Injury最新文献

{"title":"Establishing thresholds for shock index in children to identify major trauma.","authors":"Sriram Ramgopal, Jillian K Gorski, Pradip P Chaudhari, Ryan G Spurrier, Christopher M Horvat, Michelle L Macy, Rebecca E Cash, Anne M Stey, Christian Martin-Gill","doi":"10.1016/j.injury.2024.111840","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111840","url":null,"abstract":"<p><strong>Background: </strong>An abnormal shock index (SI) is associated with greater injury severity among children with trauma. We sought to empirically-derive age-adjusted SI cutpoints associated with major trauma in children, and to compare the accuracy of these cutpoints to existing criteria for pediatric SI.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the 2021 National Trauma Data Bank (NTDB) Participant Use File. We included injured children (<18 years), excluding patients with traumatic arrests, mechanical ventilation upon hospital presentation, and inter-facility transfers. Our outcome was major trauma defined by the standardized triage assessment tool (STAT) criteria. Our exposure of interest was the SI. We empirically-derived upper and lower cutpoints for the SI using age-adjusted Z-scores. We compared the performance of these to the SI, pediatric-adjusted (SIPA), and the Pediatric SI (PSI). We validated the performance of the cutpoints in the 2019 NTDB.</p><p><strong>Results: </strong>We included 64,326 and 64,316 children in the derivation and validation samples, of whom 4.9 % (derivation) and 4.0 % (validation) experienced major trauma. The empirically-derived age-adjusted SI cutpoints had a sensitivity of 43.2 % and a specificity of 79.4 % for major trauma in the validation sample. The sensitivity of the PSI for major trauma was 33.9 %, with a specificity of 90.7 % among children 1-17 years of age. The sensitivity of the SIPA was 37.4 %, with a specificity of 87.8 % among children 4-16 years of age. Evaluated using logistic regression, patients with an elevated age-adjusted SI had 3.97 greater odds (95 % confidence interval [CI] 3.63-4.33) of major trauma compared to those with a normal age-adjusted SI. Patients with a depressed SI had 1.55 greater odds (95 % CI 1.36-1.78) of major trauma. The area under the receiver operator characteristic curve (AUROC) for the empirically-derived model (0.62, 95 % CI 0.61-0.63) was similar to the AUROC for PSI (0.62, 95 % CI 0.61-0.63); both of which were greater than the SIPA model (0.58, 95 % CI 0.57-0.59).</p><p><strong>Conclusion: </strong>Age-adjusted SI cutpoints demonstrated a mild gain in sensitivity compared to existing measures. However, our findings suggest that the SI alone has a limited role in the identification of major trauma in children.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094239","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":"Blast injuries: The experience of a level 1 trauma center.","authors":"Uri Neeman, Eyal Hashavia, Dror Soffer, Idit Timor, David Zeltser, Hagit Padova, Neta Cohen","doi":"10.1016/j.injury.2024.111839","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111839","url":null,"abstract":"<p><strong>Background: </strong>There is a global surge in blast injuries, which are associated with high morbidity and mortality. To our knowledge, there are no guidelines for the management of blast injuries in the trauma bay.</p><p><strong>Methods: </strong>This single-center retrospective cohort study utilized data on all patients admitted to our emergency department (ED) with terror- or combat-related injuries between October 7, 2023 (Gaza Iron Swords War onset) and February 4, 2024. The primary outcome was trauma severity indicated by either an injury severity score (ISS) >15 and/or need for acute care. We also analyzed the mechanisms of injuries, focusing on those resulting from blasts.</p><p><strong>Results: </strong>Of 208 patients who were admitted following terror-and combat related injuries, 109 patients (101 males [93 %], median age 24.0 years) were admitted following blast injuries. Of them, 88 % were military personnel and 12 % were civilians, with a median ISS of 8 [IQR:4.0-17.0]. The level of trauma was severe in 48 patients (44 %). Tertiary sub-category of blast injuries (P =0.004), chest (P =0.032), abdomen (P =0.018), and lower extremities (P =0.044) injuries were significantly associated with severe trauma. Blast injuries mandated the urgent availability of specialist personnel and appropriate equipment to contend with multiple life-threatening sequelae of exposure to blasts upon the arrival of the victims to emergency services.</p><p><strong>Conclusion: </strong>Blast injuries present unique challenges in management and demand a multidisciplinary approach and specialized resources. We present an algorithm for terror- and combat-related blast injuries treated in our trauma bay. The step-by-step procedures may be applicable to any blast injury sustained under variable conditions.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142178","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 in response to \"Natural experiments for orthopedic trauma research: An introduction\".","authors":"Pietro Regazzoni, Wen-Chih Liu, Lucía Chiquiar, Jesse B Jupiter, Alberto Fernandez Dell'Oca","doi":"10.1016/j.injury.2024.111835","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111835","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116473","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 regarding \"Trends of impact factor contributors to the Injury Journal: A bibliometric analysis\".","authors":"Jorge H Nuñez, Ernesto Guerra-Farfán, Berta Escudero","doi":"10.1016/j.injury.2024.111795","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111795","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147190","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":"\"Fractures in the elderly in Spain: A call for enhanced quality of life and specialized care protocols\".","authors":"Yaiza Lopiz","doi":"10.1016/j.injury.2024.111812","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111812","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038088","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 additional anterior support screw (AS2) besides cephalomedullary nailing.","authors":"Shi-Yi Chen, Shi-Min Chang","doi":"10.1016/j.injury.2024.111786","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111786","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908638","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":"Beneficial effect of endovascular repair for non-aortic arterial injuries: Re-analysis using alternative approach.","authors":"I-Wen Chen, Hsiu-Jung Lin, Kuo-Chuan Hung","doi":"10.1016/j.injury.2024.111794","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111794","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989781","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: Role of extracorporeal life support for traumatic hemopericardium: A single level I trauma center review.","authors":"Syeda Zuha Sami, Myrah Hasan, Muzna Murtaza, Zainab Muhammad Hanif, Ariba Nazir","doi":"10.1016/j.injury.2024.111796","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111796","url":null,"abstract":"<p><p>While this study sheds light on the valuable clinical outcomes regarding the use of extracorporeal life support (ECLS) in managing traumatic hemopericardium, I would like to emphasize a few critical areas that would improve the study's findings.</p>","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989782","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":"Response to \"Regional anesthesia is safe for use in intramedullary nailing of low-energy tibial shaft fractures\".","authors":"Anju Gupta, Amiya Kumar Barik, Chitta Ranjan Mohanty, Rakesh Vadakkethil Radhakrishnan, Gurudip Das, Ananya Ray","doi":"10.1016/j.injury.2024.111798","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111798","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001543","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 on \"Unicortical versus bicortical plate fixation for midshaft clavicular fractures\".","authors":"Wangsheng Wu, Huajuan Wang, Bingsheng Liu","doi":"10.1016/j.injury.2024.111784","DOIUrl":"https://doi.org/10.1016/j.injury.2024.111784","url":null,"abstract":"","PeriodicalId":94042,"journal":{"name":"Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908705","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}