Injury
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Severe trauma patients often require emergent interventions, such as massive transfusion, resuscitative procedures, and surgical procedures, and consume considerable human and medical resources. However, few practical indices can be easily used for emergent interventions. In recent years, it has become clear that rSIG (Reverse Shock Index multiplied by Glasgow Coma Scale [GCS] score), which can be easily calculated from vital signs, is a promising predictor of mortality. However, it is unclear whether rSIG is useful for emergent interventions. ⋯ rSIG is a simple and effective point-of-care predictor of emergent interventions during initial management of trauma.
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Firearm-related violence (FRV) is a public health crisis in the United States that impacts individuals across the lifespan. This study sought to investigate patterns of injury and outcomes of firearm-related injury (FRI) in elderly victims and the impact of social determinants of health on this age demographic. ⋯ FRV is a public health crisis across the lifespan and elderly individuals represent a vulnerable subset of patients with unique needs and public health considerations. While many interventions target youth and young adults, it is imperative to not overlook the elderly in injury prevention efforts, particularly self-directed violence. Additionally, given most elderly victims were on government funded insurance and had a higher likelihood of requiring more costly discharge dispositions, new policies should take into consideration the potential financial burden of FRV in the elderly.
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Trauma teams play a vital role in providing prompt and specialized care to trauma patients. This study aims to provide a comprehensive description of the presence and organization of trauma teams in Italy. A nationwide cross-sectional epidemiological study was conducted between July and October 2022, involving interviews with 137 designated trauma centers. ⋯ The study revealed gaps in trauma team education and governance, with a lack of specific training for trauma team leaders and low utilization of simulation-based training. These findings emphasize the need for improvements in trauma management education, governance, and the formalization of trauma teams. This study provides valuable insights that can guide discussions and interventions aimed at enhancing trauma care at both local and national levels in Italy.
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Various attempts at automation have been made to reduce the administrative burden of manually assigning Abbreviated Injury Severity (AIS) codes to derive Injury Severity Scores (ISS) in trauma registry data. The accuracy of the resulting measures remains unclear, especially in the New Zealand (NZ) context. The aim of this study was to compare ISS derived from hospital discharge International Classification of Diseases Australian Modification (ICD-10-AM) codes with ISS recorded in the NZ Trauma Registry (NZTR). ⋯ Although the overall agreement between NZTR-ISS and ICD-ISS was slight, ICD-derived scores may be useful to describe injury patterns and for body region-specific estimations when manually coded ISS are not available.
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We applied a generalized linear mixed-effects model to determine the factors leading to injuries from wildlife-vehicle collisions (WVCs). We used the Police database representing WVCs which took place on the Czech road network between 2009 and 2022. The majority of WVCs in Czechia are with roe deer, followed by wild boar, i.e., both relatively small ungulates. ⋯ When applying an evading manoeuvre, the odds of sustaining an injury were approximately 68 times higher for car occupants while only 2.3 times higher for motorcyclists compared to a direct hit to an animal. The lack of helmets (for motorcyclists) and missing seat belts (for car occupants) were additional factors which made the outcomes worse for WVCs. While the acceptance of a direct hit (preceded by braking) seems to be a reasonable strategy for car drivers, WVC awareness (including maintaining a lower speed during critical times and places) should be raised among motorcyclists as both manoeuvres are almost comparably dangerous for them.