Injury最新文献 - Book学术

Traumatic gallbladder injury and its treatment: Changing management of a rare injury.

Injury Pub Date : 2025-04-01 DOI: 10.1016/j.injury.2025.112313

Mustafa Abid, Selena J An, Andrew Schneider, Jared Gallaher, Anthony Charles

{"title":"Traumatic gallbladder injury and its treatment: Changing management of a rare injury.","authors":"Mustafa Abid, Selena J An, Andrew Schneider, Jared Gallaher, Anthony Charles","doi":"10.1016/j.injury.2025.112313","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112313","url":null,"abstract":"Introduction: Traumatic gallbladder injury has historically been associated with high morbidity and mortality. Whether treatment patterns have changed over time as non-operative management has been adopted for abdominal trauma care remains unclear. We sought to evaluate trends in cholecystectomy as a treatment for traumatic gallbladder injury and estimate the association between operative or non-operative management of traumatic gallbladder injury and patient outcomes.Methods: Retrospective cohort analysis of the National Trauma Data Bank from 2007-2021 evaluating patients with traumatic gallbladder injury and determining whether they received no intervention, endoscopic retrograde cholangiopancreatography (ERCP), or cholecystectomy. The probability of a patient receiving cholecystectomy or operative intervention was evaluated with an adjusted multivariable logistic regression model. To estimate the effect of intervention choice on in-hospital mortality, length of stay, and intensive care unit (ICU) length of stay, an adjusted multivariable logistic regression model was used, treating the year as a fixed effect.Results: There were 6160 traumatic gallbladder injuries recorded from 2007-2021. 3909 (63.5 %) of these patients underwent some form of intervention (drainage or cholecystectomy), including 3722 (60.4 %) undergoing cholecystectomy. The odds of cholecystectomy compared to non-operative management were decreased in several, but not all, years of study as time progressed. There was no statistically significant difference in the odds of ERCP over time. Cholecystectomy was associated with decreased odds of in-hospital mortality (aOR 0.26, 95 % CI 0.22, 0.30; p < 0.001) and 16.5 % longer length of stay (coefficient 0.15, 95 % CI 0.10-0.20; p < 0.001) compared to non-operative management.Conclusions: Cholecystectomy use for traumatic gallbladder injury has decreased from 2007-2021 without a concurrent increase in ERCP. Patients who underwent cholecystectomy had lower odds of mortality in adjusted models. The increasing use of non-operative management for traumatic gallbladder injury may carry greater risk to patients, and operative intervention should remain the standard of care.","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112313"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796997","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}

引用次数: 0

The road injury chain of survival: A framework for improving trauma outcomes.

Injury Pub Date : 2025-03-24 DOI: 10.1016/j.injury.2025.112285

Tim Nutbeam, Willem Stassen

引用次数: 0

Introducing the relationship between pelvic incidence and subtype of U-shaped sacral fracture according to Roy-Camille classification: How to restore sagittal balance in spinopelvic trauma.

Injury Pub Date : 2025-03-24 DOI: 10.1016/j.injury.2025.112286

Nathan Beucler

引用次数: 0

Response to letter to the editor : Trends of impact factor contributors to the Injury Journal: A bibliometric analysis. 回复致编辑的信：《损伤杂志》影响因子贡献者的趋势：文献计量分析。

Injury Pub Date : 2025-03-24 DOI: 10.1016/j.injury.2025.112279

P V Giannoudis, Y S Ho, V Giordano, C Mauffrey

引用次数: 0

Comments on "Comparison of femoral neck shortening after femoral neck system and cannulated cancellous screw fixation for displaced femoral neck fractures in young adults".

Injury Pub Date : 2025-03-22 DOI: 10.1016/j.injury.2025.112284

Udit Kumar Jayant, Devendra Kumar Chouhan, Mandeep Singh Dhillon

引用次数: 0

Adolescent optimism - Coping well after severe injury: A qualitative study.

Injury Pub Date : 2025-03-22 DOI: 10.1016/j.injury.2025.112278

Amund Hovengen Ringen, Rachel Joergensen, Torben Wisborg, Christine Gaarder, Paal Aksel Naess

{"title":"Adolescent optimism - Coping well after severe injury: A qualitative study.","authors":"Amund Hovengen Ringen, Rachel Joergensen, Torben Wisborg, Christine Gaarder, Paal Aksel Naess","doi":"10.1016/j.injury.2025.112278","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112278","url":null,"abstract":"Background: Trauma is the leading cause of death and disability in children globally. Studies indicate that severe traumatic brain injury (TBI) negatively affects quality of life (QoL) in children, but little is known about QoL after injury in children without TBI. This study aimed to investigate QoL in this group six months post-discharge.Methods: Trauma patients aged 13-17 years admitted to a major Scandinavian trauma center were eligible if they met the following criteria: received by a trauma team, ISS > 9, required ICU monitoring, and hospital stay > 4 days. Patients with moderate to severe head injuries (AIS > 2) were excluded. Eighteen consenting adolescents were interviewed six to nine months after discharge.Results: The main finding was that most participants were \"coping well after experienced injuries.\" A minority reported challenges in daily life, including fatigue and difficulty in keeping up. Few used regular painkillers, and most were unconcerned about long-term consequences. However, many felt that more structured follow-up post-discharge would have been helpful.Conclusion: Among 18 moderate to severely injured adolescents, we found that the majority were coping well. Strong social relationships and involvement in school and social activities was important in all interviews. While several experienced fatigue and challenges in keeping up, the negative impact on daily life was manageable at the time of the interviews.","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112278"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756797","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}

引用次数: 0

Reply to comments on "long-term differences in clinical prognosis between crossed- and parallel-cannulated screw fixation in vertical femoral neck fractures of non-geriatric patients".

Injury Pub Date : 2025-03-20 DOI: 10.1016/j.injury.2025.112277

Dajun Jiang, Weitao Jia

引用次数: 0

Understanding disparities in firearm mortality: The role of person- and place-based factors.

Injury Pub Date : 2025-03-18 DOI: 10.1016/j.injury.2025.112275

Matthew C Morris, Laura Vearrier, Matthew E Kutcher, Masoumeh Karimi, Fazlay Faruque, Alyscia Severance, Michelle Brassfield, Lei Zhang

{"title":"Understanding disparities in firearm mortality: The role of person- and place-based factors.","authors":"Matthew C Morris, Laura Vearrier, Matthew E Kutcher, Masoumeh Karimi, Fazlay Faruque, Alyscia Severance, Michelle Brassfield, Lei Zhang","doi":"10.1016/j.injury.2025.112275","DOIUrl":"10.1016/j.injury.2025.112275","url":null,"abstract":"Background: Racial and socioeconomic disparities in firearm homicide rates are well-established in the United States. However, findings have been mixed regarding disparities for in-hospital mortality among firearm injury patients. The aim of this study was to evaluate the extent of in-hospital mortality disparities and whether differences persist after adjusting for person- and place-based factors.Methods: This retrospective analysis evaluated all pediatric and adult patients admitted to a single level I trauma center with a statewide catchment area from 2010 to 2020. Patients with assault-related firearm injuries were included; those with accidental or self-inflicted firearm injuries were excluded. The primary outcome was in-hospital mortality. Predictors included demographic (i.e., race, sex, age), socioeconomic (i.e., health insurance), injury (i.e., severity), and area-level (i.e., community distress, social vulnerability, rurality/urbanicity) characteristics.Results: The sample consisted of 2,081 patients with assault-related firearm injuries, including 1,836 Black patients (88 %) and 1,838 males (88 %). The mean age was 32.3 (SD=11.9) years. A smaller proportion of Black (19 %) compared to White (27 %) patients had health insurance coverage. Among injury patients, there were 210 firearm deaths (10 %). In logistic regression analyses adjusting for demographic, injury, and socioeconomic characteristics, both insured patients and those with unspecified insurance status had lower risk of mortality than uninsured patients; these differences in mortality risk remained after accounting for potential survivor bias. Contrary to expectation, there were no racial differences in mortality risk. In multilevel models accounting for nesting of patients within geographic areas (i.e., zip codes, counties), differences in mortality risk by insurance status remained after accounting for community distress, social vulnerability, and rurality/urbanicity. However, racial and area-level differences in mortality risk emerged after accounting for survivor bias.Conclusions: The present findings are consistent with research showing lower in-hospital mortality among insured compared to uninsured trauma patients. Notably, this reduced mortality risk remained after controlling for important social determinants of trauma outcomes, and extended to patients with unspecified insurance status. Future research is needed to identify person- and place-based factors that could help to explain and mitigate differences in mortality risk based on insurance status.","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112275"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694797","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}

引用次数: 0

Post-traumatic pericarditis: A single center review: Post-Traumatic Pericarditis.

Injury Pub Date : 2025-03-18 DOI: 10.1016/j.injury.2025.112276

John Marquart, Jacob Lindemann, Stephanie Joppa, Thomas Carver

{"title":"Post-traumatic pericarditis: A single center review: Post-Traumatic Pericarditis.","authors":"John Marquart, Jacob Lindemann, Stephanie Joppa, Thomas Carver","doi":"10.1016/j.injury.2025.112276","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112276","url":null,"abstract":"Background: Post-traumatic pericarditis is a rare and poorly studied entity that can have significant consequences on recovery and treatment after traumatic injury. Our objective was to identify the incidence, presentation, treatment, and complications of post-traumatic pericarditis at a level 1 trauma center.Methods: We performed a single institution retrospective review of patients with post-traumatic pericarditis admitted to our trauma center from January 2010 to December 2022. We reviewed all patients with a discharge diagnosis of pericarditis after an associated trauma, as well as trauma patients that were at high risk based on procedures performed including those having cardiothoracic procedures.Results: A total of 32 patients were identified with pericarditis out of 8,436 admitted patients with a chest AIS ≥1, giving an incidence of 0.38 % among those with thoracic injury. Penetrating and blunt mechanisms were evenly distributed. The majority had significant chest trauma on admission with a median chest-specific AIS of 3. Post-pericardiotomy pericarditis occurred in 8patients out of a total of 214 procedures that violated the pericardium for an incidence of 3.7 %. The majority (59.4 %) were treated with colchicine and 7 (20.5 %) patients required procedural intervention for significant effusions. Three (9.4 %) patients were found to have recurrent pericarditis.Conclusion: Pericarditis is an uncommon sequela of traumatic injury but can have significant consequences and management varied widely among those diagnosed. Post-traumatic pericarditis is likely underrecognized, but a large prospective study would be necessary to further identify the true incidence and risk factors.","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112276"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702486","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}

引用次数: 0

Ocular injuries after the pagers explosion in Lebanon: A novel form of modern warfare.

Injury Pub Date : 2025-03-16 DOI: 10.1016/j.injury.2025.112273

El Sett Antoine, Raad Elie, Rustom Tarek, El Helou Jennifer, Mardelli Pierre, Bejjani Riad, Zalloum Jean, Salam Hassan, Chelala Elias, Schakal Alexandre

{"title":"Ocular injuries after the pagers explosion in Lebanon: A novel form of modern warfare.","authors":"El Sett Antoine, Raad Elie, Rustom Tarek, El Helou Jennifer, Mardelli Pierre, Bejjani Riad, Zalloum Jean, Salam Hassan, Chelala Elias, Schakal Alexandre","doi":"10.1016/j.injury.2025.112273","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112273","url":null,"abstract":"Background: The incidence of ocular injuries in modern conflicts has significantly increased, particularly in explosive device-related incidents. This study aims to investigate and characterize the nature and outcomes of ocular injuries resulting from the September 2024 pagers explosions in Lebanon, which caused over 37 deaths and 3,000 injuries.Methods: This retrospective descriptive study analyzed 38 patients (76 eyes) with ocular injuries who presented to the Hôtel-Dieu de France hospital following the Pager explosion in Lebanon on September 17-18, 2024. Patients were identified from emergency department, OR, and ophthalmology clinic records. Data was collected from ED, OR, ophthalmology and imaging records.Results: Thirty-six patients (95 %) were male, and the mean age was 32.8 ± 9 years (SD), ranging from 5 to 52 years. Bilateral eye injuries were observed in 28 patients (74 %). One-third of the eyes had no light perception (NLP) at presentation. Five patients (13 %) had bilateral NLP vision on presentation. Open globe injuries were present in 42 (57 %) eyes and required immediate surgical reparation. Twenty-one percent of eyes presented expulsive injury and were eviscerated. Twenty-seven patients (36 %) had intraocular foreign bodies. Ocular surface injuries were present in 42 % of eyes. Thirty-six eyes (47 %) had superior and/or inferior lid lacerations requiring surgical repair. Twenty-four percent of eyes had an orbital wall fracture. Vitreous hemorrhage was reported in 20 eyes (26 %), while two eyes (3 %) had total hyphema. Cataract was identified in two eyes (3 %), and lens subluxation in four eyes (5 %). One eye had retrobulbar hematoma and required a lateral canthotomy. On the follow-up, four eyes developed endophthalmitis, while two eyes progressed to phtisis bulbi and were eviscerated. Five eyes developed cataract. Visual acuity remained unchanged in 60 % of eyes and deteriorated in 40 %.Conclusion: This study highlights the severity of ophthalmic injuries in modern warfare, emphasizing the need for immediate surgical intervention to optimize patient outcomes.","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112273"},"PeriodicalIF":0.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694964","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}

引用次数: 0