Injury-International Journal of the Care of the Injured最新文献

{"title":"Evaluating brain injury outcomes in female subjects: A computational approach to accident reconstruction of fatal and non-fatal cases","authors":"Carlos G.S. Cardoso,&nbsp;André A. Salgado,&nbsp;Fábio A.O. Fernandes,&nbsp;Ricardo J. Alves de Sousa","doi":"10.1016/j.injury.2025.112164","DOIUrl":"10.1016/j.injury.2025.112164","url":null,"abstract":"<div><div>Traumatic brain injury remains a significant concern in public health, affecting millions of individuals globally and leading to long-term cognitive and physical impairments. Historically, research in this field has primarily focused on male subjects, often neglecting to consider the substantial biomechanical and anatomical differences between genders and individuals of varying ages. The present study investigates sex-specific biomechanical responses to head impacts in real-world accidents, employing an advanced female finite element head model, with a particular focus on critical brain structures such as the corpus callosum and pituitary gland.</div><div>Two real-world accident scenarios were simulated: a non-fatal e-scooter collision and a fatal work-related incident involving a falling prop. A finite element analysis was conducted to determine the strain and stress distributions within the brain in response to impact conditions, assessing the potential for injury considering established failure criteria.</div><div>The analysis revealed notable discrepancies in strain and stress distributions between anthropometric models. The smallest percentiles exhibited a higher risk of strain-related injury, while larger individuals demonstrated higher strain levels in key brain regions under similar impact conditions. Additionally, it was evaluated the efficacy of a safety helmet in a work-related scenario.</div><div>These findings highlight the importance of subject-specific analyses in understanding TBIs and emphasise the need for continued refinement of FEHMs to improve the accuracy of injury prediction.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112164"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital hypernatremia prior to discharge to primary care hospitals predicts 90-day mortality in older hip fracture patients","authors":"L.Matias Pehkonen ,&nbsp;Sanna Collin ,&nbsp;Päivi Korhonen ,&nbsp;Maria S. Nuotio","doi":"10.1016/j.injury.2025.112199","DOIUrl":"10.1016/j.injury.2025.112199","url":null,"abstract":"<div><h3>Purpose</h3><div>Discharge is a critical time point in the care pathway of geriatric hospital patients, and post-acute care facilities often have less monitoring possibilities. Active medical issues such as electrolyte disturbances should be treated before transfer. We studied the impact of in-hospital hypernatremia of older hip fracture patients to mortality at 90 days.</div></div><div><h3>Methods</h3><div>A retrospective study population of 2240 hip fracture patients from 2015 to 2019 was collected from the Hospital District of Southwest Finland data pool. In the present study we included patients aged ≥65 years who were transferred from the operating hospital to primary health care wards after surgery (<em>n</em> = 1,125). Laboratory results were collected on admission and before discharge. The main outcome was mortality at 90 days.</div></div><div><h3>Results</h3><div>Hypernatremia, defined as serum sodium ≥144 mmol/l, was present in 6.8 % (<em>n</em> = 91) before discharge. For patients with hypernatremia the crude mortality at 90 days was 35.8 % (95 % CI 27.1 to 46.3) and for patients with normal serum sodium 9.6 % (95 % CI 8.0 to 11.6). The age- and sex-adjusted hazard ratio of hypernatremia compared to normal serum sodium was 3.91 (95 % CI 2.62 to 5.82).</div></div><div><h3>Conclusion</h3><div>In-hospital hypernatremia had predictive value for 90-day mortality. We recommend active screening for and prompt treatment of perioperative hypernatremia in hip fracture patients. Local guidelines and discharge checklists are recommended to secure the discharge period.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112199"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-series projecting road traffic fatalities in Australia: Insights for targeted safety interventions","authors":"Ali Soltani ,&nbsp;Saeid Afshari ,&nbsp;Mohammad Amin Amiri","doi":"10.1016/j.injury.2025.112166","DOIUrl":"10.1016/j.injury.2025.112166","url":null,"abstract":"<div><div>Despite substantial progress in road safety, road traffic fatalities (RTFs) continue to be a persistent issue in Australia. This study aims to forecast RTFs trends up to 2050 by analyzing factors such as geographic location, age, gender, speed limits, and time of occurrence. Utilizing historical data from 1989 to 2024, fatalities were categorized by road user type, demographics, and day of the week. The Facebook Prophet time series model, incorporating categorical variables like region, age, and speed limits, was employed to predict future trends. The analysis reveals significant regional disparities in fatality reduction rates, with some areas lagging others. Gender-specific forecasts indicate a sharper decline in male fatalities compared to females, while projections highlight persistent risks for older drivers. Additionally, highways with higher speed limits are expected to see a substantial decrease in fatalities. These insights emphasize the need for targeted interventions in areas with slower reductions and high-risk demographic groups, aiding policymakers in refining safety measures, enforcing speed limits, and enhancing public awareness campaigns.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112166"},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of radiation personal protection equipment design on surgeon stress–A randomised repeated-measures crossover study","authors":"Francesca Solari ,&nbsp;Emma Barlow ,&nbsp;R.J. Egan ,&nbsp;Wyn G. Lewis ,&nbsp;Clare Carpenter","doi":"10.1016/j.injury.2025.112184","DOIUrl":"10.1016/j.injury.2025.112184","url":null,"abstract":"<div><h3>Introduction</h3><div>Radiation Personal Protective Equipment (RPPE) is the subject of safety guidance from the British Orthopaedic Association (BOA). This pilot study aimed to examine potential performance differences in Trauma and Orthopaedic (T&amp;O) Higher Surgical Trainees (HST) undertaking simulated Dynamic Hip Screw (DHS) surgery related to different RPPE attire.</div></div><div><h3>Methods</h3><div>Fourteen Higher Surgical Trainees took part in a randomised, repeated-measures, crossover study (8 male, 6 female HSTs) performing two simulated DHS procedures wearing two RPPE attire styles (One Piece (OP) tabard 0.35 mm thickness, and Two-Piece skirt/top (TP), with a 0.5 mm thyroid guard). Primary outcome measures included continuous Heart Rate (HR) monitoring, body temperature, and Visual Analogue Scales (VAS) for comfort and fatigue before and after simulations.</div></div><div><h3>Results</h3><div>Mean (SD) HR in OP and TP were HR OP 98.8 bpm (10.3) vs. TP 98.1 bpm (10.8, p &lt; 0.001), Maximum HR OP 115.1 bpm (SD 12.4) vs. TP 113.4 bpm (SD 11.9) (p &lt; 0.001). Mean change in temperature were OP 0°C and TP -0.03 °C (p &lt; 0.001). Mean temperature VAS scores in OP were 1.9 (1.7) vs. TP 2.0 (1.4, p &lt; 0.001). Mean Comfort VAS scores were OP 3.1 (2.4) vs. TP 1.7 (2.1, p &lt; 0.001) and Fatigue OP 1.4 (1.9) vs. TP 0.8 (1.5, p = 0.120).</div></div><div><h3>Discussion</h3><div>Important differences in surgeon physiological measures (HR, temperature) and self-reported measures of comfort and temperature were found related to RPPE style. Understanding the effects that specific RPPE attire has on performance should influence RPPE choice and the findings help inform future research into this important topic.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112184"},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a vertical fracture fragment after indirect reduction acceptable in minimally invasive plate osteosynthesis for acute mid-shaft clavicular fractures?","authors":"Jin Hyeok Lee,&nbsp;Kyosun Hwang,&nbsp;Kanghun Yu,&nbsp;Woong Kyo Jeong","doi":"10.1016/j.injury.2025.112183","DOIUrl":"10.1016/j.injury.2025.112183","url":null,"abstract":"<div><h3>Purpose</h3><div>: Reduction and intraoperative maintenance of fracture fragments during minimally invasive plate osteosynthesis (MIPO) pose technical difficulties, particularly when the interposed fragment is angulated, prompting surgeons to attempt reduction due to concerns about nonunion or malunion. We aimed to compare the clinical and radiological outcomes of MIPO for mid-shaft clavicular fractures based on the reduced status of the interposed fragments.</div></div><div><h3>Method</h3><div>: Fifty-seven patients who underwent MIPO for acute mid-shaft Robinson type 2B clavicular fractures were divided into two groups based on the alignment of the interposed fracture fragment. A vertical fracture fragment was defined as one tilted by &gt;45° relative to the long axis of the proximal clavicular shaft. Radiological outcomes were evaluated using time to union, clavicle thickness, and length ratio after union compared with the healthy side. Clinical outcomes were assessed using the visual analog scale (VAS); the Korean Shoulder Score (KSS); Disability of the Arm, Shoulder, and Hand (DASH) score; and shoulder range of motion (ROM). Continuous variables were analyzed using Student's t-test or Mann–Whitney U test, based on data distribution.</div></div><div><h3>Result</h3><div>: The vertical fragment group comprised 21 patients, and the nonvertical fragment group comprised 36. The mean time to union was similar between the vertical (4.48 ± 1.20 months) and nonvertical group (4.64 ± 1.17 months, p = 0.162). The groups showed comparable clavicular length and thickness ratios: 0.992 ± 0.040 vs. 1.076 ± 0.045 (p = 0.175), 1.189 ± 0.102 vs. 1.186 ± 0.271 (AP view, p = 0.165), and 1.121 ± 0.238 vs. 1.112 ± 0.230 (Lordotic view, p = 0.655), respectively. At 12 months, no significant differences were observed in VAS (0.3 ± 0.7 vs. 0.8 ± 0.8, p = 0.667), KSS (97.10 ± 6.30 vs. 96.75 ± 6.77, p = 0.940), and DASH (1.44 ± 3.64 vs. 2.00 ± 4.05, p = 0.501), or in ROM forward flexion (165.24 ± 9.28 vs. 162.78 ± 12.56, p = 0.464) and external rotation (60.95 ± 13.00 vs. 60.00 ± 13.47, p = 0.965).</div></div><div><h3>Conclusion</h3><div>: Favorable radiological and clinical outcomes were achieved in all patients who underwent MIPO for mid-shaft clavicular fractures, regardless of whether the interposed fracture fragment after reduction was vertical.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112183"},"PeriodicalIF":2.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in Treatment of Ankle and Pilon Fractures with Retrograde Tibiotalocalcaneal Nailing Without Articular Preparation in the Setting of Diabetes Mellitus","authors":"Alexander Schultz ,&nbsp;Thomas Poynter ,&nbsp;Garrett Wireman ,&nbsp;Michael Sweeney ,&nbsp;Elive Likine ,&nbsp;Craig Ziegler ,&nbsp;Hari Ankem ,&nbsp;Rodolfo Zamora ,&nbsp;Nicholas Laco ,&nbsp;David Seligson","doi":"10.1016/j.injury.2025.112177","DOIUrl":"10.1016/j.injury.2025.112177","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of ankle and pilon fractures in the setting of diabetes mellitus (DM) is challenging due to a propensity for postoperative complications. Limb salvage is a primary concern following these injuries, as below knee amputation (BKA) occurs at an unacceptably high rate. Primary retrograde tibiotalocalcaneal (TTC) joint nailing without articular preparation has emerged as a solution to treat diabetics with ankle and pilon fractures to mitigate surgical complications and prevent BKA. The technique minimizes surgical dissection and has previously demonstrated utility in fragility fracture, however, there are few studies regarding the use of this technique in the setting of DM.</div></div><div><h3>Methods</h3><div>A retrospective review of diabetic patients treated with retrograde TTC nailing without articular preparation was conducted over a seven-year period. Patients were included in the study if they were skeletally mature, diabetic, and treated with retrograde TTC nailing without articular preparation over a minimum follow up period of eight months. Treatment with other forms of fixation and pediatric or adolescents were excluded. A cohort of 25 patients met the inclusion criteria. Data was collected on demographics, injury characteristics, and surgical outcomes. The average follow up period was 2.45 years (IQR 986).</div></div><div><h3>Results</h3><div>The averages for age, BMI, and Hemoglobin A1c (HbA1c) of the cohort were 64.6 (IQR 9.6), 36.7 (IQR 11.5), and 7.6 % (IQR 1.4), respectively. A majority of fractures were a closed supination-external rotation mechanism resulting from a fall from standing. The average LOS was 9.1 days (IQR 8). An ambulatory level was maintained in 72 % of patients. Limb salvage was achieved for 84 % of the cohort. Four patients ultimately required BKA. HbA1c and fracture-related infection (FRI) were statistically significant risk factors associated with BKA. For every 1 % increase in HbA1c, there was 2.63-fold odds of developing BKA. The surgical complication and reoperation rate were 56 %.</div></div><div><h3>Conclusion</h3><div>Although limb salvage was achieved for most patients within the cohort, high rates of postoperative complications and reoperations were observed using this technique. Prospective comparative studies are needed to further validate the use of retrograde nailing without articular preparation in the setting of DM.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112177"},"PeriodicalIF":2.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic patterns in horseback riding head and neck injuries within the United States: A NEISS database study","authors":"Shiven Sharma ,&nbsp;Luke M. Reardon ,&nbsp;Rahul Guda ,&nbsp;Michele M. Carr ,&nbsp;Li-Xing Man ,&nbsp;Daniel Alicea","doi":"10.1016/j.injury.2025.112167","DOIUrl":"10.1016/j.injury.2025.112167","url":null,"abstract":"<div><h3>Objective</h3><div>Our primary objective was to identify and describe demographic trends in head and neck injuries incurred while participating in horseback riding.</div></div><div><h3>Study Design</h3><div>Cross-sectional analysis.</div></div><div><h3>Setting</h3><div>National Database.</div></div><div><h3>Methods</h3><div>Head and neck injuries related to horseback riding over a ten-year period (2014–2023) were analyzed using data from the National Electronic Injury Surveillance System (NEISS). A total of 3,177 cases were identified. Inclusion criteria encompassed injuries to the head, neck, face, mouth, or ear. Variables included age, gender, injury type, anatomical location, and patient disposition. Chi-squared analyses were employed to compare the aforementioned injury variables.</div></div><div><h3>Results</h3><div>Among the 3,177 reported injuries of males and females, females (mean age 27.51 years, SD = 19.04) were more likely to be treated and released (83.29 %, <em>n</em>= 2023), while males (mean age 34.65 years, SD = 22.58) were more likely to be hospitalized. There was a significant association between gender and concussion diagnosis (<em>p</em>&lt;.001), with females more likely to be diagnosed with concussions (<em>n</em> = 687) compared to males (<em>n</em> = 129). Females experienced more head and face injuries compared to males. Age distribution varied significantly across disposition categories, indicating different management practices for various age groups. The dataset indicates that the average age of females (27.51 years) is notably lower than that of males (34.65 years), suggesting a younger demographic among females overall.</div></div><div><h3>Conclusions</h3><div>The study highlights a significant gender disparity in horseback riding-related head and neck injuries, with females more likely to be treated and released and males more often requiring hospitalization.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112167"},"PeriodicalIF":2.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has the documentation of chest injuries and the development of systemic complications in patients with long bone fractures changed over time?–A systematic literature review and meta-analysis by the IMPACT expert group","authors":"Basil Andreas Hatz ,&nbsp;Felix Karl-Ludwig Klingebiel ,&nbsp;Yannik Kalbas ,&nbsp;Sascha Halvachizadeh ,&nbsp;Roman Pfeifer ,&nbsp;Emil H. Schemitsch ,&nbsp;Hans-Christoph Pape ,&nbsp;IMPACT group International MultidisciPlinAry Consensus Panel on PolyTrauma","doi":"10.1016/j.injury.2025.112182","DOIUrl":"10.1016/j.injury.2025.112182","url":null,"abstract":"<div><h3>Introduction</h3><div>Blunt chest trauma represents a major risk factor for complications in polytrauma patients. Various scoring systems have emerged, but their impact is not fully appreciated. This review evaluates changes in chest trauma scoring over time and potential shifts in complication rates linked to modified surgical approaches in long bone fractures.</div></div><div><h3>Methods</h3><div>A systematic review was performed utilizing Medline and EMBASE. Included studies analyzed the clinical course following blunt chest trauma with orthopedic injuries requiring surgical fixation. Quantification of chest injury severity was assessed based on the utilized scores in the respective publication such as the Abbreviated Injury Scale, Injury Severity Score, Thoracic Trauma Score (TTS) or the Chest Trauma Score (CTS). The studies were categorized into two groups: “ante-millenium” (AM) (&lt;31.12.2000) and “post-millenium” (PM) (&gt;01.01.2000). Endpoint analysis focused on chest-injury-related complications, including acute respiratory distress syndrome (ARDS), pneumonia, multiple organ failure (MOF), and pulmonary embolism. A meta-analysis examined the influence of surgical timing (early vs. late) on clinical outcomes.</div></div><div><h3>Results</h3><div>Of 9,682 studies on chest trauma, 20 (4,079 patients) met the inclusion criteria. Most studies in both AM and PM reported the thoracic AIS scale for severity assessment. In group PM more clinical parameters were included in the decision making. Incidences of pooled and weighted mortality were higher in AM (5.1 %) compared to PM (2.3 %, <em>p</em> = 0.003), and ARDS incidence was also greater in AM (12.1 %) versus PM (8.9 %, <em>p</em> = 0.045), though these findings were not confirmed through indirect meta-analysis. Early fracture fixation (&lt;24 h) displayed a non-significant trend toward lower ARDS (OR: 0.60; 95 % CI, 0.23–1.52) and mortality (OR: 0.66; 95 % CI, 0.28–1.55), but significantly reduced pneumonia risk (OR, 0.53; 95 % CI, 0.40–0.71).</div></div><div><h3>Conclusion</h3><div>Prior to 2000, chest injuries were quantified using the AIS alone, while afterwards multiple scoring systems that incorporated pathophysiologic response were utilized. Possibly related to changes in timing of surgery, fixation techniques, or general improvements in-patient care seems to have improved in patients with concomitant thoracic trauma regarding mortality and ARDS. Overall, polytrauma patients with concomitant thoracic injuries might benefit from early definitive fracture care if their physiology and overall injury pattern allows it.</div></div><div><h3>Level of Evidence</h3><div>Systematic Review; Level IV</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112182"},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the structural, financial, and legal aspects of hospital-based violence intervention programs implementation on psychosocial outcomes and violence reduction: A systematic review","authors":"Philip Lee ,&nbsp;Nikita Nunes Espat ,&nbsp;Ruth Zagales ,&nbsp;Brian Chin ,&nbsp;Ian Bundschu ,&nbsp;Brevin O'Connor ,&nbsp;Logan Rogers ,&nbsp;Adel Elkbuli","doi":"10.1016/j.injury.2025.112181","DOIUrl":"10.1016/j.injury.2025.112181","url":null,"abstract":"<div><h3>Background</h3><div>This systematic review aims to assess different effective hospital-based violence intervention programs (HVIP) design strategies and their effects on reducing the incidence of violence-related injuries, impact on healthcare outcomes including behavioral and psychosocial outcomes, and effects on healthcare system costs.</div></div><div><h3>Methods</h3><div>A comprehensive search of five databases included studies that assessed the effects of HVIPs in adolescent and adult populations. The outcomes of interest included different effective HVIP design strategies that most effectively decreased the incidence of violence-related injuries, as well as their effects on behavior and psychosocial outcomes, effects on hospital costs, and whether they adequately addressed medico-legal aspects.</div></div><div><h3>Results</h3><div>Following the application of inclusion and exclusion criteria, 25 studies were included in the final analysis. Effective HVIP design strategies primarily focused on mentorship and hands-on learning, contributing to successful program implementation. Overall, HVIPs significantly reduced the incidence of violence-related injuries and recidivism rates among participants. Improvements in psychosocial outcomes were observed, with increased employment rates and educational engagement reported among HVIP participants. Additionally, the included studies demonstrated that implementing HVIPs led to cost-effectiveness as well as cost savings from reduced injury recidivism. Despite the acknowledgment of medico-legal resources' importance, the absence of formal partnerships hinders HVIPs from fully addressing legal barriers to recovery, such as housing insecurity, employment discrimination, and protection from violence.</div></div><div><h3>Conclusion</h3><div>HVIPs are effective in reducing violence-related injuries, enhancing psychosocial outcomes, and offering cost savings, however, they often lack established medico-legal resources. Further research on establishing effective medico-legal partnerships within these programs is needed.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112181"},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline predictors of depression and post-traumatic stress disorder (PTSD) symptoms in hospitalised adult burn survivors: A longitudinal, prospective cohort study","authors":"Danielle Ford ,&nbsp;Michael Waller ,&nbsp;Arpita Das ,&nbsp;Cate M Cameron ,&nbsp;Jacelle Warren ,&nbsp;Martha Druery","doi":"10.1016/j.injury.2025.112151","DOIUrl":"10.1016/j.injury.2025.112151","url":null,"abstract":"<div><h3>Background</h3><div>Depression and post-traumatic stress disorder (PTSD) are becoming more prevalent among post-burn populations. With the increase in awareness of the significance of psychosocial injury adjustment for holistic health-related quality of life, beyond just physical, occupational, and functional recovery. However, the incidence of depression and PTSD in the adult population is inconsistent across published studies. To describe the baseline predictors of depression and post-traumatic stress disorder (PTSD) symptoms in hospitalised adult burn survivors over the first 12 months post-burn.</div></div><div><h3>Method</h3><div>A total of 274 participants, aged 18 years or over, with burn injuries, were hospitalized and treated at a tertiary burns centre in Queensland, Australia between October 2015 and December 2017. Additional follow-up data collected at 3-, 6- and 12-months post-burn injury. Dataset was analysed using gamma generalized mixed effects modelling techniques to assess the predictors of depression (PHQ-9) and PTSD (PCL-C) symptoms over time. Baseline predictors from personal, environmental, burn injury and burn treatment factors were assessed.</div></div><div><h3>Results</h3><div>Both mental health outcomes followed a similar trend, with the largest decrease in symptom severity occurring between 3- and 6-months. A smaller decrease then occurred between 6- and 12-months. The baseline predictors of depression and PTSD symptoms post-burn in adults varied, however, the common predictors were increased age, a pre-injury mental health diagnosis and financial insufficiency. In addition to these predictors, intentional injury and recreational drug use were also statistically significant predictors of increased PTSD symptoms, while previous trauma exposure, longer hospital length of stay (LOS) and, surprisingly, stable housing status were also predictors of higher PHQ-9 depression scores. All predictors included in the final models were statistically significant with a p-value &lt; 0.10.</div></div><div><h3>Conclusion</h3><div>Overall, mental health symptoms in burns survivors generally improved over the 12 months of follow-up, with the largest improvement noted between 3 and 6 months. Age, pre-injury mental health diagnosis and insufficient financial status, however, were all found to be associated with poorer mental health outcomes over the first 12 months post-burn.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 3","pages":"Article 112151"},"PeriodicalIF":2.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}