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BackgroundPatients who undergo splenectomy are at increased risk of infection caused by encapsulated bacteria. The Advisory Committee on Immunization Practices recommends a series of vaccinations for asplenic patients, the first of which are generally completed prior to hospital discharge in the setting of trauma. However, studies suggest that trauma patients receive booster vaccinations at a suboptimal rate. The aim of this study was to evaluate the impact of an inpatient, pharmacist-led post-splenectomy counseling service on patient understanding and patient-reported revaccination follow-up rate.MethodsPatients who underwent splenectomy due to trauma between October 2017 and February 2019 were surveyed via telephone questionnaire at least eight weeks after initial vaccination. Responses were compared to historical data which was collected prior to the service implementation. The primary outcome was patient reported follow-up vaccination rate. Secondary outcomes included patient awareness of vaccine requirements and need for rehospitalization.ResultsA total of 67 patients met inclusion criteria, of whom 31 (46%) were successfully contacted by phone. After implementation of the post-splenectomy counseling service, 14 patients (45.2%) reported receiving second doses of pneumococcal and meningococcal vaccines, compared to 6 patients (6.3%) in the pre-implementation cohort ( p = 0.000001). Twenty-eight patients (90%) of the patients in the post-implementation cohort acknowledged awareness of the need for additional vaccines, whereas 44 (46%) of patients in the pre-implementation cohort acknowledged awareness ( p = 0.000043).ConclusionA post-splenectomy counseling service led to improved rates of patient reported adherence to booster vaccines, as well as increased awareness for need to revaccinate.

Animal-related injuries are common in rural areas. Agricultural workers can suffer severe injuries involving farm machinery or falls. The spectrum of injuries related to rural activities is poorly defined and characterizing these injuries will improve injury prevention efforts. Records for injured patients admitted between 2010 and 2013 were retrospectively reviewed. Patients with a mechanism of injury involving a large animal or with the injury site listed as “farm” were included. Patients with agricultural injuries (n = 85) were older with more multisystem injuries than patients injured by animals (n = 132) but the Injury Severity Score was equivalent. There was no difference in intensive care unit length of stay, ventilator days, or mortality. There was no difference in frequency of solid organ injury, pelvic fractures, rib fractures, or hemo- or pneumothorax between groups. Animal injuries had more frequent traumatic brain injuries (22.4% vs 10.5%, P = 0.03), whereas agricultural injuries had more vertebral fractures (20.5% vs 9.2%). Of toxicology screens performed, 25 per cent (22/88) were positive. No significant differences were found between occupational versus recreational animal injuries. Agricultural and animal-related injuries have different characteristics but Injury Severity Score and mortality were similar. Severe injuries from both mechanisms are common in rural communities and injury prevention activities are needed in both settings.

Animal-related injuries are common in rural areas. Agricultural workers can suffer severe injuries involving farm machinery or falls. The spectrum of injuries related to rural activities is poorly defined and characterizing these injuries will improve injury prevention efforts. Records for injured patients admitted between 2010 and 2013 were retrospectively reviewed. Patients with a mechanism of injury involving a large animal or with the injury site listed as "farm" were included. Patients with agricultural injuries (n = 85) were older with more multisystem injuries than patients injured by animals (n = 132) but the Injury Severity Score was equivalent. There was no difference in intensive care unit length of stay, ventilator days, or mortality. There was no difference in frequency of solid organ injury, pelvic fractures, rib fractures, or hemo- or pneumothorax between groups. Animal injuries had more frequent traumatic brain injuries (22.4% vs 10.5%, P = 0.03), whereas agricultural injuries had more vertebral fractures (20.5% vs 9.2%). Of toxicology screens performed, 25 per cent (22/88) were positive. No significant differences were found between occupational versus recreational animal injuries. Agricultural and animal-related injuries have different characteristics but Injury Severity Score and mortality were similar. Severe injuries from both mechanisms are common in rural communities and injury prevention activities are needed in both settings.

The purpose of the study was to assess whether trauma may be an independent risk factor for stroke. Evidence has shown that trauma patients experience a hypercoagulable state postinjury, increasing the risk of thrombotic events. A case-controlled, retrospective analysis was performed on admitted trauma patients over a 2-year period. Results revealed that trauma patients are 1.6 times more likely to have a cerebrovascular accident (CVA) during their hospital admission, when compared with nontrauma patients with similar CVA risk factors. Several statistically significant differences between the groups were identified. On the basis of these results, trauma appears to be an independent, nonmodifiable risk factor for CVA. Language: en