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
Increasing prehospital tourniquet use attributed to non-indicated use: an 11-year retrospective study.
The use of prehospital tourniquets (PHTQ) for haemorrhage control in the civilian trauma population has increased over the past decade with some reports documenting the overuse of the device. The aim of this study was to identify the proportion of PHTQ use that is non-indicated and determine how this proportion is changing over time. ⋯ Over this 11-year period, we identified that the increase in PHTQ use in civilian trauma is from increasing non-indicated use. Given that complications are associated with unnecessary PHTQ use, the adherence to the guidelines needs to be urgently reinforced.
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Eur J Trauma Emerg Surg · Jan 2025
Effects of early propranolol administration on mortality from severe, traumatic brain injury: a retrospective propensity score-matched registry study.
The role of beta-blockers in severe, traumatic brain injury (TBI) management is debated. Severe TBI may elicit a surge of catecholamines, which has been associated with increased morbidity and mortality. We hypothesize administering propranolol, a non-selective beta-blocker, within 48 h of TBI will reduce patient mortality within 30 days of injury. The TriNetX database was leveraged to determine if administering a propranolol within 48 h of severe TBI improves outcomes within 30 days of injury. ⋯ The results of this study demonstrate significantly reduced mortality within 30 days of injury and fewer neurosurgical interventions, seizures, and episodes of cardiac arrest in severe TBI patients who received propranolol within 48 h of injury.
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Eur J Trauma Emerg Surg · Jan 2025
The misleading terminology of minor amputation of the lower limb.
A pronounced loss of function of the lower limb of various origins, especially with an infection-related course, may require a minor (MIN) or major (MAJ) amputation of the lower limb. Our aim was to contrast the underlying etiology, including previous trauma, surgical procedure, and the subsequent function. ⋯ With MIN and MAJ results comparable in all scores and queries, it emphasizes the fact that even supposedly lower-limb MIN represents a considerable impairment of coping with daily life. If there is no prospect of preserving the limb, early transtibial amputation should be considered. However, our results support the good outcome despite lower-limb MAJ through modern prosthetic fitting.
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Eur J Trauma Emerg Surg · Jan 2025
Comparative StudyEffects of osteosynthesis of the bony thorax in the context of polytrauma compared to conservative treatment: a systematic review.
Osteosynthesis seems to have effects regarding clinical outcomes in trauma patients. However, current knowledge on chest wall osteosynthesis in polytrauma patients is insufficient, leaving its potential unanswered. Therefore, the objective of this systematic review is to assess the safety and effects of chest wall osteosynthesis compared to conservative treatment on clinical outcomes in adult polytrauma patients. ⋯ There is limited evidence regarding chest wall osteosynthesis compared to conservative treatment in polytrauma patients. One RCT shows no effect of surgical rib fixation compared to conservative treatment regarding mortality and clinical status, but a potential benefit regarding ICU length of stay.
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Eur J Trauma Emerg Surg · Jan 2025
ReviewPreventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review.
Confounding in observational studies can be mitigated by selecting only those patients, in whom equipoise of both treatments is secured by experts' disagreement over optimal therapy. ⋯ With this review we aim to provide insight into this study design and to stimulate discussions about the potential of expert panels to control for confounding in studies of medical treatments.