Injury最新文献

{"title":"Salvage tibiotarsal arthrodesis with circular external fixator for end-stage posttraumatic ankle arthritis, infection, and bone loss.","authors":"Wael Azzam, Maurizio A Catagni, Francesco Guerreschi, Ahmed M Thabet, Muhammad Shahid Khan, Mohamed Elsayed, Soyoung Jeon, Marco Camagni","doi":"10.1016/j.injury.2025.112616","DOIUrl":"10.1016/j.injury.2025.112616","url":null,"abstract":"<p><strong>Background: </strong>Chronic posttraumatic sequelae, such as chronic ankle joint infection with loss of the articular cartilage, significant ankle deformities with advanced osteoarthritis, or significant bone loss of the distal tibia or talus, cause chronic ankle pain and functional impairment. Arthrodesis is usually required to relieve pain and improve function. These disabling conditions cannot be treated with ordinary arthrodesis methods, particularly if they are associated with severe osteoporosis and/or poor soft-tissue coverage. The present study aimed to report the outcomes and complications of ankle arthrodesis with circular external fixators in patients with end-stage, posttraumatic ankle arthritis, infection, and/or bone loss.</p><p><strong>Methods: </strong>Patients treated with tibiotalar and tibiocalcaneal fusion for posttraumatic sequelae using the circular external fixator between January 2001 and January 2022 were retrospectively reviewed. The outcomes were evaluated using the Catagni tibiotarsal fusion score, and the complications were recorded.</p><p><strong>Results: </strong>The study included 81 consecutive patients; 58 were males, and 23 were females. The mean age of the patients was 41.52 years (range, 18-75). Successful arthrodesis was obtained in 73 patients (90.1 %). Twenty-four patients (29.6 %) developed complications. Most complications were minor except for unacceptable deformity in four patients, refracture of the arthrodesis site in one patient, and failure of arthrodesis in seven patients. At the final evaluation, the mean Catagni Score was 85.4 (range, 52-96). Fifty-eight patients achieved excellent results, 13 patients achieved good results, two patients achieved fair results, and eight patients achieved poor results. Higher Catagni scores were associated with patients without pre-operative infection, with union, without unplanned additional surgical procedures, without complications, and with better final results (all p < 0.001). In the multivariate regression analyses, we observed that the Catagni score tends to decrease as patient age increases (p = 0.010). Catagni scores of the anterior arthrodesis position were higher than the cases of the sinus tarsi position (p < 0.001).</p><p><strong>Conclusion: </strong>Tibiotarsal arthrodesis with the circular external fixator can effectively treat complex ankle joint problems resulting from severe injuries. The Catagni score is a simple and reliable evaluation score after tibiotarsal arthrodesis surgeries.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":"56 10","pages":"112616"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818855","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":"Outcomes of outpatient hand extensor tendon injury repairs in Northern Ireland's regional plastic surgery service.","authors":"Yizhe Lim, Su Kwan Lim, William Beswick, Michelle Razo, Shakeel Dustagheer","doi":"10.1016/j.injury.2025.112647","DOIUrl":"10.1016/j.injury.2025.112647","url":null,"abstract":"<p><strong>Background: </strong>Acute extensor tendon injuries of the hand, commonly managed by plastic surgeons, require timely repair to optimize outcomes. This study evaluates the functional results, complications, and patient-reported outcomes of acute extensor tendon repairs performed in an outpatient setting using the Wide Awake Local Anaesthetic No Tourniquet (WALANT) technique in Northern Ireland.</p><p><strong>Methods: </strong>A retrospective service evaluation analyzed 222 patients undergoing extensor tendon repair between 2018 and 2023. Inclusion criteria were adults (>18 years) with open injuries repaired via sutures. Exclusions included partial tears, fractures, and chronic injuries. Primary outcomes included Total Active Motion (TAM) and Patient-Rated Wrist/Hand Evaluation (PRWHE) scores. Secondary outcomes were infection, rupture rates, and grip strength.</p><p><strong>Results: </strong>Mean age was 41 years, with 72.5 % males and 54.1 % non-dominant hand injuries. Mechanisms included lacerations (64 %), crush injuries (22 %), and avulsions (14 %). TAM was comparable across injury zones (Verdan classification), though distal zones (e.g., Zone 1) showed ∼30° lower TAM. PRWHE scores (mean: 8.2/50) indicated minimal pain/functional disability. Complications included two superficial infections (0.82 %) and one re-rupture (0.41 %). Grip strength matched normative values. Controlled Active Motion (CAM) rehabilitation yielded satisfactory outcomes, with proximal zones (Zones 7-8) associated with poorer PROMs.</p><p><strong>Conclusion: </strong>Outpatient extensor tendon repair under WALANT is safe and effective, with low complication rates and favorable functional outcomes. Timely repair (<3 days), meticulous technique, and CAM rehabilitation contributed to success, supporting cost-effective management outside main operating theatres. Proximal injuries and rehabilitation protocols warrant further optimization. This study addresses a regional literature gap, advocating for prospective research to refine surgical and therapeutic strategies.</p><p><strong>Therapeutic level: </strong>IV.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":"56 10","pages":"112647"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812748","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":"Development and validation of a nomogram for predicting mortality for ICU patients with severe thoracic trauma: data from the MIMIC-IV.","authors":"Ziming Huang, Hengfa Ge, Ying Sun","doi":"10.1016/j.injury.2025.112666","DOIUrl":"10.1016/j.injury.2025.112666","url":null,"abstract":"<p><strong>Background: </strong>Severe thoracic trauma is a leading contributor to mortality in critically injured patients, particularly when complicated by concomitant severe traumatic brain injury (TBI), which may independently impair neurological and respiratory function. Accurate assessment and timely intervention play a crucial role in these patients. However, risk factors for severe thoracic trauma remain unclear, and a prediction rule remains to be established. We developed and internally validated a nomogram that allows clinicians to quantify the risk of severe thoracic trauma.</p><p><strong>Methods: </strong>Clinical data from the MIMIC-IV database were retrospectively searched to identify a study cohort comprising patients with severe thoracic trauma. Using LASSO regression analysis, We screened out independent risk factors associated with 28-day mortality and incorporated them into nomogram model. The performance of each model was assessed by calculating receiver operating characteristic (ROC) curves, calibration plots and decision curve analysis (DCA).</p><p><strong>Results: </strong>The final analysis incorporated 2159 patients, with 192 deaths (8.9 %) occurring within 28-day of ICU admission. we constructed a nomogram that incorporates risk factors including heart rate (HR), traumatic brain injury (TBI), oxygen saturation (SpO2), systolic blood pressure (SBP), ventilation, and Sequential Organ Failure Assessment (SOFA) score on the first day of admission to ICU. The nomogram outperformed SOFA and Model 1 (risk factors including SBP, SpO2, TBI and ventilation) with an area under the receiver operating characteristic curve (ROC) of 0.854 (95 %CI 0.736-0.791, P < 0.001) in the training cohort and 0.859 (95 %CI 0.713-0.794, P < 0.001) in the validation cohort. The analysis of the calibration curve demonstrated that the nomogram exhibited a strong alignment with the observed 28-day mortality rates in severe thoracic trauma patients.</p><p><strong>Conclusions: </strong>The study identified independent risk factors associated with the 28-day mortality risk and developed predictive nomogram models for ICU patients suffering from severe thoracic trauma. The nomogram shows promise in guiding strategies aimed at improving prognosis for patients with such injuries.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":"56 10","pages":"112666"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823511","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":"Anatomical mapping of traumatic pneumothoraces missed by prehospital ultrasonography - a retrospective cohort study.","authors":"Isabella Marie, Jimmy Bliss, Christopher Partyka","doi":"10.1016/j.injury.2025.112778","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112778","url":null,"abstract":"<p><strong>Objective: </strong>Prehospital performed Extended Focused Assessment with Sonography in Trauma (EFAST) has poor sensitivity for pneumothorax (PTX) when compared to scans performed in hospital. This study describes the computed tomography (CT) location of PTX detected after an initial negative prehospital EFAST.</p><p><strong>Methods: </strong>Trauma patients treated by New South Wales Ambulance (Aeromedical Operations) who underwent prehospital EFAST between 1^st August 2022 and 31^st December 2023 were included if they were found to have PTX on CT imaging following a negative or indeterminate prehospital EFAST ultrasound. Patients were excluded if prehospital pleural decompression was undertaken. Corresponding CT imaging was manually analysed for the location of each PTX and mapped to two-dimensional coordinates on an unfurled thoracic cage.</p><p><strong>Results: </strong>Of 58 patients median (IQR) age was 29 (20, 58) years. The majority (76 %) were male who had sustained blunt trauma. The median (IQR) estimated PTX volume was 8 % (4-10) with 43 % of patients having a pneumothorax located to either the second intercostal space or most anterior portion of the chest on CT-mapping. The midpoints of each locule were anatomically distributed with a median (IQR) of 4^th (3^rd-5^th) intercostal space and distance from the sternal edge (cm) of 4.1 (2.5-5.1) on the right, and 4.4 (3.5-5.2) on the left. Most PTX were sonographically occult due to apical, retrosternal, or posterior position.</p><p><strong>Conclusion: </strong>Most traumatic PTX missed by prehospital EFAST were truly sonographically occult, but a significant number corresponded with the traditional scanning landmarks, particularly the parasternal 4^th intercostal space. This reinforces current literature advocating this scanning region. The balance between optimal detection and sono-paralysis should be considered for ongoing education and governance.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112778"},"PeriodicalIF":2.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260370","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":"Contemporary trends in incidence and outcomes of domestic violence among trauma patients in the US.","authors":"Nam Yong Cho, Troy Coaston, Amulya Vadlakonda, Mahima Chillakanti, Areti Tillou, Peyman Benharash","doi":"10.1016/j.injury.2025.112772","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112772","url":null,"abstract":"<p><strong>Background: </strong>While domestic violence (DV) - encompassing abusive action towards children, intimate partners, and elderly patients - is frequently reported at US trauma centers each year, contemporary data on DV trends and outcomes remain limited.</p><p><strong>Methods: </strong>We identified all trauma patients with DV using the 2018-2021 American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) database. Temporal trends were analyzed using the Cochran-Armitage test. Multivariable logistic and linear regression models were used to assess the association of DV with in-hospital mortality, hospital duration of stay (LOS) and non-home discharge.</p><p><strong>Results: </strong>Among 4190,728 trauma admissions, 8677 (0.2 %) involved DV, with the majority being children (73.6 %), followed by adults (19.5 %) and elderly patients (7.0 %). DV-related trauma admissions increased significantly from 2018 to 2021 (1.7 to 2.0 per 1000 trauma admissions, trend test P < 0.001). DV victims were more frequently female (48.8 vs 39.0 %), Black (30.7 vs 15.2 %), and insured by Medicaid (61.8 vs 18.0 %). DV was associated with higher in-hospital mortality among children (AOR 4.86, 95 % CI 3.88-6.10) and elderly patients (AOR 2.59, 95 % CI 1.42-4.73). Children with DV had significantly longer LOS by 2.1 days (95 % CI 1.8-2.4 days). Children (AOR 2.98, 95 %CI 2.30-3.85) and elderly DV patients (AOR 1.60, 95 %CI 1.15-2.23) had increased odds of non-home discharge.</p><p><strong>Conclusion: </strong>DV-related trauma admissions have risen significantly across national trauma centers. Enhanced protocols at trauma centers may provide critical opportunities for DV identification and intervention as well as prevention strategies.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112772"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208414","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":"Intranasal ketamine in controlling pain caused by bone fractures: Can we go?","authors":"Camille Martinet, Julien Galant, Nicolas Cazes","doi":"10.1016/j.injury.2025.112766","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112766","url":null,"abstract":"<p><p>Not applicable.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112766"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139829","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":"External retrospective validation of the STUMBL score for patients with isolated blunt thoracic trauma presenting to the emergency department.","authors":"Samuel Blais, Valérie Boucher, Raphaëlle Brière, Améliane Tardif, Christian Malo, Éric Mercier, Pierre-Gilles Blanchard, Axel Benhamed, Manal Fouzail, Marcel Émond","doi":"10.1016/j.injury.2025.112761","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112761","url":null,"abstract":"<p><strong>Introduction: </strong>Blunt Thoracic trauma (BTT) affects over 10 % of trauma patients and may lead to delayed respiratory complications. The STUMBL (STUdy of the Management of BLunt chest wall trauma) score was developed to identify patients at high risk of complications. This study aimed to validate the STUMBL score in a Canadian setting.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients with isolated BTT presenting to a Canadian emergency department (ED) of a Level-1 trauma center between 2018 and 2020. STUMBL scores were calculated for each patient. The primary outcome was a composite of in-hospital mortality, early pulmonary complications, ICU admission, or prolonged hospital stay (≥7 days). Secondary outcomes were delayed pulmonary complications and unplanned return to the ED. Receiver operating characteristic (ROC) curves were used to evaluate predictive performance, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed for each score cutoff.</p><p><strong>Results: </strong>Among 344 included patients (mean age: 57.8 ± 17.0, male sex: 64.2 %), 18.3 % experienced the primary outcome. The STUMBL score showed good discrimination (AUROC 0.87). A cutoff of ≤10 yielded a sensitivity of 90.5 % and NPV of 97.0 %, while a cutoff of ≤15 showed a sensitivity of 66.7 % and NPV of 92.2 % to predict the composite outcome. In patients with a score ≤15, delayed pulmonary complications occurred in <2 %, and unplanned ED visits in <7 %. Conversely, 82.4 % of patients with STUMBL scores ≥21 experienced the composite outcome. This cutoff was associated with a specificity of 97.9 % and PPV of 82.4 %.</p><p><strong>Conclusions: </strong>The STUMBL score demonstrated good performance in predicting early adverse outcomes in Canadian patients with isolated BTT. Patients with a STUMBL score ≤15 and no early complications represent a low-risk group that may be safely discharged. Those with scores ≥21 warrant ICU evaluation. Further prospective validation or refinement is recommended before widespread implementation.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112761"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115705","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":"Unabated violence: Evaluating the impact of the \"state of exception\" in Ecuador on surgical trauma admissions.","authors":"Edison F Angamarca-Angamarca, Carlos A Romero, Juana E Pincay, Álvaro Romero, José Zambrano, Doris Sarmiento-Altamirano","doi":"10.1016/j.injury.2025.112758","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112758","url":null,"abstract":"<p><strong>Purpose: </strong>Ecuador has seen a dramatic increase in violence, with homicides rising from 6.4 per 100,000 inhabitants in 2015 to 47.25 in 2023. In response, the government declared a state of internal armed conflict and a \"state of emergency\" This study aims to analyze the impact of this political measure on the admission of patients who are victims of violence to a hospital in the coastal region of the country.</p><p><strong>Methods: </strong>This is an analytical cross-sectional study conducted over nine months, from October 2023 to July 2024, divided into three-month periods. The independent variable was the period of surgical trauma: pre-exception, during the state of exception, and post-exception. The dependent variable was surgical trauma due to violence. A bivariate analysis was performed and a p-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>The study included 160 cases of surgical trauma. Of the traumas reported during the nine months, 80 % (N=128) were due to violence. 78 % (N=125) of patients underwent surgery for penetrating trauma, with 77 % (96/125) of these due to firearms. The proportion of penetrating injuries due to firearms varied significantly according to period (p = 0.020). During the state of exception it fell to 60 % (21/35) from 79 % (31/39) pre-exception, but rose again in the post-exception period to 86 % (44/51).</p><p><strong>Conclusion: </strong>The strategies implemented did not significantly reduce trauma admissions due to violence at this hospital, underscoring the imperative for additional interventions and a comprehensive understanding of the social determinants underlying this public health issue.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112758"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058768","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":"Augmented reality for medical education in the primary survey of burns: an exploratory study.","authors":"Milly S van de Warenburg, Carolien Kamphuis, Stefan Hummelink, Dietmar J O Ulrich, Mariëlle L A W Vehmeijer-Heeman","doi":"10.1016/j.injury.2025.112747","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112747","url":null,"abstract":"<p><strong>Introduction: </strong>Augmented reality (AR) technology is rapidly evolving and is finding an increasing application in education, including medical training. This feasibility study aimed to explore the usability and didactic potential of AR with the HoloLens2™ for medical students, teaching the primary survey of burn wounds.</p><p><strong>Methods: </strong>This feasibility study was conducted using a prospective observational cohort design. Test groups consisted of participants with limited (n = 18), moderate (n = 10), or high (n = 5) experience in burn care, and filled in a questionnaire after training with the HoloLens2™.</p><p><strong>Results: </strong>Outcomes of the questionnaires show AR to be a promising technology for educating medical students in the primary survey of burn wounds.</p><p><strong>Discussion: </strong>However promising, there is further need for development in usability and image quality. The ability to simulate realistic scenarios in a safe and scalable environment could pave the way for a new era for medical education, where AR becomes a valuable supplement or even replacement for traditional learning methods.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112747"},"PeriodicalIF":2.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066955","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":"Autoinjector-based delivery of tranexamic acid provides pharmacokinetic efficacy in a porcine model of uncontrolled hemorrhage.","authors":"Arik Eisenkraft, Linn Wagnert-Avraham, Rotem Azmon, Michael Tabi, Elon Glassberg, Yoav Mintz, Suhair Abdeen, Muhammad Abdel-Haq, Abraham Domb, Dean Nachman, S David Gurtz","doi":"10.1016/j.injury.2025.112721","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112721","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhage remains the principal cause of death on the battlefield. It is suggested that Tranexamic acid (TXA) can improve survival of severely-bleeding casualties. The intravenous approach is not always available in the pre-hospital setting. It was shown that for every 15 min delay, the efficiency of TXA decreases by 10 %. This study was designed to assess the pharmacokinetic, pharmacodynamic, and pre-clinical efficacy of a TXA autoinjector in uncontrolled hemorrhage in swine.</p><p><strong>Methods: </strong>Non-compressible hemorrhage was induced by laparoscopic partial liver resection. TXA was administered intramuscularly by autoinjector (n = 25) or intravenously (control, n = 5). Blood levels of TXA and dynamics of clot formation were determined. Euthanasia was performed ninety minutes after injury followed by a laparotomy for the measurement of free blood and clots in the abdomen.</p><p><strong>Results: </strong>The TXA levels in the autoinjector group exceeded the effective therapeutic threshold within <5 min and remained above the 10 mg/L threshold throughout the experiment. Intra-abdominal blood volumes, hemodynamic parameters, and indices of clot formation were similar between autoinjector-delivered and intravenouslyadministered groups.</p><p><strong>Conclusions: </strong>Autoinjector-based TXA provides sustained, anti-fibrinolytic levels within 2-5 min of administration in a swine model of uncontrolled hemorrhage emphasizing its important.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112721"},"PeriodicalIF":2.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016994","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}