Injury
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Nonoperative management (NOM) of blunt splenic injury (BSI) is well accepted in appropriate patients. Splenic artery embolization (SAE) in higher-grade injuries likely plays an important role in increasing the success of NOM. We previously implemented a protocol requiring referral of all BSI grades III-V undergoing NOM for SAE. It is unknown the risk of complications as well as longitudinal outcomes. We aimed to examine the splenic salvage rate and safety profile of the protocol. We hypothesized the splenic salvage rate would be high and complications would be low. ⋯ The use of a protocol requiring routine splenic artery embolization for all high-grade spleen injuries slated for non-operative management is safe with a very low complication rate. NOM with splenic angioembolization failure rate is improved as compared to non-SAE patients' at all higher grades of injury. Thus, SAE for all hemodynamically stable patients of all high-grade types should be considered as a primary form of therapy for such injuries.
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Traumatic blunt adrenal injury (BAI) has been an area of debate, with conflicting data on its impact. BAI from blunt abdominal injury is challenging to diagnose early due to retroperitoneal gland location and minimal clinical signs. The incidence of BAI ranges from 0.03 % to 4.95 %, with an increasing trend attributed to advanced CT imaging. Conflicting data exists regarding BAI's implications on patient outcomes, necessitating a comprehensive evaluation. ⋯ The study indicates a significant association between BAI and increased trauma severity among polytrauma patients. Mortality, however, did not exhibit a consistent rise across all patients with adrenal injury, emphasizing that BAI may not independently influence outcomes. These findings align with the notion that adrenal injury is linked to the overall trauma burden rather than being a primary determinant of mortality.
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Amputations take place in the operating rooms. At dangerous sites, circumstances may necessitate on-site amputation to save lives. Currently, there are no evidence-based guidelines for the execution of the amputation or the instruments to be chosen. ⋯ With the help of AS, the usability of the used devices was determined. According to our scoring system, the reciprocating saw proved the most effective tool. Based on our results, we recommend the consideration and further investigation of the reciprocating saw as a possible on-site amputation device, as well as the introduction of the Amputation Score as an objective and quantitative indicator in the future characterization of on-site amputation devices.
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With a sustained increase in the proportion of elderly trauma patients, geriatric traumatic brain injury (TBI) is a significant source of morbidity, mortality and resource utilization. The aim of our study was to assess the predictors of mortality in geriatric TBI patients who underwent craniotomy. ⋯ Level III retrospective study.
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The rapid growth of urban instant delivery, facilitated by digital platforms and characterized by on-demand, short-term, task-based labor, has raised concerns about safety, particularly with the increasing frequency of instant delivery crashes (IDCs). This study addresses knowledge gaps in understanding injury patterns and risk factors associated with IDCs. Utilizing data extracted from judicial verdicts on IDC disputes in China, encompassing demographic, contextual, crash, and injury information, the research employs ordered logit regression to identify significant factors affecting injury patterns, the number of injuries per person (IPP), and injury severity. ⋯ Major injuries among victims emphasize potential long-term consequences and associated costs. The significance of gender, age, and risk behavior as determining factors highlights the need for targeted safety interventions. These findings offer crucial insights for stakeholders, guiding the formulation of precise safety measures and informed policy initiatives within the dynamic landscape of instant delivery safety.