Trauma Surgery & Acute Care Open最新文献

{"title":"Trauma recidivism in England and Wales: an epidemiological study.","authors":"Luke McNickle, Jared M Wohlgemut, George Ramsay, Jan O Jansen","doi":"10.1136/tsaco-2024-001669","DOIUrl":"10.1136/tsaco-2024-001669","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Background: </strong>Trauma recidivism refers to patients who are injured repeatedly. There has been no evaluation of trauma recidivism in England and Wales. We hypothesize that, because population demographics and predominant trauma mechanism differ from other studied populations, the typical demographics of patients suffering repeated trauma would differ. Our aim was to determine the demographic and injury characteristics, and outcomes of patients suffering repeated trauma.</p><p><strong>Methods: </strong>This was a national, retrospective, population-based cohort study of patients included in the prospectively collected Trauma Audit & Research Network's (TARN) National Trauma Registry for England and Wales between 2019 and 2020. We defined recidivism as a second admission, with different injuries, within 1 year of the initial admission. Analysis was descriptive.</p><p><strong>Results: </strong>2517 patients (5136 admissions) were included. Median age at first admission was 81 years, and 1888 (75%) were ≥65 years. 1301 (52%) were female. The most common mechanism of injury at first and second admission was a fall ≤2 m (2159 86%, 2237 89%). 2035 (81%) suffered a fall ≤2 m on both admissions. Patients with severe injury increased from 838 (33%) to 982 (39%) from first to second admission. Patients discharged home decreased from 1776 (71%) to 1449 (58%) from first to second admission. Mortality on 2nd admission was 10.2%.</p><p><strong>Conclusions: </strong>In England and Wales, trauma recidivism consists primarily of elderly patients who repeatedly suffer low-energy falls. It follows that prevention strategies should consist of greater and earlier involvement of multidisciplinary team input including geriatric physicians and allied health professionals, for anyone ≥65 who fulfills the criteria for TARN inclusion.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 3","pages":"e001669"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor oral health and the association with social vulnerability and adverse outcomes in trauma patients: symptom, driver or both?","authors":"Kathryn M Stadeli, Sarah M Kolnik","doi":"10.1136/tsaco-2025-001938","DOIUrl":"10.1136/tsaco-2025-001938","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 3","pages":"e001938"},"PeriodicalIF":2.1,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reevaluating postoperative management of bladder repair: the case for early catheter removal and selective cystography.","authors":"Brendan Wallace, Andrew Cohen","doi":"10.1136/tsaco-2025-001802","DOIUrl":"10.1136/tsaco-2025-001802","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 3","pages":"e001802"},"PeriodicalIF":2.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clues to survival in future LSCOs are to be found in the current war in Ukraine.","authors":"Andriy Batchinsky, Konstjantyn Gumeniuk, John B Holcomb","doi":"10.1136/tsaco-2025-001962","DOIUrl":"10.1136/tsaco-2025-001962","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 3","pages":"e001962"},"PeriodicalIF":2.1,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving from prognostication to prevention of SSIs in LMICs.","authors":"Stephanie Martinez Ugarte, Mokunfayo O Fajemisin, Lillian S Kao","doi":"10.1136/tsaco-2025-001946","DOIUrl":"10.1136/tsaco-2025-001946","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 3","pages":"e001946"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic portacaval shunt: a rare complication to be considered in patients with encephalopathy.","authors":"Louise Hebrard, Romain Cailloce, Isaure Breteau, Paer Abback, Eric Levesque","doi":"10.1136/tsaco-2024-001706","DOIUrl":"10.1136/tsaco-2024-001706","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 3","pages":"e001706"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of severe splenic trauma and its management on the occurrence of infections in intensive care unit.","authors":"Nicolas Polge, Camille Hego, Jules Grégory, Sophie Hamada, Anne Godier, Jean Charles Bijot, Axelle Dupont, Paer-Selim Abback, Caroline Jeantrelle, Emmanuel Weiss, Jean Denis Moyer","doi":"10.1136/tsaco-2024-001704","DOIUrl":"10.1136/tsaco-2024-001704","url":null,"abstract":"<p><strong>Purpose: </strong>Severe trauma can be responsible for a major systemic inflammatory response followed by post-traumatic immunosuppression. Immune imbalance promotes infections and increases mortality. This risk could be further increased in case of impaired splenic immune function due to splenic trauma. The objective of this study was to evaluate whether severe splenic trauma increased infectious complications in trauma patients during intensive care unit (ICU) stay.</p><p><strong>Methods: </strong>This was an observational, bicentric, retrospective, case-control study including patients admitted for severe trauma from January 2011 to December 2020 in two level 1 trauma centers. Patients with American Association for the Surgery of Trauma (AAST) ≥III splenic trauma (case) were matched (1:3) with patients without splenic trauma (controls) according to age, sex, Injury Severity Score, initial Glasgow Coma Score, and Simplified Acute Physiology Score II. Demographic, trauma management, and infection data were collected. The primary endpoint was the incidence density of any infectious disease during ICU stay.</p><p><strong>Results: </strong>Among 7,304 severe trauma patients, 130 patients with AAST ≥III splenic trauma were included. 10 patients could not be matched with controls. 17 patients (14.1%) underwent splenectomy, 56 patients (46.7%) had non-operative management with arterioembolization, and 47 (39.2%) had non-operative management without embolization. There was no difference between cases and controls regarding incidence density of infections (44.1 (34.6-55.5)/1,000 person days vs 43.6 (37.7-50.2)/1,000 person days, incidence rate ratio=1 95% CI (0.77 to 1.3) p=0.94), type of infection, involved microorganisms, or severity (septic shock 12% vs 9.2%, p=0.6; acute respiratory distress syndrome 14% vs 9.2%, p=0.2).</p><p><strong>Conclusion: </strong>In the present study, AAST ≥III splenic trauma in severe trauma patients was not associated with an increased risk of infection during ICU stay.Level of evidence III.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 3","pages":"e001704"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of chronic disease during admission for emergency general surgery: a portal to healthcare.","authors":"Victoria Clair, Denise M Garofalo, Ariel Wolf, Charlotte Heron, Samuel K Mathai, Kaitlyn Dickinson, India V Bonner, Catherine Garrison Velopulos, Quintin W O Myers","doi":"10.1136/tsaco-2024-001645","DOIUrl":"10.1136/tsaco-2024-001645","url":null,"abstract":"<p><strong>Background: </strong>Although nearly half of the US population has a chronic disease, many remain undiagnosed, leading to significant morbidity and mortality. Sociodemographic factors affect access to preventative healthcare, increasing rates of undiagnosed chronic disease. We hypothesize that emergency general surgery (EGS) is an important access point into the healthcare system and sought to characterize factors impacting the new diagnosis of chronic disease during admission for EGS.</p><p><strong>Methods: </strong>This was a Level III retrospective cohort study conducted at a single, academic institution. Patients undergoing EGS intervention, including colectomies, cholecystectomy, hernia repair, and peptic ulcer surgeries, were identified during 2018-2019. Univariate descriptive statistics and bivariate analyses were conducted, with χ² tests for categorical variables and Mann-Whitney U tests for continuous variables. We finally conducted a multivariable logistic regression to identify important factors related to the diagnosis of a new chronic disease.</p><p><strong>Results: </strong>A total of 978 patients were included. Of these, 42.7% received a new diagnosis of chronic disease during their EGS admission. The most common diagnoses were gastroesophageal reflux disease (n=120), obesity (n=116), type 2 diabetes (n=60), and hypertension (n=48). No significant associations were found with sociodemographic factors or prior healthcare visits. Length of stay was significantly longer for those with new diagnoses (p<0.001).</p><p><strong>Conclusions: </strong>Hospital admissions for EGS present a critical opportunity to identify undiagnosed chronic conditions, particularly in patients with limited healthcare access. Length of stay was associated with an increased likelihood of diagnosis. These findings suggest that emergency surgical care can serve as a gateway to preventive care. This study provides Level III evidence of the role of emergency general surgery in chronic disease diagnosis.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001645"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing complex pancreatic and hepatic trauma in Gaza under wartime conditions.","authors":"Hosam Shaikhkhalil, Abdulwahhab Abu Alamrain, Mohammad A M Mattar, Elinore Kaufman, Mohammed Aladini","doi":"10.1136/tsaco-2025-001777","DOIUrl":"10.1136/tsaco-2025-001777","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001777"},"PeriodicalIF":2.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144544996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bite injuries in a connected world: a call for global consensus on clinical and public health action.","authors":"Ruben Peralta, Ahmed Faidh Ramzee","doi":"10.1136/tsaco-2025-001921","DOIUrl":"10.1136/tsaco-2025-001921","url":null,"abstract":"","PeriodicalId":23307,"journal":{"name":"Trauma Surgery & Acute Care Open","volume":"10 2","pages":"e001921"},"PeriodicalIF":2.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}