Prediction Model for Blunt Thoracic Aortic Injury Evaluation in the Emergency Department.

BackgroundThe diagnosis of blunt thoracic aortic injury (BTAI) is challenging. In this study, a prediction model with a simplified scoring system for BTAI was developed for the primary evaluation of trauma patients in the emergency department.MethodsThis retrospective cohort study included blunt chest trauma patients.

Comparative analysis of AI support levels in clinical interpretation of traumatic pelvic radiographs.

Plain pelvic radiographs (PXR) remain crucial for initial trauma assessment, yet interpretation challenges persist. While artificial intelligence (AI) shows promise, its practical impact across specialties remains unexplored. We conducted a retrospective image-based, multi-reader multi-case (MRMC) study using a standardized, prospectively planned evaluation protocol.

Surgical stabilization of rib fractures improves survival in functionally dependent trauma patients.

Background: Rib fractures are frequently encountered in trauma care and are particularly hazardous for functionally dependent patients, leading to increased morbidity and mortality rates. Surgical stabilization of rib fractures (SSRF) improves outcomes in selected populations; however, its role in functionally dependent individuals remains underexplored.

Methods: A retrospective cohort analysis was conducted using the American College of Surgeons-Trauma Quality Improvement Program dataset from 2020 to 2022.

Long-term follow-up of infection, malignancy, thromboembolism, and all-cause mortality risks after splenic artery embolization for blunt splenic injury: comparison with splenectomy and conservative management.

Background: Non-operative management, including splenic artery embolization, is preferred for blunt splenic injuries, but its long-term risks need further investigation. Long-term splenic functions were assessed in patients with blunt splenic injuries, hypothesizing that splenic artery embolization would preserve function and reduce long-term risks.

Methods: This retrospective cohort study used Taiwan's National Health Insurance Research Database to analyse patients with blunt splenic injuries from 2004 to 2019.

Total care of trauma patients from triage to discharge at Chang Gung Memorial Hospital: introducing the development of an iconic acute care surgery system in Taiwan.

Background: The Acute Care Surgery (ACS) model has evolved to provide structured care across trauma, critical care, and emergency general surgery. This innovative model effectively addresses significant challenges within trauma care. Research indicates that trauma surgeons operating under this expanded scope deliver high-quality care while enjoying professional satisfaction.

Risk factors and economic impact of long-term nursing care after major trauma.

Introduction: The public could bear a heavy economic burden for trauma survivors needing long-term nursing care, especially in countries such as Taiwan that have universal health insurance coverage. The purpose of this study was to analyze the data from the National Health Insurance Research Database and to assess reimbursement to trauma patients with long-term sequelae who need nursing care.

Methods: This study included all patients who suffered major trauma (injury severity score ≥ 16) in Taiwan from 2003 to 2007.

Safety or speed? Assessing alternative vascular access for angiography after resuscitative endovascular balloon occlusion of the aorta (REBOA) in severe pelvic trauma patients.

Introduction: Pelvic fractures often result in life-threatening bleeding and hemodynamic instability. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a promising strategy for patients with severe pelvic fractures, facilitating subsequent hemostatic interventions. Transcatheter arterial embolization (TAE) is a well-established procedure for managing pelvic fractures accompanied by hemorrhage.

Fixation of rib fractures is beneficial for patients with chronic obstructive pulmonary disease, a trauma quality improvement program study.

Background: Internal fixation for multiple rib fractures is well established. Patients with underlying chronic obstructive pulmonary disease (COPD) have a higher rate of perioperative complications. It is unclear if these patients are suitable candidates for internal fixation and if surgical interventions are harmful to these patients.

Analysis of the current usage of resuscitative endovascular balloon occlusion of the aorta (REBOA) in pediatric trauma patients: a retrospective observational study from the American College of Surgeons-Trauma Quality Improvement Program databases.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been an established life-saving procedure for adult trauma patients, but the evidence for its use in pediatric patients is still under question. The purpose of this study was to examine the outcome of REBOA in pediatric patients.

Methods: We retrospectively analyzed observational cohort data from the American College of Surgeons-Trauma Quality Improvement Program from 2017 to 2019.

Evaluating the clinical impact of resuscitative endovascular balloon occlusion of the aorta in patients with blunt trauma with hemorrhagic shock and coexisting traumatic brain injuries: a retrospective cohort study.

Background: The impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) on traumatic brain injuries remains uncertain, with potential outcomes ranging from neuroprotection to exacerbation of the injury. The study aimed to evaluate consciousness recovery in patients with blunt trauma, shock, and traumatic brain injuries.

Material And Methods: Data were obtained from the American College of Surgeons Trauma Quality Improvement Program from 2017 to 2019.

Feasibility of non-operative management for patients sustained blunt splenic traumas with concomitant aortic injuries.

Purpose: This study aimed to elucidate the treatment approach for blunt splenic injuries concurrently involving the aorta. We hypothesized that non-operative management failure rates would be higher in such cases, necessitating increased hemorrhage control surgeries.

Methods: Data from the Trauma Quality Improvement Program spanning 2017 to 2019 were utilized.

The effect of transarterial embolization and nephrectomy on acute kidney injury in patients with blunt renal trauma: An American College of Surgeons - Trauma Quality Improvement Program analysis.

Introduction: Transarterial embolization (TAE) or nephrectomy for patients with blunt renal trauma might result in acute kidney injury (AKI). Thus, we analyzed the American College of Surgeons - Trauma Quality Improvement Program (TQIP) to validate this. We hypothesized that nephrectomy, and not TAE, would be a risk factor for AKI in patients with blunt renal trauma.

Low-molecular-weight heparin is associated with lower venous thromboembolism events than factor Xa inhibitors in patients with severe blunt trauma: a cohort study from the Trauma Quality Improvement Program.

Background: Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is a common complication of major trauma. Pharmacological VTE prophylactics are widely used, and low-molecular-weight heparin (LMWH) is recommended. Factor Xa inhibitors are increasingly being used for VTE prophylaxis in both medical and surgical patients.

Accelerated fixation is associated with fewer pulmonary embolism in patients with isolated and unilateral femoral shaft fractures: A TQIP analysis.

Introduction: The optimal time to intramedullary internal fixation for patients with isolated and unilateral femoral shaft fractures was investigated by the American College of Surgeons-Trauma Quality Improvement Program (ACS-TQIP).

Material And Methods: Adult patients from the TQIP between 2017 and 2019 were eligible for inclusion. The associations between time to fixation and target outcomes (pulmonary embolism [PE], deep vein thrombosis [DVT], acute respiratory distress syndrome [ARDS], and mortality) were assessed.

Speeding pelvic fracture fixation: CT scan with simultaneous 3-D pelvic reconstruction in the emergency department.

Introduction: Contrast-enhanced computed tomography (CT) scans are usually needed in the emergency department (ED) to evaluate intra-abdominal injuries associated with pelvic fractures. Three-dimensional (3-D) images for pelvis reconstruction are also needed for planning surgical fixation after admission. This study investigates the advantages integrating a one-stage computed tomography (CT) scan with these two diagnostic modalities simultaneously to reduce the time to surgery and improve the outcomes of pelvic fracture fixation.

The Feasibility and Performance of Total Hip Replacement Prediction Deep Learning Algorithm with Real World Data.

(1) Background: Hip degenerative disorder is a common geriatric disease is the main causes to lead to total hip replacement (THR). The surgical timing of THR is crucial for post-operative recovery. Deep learning (DL) algorithms can be used to detect anomalies in medical images and predict the need for THR.

Timely surgical fixation confers beneficial outcomes in patients' concomitant flail chest with mild-to-moderate traumatic brain injury: a trauma quality improvement project analysis - a cohort study.

Background: Traumatic flail chest results in respiratory distress and prolonged hospital stay. Timely surgical fixation of the flail chest reduces respiratory complications, decreases ventilator dependence, and shortens hospital stays. Concomitant head injury is not unusual in these patients and can postpone surgical timing due to the need to monitor the status of intracranial injuries.

Effect of zinc supplement on patients with trauma: A systematic review and meta-analysis.

Aims: This study aimed to assess the effect of zinc supplementation, with or without other antioxidants and trace elements, on clinical outcomes in patients with trauma.

Methods: A systematic review was conducted for adult patients with acute trauma who had been admitted to the hospital. Those who sustained burn injuries were excluded.

The Clinical Application of Machine Learning-Based Models for Early Prediction of Hemorrhage in Trauma Intensive Care Units.

Uncontrolled post-traumatic hemorrhage is an important cause of traumatic mortality that can be avoided. This study intends to use machine learning (ML) to build an algorithm based on data collected from an electronic health record (EHR) system to predict the risk of delayed bleeding in trauma patients in the ICU. We enrolled patients with torso trauma in the surgical ICU.

Does Thoracic Endovascular Aortic Repair for Blunt Thoracic Aortic Injury Increase the Probability of Delayed Intra-abdominal Hemorrhage in Patients With Concomitant Blunt Abdominal Trauma?

Purpose: Most blunt thoracic aortic injuries (BTAIs) may be treated using thoracic endovascular aortic repair (TEVAR), and most blunt abdominal traumas (BATs) are managed conservatively. We hypothesized that severe trauma that needs TEVAR may increase the risk of delayed intra-abdominal hemorrhage in patients with concomitant BTAI and BAT because of the potential hemorrhagic shock, disseminated intravascular coagulopathy, blood loss, consequent need for blood transfusion, and procedure-associated heparinization.

Materials And Methods: From 2015 to 2019, blunt trauma patients with concomitant severe chest trauma and abdominal trauma who could be managed conservatively were studied.

Could video-assisted thoracoscopic surgery be feasible for blunt trauma patients with massive haemothorax?

Introduction: The study reviewed the experience of video-assisted thoracoscopic surgery (VATS) for the treatment of massive haemothorax (MHT).

Materials And Methods: All adult patients who sustained blunt trauma with a diagnosis of traumatic haemothorax or pneumothorax (ICD9 860; ICD10 S27.0-2), injury to the heart and lungs (ICD9 861; ICD10 S26, S27.

The highest troponin I level during admission is associated with mortality in blunt cardiac injury patients.

Background: Cardiac troponin I (cTnI) levels are usually measured in primary evaluations of blunt cardiac injury (BCI) patients. We evaluated the associations of cTnI levels with the outcomes of BCI patients at different times.

Methods: From 2015 to 2019, blunt chest trauma patients with elevated cTnI levels were compared with patients without elevated cTnI levels using propensity score matching (PSM) to minimize selection bias.