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  1. Article ; Online: For you were hungry and I gave you food: The prevalence and treatment of malnutrition in patients with acute hip fracture.

    Morrison, Chet A / Morrison, Maya M

    Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition

    2021  Volume 37, Issue 1, Page(s) 59–67

    Abstract: Hip fractures are a common clinical problem with substantial morbidity and difficult recovery. Preexisting malnutrition has been shown to be common in those patients and a substantial risk factor for poorer outcomes, increased length of stay, and ... ...

    Abstract Hip fractures are a common clinical problem with substantial morbidity and difficult recovery. Preexisting malnutrition has been shown to be common in those patients and a substantial risk factor for poorer outcomes, increased length of stay, and mortality. Additionally, great variability exists in reported malnutrition prevalence rates owing to the variety of nutrition screening and assessment tools utilized globally to identify malnutrition in these patients. Although previous data and a recent Cochrane review have not proven the value of nutrition supplements, we highlight several articles that show an opportunity for improvement in the nutrition care of patients sustaining hip fractures along with a multicenter randomized trial demonstrating the value of carefully designed nutrition intervention. There is also evidence that malnourished patients with hip fracture are still being undertreated. Current guidelines are reviewed, and continued efforts on the part of the clinicians to follow the guidelines as well as lowering the barriers to high-quality nutrition research is discussed.
    MeSH term(s) Hip Fractures/complications ; Hip Fractures/epidemiology ; Hip Fractures/therapy ; Humans ; Length of Stay ; Malnutrition/diagnosis ; Malnutrition/epidemiology ; Malnutrition/etiology ; Multicenter Studies as Topic ; Nutrition Assessment ; Nutritional Status ; Prevalence ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2021-12-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1002/ncp.10809
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  2. Article: For you were hungry and I gave you food: The prevalence and treatment of malnutrition in patients with acute hip fracture

    Morrison, Chet A. / Morrison, Maya M.

    Nutrition in clinical practice. 2022 Feb., v. 37, no. 1

    2022  

    Abstract: Hip fractures are a common clinical problem with substantial morbidity and difficult recovery. Preexisting malnutrition has been shown to be common in those patients and a substantial risk factor for poorer outcomes, increased length of stay, and ... ...

    Abstract Hip fractures are a common clinical problem with substantial morbidity and difficult recovery. Preexisting malnutrition has been shown to be common in those patients and a substantial risk factor for poorer outcomes, increased length of stay, and mortality. Additionally, great variability exists in reported malnutrition prevalence rates owing to the variety of nutrition screening and assessment tools utilized globally to identify malnutrition in these patients. Although previous data and a recent Cochrane review have not proven the value of nutrition supplements, we highlight several articles that show an opportunity for improvement in the nutrition care of patients sustaining hip fractures along with a multicenter randomized trial demonstrating the value of carefully designed nutrition intervention. There is also evidence that malnourished patients with hip fracture are still being undertreated. Current guidelines are reviewed, and continued efforts on the part of the clinicians to follow the guidelines as well as lowering the barriers to high‐quality nutrition research is discussed.
    Keywords hip fractures ; malnutrition ; morbidity ; mortality ; nutrition research ; nutritional intervention ; risk factors
    Language English
    Dates of publication 2022-02
    Size p. 59-67.
    Publishing place John Wiley & Sons, Ltd
    Document type Article
    Note REVIEW
    ZDB-ID 645074-x
    ISSN 1941-2452 ; 0884-5336
    ISSN (online) 1941-2452
    ISSN 0884-5336
    DOI 10.1002/ncp.10809
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  3. Article ; Online: Inhibition of Rho kinase: the next hopeful salvo in the long war against sepsis?

    Morrison, Chet A

    The Journal of surgical research

    2013  Volume 183, Issue 2, Page(s) 542–543

    MeSH term(s) 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine/analogs & derivatives ; Animals ; Colon/drug effects ; Endotoxemia/drug therapy ; Lipopolysaccharides/pharmacology ; Male ; Protein Kinase Inhibitors/pharmacology ; rho-Associated Kinases/antagonists & inhibitors
    Chemical Substances Lipopolysaccharides ; Protein Kinase Inhibitors ; 1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine (84477-87-2) ; rho-Associated Kinases (EC 2.7.11.1)
    Language English
    Publishing date 2013-08
    Publishing country United States
    Document type Comment ; Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2012.05.009
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  4. Article ; Online: The prehospital treatment of the bleeding patient--dare to dream.

    Morrison, Chet A

    The Journal of surgical research

    2013  Volume 180, Issue 2, Page(s) 246–247

    MeSH term(s) Animals ; Emergency Medical Services ; Hemorrhage/therapy ; Humans
    Language English
    Publishing date 2013-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2011.12.022
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  5. Article ; Online: Rapid Release Protocol Optimizes Product Utilization Compared With Massive Transfusion Protocol in Selected Patients.

    Jammula, Shreya / Miller, Jo Ann / Morrison, Chet A

    The Journal of surgical research

    2018  Volume 232, Page(s) 553–558

    Abstract: Background: While massive transfusion protocols (MTPs) are effective means of expeditiously delivering blood products to patients with exsanguinating hemorrhage, activation often occurs in cases with small blood volume deficits, leading to product ... ...

    Abstract Background: While massive transfusion protocols (MTPs) are effective means of expeditiously delivering blood products to patients with exsanguinating hemorrhage, activation often occurs in cases with small blood volume deficits, leading to product wastage and overtransfusion. We sought to determine whether the additional implementation of a new protocol (called Rapid Release [RR]), which uses less resources, would result in decrease in blood product wastage. We hypothesized that RR would result in the reservation of MTPs for sicker patients and that blood product wastage would decrease.
    Methods: All MTP activations 1.5 y pre-RR and 1.5 y post-RR were analyzed. Compared with MTP (six units packed red blood cells [pRBCs], six units fresh frozen plasma [FFP], six units platelets), RR only releases four units pRBCs and one unit FFP per activation. MTP resource utilization and wastage was compared before and after RR in trauma and nontrauma populations. P ≤ 0.05 was considered significant.
    Results: One hundred nine MTPs were activated pre- (n = 48) to post-RR (n = 61), with 69 RRs activated in the post-RR period. Of these 69 RRs, 10 (14.5%) were eventually upgraded to MTP. Compared with the pre-RR group, significantly higher transfusion rates were observed for FFP and platelets. FFP wastage increased (pre: 0.65 ± 1.78 versus post: 3.46 ± 4.29; P < 0.001) over the study duration with no differences between the trauma and nontrauma populations.
    Conclusions: Contrary to our hypothesis, institution of the RR protocol resulted in higher mean wastage of FFP per activation despite the appropriateness of the RR protocol. Further efforts are warranted to refine the MTP to increase efficiency.
    MeSH term(s) Adult ; Aged ; Blood Transfusion ; Clinical Protocols ; Female ; Humans ; Male ; Middle Aged
    Language English
    Publishing date 2018-08-07
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2018.07.046
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  6. Article ; Online: Nascent to novel methods to evaluate malnutrition and frailty in the surgical patient.

    Prado, Carla M / Ford, Katherine L / Gonzalez, M Cristina / Murnane, Lisa C / Gillis, Chelsia / Wischmeyer, Paul E / Morrison, Chet A / Lobo, Dileep N

    JPEN. Journal of parenteral and enteral nutrition

    2022  Volume 47 Suppl 1, Page(s) S54–S68

    Abstract: Preoperative nutrition status is an important determinant of surgical outcomes, yet malnutrition assessment is not integrated into all surgical pathways. Given its importance and the high prevalence of malnutrition in patients undergoing surgical ... ...

    Abstract Preoperative nutrition status is an important determinant of surgical outcomes, yet malnutrition assessment is not integrated into all surgical pathways. Given its importance and the high prevalence of malnutrition in patients undergoing surgical procedures, preoperative nutrition screening, assessment, and intervention are needed to improve postoperative outcomes. This narrative review discusses novel methods to assess malnutrition and frailty in the surgical patient. The Global Leadership Initiative for Malnutrition (GLIM) criteria are increasingly used in surgical settings although further spread and implementation are strongly encouraged to help standardize the diagnosis of malnutrition. The use of body composition (ie, reduced muscle mass) as a phenotypic criterion in GLIM may lead to a greater number of patients identified as having malnutrition, which may otherwise be undetected if screened by other diagnostic tools. Skeletal muscle loss is a defining criterion of malnutrition and frailty. Novel direct and indirect approaches to assess muscle mass in clinical settings may facilitate the identification of patients with or at risk for malnutrition. Selected imaging techniques have the additional advantage of identifying myosteatosis (an independent predictor of morbidity and mortality for surgical patients). Feasible pathways for screening and assessing frailty exist and may determine the cost/benefit of surgery, long-term independence and productivity, and the value of undertaking targeted interventions. Finally, the evaluation of nutrition risk and status is essential to predict and mitigate surgical outcomes. Nascent to novel approaches are the future of objectively identifying patients at perioperative nutrition risk and guiding therapy toward optimal perioperative standards of care.
    MeSH term(s) Humans ; Frailty ; Malnutrition/diagnosis ; Nutritional Status ; Nutrition Assessment
    Language English
    Publishing date 2022-12-05
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural
    ZDB-ID 800861-9
    ISSN 1941-2444 ; 0148-6071
    ISSN (online) 1941-2444
    ISSN 0148-6071
    DOI 10.1002/jpen.2420
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  7. Article: A military surgeon questions the value of a forward austere surgical team.

    Morrison, Chet A

    Journal of the American College of Surgeons

    2006  Volume 203, Issue 2, Page(s) 262–263

    MeSH term(s) Blast Injuries/surgery ; Emergency Medical Services/organization & administration ; Humans ; Military Medicine/methods ; United States ; Warfare
    Language English
    Publishing date 2006-08
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1016/j.jamcollsurg.2006.04.024
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  8. Article ; Online: Overview of Nonoperative Blunt Splenic Injury Management with Associated Splenic Artery Pseudoaneurysm.

    Morrison, Chet A / Gross, Brian W / Kauffman, Matthew / Rittenhouse, Katelyn J / Rogers, Frederick B

    The American surgeon

    2017  Volume 83, Issue 6, Page(s) 554–558

    Abstract: The delayed development of splenic artery pseudoaneurysm (SAP) can complicate the nonoperative management of splenic injuries. We sought to determine the utility of repeat imaging in diagnosing SAP in patients managed nonoperatively without ... ...

    Abstract The delayed development of splenic artery pseudoaneurysm (SAP) can complicate the nonoperative management of splenic injuries. We sought to determine the utility of repeat imaging in diagnosing SAP in patients managed nonoperatively without angioembolization. We hypothesized that a significant rate of SAPs would be found in this population on repeat imaging. Patients undergoing nonoperative splenic injury management from January 2011 to June 2015 were queried from the trauma registry. Rates of repeat imaging, angioembolization, readmission, and SAP development were analyzed. Further, subanalyses investigating the incidence of SAP in patients managed nonoperatively without angioembolization were conducted. A total of 133 patients met inclusion criteria. Repeat imaging rate was 40 per cent, angioembolization rate was 26 per cent, and readmission rate was 6 per cent. Within the study population, nine SAPs were found (8/9 in patients with splenic injury grade ≥III). Of these nine SAPs, three (33%) were identified on initial scans and embolized, whereas six (67%) were found on repeat imaging in patients not initially receiving angioembolization. Splenic injuries are typically managed nonoperatively without serious complications. Our results suggest patients with splenic injuries grade ≥III managed nonoperatively without angioembolization should have repeat imaging within 48 hours to rule out the possibility of SAP.
    MeSH term(s) Adult ; Aneurysm, False/diagnostic imaging ; Aneurysm, False/etiology ; Aneurysm, False/therapy ; Angiography/methods ; Embolization, Therapeutic/methods ; Female ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Retrospective Studies ; Spleen/diagnostic imaging ; Spleen/injuries ; Splenic Artery/injuries ; Treatment Outcome ; Wounds, Nonpenetrating/complications ; Wounds, Nonpenetrating/diagnostic imaging ; Wounds, Nonpenetrating/therapy
    Language English
    Publishing date 2017-06-01
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
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  9. Article ; Online: Optimizing the nutrition support care model: Analysis of survey data.

    Mundi, Manpreet S / Mechanick, Jeffrey I / Mohamed Elfadil, Osman / Patel, Jayshil J / Bonnes, Sara L / Blackmer, Allison B / Christian, Vikram J / Hennessy, Sara A / Hurt, Ryan T / Jain, Ajay / Kaspar, Matthew B / Katz, Jennifer / Labossiere, Reginald / Limketkai, Berkeley N / McCarthy, Paul J / Morrison, Chet A / Newberry, Carolyn / Pimiento, Jose M / Rosenthal, Martin D /
    Taylor, Beth / McClave, Stephen A

    JPEN. Journal of parenteral and enteral nutrition

    2022  Volume 46, Issue 7, Page(s) 1709–1724

    Abstract: Background: Malnutrition is underrecognized and underdiagnosed, despite high prevalence rates and associated poor clinical outcomes. The involvement of clinical nutrition experts, especially physicians, in the care of high-risk patients with ... ...

    Abstract Background: Malnutrition is underrecognized and underdiagnosed, despite high prevalence rates and associated poor clinical outcomes. The involvement of clinical nutrition experts, especially physicians, in the care of high-risk patients with malnutrition remains low despite evidence demonstrating lower complication rates with nutrition support team (NST) management. To facilitate solutions, a survey was designed to elucidate the nature of NSTs and physician involvement and identify needs for novel nutrition support care models.
    Methods: This survey assessed demographics of NSTs, factors contributing to the success of NSTs, elements of nutrition education, and other barriers to professional growth.
    Results: Of 255 respondents, 235 complete surveys were analyzed. The geographic distribution of respondents correlated with population concentrations of the United States (r = 90.8%, p < .0001). Most responding physicians (46/57; 80.7%) reported being a member of NSTs, compared with 56.5% (88/156) of dietitians. Of those not practicing in NSTs (N = 81/235, 34.4%), 12.3% (10/81) reported an NST was previously present at their institution but had been disbanded. Regarding NSTs, financial concerns were common (115/235; 48.9%), followed by leadership (72/235; 30.6%), and healthcare professional (HCP) interest (55/235; 23.4%). A majority (173/235; 73.6%) of all respondents wanted additional training in nutrition but reported insufficient protected time, ability to travel, or support from administrators or other HCPs.
    Conclusion: Core actions resulting from this survey focused on formalizing physician roles, increasing interdisciplinary nutrition support expertise, utilizing cost-effective screening for malnutrition, and implementing intervention protocols. Additional actions included increasing funding for clinical practice, education, and research, all within an expanded portfolio of pragmatic nutrition support care models.
    MeSH term(s) Humans ; Malnutrition/prevention & control ; Malnutrition/therapy ; Nutrition Therapy ; Nutritional Support/methods ; Patient Care Team ; Surveys and Questionnaires ; United States
    Language English
    Publishing date 2022-02-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800861-9
    ISSN 1941-2444 ; 0148-6071
    ISSN (online) 1941-2444
    ISSN 0148-6071
    DOI 10.1002/jpen.2326
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  10. Article ; Online: An epidemiologic overview of 13 years of firearm hospitalizations in Pennsylvania.

    Gross, Brian W / Cook, Alan D / Rinehart, Cole D / Lynch, Caitlin A / Bradburn, Eric H / Bupp, Katherine A / Morrison, Chet A / Rogers, Frederick B

    The Journal of surgical research

    2016  Volume 210, Page(s) 188–195

    Abstract: Background: Gun violence is a controversial public health issue plagued by a lack of recent research. We sought to provide a 13-y overview of firearm hospitalizations in Pennsylvania, analyzing trends in mode, intent, and outcome. We hypothesized that ... ...

    Abstract Background: Gun violence is a controversial public health issue plagued by a lack of recent research. We sought to provide a 13-y overview of firearm hospitalizations in Pennsylvania, analyzing trends in mode, intent, and outcome. We hypothesized that no adjusted change in mortality or functional status at discharge (FSD) would be observed for gunshot wound (GSW) victims over the study period.
    Methods: All admissions to the Pennsylvania Trauma Outcome Study database from 2003 to 2015 were queried. GSWs were identified by external cause-of-injury codes. Collected variables included patient demographics, firearm type, intent (assault and attempted suicide), FSD, and mortality. Multilevel mixed-effects logistic regression models and ordinal regression analyses using generalized linear mixed models assessed the impact of admission year (continuous) on adjusted mortality and FSD score, respectively. Significance was set at P < 0.05.
    Results: Of the 462,081 patients presenting to Pennsylvania trauma centers from 2003 to 2015, 19,342 were GSWs (4.2%). Handguns were the most common weapon of injury (n = 7007; 86.7%) among cases with specified firearm type. Most GSWs were coded as assaults (n = 15,415; 79.7%), with suicide attempts accounting 1866 hospitalizations (9.2%). Suicide attempts were most prevalent among young and middle-aged white males, whereas assaults were more common in young black males. Rates of firearm hospitalizations decreased over time (test of trend P = 0.001); however, admission year was not associated with improved adjusted survival (adjusted odds ratio: 0.99, 95% confidence interval: 0.97-1.01; P = 0.353) or FSD (adjusted odds ratio: 0.99, 95% confidence interval: 0.98-1.00; P = 0.089) while controlling for demographic and injury severity covariates.
    Conclusions: Temporal trends in outcomes suggest rates of firearm hospitalizations are declining in Pennsylvania; however, outcomes remain unchanged. To combat this epidemic, a multidisciplinary, demographic-specific approach to prevention should be the focus of future scientific pursuits.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Databases, Factual ; Female ; Hospitalization/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Linear Models ; Logistic Models ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Pennsylvania/epidemiology ; Retrospective Studies ; Wounds, Gunshot/epidemiology ; Wounds, Gunshot/therapy ; Young Adult
    Language English
    Publishing date 2016-11-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2016.11.021
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