InjuryPub Date : 2024-12-13DOI: 10.1016/j.injury.2024.112088
Melissa Webb, Lara Kimmel, Cecil Johnny, Anne Holland
{"title":"Retrospective validation of the STUMBL score in a Level 1 trauma centre.","authors":"Melissa Webb, Lara Kimmel, Cecil Johnny, Anne Holland","doi":"10.1016/j.injury.2024.112088","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112088","url":null,"abstract":"<p><p>Chest trauma is a common presentation to major trauma centres. Risk assessment tools have proven useful to support decision making in this group and the STUMBL (STUdy of the Management of BLunt chest wall trauma) score is one such measure that has been increasingly utilised. The aim of this study was to retrospectively validate the STUMBL score in an Australian population of patients admitted following chest trauma.</p><p><strong>Methods: </strong>A single-centre retrospective validation study was undertaken using information from all patients with an Emergency Department (ED) attendance for isolated blunt chest trauma at a major trauma centre in Australia from 2018. The performance of the STUMBL score was measured including the cut-off score which best predicted 1) the discharge disposition from ED (ward or intensive care unit [ICU]), 2) the development of pulmonary complications, 3) an extended length of stay (LOS) (7 days or more) and 4) any complication (pulmonary, extended LOS, in hospital mortality). The performance measures included sensitivity, specificity, negative and positive predictive values as well discrimination and calibration.</p><p><strong>Results: </strong>There were 300 patients admitted between 1st January 2018 and 31st December 2018 with a median age of 60 years (IQR 44-75) and 65 % were male. The risk prediction cut-off score for our patient cohort ranged from 18.5 for LOS 7 days or more to 11.5 for ward admission from ED. The positive predictive value (PPV) ranged from 56.7 % for ward admission from ED to 21.1 % for pulmonary complications. The negative predictive value (NPV) and sensitivity was highest for ICU admission from ED (96.5 % and 80.6 %) and the specificity ranged from 78 % for all complication prediction to 65.3 % for LOS of 7 or more days. The C statistic ranged from 0.82 for ICU admission to 0.65 for pulmonary morbidity.</p><p><strong>Conclusion: </strong>The performance measures of the STUMBL score are suboptimal in our population. The best performing measure was the ability to predict ICU admission. Further validation work that includes additional factors may improve the positive predictive value and clinical utility of the score in our cohort.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112088"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879116","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}
InjuryPub Date : 2024-12-11DOI: 10.1016/j.injury.2024.112084
P Jenkins, L Sorrell, J Zhong, J Harding, S Modi, J E Smith, V Allgar, C Roobottom
{"title":"Management of penetrating splenic trauma; is it different to the management of blunt trauma?","authors":"P Jenkins, L Sorrell, J Zhong, J Harding, S Modi, J E Smith, V Allgar, C Roobottom","doi":"10.1016/j.injury.2024.112084","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112084","url":null,"abstract":"<p><strong>Purpose: </strong>We compare the treatment and outcomes of penetrating and blunt splenic trauma at Major Trauma Centres (MTC) within the UK.</p><p><strong>Methods: </strong>Data obtained from the national Trauma Audit Research Network database identified all eligible splenic injuries admitted to MTC within England between 01/01/17-31/12/21. Demographics, mechanism of injury, splenic injury classification, associated injuries, treatment, and outcomes were compared.</p><p><strong>Results: </strong>Penetrating injuries accounted for 5.9 % (235/3958) of splenic injuries, compared to blunt at 94.1 % (3723/3958). Most penetrating injuries (91.5 %, 215/235) resulted from stabbing. There was a statistically significant difference in first treatment between penetrating and blunt splenic injuries (p < 0.001), but similar trends between GSW and stab injuries. Most penetrating injuries were managed conservatively (68.9 %,162/235), with 10.6 % (25/235) embolized compared to 13.2 % (491/3723) for blunt splenic injury. More penetrating injuries (20.4 %, 48/235) underwent splenectomy compared to blunt injuries (8.8 %, 326/3723). Those receiving embolization after penetrating trauma had an 8.0 % (2/25) 30-day mortality compared with blunt at 8.6 % (42/491) and compared with 2.1 % (1/48) and 12.3 % (40/326) of those who received splenectomy in the penetrating and blunt groups, respectively. 8 out of the 25 penetrating trauma patients who underwent embolisation (32.0 %) required splenectomy due to embolisation failure compared to 5.3 % (26/491) in the blunt trauma group.</p><p><strong>Conclusion: </strong>A trend is seen towards the use of operative management in penetrating splenic trauma. There is a high splenic embolisation failure rate (32.0 %) in penetrating trauma although mortality for those embolised was similar to the blunt injury group.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112084"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866821","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}
InjuryPub Date : 2024-12-11DOI: 10.1016/j.injury.2024.112078
Zoe M F Brier, Kenneth J Ruggiero, Terri A deRoon-Cassini, Hannah C Espeleta
{"title":"Bedside mental health risk screening of traumatic injury patients is enhanced by measurement of injury mechanism and social support.","authors":"Zoe M F Brier, Kenneth J Ruggiero, Terri A deRoon-Cassini, Hannah C Espeleta","doi":"10.1016/j.injury.2024.112078","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112078","url":null,"abstract":"<p><strong>Background: </strong>The American College of Surgeons now requires mental health screening and follow up for hospitalized patients in trauma centers. National estimates indicate that 20-40 % of these patients will develop posttraumatic stress disorder (PTSD) and/or depression within one year post-injury. Research has identified brief bedside screens that predict PTSD and depression post-discharge, such as the Injured Trauma Survivor Screen and Peritraumatic Distress Inventory. However, false negatives are common; almost a quarter of patients with a negative bedside risk screen may develop PTSD or depression post-discharge and may not receive appropriate follow up. As such, there is critical need to improve bedside risk-screening tools. We aimed to identify demographic, social, and trauma-related predictors of mental health symptoms among patients with negative bedside screens.</p><p><strong>Method: </strong>Patients were injury survivors served by a Level I trauma center who were identified as \"low risk for development of PTSD/depression\" by the Injured Trauma Survivor Screen. Patient injury type and demographics were collected from the medical record.</p><p><strong>Results: </strong>Violent injuries (e.g., gunshot wound) and lower levels of available social support predicted elevated PTSD symptoms 30-days post-injury. Lower social support also was associated with increased risk for depressive symptoms 30 days post-injury.</p><p><strong>Conclusion: </strong>Findings suggest that risk-screening tools may be improved by including items that capture injury mechanism and social support. Alternatively, trauma centers should consider mental health referral for patients who have experienced violent trauma or have low levels of social support, even when bedside screening tools identify them as having low mental health risk.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112078"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873693","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}
InjuryPub Date : 2024-12-08DOI: 10.1016/j.injury.2024.112079
Wang Pong Chan, Allan E Stolarski, Sophia M Smith, Dane R Scantling, Sheina Theodore, Yorghos Tripodis, Noelle N Saillant, Crisanto M Torres
{"title":"Association of prolonged emergency department length of stay and venous thrombo-embolism prophylaxis and outcomes in trauma: A nation-wide secondary analysis.","authors":"Wang Pong Chan, Allan E Stolarski, Sophia M Smith, Dane R Scantling, Sheina Theodore, Yorghos Tripodis, Noelle N Saillant, Crisanto M Torres","doi":"10.1016/j.injury.2024.112079","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112079","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of prolonged emergency department length of stay (EDLOS) on appropriately timed pharmacological venous thromboembolism prophylaxis (VTEp) and VTE outcomes is unknown in trauma.</p><p><strong>Methods: </strong>Retrospective cohort study of adult patients admitted to civilian trauma centers participating in the American College of Surgeons' TQIP (2019-2021). Patients with severe solid organ, head, or spine injury, early hemorrhage control intervention, pre-existing home anticoagulation or bleeding disorder, inter-facility transfer or early discharge, and injury severity score ≤9 were excluded. Primary exposure was prolonged EDLOS ≥12 h from ED arrival to physical transfer to the wards. Primary outcome was time to first pharmacological VTEp, censored at 24 and 48 h.</p><p><strong>Results: </strong>A total of 191,031 patients were included, 3,827 remained in the ED ≥12 h. The median time to VTEp was 25 h (IQR 12-43). Prolonged EDLOS was associated with a 34 % and 21 % decrease in timely administration of VTEp at 24 (aHR 0.66, 95 % CI 0.61-0.72, P < 0.001) and 48 h (aHR 0.79, 95 % CI 0.74-0.84, P < 0.001), respectively. After propensity score matching, associations persisted at 24 (aHR 0.69, 95 % CI 0.61-0.77, P < 0.001) and 48 h (aHR 0.80, 95 % CI 0.74-0.86, P < 0.001). Absent VTEp by 24 h was associated with increased VTE odds (aOR 1.84, 95 % CI 1.62-2.08, P < 0.001).</p><p><strong>Conclusion: </strong>Prolonged EDLOS delayed pharmacological VTEp in a nation-wide cohort of trauma patients. Absent VTEp, consequently, increased risk of in-hospital VTE, although future study is needed to validate these findings. Timely transfer of stable trauma patients to the floor may improve outcomes by facilitating appropriately timed VTEp administration and decreasing ED overcrowding.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112079"},"PeriodicalIF":0.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820427","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}
InjuryPub Date : 2024-12-05DOI: 10.1016/j.injury.2024.112077
Caleb Chen, Apurv Sehgal, Ceri Battle, Jonathan Hardman, Benjamin Ollivere, David W Hewson
{"title":"Acute management of adults following chest wall injury: An assessment of institutional clinical practice guidelines across the UK and synthesis of care recommendations.","authors":"Caleb Chen, Apurv Sehgal, Ceri Battle, Jonathan Hardman, Benjamin Ollivere, David W Hewson","doi":"10.1016/j.injury.2024.112077","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112077","url":null,"abstract":"<p><strong>Objective: </strong>Chest wall injury causes significant morbidity and mortality. There is uncertainty regarding many aspects of clinical care for these patients, including optimal analgesia, acuity of monitoring and surgical fixation. Our aim in this work is to [1] objectively appraise the quality and extent of heterogeneity in UK major trauma centre (MTC) clinical practice guidelines regarding the management of chest wall injury; and [2] narratively summarise clinical and care process recommendations from these guidelines to provide a comparative description of recommendations between institutions.</p><p><strong>Methods: </strong>All major trauma centres in England and Wales were contacted for their institutional clinical practice guidelines relevant to chest wall injury. A literature search was executed seeking eligible supra-regional, national or international consensus documents or guidelines to serve as reference standards. Interrogation of the reference standard guidelines was performed to identify key clinical and care processes against which two blinded assessors judged the clinical validity of institutional clinical practice guidelines as part of the Appraisal of Guidelines for Research & Evaluation II Global Rating Scale (AGREE II-GRS) tool.</p><p><strong>Results: </strong>We received 17 institutional clinical practice guidelines and identified themes of care from seven reference standards identified during our literature search. Four institutional clinical practice guidelines were assessed as high-quality by pre-specified AGREE II-GRS criteria. Guidelines scored highly for the quality of their presentation of information (median (interquartile range [IQR]) AGREE II-GRS Item<sub>5</sub> score 5 (4.5-5.5)); however, the quality of guideline development methodology and the guideline completeness in comprehensively addressing the needs of this population was generally poor (median (IQR) AGREE II-GRS Item<sub>1</sub> methodology score 2.92 (2.33-5.25); AGREE II-GRS Item<sub>3</sub> completeness score 2.63 (1.75-5.25) respectively).</p><p><strong>Conclusions: </strong>This work highlights the paucity of high-quality local clinical practice guidelines to inform the management of adults with chest wall injury admitted to UK MTCs. Although some degree of variation between local guidelines is acceptable, we have identified substantial heterogeneity in the clinical care recommendations between institutions.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112077"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815295","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}
InjuryPub Date : 2024-12-03DOI: 10.1016/j.injury.2024.112075
Ceri Battle, Timothy Driscoll, Deborah Fitzsimmons, Shaun Harris, Fiona Lecky, Claire O'Neill, Alan Watkins, Jane Barnett, Susan Davies, Hayley Anne Hutchings
{"title":"EarLy Exercise in blunt Chest wall Trauma: A multi-centre, parallel randomised controlled trial (ELECT2 Trial).","authors":"Ceri Battle, Timothy Driscoll, Deborah Fitzsimmons, Shaun Harris, Fiona Lecky, Claire O'Neill, Alan Watkins, Jane Barnett, Susan Davies, Hayley Anne Hutchings","doi":"10.1016/j.injury.2024.112075","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112075","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this trial was to investigate the impact of early thoracic and shoulder girdle exercises on chronic pain and Health-Related Quality of Life in patients with blunt chest wall trauma, when compared to normal care.</p><p><strong>Methods: </strong>A multi-centre, parallel, randomised controlled trial, in which adult patients presenting to hospital with blunt chest wall trauma were allocated to either control or intervention group. The intervention was an exercise programme consisting of four simple thoracic and shoulder girdle exercises, completed for one week. Outcomes measures included prevalence and severity of chronic pain using the Brief Pain Inventory, health-related quality of life using EQ-5D-5 L, and cost effectiveness, measured at initial presentation and three months post-injury.</p><p><strong>Results: </strong>360 participants were recruited. Participants' mean age was 63.6 years (standard deviation (SD): 17.9 years) and 213 (59.8 %) were men. After loss-to-follow-up, the survey response rate at three months was 73.0 % (251/344 participants). The primary analysis, for chronic pain prevalence at three months post-injury, found no statistically significant differences between intervention and control groups, with lower rates in the control (intervention: 35/126 (27.8 %), control: 20/117 (17.1 %); adjusted odds ratio 1.862; 95 % CI: 0.892 to 3.893, p = 0.098). There were no statistically significant differences between intervention and control groups for pain severity at three months post-injury, (intervention mean (SD): 2.15 (2.49), control: 1.81 (2.10); adjusted difference 0.196, 95 % CI:0.340 to 0.731; p = 0.473); or Health-Related Quality of Life (intervention mean (SD): 0.715 (0.291), control: 0.704 (0.265); adjusted difference: 0.030; 95 % CI:0.033 to 0.094; p = 0.350). The health economic analysis found the intervention was associated with higher costs compared to normal care.</p><p><strong>Conclusion: </strong>The results of this trial did not support a 'one-size fits all' simple, early exercise programme for patients with blunt chest wall trauma. Future research should consider the impact of a personalised exercise programme, commenced by the patient at least one week post-injury.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112075"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824922","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}
InjuryPub Date : 2024-12-03DOI: 10.1016/j.injury.2024.112076
Anna Mary Jose, Aryan Rafieezadeh, Muhammad Zeeshan, Jordan Kirsch, Gabriel Froula, Kartik Prabhakaran, Bardiya Zangbar
{"title":"Hypothermia on admission predicts poor outcomes in adult trauma patients.","authors":"Anna Mary Jose, Aryan Rafieezadeh, Muhammad Zeeshan, Jordan Kirsch, Gabriel Froula, Kartik Prabhakaran, Bardiya Zangbar","doi":"10.1016/j.injury.2024.112076","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112076","url":null,"abstract":"<p><strong>Background: </strong>Hypothermia is known to contribute to poor outcomes in trauma patients during acute phases. The aim of our study is to evaluate the effect of hypothermia on admission, upon in-hospital complications and mortality in adult trauma patients.</p><p><strong>Methods: </strong>We performed a 5-year analysis of ACS-TQIP database (2017-2021). Patients with incomplete data, burns, inter-facility transfers, or documented as dead on arrival were excluded. Hypothermia (HT) was defined as a temperature of <35 degrees Celsius (°C), and Normothermia (NT) as ≥35 °C to≤40 °C measured at the time of patient arrival. Data were collected including demographic variables, mechanism of injury, injury severity, injury patterns, and shock index. Outcome variables were mortality, ICU length of stay (LOS), duration of mechanical ventilation, hospital LOS, and in-hospital complications. Multivariable regression analysis was performed.</p><p><strong>Results: </strong>A total of 3,043,030 patients were included and 1 % were hypothermic. HT patients were severely injured, developed in-hospital complications (17.1 %vs.4.5 %), had longer ICU LOS (4 (2-9) vs. 3 (2-5) days), hospital LOS (5 (2-12) vs. 4 (2-6) days), and higher mortality (23.4 % vs. 2.3 %). Hypothermia was independently associated with higher odds of mortality (OR:1.934 [1.858-2.013]). Subgroup analysis of patients with isolated traumatic brain injury revealed pre-hospital hypothermia to still be an independent predictor of mortality (OR: 1.728[1.600-1.867]). HT who underwent rewarming had a lower mortality, shorter hospital and ICU LOS.</p><p><strong>Conclusion: </strong>Pre-hospital hypothermia is independently associated with higher resource utilization, in-hospital complications, and mortality. Even in patients with isolated TBI, pre-hospital hypothermia increases the odds of mortality. Rewarming interventions can potentially improve outcomes among patients, even with mild hypothermia.</p><p><strong>Level of evidence: </strong>Level III retrospective study.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112076"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808200","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}
InjuryPub Date : 2024-12-01DOI: 10.1016/j.injury.2024.112039
Kanwal Majeed, Hassam Ali
{"title":"Letter to the editor: \"Long-term patient reported outcomes after revision surgery for lower extremity nonunion: A retrospective cohort study\".","authors":"Kanwal Majeed, Hassam Ali","doi":"10.1016/j.injury.2024.112039","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112039","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112039"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775992","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}
InjuryPub Date : 2024-11-20DOI: 10.1016/j.injury.2024.112051
Mehmet Subasi
{"title":"Preliminary results of stabilization of far distal tibial fractures with the distal tibial nail: A prospective, multicenter case series study.","authors":"Mehmet Subasi","doi":"10.1016/j.injury.2024.112051","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112051","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112051"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756065","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}
InjuryPub Date : 2024-11-18DOI: 10.1016/j.injury.2024.112025
Fnu Venjhraj, Ajeet Singh, Zainab Muhammad Hanif
{"title":"Association between surgical delays for femoral neck fractures and early postoperative complications in young and middle-aged adults: A study based on the national inpatient sample database.","authors":"Fnu Venjhraj, Ajeet Singh, Zainab Muhammad Hanif","doi":"10.1016/j.injury.2024.112025","DOIUrl":"https://doi.org/10.1016/j.injury.2024.112025","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112025"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741766","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}