Injury最新文献

{"title":"Critical Appraisal of One-stage prosthetic dermal repair of skin defects in the donor area of the great toe nails flap.","authors":"Sarah Aijaz, Hussain Ramzan, Raveen Muzaffer","doi":"10.1016/j.injury.2025.112555","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112555","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112555"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565575","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":"The 15 % Myth: Correcting a long-standing misinterpretation of arterial bleeding in pelvic fractures.","authors":"Hui Li, Guangbin Huang, Dingyuan Du","doi":"10.1016/j.injury.2025.112551","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112551","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112551"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Strengthening emergency medical services in LMICs through local initiatives and technological solutions.","authors":"Emil Iversen, Marko Hingi, Augustino Mhanga, Jason Friesen, Guttorm Brattebø","doi":"10.1016/j.injury.2025.112549","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112549","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112549"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531972","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 relevance and accuracy in AI-assisted patient consultations on ankle and clavicle fracture surgeries.: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.injury.2025.112545","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112545","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112545"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556259","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":"Surgical outcomes for Gartland type III supracondylar humerus fracture in children: Comparison between flexion and extension types.","authors":"Andreas Rehm, Ben Gompels, Ignatius Liew, Hatem Osman, Felix Morriss, Elizabeth Ashby","doi":"10.1016/j.injury.2025.112546","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112546","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112546"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556260","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":"Insights from the Indian experience on covid-19's impact on trauma care - A response to impact of covid-19 on trauma care in trauma and non-trauma centers in New York State: a SPARCS 2016-2022 analysis.","authors":"Raju Vaishya, Abhishek Vaish","doi":"10.1016/j.injury.2025.112548","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112548","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112548"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of the STAT taxonomy and T-NOTECHS for assessing trauma team non-technical skills: A secondary analysis using trauma video review.","authors":"Anisa Nazir, Eliane M Shore, Ryan P Dumas, Caitlin Fitzgerald, Melissa McGowan, Charles Keown-Stoneman, Teodor Grantcharov, Brodie Nolan","doi":"10.1016/j.injury.2025.112537","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112537","url":null,"abstract":"<p><strong>Background: </strong>Non-technical skills (NTS), such as leadership, communication and interaction, situational awareness, cooperation and resource management (CRM), and assessment and decision-making, are critical to optimizing team performance and reducing adverse events (AEs) during trauma resuscitations. This study investigates the association between NTS, assessed using the Trauma - NOn-TECHnical Skills (T-NOTECHS) tool, and AEs, classified using the STAT taxonomy.</p><p><strong>Methods: </strong>This secondary analysis included 30 adult trauma team activations at Parkland Hospital, Dallas, Texas, with inclusion criteria of patients aged >16 years and trauma video recordings available from the Trauma Video Review Repository between January 1, 2019, and January 15, 2022. T-NOTECHS assessed NTS across five domains using a 5-point Likert scale (1 = poor, 5 = excellent). AEs were identified and categorized using the STAT taxonomy. Descriptive statistics summarized T-NOTECHS scores, AEs, and demographic factors. Poisson regression models examined associations between T-NOTECHS scores, AEs, and demographic variables with reported incidence rate ratios (IRRs). Overdispersion was assessed, and Quasi-Poisson and Negative Binomial models were used for robustness when necessary.</p><p><strong>Results: </strong>T-NOTECHS scores ranged from 17 to 25, with a median of 22, indicating high team performance across domains. The total number of AEs ranged from 4 to 29, with a median of 9.5. Poisson regression analysis demonstrated a significant negative association between T-NOTECHS scores and AEs (IRR = 0.89, 95 % CI: 0.84-0.94, p < 0.001), indicating that each one-point increase in T-NOTECHS score was associated with an 11 % reduction in the expected rate of AEs. Age, sex, and Injury Severity Score (ISS) were not significant predictors of T-NOTECHS scores or AEs. Overdispersion assessments supported Poisson regression, with findings robust to Quasi-Poisson and Negative Binomial models.</p><p><strong>Conclusion: </strong>Higher non-technical performance, measured by T-NOTECHS, is strongly associated with fewer AEs in trauma resuscitations. These findings underscore the importance of structured training and assessment of NTS to enhance patient safety and team dynamics. Future studies should validate these results in larger datasets and explore interventions to further improve NTS in trauma care.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112537"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531970","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":"Traumatic Self-Harm in Older People: A 7-Year Descriptive Analysis from a London Major Trauma Centre.","authors":"Joseph H S Thompson, Dhanupriya Sivapathasuntharam, Elaine Cole, Elizabeth L Sampson","doi":"10.1016/j.injury.2025.112542","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112542","url":null,"abstract":"<p><strong>Background: </strong>Suicide in older people is increasing. We know less about serious deliberate self-harm in this population or the impact of this on Major Trauma Centres (MTC).</p><p><strong>Objectives: </strong>Investigate demographics, injury mechanism and outcomes in older people admitted with self-inflicted injury.</p><p><strong>Design: </strong>Retrospective service evaluation.</p><p><strong>Setting: </strong>Single MTC in London, UK.</p><p><strong>Subjects: </strong>60 people aged 65 years and over admitted to a MTC with self-inflicted injury.</p><p><strong>Methods: </strong>Retrospective analysis of trauma registry data (February 2015-2022).</p><p><strong>Variables: </strong>age, sex, past medical and psychiatric history, home and marital status, injury type and narrative, injury severity score (ISS), critical care admission, length of stay, discharge status and destination.</p><p><strong>Results: </strong>Self-inflicted injury represented 1.5 % of trauma admissions aged 65 and over (80 % male, median age 73 years). Most females and over half of men had a psychiatric history (females n = 11, 91.7 %; males n = 28, 58.3 %). Depression was the most common psychiatric comorbidity (n = 15). Males were more likely to suffer penetrating injury (males n = 37, 77.1 %; females n = 4, 33.3 %). The most common injury mechanism was self-stabbing amongst males (n = 37, 77.1 %) and a jump from height amongst females (n = 6, 50.0 %). Median ISS (8.5) and mortality (n = 8, 13.3 %) was low across the cohort. The most common discharge destination was psychiatric admission (males n = 28, 58.3 %; females n = 6, 50.0 %).</p><p><strong>Conclusion: </strong>Older people who present with traumatic self-inflicted injury are predominantly male, utilise violent methods, have significant psychiatric comorbidity and require psychiatric admissions.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112542"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical appraisal of interprofessional clinical practice guidelines for burn care.","authors":"Hossein Ghasemi, Mahmood Omranifard, Masoud Bahrami, Maryam Moghimian, Sedigheh Farzi","doi":"10.1016/j.injury.2025.112527","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112527","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based clinical practice guidelines play a crucial role in supporting clinical decision-making among healthcare providers, policymakers, and administrators by offering structured, research-informed recommendations. Globally, numerous guidelines have been developed for the management of burn injuries, but they vary considerably in terms of quality, structure, and methodological rigor. This study aimed to critically evaluate the quality of existing burn care guidelines from an interprofessional perspective and assess their adaptability for use in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>This appraisal study, conducted between 2024 and 2025, employed the AGREE II instrument to evaluate guideline quality through the lens of an interprofessional burn care team. The methodology involved a systematic search to identify relevant guidelines, the formation of a multidisciplinary panel of burn care professionals, and a final quality appraisal of the selected guidelines using the AGREE II framework.</p><p><strong>Results: </strong>Out of the 38 initially identified clinical guidelines, 31 were excluded due to failure to meet the preliminary thresholds for quality and methodological validity. The remaining seven guidelines were subjected to a comprehensive evaluation using the 23-item AGREE II instrument, encompassing six key quality domains. The appraisal revealed considerable variability across these domains, with particularly marked disparities in stakeholder involvement, methodological rigor, and practical applicability.</p><p><strong>Conclusion: </strong>The findings revealed significant heterogeneity in both the structural and content quality of current burn care guidelines. Among the evaluated documents, the guideline developed by the International Society for Burn Injuries (ISBI) achieved the highest AGREE II scores, demonstrating a strong interprofessional focus and relevance to LMICs. The expert panel subsequently endorsed it as the most appropriate candidate for adaptation in resource-constrained settings. These results highlight the urgent need for more robust, interdisciplinary, and context-sensitive burn care guidelines to improve patient outcomes and healthcare delivery globally.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112527"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499943","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":"Guiding rib fracture care with the STUMBL score: acute pain management and intensive care unit referrals.","authors":"Nicholas Shearer, Timothy Blakey, Daniel Wornham, Scott Taylor, Chuan-Whei Lee","doi":"10.1016/j.injury.2025.112525","DOIUrl":"https://doi.org/10.1016/j.injury.2025.112525","url":null,"abstract":"<p><strong>Background: </strong>Rib fractures are common after blunt chest trauma and are associated with significant morbidity, mortality, and prolonged hospital stays due to pulmonary complications. Effective pain management is crucial in preventing these complications. The 'STUdy of the Management of BLunt chest wall trauma' (STUMBL) score can identify patients with rib fractures at risk of complications and assist with Emergency Department (ED) disposition decisions. Its role in guiding Acute Pain Service (APS) and Intensive Care Unit (ICU) referrals was previously unexplored.</p><p><strong>Design and objectives: </strong>We conducted a retrospective cohort study on adults with radiologically confirmed rib fractures who presented to The Royal Melbourne Hospital between April 2021 and March 2022. We aimed to assess the association between STUMBL scores and advanced analgesia prescription or ICU admission. Participants were categorised into five STUMBL groups (<11, 11-20, 21-25, 26-30, ≥31). The primary outcome of interest was regional analgesia insertion. The secondary outcomes were patient-controlled analgesia (PCA) use, APS and ICU referrals, and medical emergency team (MET) calls within 48 h. Modified Poisson regression was used to analyse associations, with the <11 group used as the reference.</p><p><strong>Results: </strong>Among 344 participants, the median STUMBL score was 17 (interquartile range [IQR] 10-24). Higher STUMBL scores were strongly associated with regional analgesia insertion in the STUMBL 26-30 group (RR 15.3, 95 % CI 1.8-130.3, p = 0.013) and the STUMBL ≥31 group (RR 29.3, 95 % CI 4.0-212.5, p = 0.001). Significant associations were also observed for PCA prescription (RR 5.0, 95 % CI 2.6-9.7, p < 0.001), APS referral (RR 4.7, 95 % CI 2.7-8.1, p < 0.001), and ICU admission (RR 3.8, 95 % CI 2.0-6.9, p < 0.001) in the STUMBL ≥31 group.</p><p><strong>Conclusion: </strong>The STUMBL score is a valuable tool for identifying patients likely to require advanced analgesia and APS input, with high scores strongly associated with regional analgesia insertion and PCA prescription. Additionally, patients with STUMBL scores ≥26 were more likely to require ICU admission. Incorporating STUMBL thresholds into rib fracture guidelines could facilitate early APS involvement, guide appropriate admission destinations, optimise hospital resource allocation and improve patient outcomes. Further studies should validate these findings in larger, multi centre cohorts and explore patient-reported outcomes.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":" ","pages":"112525"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499944","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}