Factors Affecting Research Productivity of Trauma Surgeons.

This study aimed to identify factors that promote and impede research participation and productivity by Eastern Association for the Surgery of Trauma (EAST) surgeons. In addition, the study aimed to determine what changes can be implemented by surgical departments to improve this research productivity and granting. A 25-question anonymous research survey tool was offered to EAST surgeons. The questions analyzed factors including demographics, career accomplishments, current institution type, educational/research background, perceived barriers to research, and current research productivity, including grants. Chi-square tests were used to analyze significance at P < 0.05. The overall response rate was 26.2 per cent (445/1699). Most respondents reported not having any protected research time (86.3%), and no research resources were provided by their institution (78.7%). Factors that were significantly associated with greater research productivity included protected research time (P < 0.0001), having a mentor (P < 0.001), practicing in a university-affiliated hospital (P < 0.0001), publication(s) before completing residency training (P = 0.02), having institutional resources dedicated to research (P = 0.015), and male gender (P = 0.003). Age, race, marital status, and additional educational qualifications were not associated with statistically significant differences in research productivity in this study (P > 0.05). EAST surgeons are more likely to have scholarly productivity if they are supported with protected time, mentors, nonclinical staff dedicated to research, a history of research before completion of residency, and research resources from their institution. Barriers to research productivity include lack of institutional support, lack of protected research time, and increased regulatory policies.

Factors Affecting Research Productivity of Burn Surgeons: Results from a Survey of American Burn Association Members.

While previous studies have examined factors that affect research productivity for surgeons in general, few studies address research productivity specifically of burn specialists. This study aimed to identify factors that promote and impede research participation and productivity of burn surgeons and help elucidate what changes can be made by departments/divisions to improve the research productivity. A 44-question anonymous research survey tool was administered to burn surgeons who are members of the American Burn Association (ABA). The questions analyzed factors such as demographics, career accomplishments, current institution type, educational background, research background, barriers to conducting research, and current research productivity. Chi-square tests were used to analyze significance at P < .05. Most respondents reported not having any protected research time (71.4%) or resources provided by their institution (84.5%). A majority believed increasing regulatory policies/institutional review board restrictions have negatively impacted productivity (65.1%). Factors associated with positive impact on research productivity included having a mentor, conducting research prior to completing residency, and provision of research resources from the institution such as statistical support, start-up funds, grant writing support, and laboratory space. Age and sex had no statistical impact on research productivity. Burn surgeons are more likely to publish research and to receive grants when they have mentors, a history of research prior to completion of residency, and research resources from their institution. Barriers to research productivity include lack of institutional support, lack of protected research time, and increased regulatory policy.

Aggressive Crystalloid Resuscitation Outcomes in Low-Severity Pediatric Trauma.

BACKGROUND: Trauma is the leading cause of death among children. Studies have found that insufficient intravenous (IV) fluid resuscitation contributes significantly to morbidity and mortality in pediatric trauma. While large-volume resuscitation represents a potential solution, overly aggressive fluid management may complicate hospitalizations and recovery. Through this study, we aim to evaluate the impact of aggressive fluid resuscitation on outcomes in pediatric trauma. MATERIALS AND METHODS: This is a retrospective review utilizing our level I trauma center registry for pediatric patients aged <16 y admitted from 2014 to 2017. Patients transferred from our center within 24 h and those who arrived from outside hospitals were excluded. Patients who received blood product transfusions were excluded. Included patients were divided into two crystalloid groups: <60 mL/kg/24 h and ≥60 mL/kg/24 h. Outcome measures included ICU length-of-stay, length-of-hospitalization, complications, and mortality rate. RESULTS: Study sample included 320 patients (<60 mL/kg/24 h = 219; ≥60 mL/kg/24 h = 101). The ≥60 mL/kg/24 h group was younger (9.95 versus 5.27, P = 0.0001). There were no significant differences in GCS on arrival, injury severity score, Abbreviated Injury Scale, Revised Trauma Scores, traumatic brain injury, and operative intervention between groups. Outcome measures showed there was no significant difference in 30-day readmission rate, complications, or mortality. Large-volume crystalloid resuscitation was associated with longer mean ICU length-of-stay (1.5 d versus 0.8 d, P = 0.004). CONCLUSIONS: In this single-institution retrospective database analysis, large-volume crystalloid resuscitation (≥60 mL/kg) was associated with a significant increase in ICU length-of-stay without survival benefit. More research in the form of randomized trials will help determine the optimal rate for fluid resuscitation in pediatric trauma patients while weighing potential critical care complications.