UAB’s Division of Trauma and Acute Care Surgery was well-represented in the trauma research presentations at the 17th American Surgical Congress (ASC) in Orlando.

UAB General Surgery residents, one UAB research assistant, and one UAB medical student presented at eight trauma/critical care quickshot sessions and one oral session. Additionally, Associate Professor Rondi Gelbard, M.D. FACS, presented at one general surgery session.

UAB research resident Peter Abraham, M.D., who presented at ASC, said he has appreciated the ample opportunities for trauma research at UAB. Abraham points to assets that make UAB unique, like the Center for Injury Science, UAB’s robust academic research and funding infrastructure, and the division’s faculty, including division director Jeffrey Kerby, M.D., Ph.D., FACS, who was recently named chair of the American College of Surgeons Committee on Trauma, and Jan Jansen, MBBS, Ph.D., FRCS, the division’s director of research.

“It’s hard to find a place that has all of that academic research infrastructure coupled with a really strong clinical program that sees a lot of sick trauma patients,” Abraham said. “And UAB has both.”

Three abstracts presented deal with findings from a 2015 study led by John Holcomb, M.D., FACS, – the PROPPR randomized clinical trial. Abraham explains the original trial looked at the ratio of blood products given to trauma patients and how that effected their outcomes and survival.

"Now we're using that really good randomized data to look at other questions we have," Abraham said.

See below for the abstracts presented at ASC relating to trauma or involving division faculty.

90-Minute Enrollment Window for Hemorrhage Control Trials: A Secondary Analysis of PROPPR Trial Data

• First Author: Kathryn Hudak, M.D.
• Senior author: Jan Jansen, MBBS, Ph.D., FRCS
• Summary: "We reanalyzed the original PROPPR trial data using a 90-minute enrollment window instead of a 120-minute enrollment window and found the same results as the original trial. This is significant because patients enrolled in the 90-120 minute window are less severely injured and not as representative of patients most at-risk for massive transfusion."

Balancing Enrollment and Mortality in Hemorrhage Control Trials: A Secondary Analysis of the PROPPR Trial

• First author: Peter Abraham, M.D.
• Senior author: Jan Jansen, MBBS, Ph.D., FRCS
• Summary: "Randomized clinical trials of hemorrhage control often choose arbitrary enrollment windows, and previously 120 minutes has been used as the cutoff for entry into a hemorrhage control trial. We conducted an analysis of the PROPPR trial data to show why we believe that a 90-minute enrollment window may be more optimal for large hemorrhage control trials. We have used this analysis to inform our design of a future clinical trial of hemorrhage control interventions."

The Association Between Blood Type and Mortality Among Severely Injured Patients Enrolled in the PROPPR Trial

• First author: Zain Hashmi, M.D.
• Presenter: Emily Baird, M.D.
• Senior author: John Holcomb, M.D., FACS
• Summary: "Found that blood type was not associated with mortality among severely injured trauma patients."

Endotheliopathy in Blunt vs. Penetrating Trauma and Associations with Acute Kidney Injury

• First author: Anna Crawford
• Senior author: Jillian Richter, Ph.D.
• Summary: "This project evaluated the relationship between blunt and penetrating injuries and the development of acute kidney injury using several biomarkers of endotheliopathy. We found that these biomarkers could help identify patients with the highest risk of acute kidney injury after trauma."

Trauma Incidence Rates and Social Vulnerability: A Geographic Analysis

• First author: Kathryn Hudak, M.D.
• Senior author: Jan Jansen, MBBS, Ph.D., FRCS
• Summary: "We conducted a geospatial analysis looking at how trauma incidence in Alabama overlapped with social vulnerability and found that counties with higher vulnerability were more likely to be high outliers for penetrating trauma incidence. This information can be used by the trauma system to better allocate resources and plan specific prevention/mitigation initiatives."

Geographic Analysis of Assault Injury Recidivism

• First author: Mackenzie Abraham, M.D.
• Senior author: Jan Jansen, MBBS, Ph.D., FRCS
• Summary: "This project used geospatial analyses to examine the assault injury recidivism rate in the Birmingham metropolitan area, in the hopes of identifying certain areas in which targeted violent injury prevention initiatives may be most helpful."

Nationwide Estimates of the Need for Prehospital Blood Products after Injury

• First author: Zain Hashmi, M.D.
• Presenter: Emily Baird, M.D.
• Senior author: John Holcomb, M.D., FACS
• Summary: "Found that a significant number of trauma patients may potentially benefit from prehospital blood resuscitation, and determined that a significant amount of additional whole blood would be needed."

Mixed-Methods Needs Assessment to Guide Development of the Smart-C, a Highly Portable X-Ray System for Military Use

• First author: Emily Baird, M.D.
• Senior author: Daniel Cox, M.D.
• Summary: "Conducted interviews with military and civilian surgeons and found that the Smart-C device (a portable x-ray system) could potentially be modified for use in military forward operational environments."

Provider Perspectives on the Role of Cardiopulmonary Resuscitation in Traumatic Cardiac Arrest

• First author: Lindy Reynolds, M.S.
• Senior author: Jan Jansen, MBBS, Ph.D., FRCS
• Summary: "A qualitative study of trauma and emergency medicine providers that highlighted the critical need for more research on the effectiveness of chest compressions in traumatic cardiac arrest patients as well as the development and dissemination of clear protocols on the use of chest compressions in such patients at the institutional level."

Management Of Appendicitis & Cholecystitis During The COVID-19 Pandemic: An EAST Multicenter Study

• First author: Rondi Gelbard, M.D. FACS

UAB Department of Surgery research resident Peter Abraham, M.D., presents at ASC on "Balancing Enrollment and Mortality in Hemorrhage Control Trials: A Secondary Analysis of the PROPPR Trial." Photo via Wendelyn Oslock, M.D., MBA, on Twitter. Group photo, top, via Connie Shao, M.D. on Twitter.