Chinese Journal of Traumatology最新文献

{"title":"Erratum regarding missing Declaration of Competing Interest statements in previously published articles","authors":"","doi":"10.1016/j.cjtee.2020.12.007","DOIUrl":"10.1016/j.cjtee.2020.12.007","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 5","pages":"Page 389"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38759661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive reduction of irreducible, sagittally unstable peritrochanteric fractures: Novel technique and early results","authors":"Ke Li,&nbsp;Xing Du,&nbsp;Zhongyao Chen,&nbsp;Wei Shui","doi":"10.1016/j.cjtee.2024.08.010","DOIUrl":"10.1016/j.cjtee.2024.08.010","url":null,"abstract":"<div><h3>Purpose</h3><div>The management of irreducible, sagittally unstable peritrochanteric fractures presents a significant challenge due to the inability to achieve closed reduction using conventional techniques. This study introduces a novel minimally invasive technique leveraging the mechanical advantage principle with long, angled hemostatic clamps.</div></div><div><h3>Methods</h3><div>A retrospective review was performed on 16 patients who sustained sagittally unstable peritrochanteric fractures and underwent a percutaneous hemostatic clamp leverage reduction procedure. Inclusion criteria: (1) Preoperative confirmation of fracture type as peritrochanteric fracture; (2) Intraoperative imaging confirms the presence of sagittal plane displacement at the fracture site; (3) Age &gt; 18 years. Exclusion criteria: (1) Open fractures, pathological fractures, and diabetes; (2) Long-term use of corticosteroids; (3) Patients with local skin or systemic conditions not suitable for surgery. Regular follow-ups at intervals of 6 – 8 weeks continued until evidence of bone consolidation was apparent in radiographic assessments. Evaluation of the alignment quality considered factors such as the re-establishment of the neck-shaft angle, the integrity of all cortical bone edges, and the rectification of any translational displacement, while the assessment of hip functionality was performed using the Harris scoring system. Statistical analysis of the relevant data was performed using SPSS 25.0 software.</div></div><div><h3>Results</h3><div>The average age of these 16 patients was 56.8 years (ranging from 25 to 81 years), consisting of 8 males and 8 females. According to the AO/OTA fracture classification, the cohort included 13 cases of type 31A, 2 cases of type 32A, and 1 case of type 32C. The time from hospital admission to the day of surgery ranged from 3 to 11 days, with an average of 5.1 days. Closed reduction was successfully implemented in all 10 instances, negating the necessity for transition to open reduction procedures. The mean operative duration was 105.8 min (range 80 – 180 min). Satisfactory results of the quality of reduction were determined by comparison with the normal side. The average Harris hip score was 94.1 (range 87 – 99), and the fracture healing time was 4.2 months (3 – 6 months). Implant failure and malunion were not observed.</div></div><div><h3>Conclusions</h3><div>This study provides an alternative, minimally invasive technique for reducing sagittally unstable, irreducible peritrochanteric fractures. This technique holds the potential to manage complex fractures with the same efficacy as is typically reserved for simple and easily reducible fractures.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 5","pages":"Pages 330-335"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and preliminary trial test of a decision-making app for pre-hospital damage control resuscitation","authors":"Haoyang Yang,&nbsp;Wenqiong Du,&nbsp;Zhaowen Zong,&nbsp;Xin Zhong,&nbsp;Yijun Jia,&nbsp;Renqing Jiang,&nbsp;Chenglin Dai,&nbsp;Zhao Ye","doi":"10.1016/j.cjtee.2024.11.001","DOIUrl":"10.1016/j.cjtee.2024.11.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To construct a decision-making app for pre-hospital damage control resuscitation (PHDCR) for severely injured patients, and to make a preliminary trial test on the effectiveness and usability aspects of the constructed app.</div></div><div><h3>Methods</h3><div>Decision-making algorithms were first established by a thorough literature review, and were then used to be learned by computer with 3 kinds of text segmentation algorithms, i.e., dictionary-based segmentation, machine learning algorithms based on labeling, and deep learning algorithms based on understanding. B/S architecture mode and Spring Boot were used as a framework to construct the app. A total of 16 Grade-5 medical students were recruited to test the effectiveness and usability aspects of the app by using an animal model-based test on simulated PHDCR. Twelve adult Bama miniature pigs were subjected to penetrating abdominal injuries and were randomly assigned to the 16 students, who were randomly divided into 2 groups (<em>n</em> = 8 each): group A (decided on PHDCR by themselves) and group B (decided on PHDCR with the aid of the app). The students were asked to complete the PHDCR within 1 h, and then blood samples were taken and thromboelastography, routine coagulation test, blood cell count, and blood gas analysis were examined. The lab examination results along with the value of mean arterial pressure were used to compare the resuscitation effects between the 2 groups. Furthermore, a 4-statement-based post-test survey on a 5-point Likert scale was performed in group B students to test the usability aspects of the constructed app.</div></div><div><h3>Results</h3><div>With the above 3 kinds of text segmentation algorithm, B/S architecture mode, and Spring Boot as the development framework, the decision-making app for PHDCR was successfully constructed. The time to decide PHDCR was (28.8 ± 3.41) sec in group B, much shorter than that in group A (87.5 ± 8.53) sec (<em>p</em> &lt; 0.001). The outcomes of animals treated by group B students were much better than that by group A students as indicated by higher mean arterial pressure, oxygen saturation and fibrinogen concentration and maximum amplitude, and lower R values in group B than those in group A. The post-test survey revealed that group B students gave a mean score of no less than 4 for all 4 statements.</div></div><div><h3>Conclusion</h3><div>A decision-making app for PHDCR was constructed in the present study and the preliminary trial test revealed that it could help to improve the resuscitation effect in animal models of penetrating abdominal injury.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 5","pages":"Pages 313-318"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new approach for percutaneous ilio-sacral screw fixation: CT-based pre-operative planning with conventional fluoroscopy to reduce malposition rate and operating time","authors":"Xinyou Han,&nbsp;Qingsong Fu,&nbsp;Xinhua Yuan,&nbsp;Weibin Wang","doi":"10.1016/j.cjtee.2024.09.002","DOIUrl":"10.1016/j.cjtee.2024.09.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Percutaneous ilio-sacral screw (ISS) insertion using conventional C-arm fluoroscopy has been a widely employed technique for pelvic posterior ring fixation, particularly in developing regions. However, this approach presents technical challenges, leading to a high malposition rate. We introduced a new method for ISS insertion without additional equipment or software and suggested whether it could reduce the malposition rate and operating time.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study. The study included all patients who underwent percutaneous ISS fixation between January 2020 and December 2022. Patients treated with open reduction or other types of implants were excluded. The patients were divided into 2 groups based on the screw insertion method: Group A utilized the traditional dual-plane adjustment method, while Group B received the newly introduced method. In all cases, conventional C-arm fluoroscopy was the sole guidance during the surgical procedure. Malposition rate, radiation exposure, and operating time were compared between groups. Post-operative CT scans were used to assess screw accuracy using the Smith grading method. The Student's <em>t</em>-test or the Mann-Whitney <em>U</em> test was chosen for comparing the quantitative variables based on the normality test results. The Chi-squared test was utilized for comparing qualitative variables.</div></div><div><h3>Results</h3><div>A total of 72 patients with pelvic posterior ring disruption treated with percutaneous ISS under conventional fluoroscopy guidance were included in this study. Among them, 32 patients were in Group A and 40 patients were in Group B. In Group B, the average operation duration per screw was 33 min with 29 fluoroscopy applications, which was significantly lower than that in Group A (44 min, <em>p</em> &lt; 0.001, 38 times, <em>p</em> &lt; 0.001, respectively). Furthermore, the post-operative CT scan revealed that only 10.7% (6/56) of screws in Group B were inappropriately positioned according to the Smith criteria.</div></div><div><h3>Conclusion</h3><div>The novel method introduced in this study demonstrated a reduction in both malposition rates and operating time compared to the traditional dual-plane adjustment method. Precise pre-operative CT planning in conjunction with conventional fluoroscopy could establish this method as a widely applicable technique for percutaneous ISS fixation.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 5","pages":"Pages 342-351"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACE2 gene expression in skin and subcutaneous tissues of free flaps","authors":"Sammy Al-Benna","doi":"10.1016/j.cjtee.2024.02.008","DOIUrl":"10.1016/j.cjtee.2024.02.008","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 5","pages":"Page 385"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of two hemopurification filters for treating intra-abdominal sepsis: A retrospective study","authors":"Ye Zhou ,&nbsp;Ming-Jun Liu ,&nbsp;Xiao Lin ,&nbsp;Jin-Hua Jiang ,&nbsp;Hui-Chang Zhuo","doi":"10.1016/j.cjtee.2024.12.003","DOIUrl":"10.1016/j.cjtee.2024.12.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To compare the efficacy of continuous renal replacement therapy (CRRT) using either oXiris or conventional hemopurification filters in the treatment of intra-abdominal sepsis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective analysis of septic patients with severe intra-abdominal infections admitted to our hospital from October 2019 to August 2023. Patients who meet the criteria for intra-abdominal sepsis based on medical history, symptoms, physical examination, and laboratory/imaging findings were included. Exclusion criteria: pregnancy, terminal malignancy, prior CRRT before intensive care unit admission, pre-existing liver or renal failure. Heart rate (HR), mean arterial pressure, oxygenation index, lactic acid level (Lac), platelet count (PLT), neutrophil percentage, serum levels of procalcitonin, C-reactive protein, interleukin (IL)-6, norepinephrine dosage, acute physiology and chronic health evaluation II (APACHE II), and sequential organ failure assessment (SOFA) scores before and after 24 h and 72 h of treatment, as well as ventilator use time, hemopurification treatment time, intensive care unit and hospital lengths of stay, and 14-day and 28-day mortality were compared between patients receiving CRRT using either oXiris or conventional hemofiltration. Statistical analysis was performed using SPSS Statistics 26.0 software, including the construction of predictive models via logistic regression equations and repeated measures ANOVA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Baseline values including time to antibiotic administration, time to source control, and time to initiation of CRRT were similar between the 2 groups (all &lt;em&gt;p&lt;/em&gt;&gt;0.05). Patients receiving conventional CRRT exhibited significant changes in HR but of none of the other indexes at the 24 h and 72 h time points (&lt;em&gt;p&lt;/em&gt;=0.041, &lt;em&gt;p&lt;/em&gt;=0.026, respectively). The oXiris group showed significant improvements in HR, Lac, IL-6, and APACHE II score 24 h after treatment (&lt;em&gt;p&lt;/em&gt;&lt;0.05); after 72 h, all indexes were improved except PLT (all &lt;em&gt;p&lt;/em&gt;&lt;0.05). Intergroup comparison disclosed significant differences in HR, Lac, norepinephrine dose, APACHE II, SOFA, neutrophil percentage, and IL-6 after 24 h of treatment (&lt;em&gt;p&lt;/em&gt;&lt;0.05). Mean arterial pressure, serum levels of procalcitonin, C-reactive protein, SOFA score, and norepinephrine dosage were similar between the 2 groups at 24 h (&lt;em&gt;p&lt;/em&gt;&gt;0.05). Except for HR, oxygenation index, and PLT, post-treatment change rates of △ (%) were significantly greater in the oXiris group (&lt;em&gt;p&lt;/em&gt; &lt; 0.05). Duration of ventilator use, CRRT time, and intensive care unit and hospital lengths of stay were similar between the 2 groups (&lt;em&gt;p&lt;/em&gt;&gt;0.05). The 14-day mortality rates of the 2 groups were similar (&lt;em&gt;p&lt;/em&gt;=0.091). After excluding patients whose CRRT was interrupted, 28-day mortality was significantly lower in the oXiris than in the conventional group (25.0% ","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 5","pages":"Pages 352-360"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prediction and warning of MODS following major trauma via identification of cytokine storm: A prospective cohort study.","authors":"Panpan Chang, Rui Li, Jiahe Wen, Guanjun Liu, Feifei Jin, Yongpei Yu, Yongzheng Li, Guang Zhang, Tianbing Wang","doi":"10.1016/j.cjtee.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.05.001","url":null,"abstract":"<p><strong>Purpose: </strong>Early mortality in major trauma has decreased, but MODS remains a leading cause of poor outcomes, driven by trauma-induced cytokine storms that exacerbate injuries and organ damage.</p><p><strong>Methods: </strong>This prospective cohort study included 79 major trauma patients (ISS >15) treated in the National Center for Trauma Medicine, Peking University People's Hospital, from September 1, 2021, to July 31, 2023. Patients (1) with ISS >15 (according to AIS 2015), (2) aged 15-80 years, (3) admitted within 6 h of injury, (4) having no prior treatment before admission, were included. Exclusion criteria were (1) GCS score <9 or AIS score ≥3 for TBI, (2) confirmed infection, infectious disease, or high infection risk, (3) pregnancy, (4) severe primary diseases affecting survival, (5) recent use of immunosuppressive or cytotoxic drugs within the past 6 months, (6) psychiatric patients, (7) participation in other clinical trials within the past 30 days, (8) patients with incomplete data or missing blood samples. Admission serum inflammatory cytokines and pathophysiological data were analyzed to develop machine learning models predicting MODS within 7 days. LR, DR, RF, SVM, NB, and XGBoost were evaluated based on the area under the AUROC. The SHAP method was used to interpret results.</p><p><strong>Results: </strong>This study enrolled 79 patients with major trauma, and the median (Q₁, Q₃) age was 51 (35, 59) years (52 males, 65.8%). The inflammatory cytokine data were collected for all participants. Among these patients, 35 (44.3%) developed MODS, and 44 (55.7%) did not. Additionally, 2 patients (2.5%) from the MODS group succumbed. The logistic regression model showed strong performance in predicting MODS. Ten key cytokines, IL-18, Eotaxin, MCP-4, IP-10, CXCL12, MIP-3α, MCP-1, IL-1RA, Cystatin C, and MRP8/14 were identified as critical to the trauma-induced cytokine storm and MODS development. Early elevation of these cytokines achieved high predictive accuracy, with an AUROC of 0.887 (95% CI 0.813-0.976).</p><p><strong>Conclusion: </strong>Trauma-induced cytokine storms are strongly associated with MODS. Early identification of inflammatory cytokine changes enables better prediction and timely interventions to improve outcomes.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and hotspots in epiphyseal injury studies over 2 decades: A bibliometric analysis.","authors":"Huan Wang, Qing-Da Lu, Chen-Xin Liu, Xiao-Ju Liang, Fei Su, Ya-Ting Yang, Ji-Ning Qu, Jia-Ju Wang, Qiang Jie","doi":"10.1016/j.cjtee.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.02.009","url":null,"abstract":"<p><strong>Purpose: </strong>This review provides guidance and ideas for researchers through a comprehensive and comparative analysis of the present state, trends, and hotspots in the epiphyseal injury literature in the last 2 decades.</p><p><strong>Methods: </strong>We searched the Web of Science core database to explore the epiphyseal injury literature from January 1, 2003 to December 31, 2022. (1) Search parameters: #1.TS = \"epiphysis\" or \"epiphyseal\" or \"growth plate\"; #2.TS = \"injury\" or \"trauma\". (2) Document types: \"Article\" and \"Review\"; (3) Time: January 1, 2003-December 31, 2022; (4) Languages: \"English\". We used Citespace 6.2.R3 software to explore the country/region distribution, institutions, journals, keyword analysis, and co-cited references of the literature.</p><p><strong>Results: </strong>A total of 2138 relevant literature were obtained, with the number of publications increasing annually. The country with the highest number of publications is the United States. The highest-producing institution was Harvard University. The most cited journal was the Journal of Bone and Joint Surgery-American Volume. The first tag for keyword clustering was the anterior cruciate ligament (ACL). Keyword bursts were found in the recent attention to the words: outcome, physeal fractures, risk factors, fixation, risk, transplantation, and osteoarthritis. The analysis of the literature co-citation found that the topic of ACL and regeneration of epiphysis is a trend in research and high-quality literature in this field.</p><p><strong>Conclusions: </strong>We can quickly get a sense of the focus and changing trends in epiphyseal injuries through keywords and co-citation reference bursts. The treatment of ACL injuries is a major area of interest for researchers. The most common concerns are MRI assessment of ACL injury reconstruction, comparison of different treatment methods, such as avoiding damage in epiphyseal reconstruction surgery, and associated complications. The analysis of the keywords and the co-citation references revealed that managing risk factors, treatment modalities, and complications related to epiphyseal injury after epiphyseal fracture will be a trend in future research.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LST-A novel junctional tourniquet: A study of feasibility and effectiveness.","authors":"Giora Weiser","doi":"10.1016/j.cjtee.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.04.004","url":null,"abstract":"<p><p>Uncontrolled hemorrhage is a leading cause of mortality in trauma. It is considered the most significant preventable cause of death in trauma patients. Junctional hemorrhages are responsible for approximately 20% of this possibly preventable mortality. At this time, the options for controlling such hemorrhages are either by manual pressure points or the use of junctional tourniquets, which, although they have been proven to be effective, are cumbersome and not readily available to the medical team in the field. The objective of this study was to evaluate the effectiveness and feasibility of a new junctional tourniquet (Life Saving Tourniquet, T-W-Medical ltd.) that is simpler to use and can perform both as a regular tourniquet and a junctional one.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disability in subjects who survive road traffic injuries in 2 regions of southwest Colombia: A causal mediation analysis.","authors":"Lina Marcela Sandoval, Andrés Fandiño-Losada, Elvis Siprian Castro-Alzate, Claudio Bustos, Alberto Federico García, Adrián David Fernández","doi":"10.1016/j.cjtee.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.01.005","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of the study was to determine the causal interrelationships between sociodemography, clinic, and injury characteristics, and to access to rehabilitation services that generate disability in road traffic injury survivors in 2 regions of Southwest Colombia during the 2018-2021 period.</p><p><strong>Methods: </strong>An ambispective cohort study included 261 survivors from road traffic in 2 regions of Southwest Colombia (Cauca and Valle del Cauca) between April 19, 2021 and June 03, 2022. These survivors accepted treatment in 3 high-level comprehensive health institutions in Cali, Colombia, which are regional referral centers for trauma in the region. Patients (1) with hospitalization time ≥12 h, (2) aged ≥18 years, and (3) having the ability to understand the research questionnaires by themselves or their legal representatives, were included. Those with a history of deficiency before the road traffic injury were excluded. A structural equation model of causal pathways of disability was established to estimate exposure variables that are sociodemography, clinic, and access to rehabilitation services. The main outcome variable was disability, estimated by the World Health Organization Disability Assessment Schedule 2.0. Exposure variables related to clinical characteristics were measured through medical record review. The variables of access to rehabilitation services and disability were measured through a telephone-based survey. Structural equation analysis was performed, estimating the mediating effects of disability. The analyses were conducted in the software R Studio® y Mplus®.</p><p><strong>Results: </strong>The study found a significant gender difference in disability, with women presenting a significantly higher disability than men (β: 6.21; p = 0.041). Disability was also associated with clinical conditions, such as injury severity score (β: 0.67; p < 0.001) and length of hospitalization (β: 0.28; p < 0.001). Regarding access to health services, the risk of disability was higher among those who were readmitted to the health institution (β: 4.96; p < 0.001).</p><p><strong>Conclusions: </strong>Disability caused by road traffic injuries must be conceived as a complex phenomenon to be studied, involving the non-linear interaction between the individual's deficiencies and contextual factors.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}