A recent episode of Behind the Knife, a popular surgical education podcast, featured research findings from a study by several faculty members and residents from the UAB Department of Surgery, including principal investigator Jonathan Black, M.D., an assistant professor with the Division of Trauma and Acute Care Surgery.
The episode features a discussion on the paper “Universal Screening for Blunt Cerebrovascular Injury,” which was published in the Journal of Trauma and Acute Care Surgery in February of 2021. Black describes BCVI as “potentially devastating” because it’s an injury that can result in stroke, even in young and previously healthy people who otherwise don’t have risk factors for stroke.
The study began in 2016 when UAB adopted universal screening for BCVI for all blunt trauma patients using CT angiography, thereby allowing the researchers to evaluate the performance of three commonly used screening methods.
According to the podcast, screening guidelines for BCVI have been controversial. Before any screening guidelines were adopted, BCVI was thought to only exist in one out of a thousand of blunt trauma patients, and modern studies found the number was closer to 1 – 3%. But the results of UAB’s 2021 study showed that 7.6% of the 6,287 blunt trauma patients who had a neck CTA had evidence of BCVI.
In addition to showing that BCVI is more common than previously thought, the study also concluded that the diagnostic performance of selective screening criteria is poor.
“There’s really very little downside to incorporating universal screening, especially if hospitals are already obtaining whole body CT scans with IV contrast for blunt trauma patients anyway,” Black said.
The other study authors are:
- Peter Abraham, M.D., General Surgery Resident
- Mackenzie Abraham, M.D., General Surgery Resident
- Daniel Cox, M.D., Chief of Trauma Service
- Russell Griffin, Ph.D., Associate Professor in the School of Public Health
- John Holcomb, M.D., FACS, Trauma and Acute Care Professor
- Parker Hu, M.D., FACS, Assistant Trauma Medical Director
- Jeffrey Kerby, M.D., Ph.D., FACS, Director of the Division of Trauma and Acute Care Surgery
- Elizabeth Liptrap, M.D., Assistant Professor in the Department of Neurosurgery
- Bart Thaci, M.D., former fellow in Endovascular Neurosurgery
- Mark Harrigan, M.D., Professor of Neurosurgery
- Jan Jansen, MBBS, Ph.D., FRCS, Associate Vice Chair for Clinical Trials, Director of Research for Trauma and Acute Care Surgery, and Director of the UAB Center for Injury Science
Black and others recently published a paper examining the patients with BCVI who went on to have a stroke, and they’re currently working on another paper that will be a qualitative review of those stroke patients.
Behind the Knife is “the world’s #1 surgery podcast,” according to its website, and aims to revolutionize surgical education by creating content that’s easily accessible for busy surgeons and trainees. Black says it’s “humbling and affirming” to know his work was featured on the podcast.
“We think it’s an important paper, so it’s nice that one of the premier general surgery podcasts thought highly enough of our work to feature it,” Black said.
Listen to Episode 496 of Behind the Knife, “Journal Review in Trauma Surgery: Imaging for Blunt Cerebrovascular Injury (BCVI)” here.