Breast, 51Pelvis 59 Pancreas plans like Pitch, Gantry period, time, modulation, total dose, calculated length slice width...
Limiting CT imaging in the ED has gained interest recently. After initial trauma workup for consultations ED, additional is frequently ordered. We assessed benefits of this imaging. Our hypothesis was that lower acuity consults results diagnosis new significant injuries with a change treatment plan and increased Injury Severity Score (ISS). The registry at our Level I center queried from November 2015 to 2016 initially evaluated by physicians. Patients mild moderate were included. findings...