Scandinavian Journal of Trauma Resuscitation & Emergency Medicine最新文献

{"title":"POCUS vs. CT in acute cholecystitis: are we really reducing ED length of stay?","authors":"Caglar Kuas, Volkan Ercan, Mustafa Emin Canakci","doi":"10.1186/s13049-025-01367-6","DOIUrl":"10.1186/s13049-025-01367-6","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"53"},"PeriodicalIF":3.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A head-to-head comparison of S100B and GFAP/UCH-L1 for detection of traumatic intracranial lesions in a Scandinavian trauma cohort.","authors":"Thea Overgaard Wichmann, Ayad Babaee, Kirsten Duch, Mikkel Mylius Rasmussen, Maj Lesbo, Ole Brink, Lars C Borris, Claus V B Hviid","doi":"10.1186/s13049-025-01364-9","DOIUrl":"10.1186/s13049-025-01364-9","url":null,"abstract":"<p><strong>Background: </strong>Few countries recommend glial fibrillary protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) as a substitute for S100 astroglial calcium-binding protein B (S100B) in early detection of traumatic intracranial lesions in mild TBI (mTBI). This study aims to evaluate the classification agreement between S100B and GFAP/UCH-L1 in a Scandinavian trauma cohort, to evaluate the performance characteristics of S100B and GFAP/UCH-L1 for detection of traumatic intracranial lesions, and lastly to evaluate the laboratory performance of the GFAP/UCH-L1 assay.</p><p><strong>Methods: </strong>Prospectively collected data from an unselected cohort of 379 adult trauma patients admitted to a level I trauma center at Aarhus University Hospital, Denmark, were retrospectively analyzed. Analyses were performed in the unselected cohort, in sub-cohort 1 (n = 218) i.e. patients with any evidence of TBI in their chart as well as in sub-cohort 2 (n = 105) i.e. patients with mTBI defined as Glasgow Coma Scale score ≥ 14, an injury severity score ≤ 15, and blood sampling within 6 h or 12 h after trauma. Plasma-samples were used for GFAP/UCH-L1 measurement and serum-samples were used for S100B measurement. Data analysis involved agreement analysis using Cohens kappa and sensitivity, specificity, positive predictive value and negative predictive value for each biomarker in each of the three cohorts. Lastly, levels of GFAP/UCH-L1 measured by the Alinity-I platform and the Simoa platform were compared.</p><p><strong>Results: </strong>Classification agreement between GFAP/UCH-L1 and S100B was high in all three cohorts, but Cohens kappa improved with increasing proximity to clinical biomarker use and reached an almost perfect identity in sub-cohort 2 (0.70, 95% CI 0.62-0.92). S100b had a sensitivity and negative predictive value of 100% in sub-cohort 2, while GFAP/UCH-L1 reached 100% across all three cohorts. The specificities for both S100B and GFAP/UCH-L1 were relatively low. Comparing GFAP/UCH-L1 levels between platforms revealed a low concordance with the Alinity-I platform measuring GFAP levels on average 65% lower and UCH-L1 levels 84% higher than the Simoa platform.</p><p><strong>Conclusions: </strong>In this study, S100B and GFAP/UCH-L1 had an almost perfect agreement for classification of mTBI patients and comparable diagnostic performances for detecting traumatic intracranial lesions. Our results therefore support GFAP/UCH-L1 as a feasible alternative to S100B for detecting traumatic intracranial lesions in mTBI.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"52"},"PeriodicalIF":3.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of traumatic spinal cord injury in the Nordic countries: a multidisciplinary survey.","authors":"Anders C Feyling, Johan Undén, Niklas Marklund, Ilke Malak, Ramona Åstrand, Jussi P Posti, Tor Brommeland","doi":"10.1186/s13049-025-01349-8","DOIUrl":"10.1186/s13049-025-01349-8","url":null,"abstract":"<p><strong>Background: </strong>Management of traumatic spinal cord injury is complex and depends on a multidisciplinary approach involving pre-hospital services, spinal surgery, intensive care unit treatment and specialized rehabilitation. International clinical practice guidelines for the handling of these patients offer specific recommendations regarding transportation, radiological investigations, timing of surgery, intensive care management and rehabilitation. We performed a comprehensive multicenter survey to assess the agreement between the Nordic countries on the different aspects of traumatic spinal cord injury management.</p><p><strong>Methods: </strong>Sequential, cross-sectional, structured survey comprising the key clinical domains (pre-hospital services, spinal surgery, intensive care management and rehabilitation) in all tertiary spine trauma centers in Sweden, Denmark, Norway, Iceland and Finland. Data are presented descriptively.</p><p><strong>Results: </strong>A total of 109 respondents from 22 Nordic centers were invited to take the survey, with a response rate of 90% (98/109). Overall, clinical practices were comparable within the domains. Prehospital services had similar practices for airway management, clinical spine clearance and patient transport. Preoperative magnetic resonance imaging was available to 33/35 of the spine surgeons (94%) on a 24/7 basis. This examination was considered mandatory prior to surgery by 66% (23/35) of the surgeons. Surgery was defined as early if performed within 24 h of the injury by all surveyed surgeons. Augmented blood pressure regimens were widely applied in the intensive care units, with mean arterial pressure targets varying between > 80 and > 90 mmHg. Postoperative thromboprophylaxis was administered within 48 h by all centers and rehabilitation policies were similar overall. Notable variations in practice were the occasional steroid administration and the use of lumbar drains in 54% (14/26) of intensive care units.</p><p><strong>Conclusion: </strong>Although there is some variability in the current management of traumatic spinal cord injury in the Nordic countries at the center- and country-level, practices in most key clinical domains are similar and follow established international guidelines.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"51"},"PeriodicalIF":3.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echoes of precision: feedback, governance and ultrasound in prehospital care.","authors":"Marco Tartaglione, Luca Carenzo","doi":"10.1186/s13049-025-01362-x","DOIUrl":"10.1186/s13049-025-01362-x","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"50"},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment: Prolonged critical avalanche burial for nearly 23 h with severe hypothermia and severe frostbite with good recovery: a case report.","authors":"Ian J Cohen","doi":"10.1186/s13049-025-01366-7","DOIUrl":"10.1186/s13049-025-01366-7","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"49"},"PeriodicalIF":3.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temperature should not be ignored when analyzing the factors affecting trauma outcomes.","authors":"Yuliu Li, Tian Gu, Hongbing Yin","doi":"10.1186/s13049-025-01363-w","DOIUrl":"10.1186/s13049-025-01363-w","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"48"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxemia in trauma patients receiving two different oxygen strategies: a TRAUMOX2 substudy.","authors":"Oscar Rosenkrantz, Tobias Arleth, Andreas Creutzburg, Louise Breum Petersen, Josefine Baekgaard, Stine Zwisler, Søren Mikkelsen, Markus Klimek, Lars Simon Rasmussen, Jacob Steinmetz","doi":"10.1186/s13049-025-01360-z","DOIUrl":"10.1186/s13049-025-01360-z","url":null,"abstract":"<p><strong>Background: </strong>The randomized controlled trial, TRAUMOX2, compared early restrictive vs. liberal oxygen strategies for trauma patients. The objective of this substudy was to quantify the occurrence and duration of hypoxemic episodes during the trial's eight-hour intervention.</p><p><strong>Methods: </strong>This observational substudy analyzed a subset of patients at two trial sites in Denmark. Continuous pulse oximetry recorded arterial oxygen saturation (SpO₂) during the intervention. The primary outcome was the proportion of patients who had episodes of hypoxemia with SpO₂ < 90% for at least five minutes. Additionally, the study assessed differences in the occurrence and duration of hypoxemia between the restrictive and liberal oxygen groups.</p><p><strong>Results: </strong>This substudy included 82 patients. After secondary exclusion, 60 patients (median age, 49 years [interquartile range 33-61] and 75% male) were analyzed. Three out of 60 patients (5%) had at least one episode of SpO₂ < 90% for at least five minutes (95% confidence interval 1-14%); Two patients in the restrictive oxygen group and one in the liberal oxygen group. Two episodes occurred during initial resuscitation, and one episode occurred in the intensive care unit following a procedure related to thoracic injuries.</p><p><strong>Conclusions: </strong>In this substudy of 60 patients from the TRAUMOX2 trial, hypoxemia (SpO₂ < 90% for at least five minutes) was observed in 5% of patients, with no difference between the restrictive and liberal oxygen groups. These findings suggest that, among trauma patients not already requiring continuous monitoring, such episodes of hypoxemia are relatively rare early post-trauma.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"47"},"PeriodicalIF":3.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of targeted deployment of physician- led interprofessional pre-hospital teams on the care of critically ill and injured patients: a systematic review and meta-analysis - matters arising response.","authors":"Matthew D Lavery, Arshbir Aulakh, Michael D Christian","doi":"10.1186/s13049-025-01355-w","DOIUrl":"10.1186/s13049-025-01355-w","url":null,"abstract":"","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"46"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and outcomes of hypocalcemia on ED arrival in traumatic patients before blood transfusions: a systematic review and meta-analysis.","authors":"Wuttipong Srichuachom, Sarunsorn Krintratun, Boriboon Chenthanakij, Wachira Wongtanasarasin","doi":"10.1186/s13049-025-01361-y","DOIUrl":"10.1186/s13049-025-01361-y","url":null,"abstract":"<p><strong>Background: </strong>Hypocalcemia represents a critical physiological disturbance in trauma-related hemorrhagic shock patients. Nonetheless, the prevalence and effects of hypocalcemia remain uncertain. This study aims to explore the prevalence of hypocalcemia before blood transfusions and its related mortality in adult patients with major traumatic injuries.</p><p><strong>Method: </strong>We conducted a systematic search through databases, including PubMed, EMBASE, Scopus, and Web of Science, from their inception until June 30, 2024. Patients with major traumatic injuries whose serum calcium was measured upon arrival at the emergency department (ED) were included. We excluded those with prior blood transfusions, pre-clinical studies, review articles, and studies without a control group. Meta-analysis using a random-effect model was performed. Heterogeneity was evaluated using Cochrane Q and I² statistics. The study's risk of bias was assessed using the Joanna Briggs Institute's critical appraisal checklist. Publication bias was assessed using Egger's test and contour funnel plot visualization.</p><p><strong>Results: </strong>Of the total, 1,984 abstracts were screened, leading to 15 studies in this review and meta-analysis. The overall prevalence of hypocalcemia upon ED arrival was 56% (95% CI 37%-74%), with high heterogeneity (I² 99.8%) observed. Hypocalcemia patients also had higher mortality rates than normocalcemia patients (OR 2.44, 95% CI 1.76-3.40).</p><p><strong>Conclusion: </strong>Hypocalcemia on ED arrival is common among adult trauma patients, who also exhibit a notably high mortality rate within this demographic. We recommend the monitoring of ionized calcium levels in traumatic adult patients. Furthermore, systematically designed studies examining the optimal thresholds, treatment protocols, and outcomes should be prioritized as the focal point of research.</p><p><strong>Trial registration: </strong>CRD42024549054 ( http://www.crd.york.ac.uk/PROSPERO ).</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"43"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11916158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender (in)equality in nordic ambulance services: do ambulances have glass ceilings?","authors":"Christoffer Ericsson, Veronica Lindström, Jeanette Viggen Andersen, Trine Møgster Jørgensen, Jonas Alex, Anu Venesoja","doi":"10.1186/s13049-025-01358-7","DOIUrl":"10.1186/s13049-025-01358-7","url":null,"abstract":"<p><p>Political efforts in the Nordic countries aim to promote gender equality. However, an assumption is that patriarchal structures remain embedded in EMS organizations, often leading to a 'glass ceiling' effect for women. The Emergency Medical Services (EMS), generally positioned at the intersection of safety authorities and healthcare, operates within environments often shaped by masculine values and norms. Concurrently, the service also connects strongly to compassion, caring and nursing, which have been historically female-dominant professions and working environments. In recent decades, more females have entered the EMS. Despite the growing number of female paramedics, challenges persist, particularly in relation to gender inequality and workplace culture. Females in EMS field continue to face gender stereotypes, which may contribute to inequality. Gender stereotypes, combined with research describing sexual harassment and bias, underscore the need for further discussions and research on the impact of gender on paramedic work environments and career pathways for women working in the service.</p>","PeriodicalId":49292,"journal":{"name":"Scandinavian Journal of Trauma Resuscitation & Emergency Medicine","volume":"33 1","pages":"45"},"PeriodicalIF":3.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}