Outcomes after emergency general surgery and trauma care in incarcerated individuals: An EAST multicenter study

Abstract

Maine et al describe the first national look at surgical outcomes in incarcerated patients in this EAST Multi-center Study. How can we improve trauma and surgical care for this population? #EASTMulticenterStudy #Healthdisparities

Subcutaneous Emphysema, Pneumothorax, Pneumomediastinum, and Pneumoperitoneum Following Synthetic Cannabinoid Toxicity in an Incarcerated Man

“…These findings were attributed to a complex interaction of correctional facility and hospital factors that make it difficult for these patients to receive proper longitudinal care. 4…”

“…1 Case A 21-year-old incarcerated male with no past medical history was sent to the emergency department for trauma evaluation by the prison mental health provider after 6 days of new onset catatonia following synthetic marijuana use. Primary survey revealed an intact airway, bilateral breath sounds, hemodynamic sufficiency, 100% oxygen saturation on room air, and a Glasgow Coma Score (GCS) of 13 (4,3,6) as he was mostly non-verbal except to painful stimuli which limited a subjective account of the preceding events. Physical exam during the secondary survey did not reveal any shortness of breath or increased work of breathing; he appeared comfortable.…”

Quality of Surgical Care Within the Criminal Justice Health Care System

“…Much of the literature surrounding the correctional health care system is written from the public health perspective and discusses treatment of communicable diseases (eg, HIV or hepatitis C) and access to mental health services, with a notable lack of data on surgical treatments and outcomes . To our knowledge, the largest studies of patients who are incarcerated and treated by a surgical team have focused on trauma and acute care surgery, with studies conducted by the Eastern Association for the Surgery of Trauma and using large trauma databases . While these studies provided important insight, a considerable proportion of surgical patients, such as those who present for less urgent or elective procedures, remains excluded.…”

“…5,6 To our knowledge, the largest studies of patients who are incarcerated and treated by a surgical team have focused on trauma and acute care surgery, with studies conducted by the Eastern Association for the Surgery of Trauma and using large trauma databases. [7][8][9] While these studies provided important insight, a considerable proportion of surgical patients, such as those who present for less urgent or elective procedures, remains excluded. This study sought to evaluate quality outcomes from a broader range of surgical patients and subspecialties by using data from one of the largest correctional hospitals in the US, while also comparing these metrics to institutional and national benchmarks.…”

Hospital care while incarcerated: A tale of two policies

“…The United States incarcerates nearly two million people 1 . When medical care for those in jail or prison exceeds the capabilities of the correctional facility's healthcare services, patients are transferred to community medical centers for emergency services, specialty care, and surgery 2,3 . Given the scale of mass incarceration in the United States and the high burden of disease among incarcerated individuals, 4 many hospital‐based clinicians will provide care for incarcerated patients during their careers even if they never set foot in a jail or prison.…”