Introduction Computed tomography scans became the mainstay of emergency department (ED) evaluation of trauma patients including those with a high Glasgow Coma Scale (GCS) and a low Injury Severity Score (ISS). We elected to find the value of abdominal and pelvic CT in patients with negative physical examination and Focused Assessment of Sonography for Trauma (FAST) on arrival to the ED. Methods This study is a retrospective analysis of 901 consecutive patients from 2017 to 2019 who presented to the ED with level 2 and 3 activation criteria. Each patient received a physical examination, CT abdomen and pelvis, and FAST exam. Data were collected on external factor including GCS, ISS, age, sex, comorbidities, anticoagulation use, and surgical intervention. The patients were divided into 2 groups, Group A and B. Group A consisted of patients with a negative physical exam, FAST, and CT result. Group B included patients with a negative physical exam and FAST exam with positive CT findings. Statistical analysis was done using a Student’s t-test and chi-square test for significance value of P < .05. Institutional Review Board approval was obtained for this study. Results A total of 901 patients were analyzed which included 489 (54.3%) male and 412 (45.7%) female with a mean age of 56.2 (SD = 22.62) years. Out of the 901 patients, 461 patients received a physical, FAST, and CT exam. Group A consisted of 442 (95.9%) patients and Group B had 19 (4.1%) patients. Both groups were similar in GCS and ISS scoring with no significance difference in age, sex, comorbidities, and anticoagulation use. There was a significant difference in the ICU and hospital mean length of stay when CT scan was positive [2 (SD = 4.23) days vs. .6 (SD = 1.33) days with P < .0001 and 4.57 (SD ± 4.17) days vs. 2.5 (SD = 2.00) days with P < .0001, respectively]. The CT findings of the 19 patients in group B consisted of 6 incidentalomas, 5 vertebral compression fractures, 4 pelvic bone fractures, 1 minor liver contusion, 1 non-specific bowel thickening, 1 non-displaced rib fracture, and 1 case of small amount of free fluid in the pelvis. None of the CT findings required surgical intervention. Conclusion Computed tomography of the abdomen and pelvis in trauma patients with high GCS and low ISS with initial negative physical and FAST examination did not provide additional critical information.

analysis were used to further analyze data. Major complications were defined as unplanned readmission or reoperation. RESULTS:A total of 31,755 females were identified, all cancer related cases were excluded. Compared to previous studies, there was nearly double the total cases identified within the database over the last 5 years. Median age was 42.1, average BMI 30.8, and average operative time was 152 minutes. The overall major complication rate was 2.8%, similar to previous studies. Wound complication rate was 4.2%. Statistically significant factors of hypertension, bleeding disorder, diabetes, long-term steroid use, positive smoking status, high BMI and prolonged operative time were associated with increased risk of major complication. There was no significant difference in wound complication rate or major complication rates when stratified by specialty performing breast reductions. CONCLUSION:Well known risk factors for major complications that were previously identified using the NSQIP database continue to be demonstrated in recent data. These considerations should be taken into account on preoperative evaluation/discussions with patients undergoing breast reductions. Previously unexplored datapoints should be considered in future datasets such as marijuana use to further identify potential risks for complications.

and functional results for patients. Using the indications we have developed for the use of pedicled flaps versus free tissue transfers can help other surgeons tackle these difficult cases.