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
Inter-facility transfers to an urban level 1 trauma center and rates of secondary overtriage.
Many patients originally transported to non-trauma centers (NTC) require transfer to a trauma center (TC) for treatment. The aim was to analyze injury characteristics and outcomes of transfer patients and investigate the secondary overtriage (SOT). ⋯ Transfers constituted a third of all TC admissions. The main reasons for transfer were head and spine injuries. SOT accounted for one third of transfers and occurred primarily in patients with spine and head injuries.
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Eur J Trauma Emerg Surg · Jan 2025
Impact of obstructive jaundice on outcomes in acute biliary pancreatitis: a retrospective study.
To examine the effects of obstructive jaundice on the outcomes of patients with acute biliary pancreatitis. ⋯ The outcomes of jaundiced and non-jaundiced patients with acute biliary pancreatitis were found to be similar, despite initial predictions of worse outcomes in the jaundiced population. A lower threshold for initiation of rigorous treatment, including more frequent endoscopic procedures, administration of antibiotics and early surgical intervention may facilitate these results. Further studies with a larger sample size and long-term follow-up are warranted to validate these findings.
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Eur J Trauma Emerg Surg · Jan 2025
LetterCommentary on "preoperative cardiology consultations for geriatric patients with hip fractures rarely provide additional recommendations and are associated with prolonged hospital stays and delayed surgery: a retrospective case control study".
This letter discusses the recent study by Vahabi et al., which examined the role of preoperative cardiology consultations in geriatric patients undergoing hip fracture surgery. While the study highlights the limited impact of these consultations on treatment modifications and the associated delays in surgical intervention, this letter suggests areas for further exploration. Specifically, it proposes extending outcome monitoring to include long-term cardiovascular events and incorporating cost-effectiveness analysis to better assess the value of preoperative consultations. Moreover, the letter advocates for the use of blinding in future studies to minimize selection bias and enhance the reliability of results.
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Eur J Trauma Emerg Surg · Jan 2025
In the last 10 years, have our polytrauma patients become geriatric? The emergency trauma bay in the context of demographic change.
One of the key challenges trauma centres are currently facing is the management of polytraumata in an ageing population. The aim of this study is to assess the extent to which demographic changes are reflected in the trauma bay population and the impact on geriatric polytrauma patient outcomes. ⋯ The ageing trauma bay population presents new challenges for medical staff, because polypharmacy, multiple comorbidities and frailty become more significant in an ageing population. Enhanced interdisciplinary management, particularly between trauma and geriatric specialists, may mitigate rising mortality rates. Geriatric trauma centres or at least more geriatric expertise might be required to improve the treatment and outcome in this changing population.
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Eur J Trauma Emerg Surg · Jan 2025
Patient-specific implants combined with 3D-printed drilling guides for corrective osteotomies of multiplanar tibial and femoral shaft malunions leads to more accurate corrections.
The aim of this study was to evaluate the feasibility of using patient-specific implants (PSI) for complex shaft corrective osteotomies in multiplanar deformities of long bones in the lower extremities. Additionally, it aimed to investigate the added value of these implants by quantifying surgical accuracy on postoperative CT, comparing their outcomes to two commonly used techniques: 3D virtual visualizations and 3D-printed surgical guides. ⋯ PSIs with 3D-printed drilling guides for complex multiplanar corrective osteotomies of femoral and tibial shaft malunions is feasible and achieves accurate corrections. This technique enables precise determination of the osteotomy plane, guides correction in all three planes, and ensures satisfactory implant fitting; thus accurately translating the virtual surgical plan into clinical practice. The 3D PSI method is beneficial for complex cases with significant multiplanar deformities in bone anatomy, particularly with rotational malalignment.