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Eickholtz A, Mormol J, Kelley J, Mangione M, Pounders S, Groseclose R, Lypka M, Gibson C, Chapman A, Chadwick C, Krech L. The Effect of COVID-19 on Rib Fracture Patients in Michigan. Am Surg 2024:31348241241634. [PMID: 38565216 DOI: 10.1177/00031348241241634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
This study aims to compare outcomes of rib fracture patients with and without COVID-19 in Michigan. Data from the Michigan Trauma Quality Improvement Program (MTQIP) identified adults hospitalized from January 1, 2020, to October 31, 2022, with at least one rib fracture and a completed COVID-19 test on admission. Patients were propensity score matched 1:1 using 20 variables. The primary outcome was hospital length of stay (LOS). Secondary outcomes were mortality, ventilator days, intensive care unit (ICU) LOS, pneumonia, and ventilator-assisted pneumonia (VAP). 13,305 total patients were identified. 232 patients matched into both the COVID+ and COVID- groups. COVID was associated with increased LOS (7 days vs. 5 days, P < 0.001). There were no significant differences between the two groups when evaluating secondary outcomes. Our study indicates that although COVID-19 infection is associated with increased LOS, COVID may not contribute to additional morbidity or mortality in traumatic rib fracture patients.
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Affiliation(s)
- Allie Eickholtz
- Department of Acute Care Surgery, Corewell Health West, Grand Rapids, MI, USA
| | - Jeremy Mormol
- Trauma Research Institute, Corewell Health West, Grand Rapids, MI, USA
| | - Jesse Kelley
- Department of Acute Care Surgery, Corewell Health West, Grand Rapids, MI, USA
| | - Madi Mangione
- Department of Acute Care Surgery, Corewell Health West, Grand Rapids, MI, USA
| | - Steffen Pounders
- Trauma Research Institute, Corewell Health West, Grand Rapids, MI, USA
| | - Ryan Groseclose
- Trauma Research Institute, Corewell Health West, Grand Rapids, MI, USA
| | - Matthew Lypka
- Scholarly Activity and Scientific Support, Corewell Health, Grand Rapids, MI, USA
| | - Charles Gibson
- Department of Acute Care Surgery, Corewell Health West, Grand Rapids, MI, USA
| | - Alistair Chapman
- Department of Acute Care Surgery, Corewell Health West, Grand Rapids, MI, USA
| | - Cathryn Chadwick
- Department of Acute Care Surgery, Corewell Health West, Grand Rapids, MI, USA
| | - Laura Krech
- Trauma Research Institute, Corewell Health West, Grand Rapids, MI, USA
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Eickholtz A, Abbas S, James E, Gibson C, Iskander G, Lypka M, Krech L, Pounders S, Burns K, Chapman AJ. Ride the Wave: Continuous Electroencephalography is Indicated in the Management of Traumatic Brain Injury. Clin EEG Neurosci 2022; 53:513-518. [PMID: 35957599 DOI: 10.1177/15500594221120132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Patients with traumatic brain injury (TBI) are at risk for seizures and other abnormalities that can have permanent adverse effects on the brain. We aimed to report the incidence of seizures and continuous EEG (cEEG) abnormalities after TBI and identify any risk factors associated with the development of these abnormalities. Materials and Methods: This retrospective study identified 245 adult patients with mild to severe TBI who had a cEEG performed within one week of admission to a Midwest Level 1 Trauma Center between July 2014 and July 2019. Trauma registry and electronic medical record (EPIC) data were extracted. Results: Twelve percent of patients with TBI developed seizures and an additional 23% demonstrated electrographic patterns that are correlated with risk for seizures (such as lateralized periodic patterns and sporadic epileptiform discharges). Fifty three percent of seizures would have been missed unless a cEEG was performed. Age, history of epilepsy or prior TBI, hypertension, bleeding disorder, and dementia were associated with an increased risk of developing seizures or higher risk patterns. Conclusions: Thirty-five percent of patients who presented with TBI were noted to have seizures or electrographic patterns associated with a higher risk of seizures. The incidence of cEEG abnormalities in this study is higher than previously reported and these patients are at risk for permanent neurological injury. We recommend the routine use of cEEG for all critically ill patients with TBI as over half of the seizures would have been missed if cEEG was not employed.
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Affiliation(s)
- Allie Eickholtz
- 24317Spectrum Health, Butterworth Hospital, General Surgery Residency, Grand Rapids, MI, USA
| | - Shan Abbas
- Department of Clinical Neurosciences, 3591Spectrum Health, Grand Rapids, Michigan, USA
| | - Elysia James
- Department of Neurology, 89021University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Charles Gibson
- Division of Acute Care Surgery, 3591Spectrum Health, Grand Rapids, MI, USA
| | - Gaby Iskander
- Division of Acute Care Surgery, 3591Spectrum Health, Grand Rapids, MI, USA
| | - Matthew Lypka
- Bioinformatics Core, 3591Spectrum Health, Grand Rapids, Michigan, USA
| | - Laura Krech
- Division of Acute Care Surgery, Trauma Research Institute, Spectrum Health, Grand Rapids, MI USA
| | - Steffen Pounders
- Division of Acute Care Surgery, Trauma Research Institute, Spectrum Health, Grand Rapids, MI USA
| | - Kelly Burns
- Division of Acute Care Surgery, 3591Spectrum Health, Grand Rapids, MI, USA
| | - Alistair J Chapman
- Division of Acute Care Surgery, Trauma Research Institute, Spectrum Health, Grand Rapids, MI USA
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