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Conservative treatment versus transverse pinning in fifth metacarpal neck fractures in active adults: a randomized controlled trial
ConclusionBoth conservative management in ulnar gutter slab and percutaneous transverse pinning are considered effective methods in the treatment of simple extra-articular fifth metacarpal neck fractures with angulation between 30 and 70 degrees (AO: 77 A3.1). The functional and radiological results using both methods were satisfactory and statistically comparable. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 27, 2023 Category: Emergency Medicine Source Type: research

Traumatic inflammatory response: pathophysiological role and clinical value of cytokines
AbstractSevere trauma is an intractable problem in healthcare. Patients have a widespread immune system response that is complex and vital to survival. Excessive inflammatory response is the main cause of poor prognosis and poor therapeutic effect of medications in trauma patients. Cytokines are signaling proteins that play critical roles in the body's response to injuries, which could amplify or suppress immune responses. Studies have demonstrated that cytokines are closely related to the severity of injuries and prognosis of trauma patients and help present cytokine-based diagnosis and treatment plans for trauma patients...
Source: European Journal of Trauma and Emergency Surgery - December 27, 2023 Category: Emergency Medicine Source Type: research

Pre-oxygenation with high-flow oxygen through the nasopharyngeal airway compared to facemask on carbon dioxide clearance in emergency adults: a prospective randomized non-blinded clinical trial
ConclusionsCompared to facemasks, pre-oxygenation with high-flow oxygen through NPA offers improved carbon dioxide clearance and enhanced oxygenation prior to tracheal intubation in patients undergoing emergency surgery, while the risk of gastric inflation had not been ruled out.Trial registrationThis trial was registered prospectively at the Chinese Clinical Research Registry on 26/4/2022 (Registration number: ChiCTR2200059192). (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 26, 2023 Category: Emergency Medicine Source Type: research

Evaluation of prehospital preparedness for major incidents on a national level, with focus on mass casualty incidents
ConclusionThe study indicates considerable variance and gaps among Prehospital Rescue and Emergency Services in Norway regarding MCI/MI preparedness work, calling for national benchmarks, minimum requirements, follow-up routines of the organisations and future reassessments. Implementation of mandatory PLIVO exercises seems to have contributed to interdisciplinary exercises between Fire/Rescue, Police and Ambulance Emergency Service. Repeated standardised surveys can be a useful tool to assess and follow-up the MI preparedness work among Prehospital Rescue and Emergency Services at a national, regional and local level. (So...
Source: European Journal of Trauma and Emergency Surgery - December 20, 2023 Category: Emergency Medicine Source Type: research

Epidemiologic features and outcomes associated with caustic ingestion among adults admitted in intensive care unit from 2013 to 2019: a French national observational study
ConclusionICU admission for severe caustic ingestion is associated with 9.8% mortality and 74% complications. Age  >  40 years and SAPS 2 score were independently associated with mortality. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 20, 2023 Category: Emergency Medicine Source Type: research

Clinical efficacy of percutaneous vertebroplasty versus percutaneous kyphoplasty treating osteoporotic vertebral compression fractures with kyphosis
ConclusionPVP and PKP can restore partial vertebral height and improve kyphosis with similar clinical outcomes. PVP has a shorter operating time, is more economical, and can represent a therapeutic choice. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 19, 2023 Category: Emergency Medicine Source Type: research

Staged treatment of bicondylar tibial plateau fractures: influence of frame configuration and quality of reduction on outcomes
ConclusionsStaged management of bicondylar TPF resulted in a reasonable rate of complications. A direct relationship between QORs obtained with EF and after ORIF was found. Squared frames were associated with faster and better reductions, regardless of the surgeon ’s background. Considering our results, we advocate for the wider use of squared EF configurations in these patients. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 18, 2023 Category: Emergency Medicine Source Type: research

Prognostic accuracy of emergency surgery score: a systematic review
ConclusionDespite the acceptable prognostic accuracy of ESS in 30-day mortality, morbidities, and in-hospital ICU admission in different emergency surgeries, the high number of required variables and the high probability of missing data highlight the need for modifications to this scoring system. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 18, 2023 Category: Emergency Medicine Source Type: research

The predictive value of four traumatic hemorrhage scores for early massive blood transfusion in trauma patients in the pre-hospital setting
ConclusionsAll four pre-hospital trauma hemorrhage scores have a high predictive value in assessing massive blood transfusion in trauma patients. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 18, 2023 Category: Emergency Medicine Source Type: research

The outcomes of the most severe polytrauma patients: a systematic review of the use of high ISS cutoffs for performance measurement
ConclusionsThere are very few critically injured patients reported during the last 48 years. The most critically injured polytrauma patients still have at least a 50% risk of death. There is no consistent inclusion and exclusion criteria for this high-risk cohort. The current approach to reporting is not suitable for monitoring the epidemiology and outcomes of the critically injured polytrauma patients.Level of evidenceLevel 4 —systematic review of level 4 studies. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 18, 2023 Category: Emergency Medicine Source Type: research

Feasibility of non-operative management for patients sustained blunt splenic traumas with concomitant aortic injuries
ConclusionThis study demonstrated that patients with concurrent aortic and splenic injuries presented with more severe conditions, higher mortality rates, and extended hospital stays. The presence of aortic injuries did not substantially influence the utilization of TAE or the necessity for splenectomy or splenorrhaphy. Patients of this type can be managed in accordance with current treatment guidelines. Nonetheless, given their less favorable prognosis, they necessitate prompt and proactive intervention. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 14, 2023 Category: Emergency Medicine Source Type: research

Recovery to normal vital functions and acid –base status after a severe trauma in Level I versus Level II Trauma Centres
ConclusionSeverely injured patients admitted to a Level I trauma center require less time to normalize their vital functions. Level I centers are better equipped, resulting in better in-hospital processes with shorter time at the emergency department and shorter time until a CT scan. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 14, 2023 Category: Emergency Medicine Source Type: research

Witnessed prehospital traumatic arrest: predictors of survival to hospital discharge
ConclusionAfter EMS-witnessed traumatic cardiac arrest, survivors were more likely to be young, female, injured by blunt trauma, and less hypotensive/comatose on-scene. These findings may have implications for ED resuscitation or declaration of care futility and should be further investigated with a prospective multicenter study. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 12, 2023 Category: Emergency Medicine Source Type: research

Development of early complications after treatment of trochanteric fractures with an intramedullary sliding hip screw in a geriatric population
ConclusionComplications after TF treatment occur frequently. While patient-associated variables such as morbid obesity cannot be influenced by the surgeon, correct fracture reduction and implant positioning remain to be of highest importance. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 11, 2023 Category: Emergency Medicine Source Type: research

The impact of chronic obstructive pulmonary disease on surgical outcomes after surgery for an acute abdominal diagnosis
ConclusionsPreexisting COPD may alter a patient ’s risk of PPCs and VD. However, it was not associated with an increased risk of in-hospital mortality. (Source: European Journal of Trauma and Emergency Surgery)
Source: European Journal of Trauma and Emergency Surgery - December 8, 2023 Category: Emergency Medicine Source Type: research