In a new study titled “The Value of Trauma Center Care,” the authors report that while trauma center care is expensive, the benefits in terms of lives saved and productive life years gained outweigh the costs associated with it. Particularly, for those with severe injuries and those younger than 55, the gains have most value because the costs associated with trauma care for those who are less severely injured are higher. The findings indicate the importance of ensuring that patients are taken to appropriate levels of care in order to increase the efficiency of the system.

The results of the study are reported in the July issue of The Journal of Trauma Injury, Infection and Critical Care. Two of the authors are NTI board members: Ellen MacKenzie, PhD, at the Bloomberg School of Public Health, and Gregory J. Jurkovich, MD, at the University of Washington School of Medicine.

Read a good summary of the article.

With the deadline closing last Friday, July 23, NTI saw 92 pre-proposals submitted for $2.8 million in available trauma research funding. The science committee now takes on the difficult task of reviewing them and choosing the most scientifically sound and promising, which will receive invitations to submit full proposals. The large number of high-quality pre-proposals is indication of a pent-up demand for trauma research and the great need to secure more funding.

Those who submitted pre-proposals can follow the status of their application here.

A cheap and effective drug used in elective surgeries to hinder bleeding can be safely and effectively used in trauma victims as well, says a team of British scientists in the Online First edition of The Lancet. The drug, tranexamic acid, or TXA, inhibits an enzyme that breaks down blood clots.

In a study that included 20,000 patients in 40 countries, the researchers found that use of TXA cut death rates by 15%. An off-patent medication that has many generic manufacturers, the potential applications for the drug, particularly in developing countries, are tremendous. Replication of the study would be required before any major practice changes are made. Read more about the study in this CTV News story and also on MedPage Today.

Researchers from the University of California-Davis presented evidence at the American Association for Thoracic Surgery Aortic Symposium last week indicating that stents are effective, compared to traditional open-chest surgery, in treating torn aortas. Especially in cases of trauma, where a patient has multiple life-threatening injuries, reducing the impact of surgical treatment is paramount.

A stent is a small, mesh-encased fabric sleeve that a surgeon inserts into a blood vessel through a small incision and guides to the injury site, where it expands against the blood vessel walls and and patches the injury. Open chest surgery, on the other hand, involves lengthy incisions of the chest and spreading of the rib cage, or worse, removal of some ribs.

The stent procedure is associated with fewer complications and a quicker recovery. While the stents are FDA approved for repairing aneurysms, their application in trauma repair is currently off-label usage. The UC-Davis researchers are preparing to participate in a multi-institution clinical trial to confirm stent efficacy in trauma situations, the results of which will be used to seek broader FDA approval.

An article in the March issue of the Archives of Surgery reports that trauma patients bathed with antiseptic cloths contracted significantly fewer infections during their hospital stay than those treated with cloths not having any antibacterial properties. A major issue for trauma patients, especially, who are susceptible to hard-to-treat bacterial infections due to the extent of their injuries, surgeries and indwelling devices, hospital-aquired infections (HAI) are an NTI research priority area.

The cloths employed in the study were soaked in a Chlorhexidine gluconate solution, and the authors suggest that their daily use should supplement hand hygiene to reduce the acquisition of MRSA and other resistant organisms.

Read a summary of the article.