Use the Evidence Table to organize your literature review of the five research studies you gathered.  All 5 studies selected will be used to develop the Evidence Table portion of this project. The template is attached here, and the 5 researches study too. 243

Int Marit Health
2018; 69, 4: 243–247

DOI: 10.5603/IMH.2018.0039

Copyright © 2018 PSMTTM
ISSN 1641–9251


William J. Isom, MD, Florida International University-Herbert Wertheim School of Medicine, Miami, Florida, USA, e-mail: [email protected]

Patterns of injury amongst cruise ship
passengers requiring hospitalisation

William J. Isom1, Yves-Dany Accilien1, Stevenson B. Chery1,
Dalier Mederos-Rodriguez2, John D. Berne2

1Florida International University-Herbert Wertheim School of Medicine, Miami, Florida, USA
2Broward Health Medical Centre, Division of Trauma & Critical Care, Fort Lauderdale, Florida, USA

Background: The number of commercial cruise ship passengers continues to rise and is projected to reach
27.2 million passengers worldwide in 2018. Accidental injury aboard these ships can result in serious mor-
bidity and mortality. This study examines the injury mechanisms, patterns, demographics, and outcomes
of these injuries which are serious enough to require hospitalisation in order to facilitate administrative,
financial, and medical decision making to aid in injury prevention and treatment.
Materials and methods: This is a cross-sectional, retrospective, registry-based study of adult patients su-
staining injury while on a cruise ship admitted to a Level I Trauma Centre in the United States over a 2-year
period. Data on demographics, injury type and severity, surgical management, hospital charges, length of
stay, mortality, and discharge disposition were recorded.
Results: Sixty seven patients were identified and included in the analysis. 70.1% of patients were 65 or
older and a  majority were female (59.7%). The most common mechanism of injury was a  ground level
fall (79.1%), and the most common injury encountered was a femur fracture (52.2%) which involved the
acetabulo-femoral joint in 85.7% of cases. Traumatic brain injuries were uncommon occurring in 7.5% of
cases. There were no fatalities in this series.
Conclusions: The most common injuries aboard cruise ships requiring hospitalisation occur in the geriatric
population as a  result of a  ground level fall. Most commonly, the injuries are long bone fractures, with
femur fractures occurring most frequently and accounting for over half of all injuries sustained. Resources
and protocols for pre-hospital management of cruise ship injuries should prioritise these patients, and fall
prevention measures for this demographic should be mandatory aboard all cruise ships.

(Int Marit Health 2018; 69, 4: 243–247)

Key words: cruise ship, travel medicine, trauma, injury

Trauma is one of the leading causes of hospital





















Blunt small bowel perforation (SBP): An Eastern Association for the
Surgery of Trauma multicenter update 15 years later

Samir M. Fakhry, MD, Ahmed Allawi, MD, Pamela L. Ferguson, PhD, Christopher P. Michetti, MD,
Anna B. Newcomb, PhD, Chang Liu, PhD,

Michelle R. Brownstein, MD, and the EAST small bowel perforation (SBP)
Multi-Center Study Group, Reston, Virginia

AAST Continuing Medical Education Article

Accreditation Statement
This activity has been planned and implemented in accordance with the Es-
sential Areas and Policies of the Accreditation Council for Continuing Medical
Education through the joint providership of the American College of Surgeons
and the American Association for the Surgery of Trauma. The American
College Surgeons is accredited by the ACCME to provide continuing medical
education for physicians.

AMA PRA Category 1 Credits™
The American College of Surgeons designates this journal-based CME activity for
a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit
commensurate with the extent of their participation in the activity.
Of the AMA PRA Category 1 Credit™ listed above, a maximum of 1 credit meets
the requirements for self-assessment.

Credits can only be claimed online

After reading the featured articles published in the Journal of Trauma and Acute
Care Surgery, participants should be able to demonstrate increased understanding
of the material specific to the article. Objectives for each article are featured at the
beginning of each article and online. Test questions are at the end of the article,
with a critique and specific location in the article referencing the question topic.

Claiming Credit
To claim credit, please visit the AAST website at and click on
the “e-Learning/MOC” tab. You must read the article, successfully complete the
post-test and evaluation. Your CME certificate will be available immediately upon re-
ceiving a passing score of 75% or higher on the post-test. Post-tests receiving a score
of below 75% will require a retake of the test to receive credit.

Disclosure Information
In accordance with the ACCME Accreditation Criteria, the American College of
Surgeons, as the accredited provider of this journal activity, must ensure that anyone
in a position to control the content of J Trauma Acute Care Surg a

lable at ScienceDirect

Surgery 169 (2021) 470e476

Contents lists avai


journal homepage:

Anticoagulation therapy in patients with traumatic brain injury:
An Eastern Association for the Surgery of Trauma multicenter
prospective study

Kazuhide Matsushima, MDa,*, Stefan W. Leichtle, MDb, Jeffrey Wild, MDc,
Katelyn Young, BSc, Grace Chang, MDd, Demetrios Demetriades, MD, PhDa, EAST ACT-TBI
Multicenter Study Group*

a Division of Acute Care Surgery, LACþUSC Medical Center, Los Angeles, CA
b Division of Acute Care Surgical Services, VCU Medical Center, Richmond, VA
c Section of Trauma and Emergency General Surgery, Geisinger Medical Center, Danville, PA
d Division of Trauma and Surgical Critical Care, Mount Sinai; Division of Surgical Critical Care, University of Chicago, Chicago, IL

a r t i c l e i n f o

Article history:
Accepted 12 July 2020
Available online 12 September 2020

Presented at the 32nd Annual Scientific Assembly
the Surgery of Trauma, January 17, 2019.
* Reprint requests: Kazuhide Matsushima, MD, A

University of Southern California, LACþUSC Medical
Inpatient Tower (C), C5L100, Los Angeles, CA 90033,

E-mail address: kazuhide.matsush[email protected]
* The EAST ACT-TBI Multicenter Study Group: Cara

nifer Massetti, ACNP, R Adams Cowley Shock Trauma
Medical Center, Baltimore, MD. Nina E. Glass, MD, David
Trauma and Acute Care Surgery, Rutgers-New Jersey Me
O’Bosky, MD, Julie L. Chan, MD, PhD, Division of Tr
University Medical Center, Loma Linda, CA. Daniel C.
Surgery, Marshfield Clinic, Marshfield, WI. Kelly A. Ri
Division of Trauma, Surgical Critical Care and Injury Pre
0039-6060/© 2020 Elsevier Inc. All rights reserved.

a b s t r a c t

Background: Trauma care providers often face a dilemma regarding anticoagulation therapy initiation in
patients with traumatic brain injury owing to the associated risks of traumatic brain injury progression.
The aims of this study were the following: (1) to describe the current practice of anticoagulation therapy
in traumatic brain injury patients and their outcomes and (2) to identify factors associated with the
progression of traumatic brain injury after anticoagulation therapy.
Methods: In this multicenter prospective observational study, we included computed tomography
eproven traumatic brain injury patients who received anticoagulation therapy within 30 days of hos-
pital admission. Our primary outcome was the incidence of clinically significant progression of traumatic
brain injury after anticoagulation therapy initiation.
Results: A total of 168 patients were enrolled more than 22 months. Atrial fibrillation and venous
thromboembolism were the most common

Hospital Pharmacy
1 –6
© The Author(s) 2020
Article reuse guidelines:
DOI: 10.1177/0018578720954154

Critical Care Series


It has been theorized that once SARS-CoV-2 infects a patient,
viremia ensues and by using the bloodstream, the virus
spreads to other parts of the body, gaining access to the lungs,
kidneys and gastrointestinal tract possibly using ACE2 recep-
tors. One distinct feature identified in severe SARS-CoV-2
disease is abnormal coagulation parameters and complex
hematologic abnormalities, including significantly elevated
D-dimer and fibrin/fibrinogen values.1,2 This characteristic
may confer higher mortality among patients with severe
SARS-CoV-2 infection.1-4

Due to the increased risk for coagulopathy, clinicians are
reconsidering their approach to anticoagulation in the inten-
sive care unit (ICU) advocating to aggressively utilize low
molecular weight heparin (LMWH) in this patient’s popula-
tion. Emerging data suggests there may be a benefit from
aggressive anticoagulation therapy in patients suffering from
severe SARS-CoV-2 disease.3 At Tongji Hospital of Huazhong
University of Science and Technology in Wuhan, Tang and
colleagues enrolled 449 patients with SARS-CoV-2 disease.
They concluded that anticoagulation therapy with LMWH
leads to better outcomes in patients with elevated D-dimers
and signs and symptoms of sepsis-induced coagulopathy.3,5,6

Although the definition of severe SARS-CoV-2 disease
varies among countries and institutions, the Center for
Disease Control (CDC) defines severe disease as patients
with radiographic evidence of pneumonia, or acute respira-

tory distress syndrome (ARDS) or autopsy findings consis-
tent with the either of these 2 conditions.7

In the setting of lack of medical literature that otherwise
may dictate anticoagulation therapy in this novel disease,
peak anti-Xa level monitoring to target prophylactic and
therapeutic levels could be utilized to guide therapy. The aim
of this case series is to describe our experience in critically ill
patients with SARS-CoV-2 disease in the ICU.

Case Series Report

Case 1

A 43-year-old Hispanic male (80 kg) presented directly from a
cruise ship after testing positive for SARS-CoV-2 with com-
plaints of cough, fevers, and shortness of breath. He arrived on
a non-rebreather mask (NRB) at 15 L/min supplementation
with oxygen saturation (SpO2) above 90%. Upon admission, a
chest x-ray showed multifocal ground opacities with worsen-
ing bilateral infiltrates at hospital day (HD) 3 with no signs of
pulmonary emboli. The patient was started on an anti-SARS-
CoV-2 medication regimen (see Table 1). Enoxaparin 40 mg

954154HPXXXX10.1177/0018578720954154Hospital PharmacyZamora et al

J o u r n a l o f S u r g i c a l R e s e a r c h • m o n t h 2 0 2 1 ( 2 6 4 ) 1 4 9 – 1 5 7

Available online at

j o u r n a l h o m e p a g e : w w w . e l s e v i e r. c o m / l o c a t e / Y J S R E

Comparison of Geriatric Versus Non-geriatric
Trauma Patients With Palliative Care
Consultations ✩ , ✩✩

Joanna Wycech, MS,a , c Alexander A Fokin, MDPhD,a , b , ∗

Jeffrey K. Katz, MD,a , b Sari Viitaniemi, RNMSN,a Nicholas Menzione, MD,a

and Ivan Puente, MDFACS,a , b , c , d

a Division of Trauma and Critical Care Services, Delray Medical Center, Delray Beach, Florida
b Department of Surgery, Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, Florida
c Division of Trauma and Critical Care Services, Broward Health Medical Center, Fort Lauderdale, Florida
d Department of Surgery, Florida International University, Herbert Wertheim College of Medicine, Miami, Florida

a r t i c l e i n f o

Article history:

Received 8 October 2020

Revised 22 January 2021

Accepted 27 February 2021


Geriatric trauma

Palliative care

Palliative care consultations

Do-Not-Resuscitate orders


Futile interventions

Propensity matched comparison

a b s t r a c t

Background: Palliative care in trauma patients is still evolving. The goal was to compare char-

acteristics, outcomes, triggers and timing for palliative care consultations (PCC) in geriatric

( ≥65 y.o.) and non-geriatric trauma patients .
Materials and methods: Retrospective study included 432 patients from two level 1 trauma

centers who received PCC between December 2012 and January 2019. Non-geriatric ( n = 61)
and geriatric ( n = 371) groups were compared for: mechanism of injury (MOI), Injury Sever-
ity Score (ISS), Revised Trauma Score (RTS), Glasgow Coma Score (GCS), Do-Not-Resuscitate

(DNR) orders, futile interventions (FI), duration of mechanical ventilation (DMV), ICU admis-

sions, ICU and hospital lengths of stay (ICULOS; HLOS), timing to PCC, and mortality. Fur-

ther propensity matching (PM) analysis compared 59 non-geriatric to 59 Geriatric patients

matched by ISS, GCS, and DNR.

Results: Geriatric patients were older (85.2 versus 49.7), with falls as predominant MOI. Non-

geriatric patients comprised 14.1% of all patients with PCC and were more severely injured

than Geriatrics: with statistically higher ISS (24.1 versus 18.5), lower RTS (5.4 versus 7.0), GCS

(7.1 versus 11.5), with predominant MOI being traffic accidents, all P < 0.01. Non-Geriatrics

had more ICU admissions (96.7% versus 88.1%), longer ICULOS (10.2 versus 4.7 days), DMV

(11.1 versus 4.1 days), less DNR (5

MSN5300 Evidence Table

A literature review is the foundation for every research project. The matrix reflects the structure of empirical research articles. Summarize each study across the row. Adding pg #s will help keep track of where specific information is located. Try to summarize in your own words – add quotes where you don’t.

Citation (APA format)

Research question/ Purpose/Hypothesis

Theory/ Framework

Research Design



Research variables/ measures








MSN 5300 Evidence Table (…con’t…)

Purposefully look for similarities and differences between studies, identify themes that emerge and think about how each study might relate to others reviewed.

What are the implications of your analysis? What is missing? Where are the gaps in the body of literature? What would you suggest for future research? For practice? What new questions should be asked?

Major findings, contributions

Study limitations, gaps that remain

Study implications for research, practice, policy

Make note of how this research is linked to other studies reviewed