Injury最新文献

{"title":"Consensus-based indications for resuscitative endovascular balloon occlusion of the aorta: a combined survey and descriptive database study in Japan.","authors":"Toshinao Suzuki, Atsushi Shiraishi, Akira Endo, Hayaki Uchino, Yasuhiro Otomo","doi":"10.1016/j.injury.2025.112589","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112589","url":null,"abstract":"<p><strong>Background: </strong>Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been increasingly used in recent years as an adjunctive strategy to haemostatic procedures to counteract exsanguination in patients with trauma. However, no consensus has been reached regarding the haemostatic procedures deemed appropriate indications for REBOA. This study aimed to define appropriate indications for REBOA through consensus among trauma specialists and to investigate the characteristics and outcomes of patients undergoing REBOA with or without appropriate indications defined in this study.</p><p><strong>Methods: </strong>Using the 42 haemostatic procedures defined in the Japan Trauma Databank (JTDB), we conducted a repeated Delphi survey to obtain consensus from trauma specialists on the haemostatic procedures deemed appropriate indications for REBOA. Subsequently, patients registered in the JTDB who underwent REBOA were divided into two groups based on whether they had appropriate or inappropriate indications, as defined through the Delphi survey. Patient baseline characteristics, door-to-haemostasis time, door-to-blood transfusion time, emergency-department and in-hospital mortality, and complications were compared between the groups. The observed mortality and predicted mortality were compared.</p><p><strong>Results: </strong>After five rounds of questionnaire assessments including 11 trauma specialists, intraabdominal, retroperitoneal, pelvic, and extremity haemorrhage were defined as consensus-based appropriate indications for REBOA. Among the 361,706 patients with trauma registered in the JTDB, 1833 underwent REBOA: 1077 with appropriate and 756 with inappropriate indications. Crude in-hospital mortality (57.6 vs. 72.9 %, p < 0.001) and crude emergency-department mortality (15.4 vs. 38.6 %, p < 0.001) were significantly higher in patients with inappropriate indications than in those with appropriate indications. The observed mortality was higher than the predicted mortality, but it more closely aligned with the predicted mortality in 2013-2019 than in 2004-2012.</p><p><strong>Conclusion: </strong>In over 40 % of cases in which REBOA was employed, it was used outside the appropriate indications defined in this study. Mortality was higher among patients with inappropriate indications than in those with appropriate indications. Further studies are required to elucidate the association between corresponding haemostatic procedures and outcomes for REBOA.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112589"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"Health behavior, health, and socioeconomic background in adolescence as risk factors for traumatic brain injuries: A longitudinal study\".","authors":"Shashank Dokania, Dr Parth Aphale, Himanshu Shekhar","doi":"10.1016/j.injury.2025.112598","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112598","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112598"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Association between acute pre-injury alcohol use and 12-month health outcomes for survivors of major trauma: A registry-based study.","authors":"Karthikeyan Kandaswamy, Ajay Guru","doi":"10.1016/j.injury.2025.112603","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112603","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112603"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nationwide Australian cross-sectional study assessing current management and infection prevention practices after Splenic Artery Embolisation (SAE) following trauma.","authors":"Warren Clements, Ian Woolley, Adil Zia, Helen Kavnoudias, Dieter G Weber, Denis W Spelman, Joseph Mathew","doi":"10.1016/j.injury.2025.112593","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112593","url":null,"abstract":"<p><strong>Introduction: </strong>Management of patients after blunt splenic injury treated with Splenic Artery Embolisation (SAE) varies. This includes vaccination, post-procedure antibiotic use, and follow-up. This study aimed to assess current practice of management and infection prevention across Australia.</p><p><strong>Methods: </strong>A 29-question survey was sent via the Australian and New Zealand Trauma Registry to all 28 contributing trauma hospitals in Australia. Questions were based on data from the 2022 calendar year.</p><p><strong>Results: </strong>Responses were received from 12 sites (43 %) including 6 of 8 Australian regions (75 %). Of responding sites, 10 (83 %) offer SAE via a 24-hour 7-day rostered service. Of a total 568 splenic injuries, there were 177 SAE treatments with a median of 8 per site (range 0-65). SAE constituted 31 % of all splenic management, conservative management in 65 %, and splenectomy in 4 %. 8 sites (67 %) had a protocol for splenic trauma. Prophylactic SAE was performed for AAST IV-V injuries at 8 sites (67 %), which included 80 % of adult hospitals. Distal SAE was the predominant treatment type (70 %). Patients were routinely admitted for median 4 days after SAE (range 2-5). Routine inpatient antibiotics were administered to SAE patients at 2 sites (17 %) while 1 site (8 %) routinely recommended lifelong antibiotics after SAE. Routine inpatient vaccinations were used by 4 of 11 sites (36 %), while 3 sites (25 %) recommend vaccinations in the future. 11 sites (92 %) follow-up patients post-discharge. Written information on SAE was given to patients at 9 hospitals (75 %) while splenic function testing was performed at 5 sites (42 %), mostly assessment for Howell-Jolly Bodies (80 %). 11 sites (92 %) would change clinical practice in the future if evidence on splenic immune function evolved.</p><p><strong>Conclusion: </strong>Across responding Australian hospitals, the use of vaccinations, antibiotics, and splenic function testing after SAE was low, which reflects existing evidence for preserved splenic function after SAE, plus unpublished experience of key stakeholders. Key societies should consider clinical practice guidelines that merge existing evidence with modern practice.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112593"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Efficacy of intranasal ketamine in controlling pain caused by bone fractures: A single-center double blind randomized controlled trial\".","authors":"Shashank Dokania, Dr Parth Aphale, Himanshu Shekhar","doi":"10.1016/j.injury.2025.112590","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112590","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112590"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When systems break: Rethinking polytrauma from acute to chronic disease through the psychoneuroimmunological (PNI) Axis.","authors":"Rebecca Ryznar, Zsolt J Balogh","doi":"10.1016/j.injury.2025.112581","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112581","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112581"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter to the editor - An additional anterior support screw (AS2) besides cephalomedullary nailing.","authors":"Takashi Maehara","doi":"10.1016/j.injury.2025.112585","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112585","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112585"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter to the editor on : Preliminary results of stabilization of far distal tibial fractures with the distal tibial nail: a prospective, multicenter case series study.\"","authors":"","doi":"10.1016/j.injury.2025.112587","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112587","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112587"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Early surgical care of the anticoagulated hip fracture patient within 24 hours.","authors":"Cumhur Deniz Davulcu","doi":"10.1016/j.injury.2025.112554","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112554","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112554"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the editor on \"Injury patterns and outcomes in motorcycle driver crashes in the United States: The effect of helmet use\".","authors":"Lara A Brockhus, Panagiotis Liasidis, Meghan Lewis, Dominik A Jakob, Demetrios Demetriades","doi":"10.1016/j.injury.2025.112583","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112583","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112583"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}