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rwise normal kidney, however, resolved spontaneously or remained asymptomatic. Prenatally-detected simple cysts should be monitored with serial imaging.

Firearm-related injuries (FRI) are an important public health crisis in the US. There is relatively less city level data examining the injury-related trends in Tucson, Arizona. Our study aims to examine FRI, in Southern Arizona’s only Level I trauma center.

We conducted a (2014-2019) review of our Level-I trauma center registry. We selected all patients who were evaluated for a FRI. We collected patient and center related variables. Our outcomes were the trends of FRI, injury-related characteristics, and mortality. Cochran-Armitage trend analysis was performed.

A total of 1012 FRI patients were identified. The majority of patients were teenagers (32%) and young adults (30%), and 88% were male. Greater than 80% of patients belonged to the low/low-middle socioeconomic class, and 18.5% completed college. The most common firearm utilized was the handgun (45%). The prevalence of FRI increased significantly (201415%; 201921%; P< 0.01). The most common injury intention was assault (75%). The median ISS was 17(9-25) with most injuries sustained to the extremities (23%). Also, 25% required emergent operative intervention. There is a significant rise in the number of severely injured patients (ISS≥25) (201412.1%, 201920%; P< 0.01), self-inflicted injuries (201410%, 201917%; P < 0.01), unintentional injuries (20146%, 201912%; P< 0.01), and mortality (201411%; 201919%; P< 0.01). A high prevalence of substance abuse was noted (73% alcohol, 64% drugs).

The prevalence of FRI at our center has been rising over the past decade with a shift towards more severe injuries and higher mortality rates. AZD8055 cell line Addressing these alarming changes requires targeted interventions on multiple frontiers.

The prevalence of FRI at our center has been rising over the past decade with a shift towards more severe injuries and higher mortality rates. Addressing these alarming changes requires targeted interventions on multiple frontiers.

Changes in discharge disposition and delays in discharge negatively impact the patient and hospital system. Our objectives were

to determine the accuracy with which trauma and emergency general surgery (TEGS) providers could predict the discharge disposition for patients and

determine the factors associated with incorrect predictions.

Discharge dispositions and barriers to discharge for 200 TEGS patients were predicted individually by members of the multidisciplinary TEGS team within 24 h of patient admission. Univariate analyses and multivariable logistic least absolute shrinkage and selection operator regressions determined the associations between patient characteristics and correct predictions.

A total of 1,498 predictions of discharge disposition were made by the multidisciplinary TEGS team for 200 TEGS patients. Providers correctly predicted 74% of discharge dispositions. Prediction accuracy was not associated with clinical experience or job title. Incorrect predictions were independently associated with older age (OR 0.98; P < 0.001), trauma admission as compared to emergency general surgery (OR 0.33; P < 0.001), higher Injury Severity Scores (OR 0.96; P < 0.001), longer lengths of stay (OR 0.90; P < 0.001), frailty (OR 0.43; P=0.001), ICU admission (OR 0.54; P < 0.001), and higher Acute Physiology and Chronic Health Evaluation II scores (OR 0.94; P=0.006).

The TEGS team can accurately predict the majority of discharge dispositions. Patients with risk factors for unpredictable dispositions should be flagged to better allocate appropriate resources and more intensively plan their discharges.

The TEGS team can accurately predict the majority of discharge dispositions. Patients with risk factors for unpredictable dispositions should be flagged to better allocate appropriate resources and more intensively plan their discharges.

Iatrogenic ureteral injury (IUI) is an uncommon complication in colorectal surgery. Prophylactic ureteral stenting (PUS) gained acceptance to aid in intraoperative identification of the ureter. Despite its use, the benefit of pus to avoid IUI remains debatable. We sought to analyze the rates of IUI after colorectal surgery in veterans and to compare the outcomes after PUS using a large matched cohort.

The veterans affairs surgical quality improvement program database was queried for patients who underwent colorectal surgery from 2008-2015. To analyze the outcomes of PUS, we created two matched groups using propensity-score matching accounting for demographical and clinical cofactors to assess variable outcomes. Cross-tabulation was used to calculate rates of IUI and univariate and multivariate analyses were performed to evaluate risk factors associated with IUI.

27,448 patients were identified and 458 underwent PUS placement (1.6%). The majority of procedures were performed electively and with an open acally significant. The risk and/or benefit ratio of PUS should be considered for each individual case, with its selective use based on the presence of risk factors for IUI, such as female patients and left-sided resections.

The Script Concordance Test (SCT) is a test of clinical decision-making that relies on an expert panel to create its scoring key. Existing literature demonstrates the value of specialty-specific experts, but the effect of experience among the expert panel is unknown. The purpose of this study was to explore the role of surgeon experience in SCT scoring.

An SCT was administered to 29 general surgery residents and 14 staff surgeons. Staff surgeons were stratified as either junior or senior experts based on years since completing residency training (<15 versus >25 years). The SCT was scored using the full expert panel, the senior panel, the junior panel, and a subgroup junior panel in practice <5 years. A one-way ANOVA was used to compare the scores of first (R1) and fifth (R5) year residents using each scoring scheme. Cognitive interviews were analyzed for differences between junior and senior expert panelist responses.

There was no statistically significant difference between the mean score of six R1s and five R5s using the full expert panel (R1 69.