• Patient Assessment Committee

    The AAST Patient Assessment Committee is focused on developing systems to measure disease severity and patient outcomes for research and quality improvement in acute care surgery. 

    One of our largest projects in the past five years has been to define the scope and burden of emergency general surgery diseases (EGS) in the United States and to create an anatomic grading scale for EGS diseases that is intuitive and that can be used for both clinical and research purposes.  Anatomic severity of illness scales have been described for 20 of the most common EGS conditions, and many of these scales have been externally validated.  In addition, we have created EGS guideline summaries and have helped create a framework for EGS risk stratification.

    Our committee has also created a draft of an EGS Optimal Resources Document, which is similar to the trauma optimal resources document.  We have been working with a group led by the American College of Surgeons David Hoyt, Raul Coimbra, and multiple stakeholders from other organizations to edit the document as well as determining the feasibility of a verification/certification process for EGS.  This also includes an EGS registry/data standards project; these elements have been identified and the data dictionary is being created with the ACS, to align language with similar quality data standards, such as NSQIP and TQIP.

    Some of our new and ongoing projects include a multi-centered prospective clinical trial of cholecystitis; multiple collaborative efforts with groups interested in geriatric trauma, EGS triage and transfer guidelines, and participation in the Center for National Trauma Research Scientific Advisory Committee.  This year, we completed a multi-institutional study of necrotizing soft tissue infection, and helped update the AAST Anatomic Injury Score for solid organ injuries.  Finally, we just completed a survey of comfort level among acute care sureons of vascular trauma and non-trauma emergencies that will be forthcoming this year.  Our group also welcomes any suggestions for projects and papers.

    In summary, I would like to thank all the hard-working members of the Patient Assessment Committee, the Board of Managers, and Ms. Sharon Gautschy, and Ms. Brea Sanders for their invaluable support.  Thank you for the opportunity to highlight our work!

     

    AAST PAC Publications, 2018-2019

    1. Santry H, Kao L, Shafi S, Lottenberg L, Crandall M.  A PRO CON DEBATE, Emergency General Surgery regionalization: controversy or common sense? Trauma Surgery Acute Care Open 2019; 10.1136/tsaco-2019-000319
    2. Louis A, Savage S, Utter GH, Li SW, Crandall M. NSTI organisms and regions: multicenter study from the American Association for Surgery of Trauma Journal of Surgical Research 2019;243:108-13
    3. Savage SA, Li SW, Utter GH, Cox JA, Wydo SM, Cahill K, Sarani B, Holzmacher J, Duane TM, Gandhi RR, Zielinski MD, Ray-Zack M, Tierney J, Chapin T, Murphy PB, Vogt, KN, Schroeppel TJ, Callaghan E, Kobayashi L, Coimbra R, Schuster KM, Gillespie D, Timsina L, Louis A, Crandall M.  The AAST grading scale for skin and soft tissue infections is predictive of poor outcomes: a multicenter validation study Journal of Trauma and Acute Care Surgery 2019;86(4):601-8
    4. Schuster K, Davis K, Hernandez M, Holena D, Salim A, Crandall M.  American Association for the Surgery of Trauma (AAST) emergency general surgery guidelines gap analysis Journal of Trauma and Acute Care Surgery 2019;86(5):909-15
    5. Hernandez M, Madbak F, Parikh K, Crandall M.  GI surgical emergencies: scope and burden of disease Journal of Gastrointestinal Surgery 2019;23(4):827-36
    6. Kozar RA, Crandall M, Shanmuganathan K, Zarzaur B, Coburn M, Cribari C, Kaups K, Schuster K, Tominaga G, & the AAST Patient Assessment Committee. Organ Injury Scaling 2018 update: spleen, liver, and kidney Journal of Trauma and Acute Care Surgery 2018;85(6):1119-22
    7. Havens JM, Columbus AB, Brown CVR, Tominaga G, Mowery NT, Crandall M. Risk stratification tools in emergency general surgery Trauma Surgery and Acute Care Open 2018;3(1):e000160. Doi: 10.1136/tsaco-2017-000160
    8. Hernandez M, Havens J, Shafi S, Crandall M.  Risk assessment in emergency general surgery Journal of Trauma and Acute Care Surgery 2018;84(6):956-62
    9. Tominaga GT, Brown CVR, Schulz JT, Barbosa R, Agarwal S, McQuay N, Utter G, Crandall M.  Uniform grading of hemorrhagic emergency general surgery diseases Journal of Trauma and Acute Care Surgery 2018;84(4):670-3.

     

    AAST PAC Collaborative Publications, 2018-2019

    1. Mukherjee K, Brooks SE, Barraco RD, Como JJ, Hwang F, Robinson BRH, Crandall M. Elderly adults with isolated hip fractures - orthogeriatric care versus standard care: a practice management guideline from the Eastern Association for the Surgery Of Trauma Journal of Trauma and Acute Care Surgery 2019 Epub ahead of print https://www.ncbi.nlm.nih.gov/pubmed/?term=Elderly+adults+with+isolated+hip+fractures+-+orthogeriatric+care+versus+standard+care%3A+a+practice+management+guideline
    2. Michetti CP, Fakhry SM, Brasel K, Martin ND, Teicher E, Liu C, Newcomb A,

    with the TRIPP Study Group collaborators.  Trauma ICU prevalence project (TRIPP): the phenotype of a trauma ICU. An AAST multi-institutional study   (in press for Journal of Trauma and Acute Care Surgery)

    1. Vasileiou G, Ray-Zack M, Zielinski M, Qian S, Yeh DD, Crandall M, with the EAST Appendicitis Study Group.  Validation of the American Association for the Surgery of Trauma (AAST) emergency general surgery score for acute appendicitis Journal of Trauma and Acute Care Surgery 2019;87(1):134-9
    2. Aziz H, Lunde J, Barraco R, Como J, Cooper Z, Hayward T, Hwang F, Lottenberg L, Mosenthal A, Mukherjee K, Nash J, Robinson B, Staudenmayer K, Wright R, Yon J, Crandall M.  Evidence-based review of trauma center care and routine palliative care processes for geriatric trauma patients Journal of Trauma and Acute Care Surgery 2019;86(4):737-43
    3. Michetti CP, Fakhry SM, Brasel K, Niels ND, Martin MD, Teicher E, Newcomb A, with the TRIPP Study Group collaborators   Trauma ICU Prevalence Project (TRIPP): the diversity of surgical critical care Trauma Surgery and Acute Care Open 2019;4(1):e000288