{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:37:32Z","timestamp":1791571052842,"version":"4.3.4"},"reference-count":19,"publisher":"BMJ","issue":"1","funder":[{"name":"AAST MITC"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2019,1,3]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Surgical critical care is crucial to the care of trauma and surgical patients. This study was designed to provide a contemporary assessment of patient types, injuries, and conditions in intensive care units (ICU) caring for trauma patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a multicenter prevalence study of the American Association for the Surgery of Trauma; data were collected on all patients present in participating centers\u2019 trauma ICU (TICU) on November 2, 2017 and April 10, 2018.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-nine centers submitted data on 1416 patients. Median age was 58 years (IQR 41\u201370). Patient types included trauma (n=665, 46.9%), non-trauma surgical (n=536, 37.8%), medical (n=204, 14.4% overall), or unspecified (n=11). Surgical intensivists managed 73.1% of patients. Of ICU-specific diagnoses, 57% were pulmonary related. Multiple high-intensity diagnoses were represented (septic shock, 10.2%; multiple organ failure, 5.58%; adult respiratory distress syndrome, 4.38%). Hemorrhagic shock was seen in 11.6% of trauma patients and 6.55% of all patients. The most common traumatic injuries were rib fractures (41.6%), brain (38.8%), hemothorax\/pneumothorax (30.8%), and facial fractures (23.7%). Forty-four percent were on mechanical ventilation, and 17.6% had a tracheostomy. One-third (33%) had an infection, and over half (54.3%) were on antibiotics. Operations were performed in 70.2%, with 23.7% having abdominal surgery. At 30 days, 5.4% were still in the ICU. Median ICU length of stay was 9 days (IQR 4\u201320). 30-day mortality was 11.2%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patient acuity in TICUs in the USA is very high, as is the breadth of pathology and the interventions provided. Non-trauma patients constitute a significant proportion of TICU care. Further assessment of the global predictors of outcome is needed to inform the education, research, clinical practice, and staffing of surgical critical care providers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of evidence<\/jats:title>\n                  <jats:p>IV, prospective observational study.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2018-000288","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T05:45:39Z","timestamp":1550555139000},"page":"e000288","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Trauma ICU Prevalence Project: the diversity of surgical critical care"],"prefix":"10.1136","volume":"4","author":[{"given":"Christopher P","family":"Michetti","sequence":"first","affiliation":[{"name":"Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir M","family":"Fakhry","sequence":"additional","affiliation":[{"name":"Surgery, Reston Hospital Center, Reston, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Brasel","sequence":"additional","affiliation":[{"name":"Surgery, Oregon Health and Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2157-0825","authenticated-orcid":false,"given":"Niels D","family":"Martin","sequence":"additional","affiliation":[{"name":"Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik J","family":"Teicher","sequence":"additional","affiliation":[{"name":"Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Newcomb","sequence":"additional","affiliation":[{"name":"Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,18]]},"reference":[{"key":"2025082410413727000_4.1.e000288.1","unstructured":"Committee on Trauma, American College of Surgeons . Resources for the optimal care of the injured patient. 2014. https:\/\/www.facs.org\/quality-programs\/trauma\/vrc\/resources (8 Jul 2018)."},{"key":"2025082410413727000_4.1.e000288.2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.4103\/0974-2700.43183","article-title":"Are trauma patients better off in a trauma ICU?","volume":"1","author":"Duane","year":"2008","journal-title":"J Emerg Trauma Shock"},{"key":"2025082410413727000_4.1.e000288.3","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1097\/TA.0000000000000460","article-title":"Implementation of a surgical intensive care unit service is associated with improved outcomes for trauma patients","volume":"77","author":"Klein","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082410413727000_4.1.e000288.4","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1097\/TA.0000000000000613","article-title":"Does unit designation matter? A dedicated trauma intensive care unit is associated with lower postinjury complication rates and death after major complication","volume":"78","author":"Bukur","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082410413727000_4.1.e000288.5","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1097\/TA.0000000000001361","article-title":"Neuro, trauma, or med\/surg intensive care unit: does it matter where multiple injuries patients with traumatic brain injury are admitted? secondary analysis of the American Association for the surgery of trauma multi-institutional trials Committee decompressive craniectomy study","volume":"82","author":"Lombardo","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082410413727000_4.1.e000288.6","unstructured":"American Association for the Surgery of Trauma. http:\/\/www.aast.org\/AcuteCareSurgery.aspx (Accessed 8\/31\/18)."},{"key":"2025082410413727000_4.1.e000288.7","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182011089"},{"key":"2025082410413727000_4.1.e000288.8","unstructured":"American Board of Medical Specialties Board Certification. 2016. https:\/\/www.abms.org\/board-certification\/abms-board-certification-report\/ (29 Oct 2018)."},{"key":"2025082410413727000_4.1.e000288.9","unstructured":"The American Board of Surgery . Promoting Surgical Excellence. 1937. www.absurgery.org (8 Jul 2018)."},{"key":"2025082410413727000_4.1.e000288.10","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1067\/j.cpsurg.2017.05.001","article-title":"Acute care surgery: an evolving paradigm","volume":"54","author":"Jurkovich","year":"2017","journal-title":"Curr Probl Surg"},{"key":"2025082410413727000_4.1.e000288.11","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1097\/CCM.0000000000001856","article-title":"ICU admission, discharge, and triage guidelines: a framework to enhance clinical operations, development of institutional policies, and further research","volume":"44","author":"Nates","year":"2016","journal-title":"Crit Care Med"},{"key":"2025082410413727000_4.1.e000288.12","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-0718"},{"key":"2025082410413727000_4.1.e000288.13","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31824d10fa"},{"key":"2025082410413727000_4.1.e000288.14","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1089\/sur.2014.076","article-title":"Ventilator-associated pneumonia in trauma patients: different criteria, different rates","volume":"17","author":"Leonard","year":"2016","journal-title":"Surg Infect"},{"key":"2025082410413727000_4.1.e000288.15","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1016\/j.ajic.2017.11.032","article-title":"Effectiveness of a bundled approach to reduce urinary catheters and infection rates in trauma patients","volume":"46","author":"Davies","year":"2018","journal-title":"Am J Infect Control"},{"key":"2025082410413727000_4.1.e000288.16","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-420"},{"key":"2025082410413727000_4.1.e000288.17","unstructured":"ADS . 2018. https:\/\/www.acgme.org\/Specialties\/Program-Requirements-and-FAQs-and-Applications\/pfcatid\/24\/Surgery (19 Oct 2018)."},{"key":"2025082410413727000_4.1.e000288.18","first-page":"471","article-title":"Surgical critical care program directors Society","volume":"69","author":"Alam","year":"2010","journal-title":"J Trauma"},{"key":"2025082410413727000_4.1.e000288.19","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200808-1281OC"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2018-000288","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T17:41:51Z","timestamp":1756057311000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2018-000288"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,2,18]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/tsaco-2018-000288"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2018-000288","relation":{},"ISSN":["2397-5776"],"issn-type":[{"value":"2397-5776","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}