sj-jpeg-4-tra-10.1177_14604086241241857 - Supplemental material for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury

Supplemental material, sj-jpeg-4-tra-10.1177_14604086241241857 for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury by Adam S Levy, Connor Berger, Vignessh Kumar, Abbasali Badami and Ian Côté in Trauma</p

sj-jpeg-2-tra-10.1177_14604086241241857 - Supplemental material for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury

Supplemental material, sj-jpeg-2-tra-10.1177_14604086241241857 for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury by Adam S Levy, Connor Berger, Vignessh Kumar, Abbasali Badami and Ian Côté in Trauma</p

sj-jpeg-3-tra-10.1177_14604086241241857 - Supplemental material for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury

Supplemental material, sj-jpeg-3-tra-10.1177_14604086241241857 for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury by Adam S Levy, Connor Berger, Vignessh Kumar, Abbasali Badami and Ian Côté in Trauma</p

sj-jpeg-1-tra-10.1177_14604086241241857 - Supplemental material for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury

Supplemental material, sj-jpeg-1-tra-10.1177_14604086241241857 for Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury by Adam S Levy, Connor Berger, Vignessh Kumar, Abbasali Badami and Ian Côté in Trauma</p

Statistical Power of Randomized Controlled Trials in Trauma Surgery

Background: Our purpose was to conduct a bibliometric study investigating the prevalence of underpowered randomized controlled trials (RCTs) in Trauma Surgery. Methods: A medical librarian conducted a search of RCTs in trauma published from 2000-2021. Data extracted included study type, sample size calculation, and power analysis. Post hoc calculations were performed using a power of 80% and an alpha level of 0.05. A CONSORT checklist was then tabulated from each study as well as a fragility index for studies with statistical significance. Results: In total, 187 RCTs from multiple continents and 60 journals were examined. A total of 133 (71%) were found to have “positive” findings consistent with their hypothesis. When evaluating their methods, 51.3% of manuscripts did not report how they calculated their intended sample size. Of those that did, 25 (27%) did not meet their target enrollment. When examining post hoc power, 46%, 57%, and 65% were adequately powered to detect a small, medium, and large effect sizes respectively. Only 11% of RCTs had complete adherence with CONSORT reporting guidelines and the average CONSORT score was 19 out of 25. For positive superiority trials with binary outcomes, the median (IQR) fragility index was 2 (2-8). Conclusion: A concerningly large proportion of recently published RCTs in trauma surgery 1) do not report a priori sample size calculations, 2) do not meet enrollment targets, and 3) are not adequately powered to detect even large effect sizes. There exists opportunity for improvement of trauma surgery study design, conduct, and reporting

Coronavirus Disease 2019 in Solid Organ Transplant: A Multicenter Cohort Study

Background. The coronavirus disease 2019 (COVID-19) pandemic has led to significant reductions in transplantation, motivated in part by concerns of disproportionately more severe disease among solid organ transplant (SOT) recipients. However, clinical features, outcomes, and predictors of mortality in SOT recipients are not well described. Methods. We performed a multicenter cohort study of SOT recipients with laboratory-confirmed COVID-19. Data were collected using standardized intake and 28-day follow-up electronic case report forms. Multivariable logistic regression was used to identify risk factors for the primary endpoint, 28-day mortality, among hospitalized patients. Results. Four hundred eighty-two SOT recipients from >50 transplant centers were included: 318 (66%) kidney or kidney/pancreas, 73 (15.1%) liver, 57 (11.8%) heart, and 30 (6.2%) lung. Median age was 58 (interquartile range [IQR] 46-57), median time post-transplant was 5 years (IQR 2-10), 61% were male, and 92% had >= 1 underlying comorbidity. Among those hospitalized (376 [78%]), 117 (31%) required mechanical ventilation, and 77 (20.5%) died by 28 days after diagnosis. Specific underlying comorbidities (age >65 [adjusted odds ratio [aOR] 3.0, 95% confidence interval [CI] 1.7-5.5, P < .001], congestive heart failure [aOR 3.2, 95% CI 1.4-7.0, P = .004], chronic lung disease [aOR 2.5, 95% CI 1.2-5.2, P = .018], obesity [aOR 1.9, 95% CI 1.0-3.4, P = .039]) and presenting findings (lymphopenia [aOR 1.9, 95% CI 1.1-3.5, P = .033], abnormal chest imaging [aOR 2.9, 95% CI 1.1-7.5, P = .027]) were independently associated with mortality. Multiple measures of immunosuppression intensity were not associated with mortality. Conclusions. Mortality among SOT recipients hospitalized for COVID-19 was 20.5%. Age and underlying comorbidities rather than immunosuppression intensity-related measures were major drivers of mortality

COVID-19 in solid organ transplant: A multi-center cohort study.

BACKGROUND: The COVID-19 pandemic has led to significant reductions in transplantation, motivated in part by concerns of disproportionately more severe disease among solid organ transplant (SOT) recipients. However, clinical features, outcomes, and predictors of mortality in SOT recipients are not well-described. METHODS: We performed a multi-center cohort study of SOT recipients with laboratory-confirmed COVID-19. Data were collected using standardized intake and 28-day follow-up electronic case report forms. Multivariable logistic regression was used to identify risk factors for the primary endpoint, 28-day mortality, among hospitalized patients. RESULTS: Four hundred eighty-two SOT recipients from \u3e50 transplant centers were included: 318 (66%) kidney or kidney/pancreas, 73 (15.1%) liver, 57 (11.8%) heart, and 30 (6.2%) lung. Median age was 58 (IQR 46-57), median time post-transplant was 5 years (IQR 2-10), 61% were male, and 92% had ≥1 underlying comorbidity. Among those hospitalized (376 [78%]), 117 (31%) required mechanical ventilation, and 77 (20.5%) died by 28 days after diagnosis. Specific underlying comorbidities (age \u3e65 [aOR 3.0, 95%CI 1.7-5.5, p CONCLUSIONS: Mortality among SOT recipients hospitalized for COVID-19 was 20.5%. Age and underlying comorbidities rather than immunosuppression intensity-related measures were major drivers of mortality