Enhancing patient safety in trauma: Understanding adverse events, assessment tools, and the role of trauma video review.

OBJECTIVES: This study aimed to investigate adverse events (AEs) in trauma resuscitation, evaluate contributing factors, and assess methods, such as trauma video review (TVR), to mitigate AEs. BACKGROUND: Trauma remains a leading cause of global mortality and morbidity, necessitating effective trauma care. Despite progress, AEs during trauma resuscitation persist, impacting patient outcomes and the healthcare system. Identifying and analyzing AEs and their determinants are crucial for improving trauma care. METHODS: This narrative review explored the definition, identification, and assessment of AEs associated with trauma resuscitation within the trauma system. It includes various studies and assessment tools such as STAT Taxonomy and T-NOTECHs. Additionally, it assessed the role of TVR in detecting AEs and strategies to enhance patient safety. CONCLUSION: Integrated with standardized tools, TVR shows promise for identifying AEs. Challenges include ensuring reporting consistency and integrating approaches into existing protocols. Future research should prioritize linking trauma team performance to patient outcomes, and develop sustainable TVR programs to enhance patient safety.

Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood.

Importance: The long-term cardiometabolic consequences of late preterm birth (34-36 weeks' gestation) are not well understood. Objective: To assess whether late preterm birth and size for gestational age are associated with cardiometabolic risk (CMR) in childhood. Design, Setting, and Participants: This retrospective cohort study included 1742 children born in Ontario, Canada, between April 1, 2006, and September 30, 2014, and followed up until September 30, 2019. Data from children enrolled in The Applied Research Group for Kids (TARGet Kids!) primary care practice-based research network were linked to administrative health care data at ICES (formerly known as the Institute for Clinical Evaluative Sciences). Participants were excluded if they had conditions affecting growth (eg, failure to thrive or cystic fibrosis), any acute or chronic conditions (other than asthma and high-functioning autism), severe developmental delay, or families who were unable to communicate in English. Exposures: Late preterm birth, gestational age as a continuous measure, and size for gestational age. Main Outcomes and Measures: The primary outcome was composite CMR score (overall age- and sex-standardized z score of CMR components, including waist circumference, log triglyceride level, glucose level, systolic blood pressure, and high-density lipoprotein cholesterol level). Secondary outcomes were the individual CMR components. Multivariable linear regression analysis was used to separately evaluate the associations of late preterm birth, continuous gestational age, and size for gestational age with CMR at ages 3 to 12 years. Results: Among 2440 eligible children, 1742 (mean [SD] age, 5.6 [2.2] years; 951 boys [54.6%]) were included in the final cohort. Overall, 87 children (5.0%) were born moderately preterm (<34 weeks' gestation), 145 (8.3%) were born late preterm (34-36 weeks' gestation), 455 (26.1%) were born early term (37-38 weeks' gestation), and 1055 (60.6%) were born full term (≥39 weeks' gestation). Compared with children born full term, those born moderately preterm (adjusted ß = 0.50; 95% CI, 0.24-0.75) and late preterm (adjusted ß = 0.27; 95% CI, 0.06-0.47) had higher CMR scores. Each additional gestational week was associated with a 0.06 U (adjusted ß; 95% CI, -0.08 to -0.03 U) decrease in CMR. Conclusions and Relevance: In this study, children born late preterm and moderately preterm had higher CMR. These results suggest that screening and early-life interventions for these children may prevent cardiometabolic outcomes.

Differences in physical and mental health-related quality of life outcomes 3 years after bariatric surgery: a group-based trajectory analysis.

BACKGROUND: While bariatric surgery has proven to be effective to achieve significant weight loss and short-term improvements in both physical and mental (HRQoL), little is known about the factors associated with long-term decline in mental HRQoL after bariatric surgery. OBJECTIVE: To examine differences in physical and mental HRQoL trajectories in a bariatric patient population 3 years after bariatric surgery and examine associated sociodemographic, weight, and mental health factors. SETTING: A Canadian academic bariatric care center. METHODS: A group-based trajectory model was used to examine physical and mental HRQoL trajectories 3 years after bariatric surgery. In a prospective cohort bariatric sample (n = 2270), demographic factors, body mass index, binge eating symptoms, anxiety symptoms (Generalized Anxiety Disorder-7), depressive symptoms (Patient Health Questionnaire-9), and physical and mental HRQoL (Short-form health survey-36 (SF-36)), were measured at baseline, 6 months, 1, 2, and 3 years respectively. The effect of time-varying covariates (body mass index, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7) were investigated to examine effects on physical and mental HRQoL trajectories. RESULTS: Five distinct trajectories described changes in (n = 1939 of 2270) individuals' physical HRQoL outcomes (SF-36-physical health component summary score) and five other trajectories described changes in mental HRQoL (SF-36-mental health component summary score) outcomes from baseline to 3 years postsurgery. The group-based distribution for the 5 physical HRQoL trajectories were as follows: (1) low baseline-stable low (5.8%); (2) low baseline-moderate rise (12%); (3) low baseline-stable high (41.1%); (4) high baseline-stable high (33.2%); and (5) moderate baseline-decline (7.9%). The 5 mental HRQoL trajectories were as follows: (1) low baseline-slow decline (10%); (2) low baseline-stable high (25%); (3) high baseline-unstable rise (12%); (4) high baseline-stable high (48.9%); and (5) high baseline-transient decline (4.1%). Compared with physical HRQoL, mental HRQoL trajectories were not associated with changes in body mass index, yet strongly correlated with changes in binge eating symptoms, Generalized Anxiety Disorder-7, and Patient Health Questionnaire measures at all time points. CONCLUSION: This study demonstrates distinct patterns in physical and mental HRQoL trajectories after bariatric surgery. The decline in mental HRQoL trajectories was more heterogeneous and associated with several psychosocial predictors that may be useful to guide risk prediction of long-term physical and mental HRQoL outcomes postbariatric surgery.