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Bulletin

Trauma at Thanksgiving

This month’s column examines National Trauma Data Bank records on the occurrence of injuries sustained during the 24 hours of Thanksgiving Day 2017.

Richard J. Fantus, MD, FACS

November 1, 2019

Editor’s note: The Bulletin team thanks Dr. Fantus for his dedication to writing these lively and informative columns every month for the last 17 years. He has been a pleasure to work with, and we wish him good health and happiness in the future.

This month’s column marks the 200th consecutive monthly appearance of National Trauma Data Bank® (NTDB®) data points. I am thankful to have been able to contribute to the Bulletin and promote the NTDB over the years.

The fourth Thursday of this month is Thanksgiving. Thanksgiving is an annual North American holiday with religious observations to give thanks for the harvest and for health. In the U.S., the holiday lands on the fourth Thursday of November, whereas in Canada it is on the second Monday in October.*

In November 1621, Massachusetts Gov. William Bradford invited the Native American allies of the Plymouth colonists to help celebrate the first successful corn harvest. Members of the Wampanoag tribe brought food to share and participated in a three-day celebration. It is unclear whether turkey was part of this feast. The members of the Wampanoag tribe brought deer and local seafood, which would have included mussels, lobster, and bass, along with the season’s first harvest of corn and pumpkin.

Today, approximately 46 million turkeys are cooked each Thanksgiving. Another 50 million pumpkin pies are consumed—along with all the other fixings—and that may be responsible for a meal that can total more than 3,000 calories, including 229 grams of fat, even before participants go back for seconds.

To examine the occurrence of injuries sustained during the 24 hours of Thanksgiving Day 2017, NTDB research admission year 2017 medical records were searched using an injury incident date of Thanksgiving Day, November 23. A total of 5,441 records were found, 4,533 of which contained a discharge status, including 2,997 patients discharged to home, 587 to acute care/rehab, 757 to skilled nursing facilities, and 36 to law enforcement; 156 died (see Figure 1). Of these patients, 60 percent were men, were on average 50.7 years of age, and had an average hospital length of stay of five days, an intensive care unit length of stay of 4.8 days, an average injury severity score of 9.3, and were on the ventilator for an average of 5.6 days. The top three mechanisms of injury accounting for more than 80 percent of all cases were fall (50.7 percent), motor vehicle-related (24.2 percent), and struck by/against (7.1 percent) (see Figure 2). Of those tested for alcohol, more than 27 percent (629 out of 2,299) tested positive.

Figure 1. Hospital Discharge Status

Figure 1. Hospital Discharge Status
Figure 1. Hospital Discharge Status

Figure 2. Mechanism of Injury

Figure 2. Mechanism of Injury
Figure 2. Mechanism of Injury

Giving thanks

Because this is my final column, and in keeping with the spirit of Thanksgiving, I would like to thank those involved in reaching this 200th milestone—first and foremost, John Fildes, MD, FACS, who came up with the concept for this column at the March 2003 Annual Meeting of the American College of Surgeons (ACS) Committee on Trauma (COT) NTDB Subcommittee meeting that he chaired. We then went on to collaborate on the first 47 monthly columns.

I would like to thank the staff of the ACS COT, who have assisted with the data collection over these past 17 years, as well as the great editorial team of the Bulletin. I also would like to thank all of my co-authors, including my two sons, who have joined the Resident Member ranks of the ACS. Lastly, I would like to thank my wife, who proofread all of these columns before I sent them to the Bulletin editorial team. I wish you a happy holiday season.

If you are interested in obtaining Trauma Quality Programs (TQP) data for your own analysis, or your trauma center is interested in participating in the TQP, you can e-mail us at traumaquality@facs.org or find more information on the ACS website.

Acknowledgment

Statistical support for this column was provided by Ryan Murphy, Data Analyst, NTDB.


*Oxford Learner’s Dictionaries. Thanksgiving definition. Available at: www.oxfordlearnersdictionaries.com/us/definition/english/thanksgiving. Accessed September 30, 2019.

History.com. Thanksgiving history facts and trivia. Available at: www.history.com/news/thanksgiving-history-trivia-facts. Accessed September 30, 2019.

Murphy T. Quirky Thanksgiving trivia facts to impress your friends this holiday. Good Housekeeping. August 20, 2019. Available at: www.goodhousekeeping.com/holidays/thanksgiving-ideas/a35457/thanksgiving-trivia/. Accessed September 30, 2019.