Injury最新文献

{"title":"Beyond the null result: Unpacking the clinical nuance of concomitant carpal tunnel release with distal radius fracture fixation.","authors":"Jinwen Sima, Mingyao Jiang, Xing Chen, Jingxi Wang, Mingxuan Gao","doi":"10.1016/j.injury.2026.113590","DOIUrl":"10.1016/j.injury.2026.113590","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"113590"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764006","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":"Loading conditions during femoral preparation for THA procedures: Mechanical effects of broach holder offset.","authors":"Thomas Bridoux, François Zot, Arnaud Germaneau, Tanguy Vendeuvre, Guillaume Anthony Odri, Mathieu Severyns","doi":"10.1016/j.injury.2026.113646","DOIUrl":"10.1016/j.injury.2026.113646","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to compare the cumulative loading needed to seat the planned stem size between straight and offset broach handles. We hypothesized that the cumulative loading is higher when using the offset broach handle, whose force vector is not truly in the axis of the recipient femoral shaft. Thus, the increased stresses applied to the femur intraoperatively could contribute to increased risk of perioperative fracture.</p><p><strong>Methods: </strong>For each broach insertion and for each of our 20 femurs specimens, the mean force, maximum force and cumulative force were recorded. The number of strikes was also collected. Thus, the primary outcomes were the cumulative force, mean force, maximum force and the number of strikes made by the surgeon until the planned broach size was fully seated. A subgroup analysis was done based on the morphology of the intramedullary canal (Dorr classification). An inter-rater analysis was also done to remove the surgeon effect on the femoral preparation.</p><p><strong>Results: </strong>Using an offset broach handle required significantly more strikes to insert the broaches into the femurs until the planned size was seated (p = 0.049). No significant differences were observed between the two broach handle types in the maximum force, mean force, or cumulative force.</p><p><strong>Conclusion: </strong>This biomechanics study showed that use of an offset broach handle requires significantly more strikes and repeated impacts than use of a more conventional straight broach handle. While there was no significant difference in terms of forces applied between the two strategies, if the surgeon wants to have the same operating time for both techniques, he/she will be required to apply larger forces at each strike to achieve the same advancement of the broach in the femur.</p><p><strong>Registration: </strong>Authorization of the Minister of Education and Research No. DC-2008-137.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":"57 10","pages":"113646"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907715","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":"Characterizing alcohol and drug positivity among adult pedestrians injured in motor vehicle-pedestrian collisions: A level I trauma center study (2007-2022).","authors":"Nishita Sinha, Eva Shipp, Robert Wunderlich, Laura Zima, Glenda Torres, Ryan S Kitagawa, Shashank Patil, Christopher R Conner","doi":"10.1016/j.injury.2026.113668","DOIUrl":"10.1016/j.injury.2026.113668","url":null,"abstract":"<p><strong>Purpose: </strong>While prior research has documented substance involvement among pedestrians injured in motor-vehicle collisions, fewer studies have examined how alcohol and drug positivity varies across temporal, demographic, and socioeconomic characteristics. This study characterized alcohol and drug positivity among adult pedestrians injured in motor vehicle-pedestrian collisions and examined variation in positivity across these characteristics.</p><p><strong>Methods: </strong>Patient-level data were retrospectively obtained for adult pedestrians (≥18 years) evaluated at Memorial Hermann-Texas Medical Center following trauma activation for motor vehicle-pedestrian collisions between 2007 and 2022. The study included 3220 injured pedestrians treated at this Level I trauma center in Houston, Texas. Data included age, sex, race/ethnicity, date and time of injury, residential ZIP code, clinical outcomes, blood alcohol concentration (BAC), and urine toxicology results for amphetamines, barbiturates, marijuana, cocaine, opiates, benzodiazepines, and phencyclidine (PCP). Alcohol and drug testing were performed according to institutional trauma evaluation practices and were not universal. Descriptive and bivariate analyses examined substance positivity across temporal, demographic, and area-level socioeconomic characteristics.</p><p><strong>Results: </strong>Of the 3220 injured pedestrians, 2136 (66.3%) underwent alcohol testing and 975 (30.3%) underwent drug testing. Among those tested, 40.4% (n = 862) were positive for alcohol and 83.8% (n = 817) for at least one drug. Alcohol positivity was highest during early morning and evening periods and was significantly higher among males. Alcohol positivity also varied significantly by age, peaking among pedestrians aged 35-49 years and declining substantially among those aged ≥ 65 years. Drug positivity also varied significantly by age. Pedestrians residing in more socioeconomically disadvantaged ZIP codes accounted for a greater share of injuries, and drug positivity differed significantly across quartiles of socioeconomic disadvantage, with generally higher positivity among residents of more disadvantaged areas.</p><p><strong>Conclusion: </strong>Substance positivity among injured pedestrians varied across temporal, demographic, and socioeconomic characteristics. Higher nighttime alcohol positivity and drug positivity among pedestrians residing in lower-SES areas highlight opportunities for targeted pedestrian-safety and public-health interventions. More systematic toxicological testing and linkage of trauma records with crash, roadway, and neighborhood-level data could improve understanding of substance involvement and inform prevention strategies.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":"57 10","pages":"113668"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027259","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":"Pediatric perineal trauma: a prospective observational study of mechanisms, surgical management, and outcomes.","authors":"Ezza Ahmed, Nabila Talat, Hafiz Muhammad Waqar Afzal, Hafiz Muhammad Adnan, Umar Mahmood","doi":"10.1016/j.injury.2026.113751","DOIUrl":"https://doi.org/10.1016/j.injury.2026.113751","url":null,"abstract":"<p><strong>Background: </strong>Paediatric perineal trauma is uncommon but may involve the genital, urinary, anorectal, and pelvic-floor structures. Accurate assessment and individualized reconstruction are essential to preserve function and achieve satisfactory anatomical and cosmetic outcomes. This study evaluated the mechanisms, injury patterns, surgical management, and outcomes of surgically managed paediatric perineal trauma.</p><p><strong>Methods: </strong>This prospective observational study included consecutive children with perineal trauma requiring surgical management at the Children's Hospital and University of Child Health Sciences, Lahore, between October 2020 and October 2021. All patients underwent examination under general anaesthesia, with vaginoscopy, cystoscopy, or proctoscopy performed according to the suspected anatomical involvement. Injuries were categorized using the Genital Injury Score. Functional and cosmetic outcomes were assessed during follow-up.</p><p><strong>Results: </strong>Twenty-eight children were included; the median age was 6 years (range, 1-11), and 21 (75.0%) were female. Falls onto objects accounted for 15 injuries (53.6%), road traffic accidents for nine (32.1%), and child sexual abuse for four (14.3%). Seven patients had GIS Grade I injuries, three Grade II, five Grade III, five Grade IV, and eight Grade V. All road traffic accident-related injuries were GIS Grade III-V. Vaginoscopy, cystoscopy, and proctoscopy were performed in 21, 11, and 16 patients, respectively. Primary repair was undertaken in 22 patients (78.6%), while six (21.4%) required delayed reconstruction. Eleven patients underwent anal sphincter repair. Three adverse outcomes occurred. Anal sphincter function was good in 23 patients (82.1%), weak in four (14.3%), and absent in one (3.6%). No vaginal stenosis was identified during follow-up.</p><p><strong>Conclusion: </strong>Examination under general anaesthesia with selective endoscopic evaluation enables accurate assessment of surgically managed paediatric perineal trauma. Primary anatomical repair is feasible in most patients, while delayed reconstruction and selective diversion may be required for infected or complex injuries. Structured multidisciplinary management can achieve favourable functional and cosmetic outcomes.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"113751"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120793","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":"Trends in medical healthcare complaints at two Danish orthopedic departments - A descriptive study.","authors":"Oliver Lyndrup, Johanne Louise Christiansen, Charlotte Juhl Lorentsen, Ane Simony","doi":"10.1016/j.injury.2026.113519","DOIUrl":"10.1016/j.injury.2026.113519","url":null,"abstract":"<p><strong>Introduction: </strong>Medical healthcare complaints are commonly encountered in orthopedic surgery departments. Consequently, the heads of departments spend considerable amount of time addressing these complaints. Younger doctors report that their concern for receiving medial complaints may create a stressful work environment. This study investigated trends in formal complaints regarding medical treatment at orthopedic departments at Lillebaelt Hospital METHODS: This descriptive study included all formal complaints regarding medical treatment, submitted through the Danish Healthcare Authorities, and received at at two orthopedic departments at Lillebaelt Hospital, Region of Southern Denmark, during 2023. Outcomes were the number of complaints for each medical staff group, elective or acute setting, the reason for the complaint and the distribution of complaints between the two hospitals.</p><p><strong>Results: </strong>58 formal complaints were registered during the study period, 16 of these involved more than one staff group. 39 (67%) complaints included a consultant and 16 (28%) a resident in training. 42 (72%) patients complained about treatment, five (9%) of behavior, and one (2%) of the examination performed. The complaints were distributed between 22 (38%) from the elective department and 36 (62%) from the traumatology department.</p><p><strong>Conclusion: </strong>Few complaints involved residents and most of these were aimed at more than one staff group, indicating that fear of complaints among younger doctors should be low. The elective department had fewer complaints than the department of traumatology. However, no difference was observed when adjusted for number of patient visits.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"113519"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537580","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":"Clinical outcomes of interventional radiology versus operative management in hemodynamically stable and unstable moderate-to-severe high-grade blunt renal trauma.","authors":"Ariel Hus, Yumna Indorewala, Hazem Nasef, Sukriti Prashar, Logan Rogers, Youssef Nasef, Adel Elkbuli","doi":"10.1016/j.injury.2026.113634","DOIUrl":"10.1016/j.injury.2026.113634","url":null,"abstract":"<p><strong>Background: </strong>Blunt renal trauma remains a major source of morbidity and mortality despite advances in non-operative management. This study evaluates clinical outcomes in adults with moderate-to-severe high-grade blunt renal trauma, comparing interventional radiology (IR) and operative management.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the ACS-TQIP-PUF dataset (2017-2023) to evaluate outcomes in adult (≥18 years) trauma patients with moderate-to-severe (AIS abdomen ≥ 2, ISS ≥ 9) high-grade (AAST grade ≥4) blunt renal trauma who underwent operative management or IR approach. Patients were stratified by hemodynamic stability, initial hypertension, and trauma center level. Primary outcomes included mortality and nephrectomy rates. Secondary outcomes included transfusion requirements, nonoperative management failure, and complications.</p><p><strong>Results: </strong>In hemodynamically stable adult trauma patients with moderate-to-severe blunt renal injuries, IR was associated with lower 24-hour (aOR 0.477, 95% CI 0.274-0.83, p = 0.009) and in-hospital mortality (aOR 0.210, 95% CI 0.116-0.378, p < 0.001). Among unstable patients, IR was associated with reduced in-hospital mortality (aOR 0.076, CI: 0.007-0.847, p = 0.036). IR was also associated with reduced in-hospital mortality when stratifying by presence of initial hypertension (aOR 0.317, 95% CI:0.103-0.973, p = 0.045) and trauma center level, specifically at level I centers (24-hour mortality: aOR 0.047, CI:0.006-0.370, p = 0.004; in-hospital mortality: aOR 0.135, CI: 0.042-0.435, p < 0.001). Overall, no significant difference in odds of complications were observed.</p><p><strong>Conclusion: </strong>IR intervention was determined to be a safe and effective management approach for adult trauma patients with moderate-to-severe high-grade blunt renal injuries regardless of hemodynamic stability, initial hypertension, or trauma center level.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":"57 10","pages":"113634"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889801","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":"Mechanism-specific structural patterns in hospitalized severe mechanical open-globe injury: Implications for triage and operative preparedness in a 13-year tertiary referral cohort.","authors":"Chen Qin, Xin Hua, Jie Zhu, Tian Yang","doi":"10.1016/j.injury.2026.113750","DOIUrl":"https://doi.org/10.1016/j.injury.2026.113750","url":null,"abstract":"<p><strong>Background: </strong>Severe mechanical open-globe injury (OGI) is a vision-threatening emergency. Injury mechanism is often available at first contact, whereas definitive structural classification may emerge only after clinical and operative assessment. We examined whether hospitalized severe mechanical OGI shows mechanism-specific structural patterns and whether final structural phenotype is associated with short-term inpatient course.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort of 1096 index hospitalizations for severe mechanical OGI during 2013-2025 at a tertiary referral center in eastern China. Injury mechanisms were adjudicated from free-text cause fields using a prespecified coding framework. The primary outcome was final Birmingham Eye Trauma Terminology (BETT) phenotype. Mechanism-phenotype associations were assessed using an L2-penalized multinomial logistic model adjusted for age, sex, and calendar year; exponentiated contrasts were reported as adjusted odds ratios. Secondary classification-to-course analyses evaluated early visual status, visual-category improvement, length of stay, procedural burden, and treatment non-completion, with presenting visual acuity added to secondary models.</p><p><strong>Results: </strong>Industrial metal injury was the dominant mechanism (45.5%), followed by plastic/other foreign-body injury (9.7%) and falls (7.2%). Mechanism was strongly associated with final BETT phenotype (Pearson χ² = 425.62, p < 0.001). Industrial metal injury clustered toward intraocular foreign body (IOFB)-related injury and laceration without IOFB (37.3% and 36.3%), whereas falls and fireworks were rupture-dominant (96.2% and 96.0%). In the adjusted multinomial model, falls were strongly associated with globe rupture rather than laceration without IOFB compared with industrial metal injury (adjusted OR 27.40, 95% CI 12.71-77.54). Globe rupture showed the most severe inpatient course: 79.6% presented with light perception/no light perception, 94.0% had poor discharge visual acuity, and 34.3% had documented treatment non-completion. After additional adjustment for presenting visual acuity, rupture remained associated with poor discharge visual acuity (adjusted OR 5.25, 95% CI 2.84-9.71) and treatment non-completion (adjusted OR 3.78, 95% CI 2.19-6.52).</p><p><strong>Conclusions: </strong>Hospitalized severe mechanical OGI exhibited mechanism-specific structural patterns that extended beyond anatomical classification by mapping onto short-term inpatient course. Mechanism may support early structural suspicion, operative preparedness, expectation management, and treatment-pathway counseling, complementing rather than replacing examination, imaging, and operative assessment.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"113750"},"PeriodicalIF":2.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120806","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":"Plastic and reconstructive surgery management of civilians and military injuries during the 2023-2024 Middle East conflict.","authors":"Dana Adelson, Ravit Yanko, Atalia Soriano, Arik Zaretski, Daniel Kedar, Roei Singolda, Moshe Lachiani, Ehud Arad, David Leshem, Yoav Barnea","doi":"10.1016/j.injury.2026.113720","DOIUrl":"https://doi.org/10.1016/j.injury.2026.113720","url":null,"abstract":"<p><strong>Background: </strong>On October 7, 2023, a large-scale regional attack amid an armed conflict in the Middle East, resulting in an unprecedented number of wounded civilians and soldiers. Medical centers faced the challenge of managing a large influx of trauma patients on the day of the attack and throughout the ensuing conflict. This study presents our plastic surgery team's experience in immediate and reconstructive care highlighting key lessons learned.</p><p><strong>Methods: </strong>This retrospective study includes data on war-related injuries treated by our Plastic Surgery team from October 7, 2023, to June 1, 2024. Treatment varied by injury type and severity, with patients receiving care solely by plastic surgeons or within a multidisciplinary team. Data included demographics, injury types, wound management, complications, and microbiology.</p><p><strong>Results: </strong>Seventy-two patients with 132 wounds were included, predominantly involving the extremities, with lower limbs most frequently affected (53%). Blast-related shrapnel injuries were the leading mechanism (68%). One-third of wounds demonstrated bacterial growth, predominantly Gram-negative organisms. While a subset of wounds healed by secondary intention, most required surgical intervention, often following a staged approach. Notably, immediate closure performed by non-plastic surgery teams was associated with a complication rate of 72%, compared to 18% and 17% for immediate and delayed closure performed by the plastic surgery team, respectively (p < 0.001). Overall, early primary closure was associated with significantly higher complication rates compared to delayed closure or reconstructive techniques (p = 0.025), further supporting the importance of specialist involvement in closure decision-making.</p><p><strong>Conclusion: </strong>Plastic surgery plays a pivotal role in the management of traumatic wounds, addressing both acute injuries and delayed reconstruction. Early involvement of plastic surgeons in the management of war-related injuries is essential for optimizing decision-making through careful wound assessment and appropriate timing of closure, ultimately improving outcomes.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"113720"},"PeriodicalIF":2.0,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070720","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":"An evaluation of the variability in the number of high-level trauma centers per million people across the United States.","authors":"William Y York, Russell B Wohl, Ernest E Moore, Jaimo Ahn, Mara L Schenker, Joshua A Parry","doi":"10.1016/j.injury.2026.113723","DOIUrl":"https://doi.org/10.1016/j.injury.2026.113723","url":null,"abstract":"<p><strong>Introduction: </strong>The number of High-Level Trauma Centers (HLTCs) (Level I or II) per million people across the United States (US) is variable. The purpose of this study was to describe that variability and to determine if it was correlated with state characteristics.</p><p><strong>Methods: </strong>A cross-sectional study of the US was performed utilizing census data. The number of HLTCs per million people in each state was calculated. The correlation between the number of HLTCs per million and the following variables was evaluated for: population density, black and white race, land area, median household income, employment rate, uninsured rate, poverty rate, and public health insurance coverage rate.</p><p><strong>Results: </strong>All fifty states were included. The median number of HLTCs per million was 1.58 (IQR 1.14-2.45) and ranged from 0.47 in New Mexico to 6.28 in North Dakota. The median ratio of level 1 to level 2 trauma centers located in each area was 0.51 (IQR 0.25-1.0) and ranged from 0.0 to 4.0. HLTCs per million was positively correlated with white race (R=0.41, p = 0.002) and employment rate (R=0.32, p = 0.02) and negatively correlated with population density (R=-0.31, p = 0.02) and black race (R=-0.37, p = 0.008). No statistically significant correlations were observed between HLTCs per million and land area, median household income, uninsured rate, poverty rate, disability rate, or public health insurance coverage rate (p > 0.05).</p><p><strong>Conclusions: </strong>The number of HLTCs per million across the United States varied widely and was positively correlated with white race and employment rate and negatively correlated with black race and population density.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"113723"},"PeriodicalIF":2.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032332","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":"Comorbidities in major trauma patients in New Zealand: A retrospective cohort study of prevalence and associations with healthcare utilisation, mortality and cost.","authors":"Helen Harcombe, Gabrielle Davie, Dave Barson, Brett Maclennan, Trudy Sullivan","doi":"10.1016/j.injury.2026.113721","DOIUrl":"https://doi.org/10.1016/j.injury.2026.113721","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of chronic health conditions is increasing in New Zealand (NZ) and internationally. This means that more people entering the health system for an acute event, such as major trauma, are likely to have other health conditions (i.e. comorbidities) that may impact their healthcare needs, outcomes and/or cost. This study examines comorbidities among major trauma patients injured in NZ between 2018 and 2022.</p><p><strong>Methods: </strong>In this retrospective cohort study, records were linked between Te Rēhita Whētuki o Aotearoa, the New Zealand Trauma Registry and the National Minimum Dataset of hospital discharges for those who experienced a major trauma event (Injury Severity Score (ISS) > 12 or had died in hospital following trauma) in NZ during 2018-2022. Comorbidities were determined using the Multimorbidity Index (M3) using a five-year lookback from the date of discharge.</p><p><strong>Results: </strong>Over 5 years, 11,768 patients were hospitalised for major trauma in NZ. Over half of these (54%) had at least one comorbidity as assessed by the M3. Of those hospitalised with major trauma in 2018, 53% had at least one comorbidity, rising to 56% in 2022. Comorbidities typically resulted in longer length of stay, longer length of ICU stay, longer hours on a ventilator and higher in-hospital and 12-month post-discharge mortality. For example, for the 5143 with serious injury (ISS 16-24), median length of stay was 6 days for those with no comorbidities (M3 =0) and 18 days for those with an M3 > 2; median length of ICU stay was 39 h for those with no comorbidities (M3 =0), and 116 h for those with an M3 > 2. Publicly-funded healthcare costs tended to be higher for those with more comorbidities.</p><p><strong>Discussion: </strong>The increasing presence of comorbidities has implications for patient care, complexity and healthcare needs of those hospitalised following major trauma. As well as having implications for health service delivery, the findings of this study suggest that it is important to consider prevention, not only with regard to trauma, but also in relation to comorbidities, to reduce the burden on individuals and the healthcare system.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"113721"},"PeriodicalIF":2.0,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027252","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}