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McKinley TO, Gaski GE, Billiar TR, et al. Patient-Specific Precision Injury Signatures to Optimize Orthopaedic Interventions in Multiply Injured Patients (PRECISE STUDY). J Orthop Trauma. 2022;36:S14-S20doi: 10.1097/BOT.0000000000002289.
McKinley, T. O., Gaski, G. E., Billiar, T. R., Vodovotz, Y., Brown, K. M., Elster, E. A., Constantine, G. M., Schobel, S. A., Robertson, H. T., Meagher, A. D., Firoozabadi, R., Gary, J. L., O'Toole, R. V., Aneja, A., Trochez, K. M., Kempton, L. B., Steenburg, S. D., Collins, S. C., Frey, K. P., Castillo, R. C. (2022). Patient-Specific Precision Injury Signatures to Optimize Orthopaedic Interventions in Multiply Injured Patients (PRECISE STUDY). Journal of orthopaedic trauma, 36S14-S20. https://doi.org/10.1097/BOT.0000000000002289
McKinley, Todd O, et al. "Patient-Specific Precision Injury Signatures to Optimize Orthopaedic Interventions in Multiply Injured Patients (PRECISE STUDY)." Journal of orthopaedic trauma vol. 36 (2022): S14-S20. doi: https://doi.org/10.1097/BOT.0000000000002289
McKinley TO, Gaski GE, Billiar TR, Vodovotz Y, Brown KM, Elster EA, Constantine GM, Schobel SA, Robertson HT, Meagher AD, Firoozabadi R, Gary JL, O'Toole RV, Aneja A, Trochez KM, Kempton LB, Steenburg SD, Collins SC, Frey KP, Castillo RC. Patient-Specific Precision Injury Signatures to Optimize Orthopaedic Interventions in Multiply Injured Patients (PRECISE STUDY). J Orthop Trauma. 2022 Jan 01;36:S14-S20. doi: 10.1097/BOT.0000000000002289. PMID: 34924514.
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J Orthop Trauma. 2022 Jan 01;36:S14-S20. doi: 10.1097/BOT.0000000000002289.

Patient-Specific Precision Injury Signatures to Optimize Orthopaedic Interventions in Multiply Injured Patients (PRECISE STUDY).

Journal of orthopaedic trauma

Todd O McKinley, Greg E Gaski, Timothy R Billiar, Yoram Vodovotz, Krista M Brown, Eric A Elster, Greg M Constantine, Seth A Schobel, Henry T Robertson, Ashley D Meagher, Reza Firoozabadi, Joshua L Gary, Robert V O'Toole, Arun Aneja, Karen M Trochez, Laurence B Kempton, Scott D Steenburg, Susan C Collins, Katherine P Frey, Renan C Castillo,

Affiliations

  1. Department of Orthopedic Surgery, Indiana University Health Methodist Hospital, Indianapolis, IN.
  2. Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Falls Church, VA.
  3. Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
  4. Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.
  5. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
  6. Department of Mathematics and Statistics, University of Pittsburgh, Pittsburgh, PA.
  7. Department of Surgery, Uniformed Services University of the Health Sciences, Surgical Critical Care Initiative, Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.
  8. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.
  9. Department of Orthopaedics and Sports Medicine, University of Washington Harborview Medical Center, Seattle, WA.
  10. Department of Orthopedic Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX (now at Keck School of Medicine of University of Southern California, Los Angeles, CA).
  11. Department of Orthopaedics, R Adams Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD.
  12. Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY.
  13. Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN.
  14. Department of Orthopaedic Surgery, Carolinas Medical Center, Atrium Health Musculoskeletal Institute, Charlotte, NC.
  15. Department of Radiology and Imaging Sciences, Indiana University School of Medicine and Indiana University Health Methodist Hospital, Indianapolis, IN; and.
  16. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

PMID: 34924514 DOI: 10.1097/BOT.0000000000002289

Abstract

SUMMARY: Optimal timing and procedure selection that define staged treatment strategies can affect outcomes dramatically and remain an area of major debate in the treatment of multiply injured orthopaedic trauma patients. Decisions regarding timing and choice of orthopaedic procedure(s) are currently based on the physiologic condition of the patient, resource availability, and the expected magnitude of the intervention. Surgical decision-making algorithms rarely rely on precision-type data that account for demographics, magnitude of injury, and the physiologic/immunologic response to injury on a patient-specific basis. This study is a multicenter prospective investigation that will work toward developing a precision medicine approach to managing multiply injured patients by incorporating patient-specific indices that quantify (1) mechanical tissue damage volume; (2) cumulative hypoperfusion; (3) immunologic response; and (4) demographics. These indices will formulate a precision injury signature, unique to each patient, which will be explored for correspondence to outcomes and response to surgical interventions. The impact of the timing and magnitude of initial and staged surgical interventions on patient-specific physiologic and immunologic responses will be evaluated and described. The primary goal of the study will be the development of data-driven models that will inform clinical decision-making tools that can be used to predict outcomes and guide intervention decisions.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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