European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jan 2025
Assessing the role of chest CT in minor blunt trauma: evaluation of the NEXUS decision instrument across an expanded population.
To evaluate the NEXUS Chest CT ALL decision instrument (DI) in reducing unnecessary chest CT imaging in minor blunt trauma patients while preserving high sensitivity for detecting clinically meaningful injuries. Additionally, we examined the impact of delayed presentation, chronic disease, and anticoagulation/anti-aggregation medications on trauma outcomes. ⋯ The NEXUS Chest CT ALL DI significantly reduces unnecessary imaging while maintaining high diagnostic precision. A modified version enhances sensitivity, refining decision-making in emergency care. Integrating such decision tools, particularly in cases of minor trauma, is highly recommended to optimize resource use and improve patient outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Quality of referrals and adherence to guidelines for adult patients with minimal to moderate head injuries in a selection of Norwegian hospitals.
This study aimed to assess adherence to the Scandinavian guidelines, the justification of referrals, and the quality of referrals of patients with mild, minimal, and moderate head injuries in a selection of Norwegian hospitals. ⋯ Adherence to the Scandinavian guidelines and the quality of referrals of patients with mild, minimal, and moderate head injuries are low. Training and using S100B is recommended to improve the justification rate and quality of patient care.
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Eur J Trauma Emerg Surg · Jan 2025
Ulnoradial - metacarpal reconstruction for emergency one-stage procedure in complicated wrist amputation.
Complicated wrist amputation caused by severe trauma poses a real challenge for orthopedic and hand surgeons. This study aimed to evaluate a procedure of ulnoradial-metacarpal reconstruction as a rescue option in this challenging situation. ⋯ Therapeutic IV.
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Eur J Trauma Emerg Surg · Jan 2025
Dual-energy CT in diagnosing sacral fractures: assessment of diagnostic accuracy and intra- and inter-rater reliabilities.
Evaluating sacral fractures is crucial in fragility fractures of the pelvis. Dual-energy CT (DECT) is considered useful for diagnosing unclear fractures on single-energy CT (SECT). This study aims to investigate the effectiveness of DECT in diagnosing sacral fractures. ⋯ Combined use of DECT with SECT improved the detection rate of sacral fractures and enhanced intra-rater and inter-rater reliability. High diagnostic accuracy was achieved regardless of the observer's experience. These results indicate that DECT is a useful imaging modality for diagnosing sacral fractures.
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Eur J Trauma Emerg Surg · Jan 2025
Review Meta AnalysisAccuracy of GFAP and UCH-L1 in predicting brain abnormalities on CT scans after mild traumatic brain injury: a systematic review and meta-analysis.
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In recent years, blood biomarkers including glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have shown a promising ability to detect head CT abnormalities following TBI. This review aims to combine the existing research on GFAP and UCH-L1 biomarkers and examine how well they can predict abnormal CT results after mild TBI. ⋯ Present results suggest that GFAP and UCH-L1 have the clinical potential for screening mild TBI patients for intracranial abnormalities on head CT scans.