Injury severity-based discrepancies in severe trauma survival improvement.

Purpose: Current trauma outcome reporting via registries captures nearly all trauma patients at risk of death. Most of these patients have milder injuries and they considerably outnumber the most critically injured patients. A change in outcomes of the whole group, may not be shared equally among all patients.

Demographics, treatment, and outcomes of rib fractures in older adults: a retrospective multi-institutional study.

Purpose: Rib fractures in the elderly can lead to significant morbidity and mortality. Management is generally conservative due to the perceived risks related to frailty and co-morbidities. The primary aim of this exploratory study was to describe the demographics and outcomes of traumatic rib fractures in older Australians admitted to major trauma centres.

The impact of direct oral anticoagulants on hip fracture care in Australia and New Zealand: a prospective patient sprint audit.

Unlabelled: Management of hip fracture patients on direct oral anticoagulants in Australia and New Zealand is unclear. Hip fracture patients on DOACs had three times higher odds of time to surgery > 36 h than patients on no antithrombotic medication. Balancing individual considerations and guidelines may shorten time to surgery.

State of orthopaedic trauma registries in South Korea, Japan, and Australia.

Introduction: The scope and complexity of orthopaedic trauma registries differ across the Asia-Pacific region. The purpose of this report was to review the existing registries in South Korea, Japan, and Australia focusing on their current utility, processes, and future directions.

Methods: Representatives of the International Orthopaedic Trauma Associations and relevant national registry experts provided a comprehensive overview of their countries' orthopaedic trauma registries based on predetermined mandatory aspects of their systems consistent with the goals of the global review, which includes other regions in a review series.

Avoidable and unavoidable delays in hip fracture surgery : a prospective observational study of who, what, and why?

Aims: Surgical management of hip fracture is often delayed, which is associated with increased mortality. We aimed to prospectively determine the proportion of potentially avoidable delay to surgery beyond 48 hours, and its causes, as clinically relevant margins for quality improvement.

Methods: A 12-month prospective cohort study from September 2022 to September 2023 was conducted on all 427 hip fracture surgery patients aged ≥ 50 years who were admitted to a trauma centre in New South Wales, Australia.

Time to Computed Tomography for Major Trauma Patients: 10-Year Trends at a Level-1 Trauma Centre.

Introduction: Computed tomography (CT) is an essential part of trauma patient initial workup. Rapid performance of CT has become the standard of care in most parts of the world. This study aims to assess if the time to CT has changed over a 10-year period at the study centre and examine the potential impact on patient outcomes.

Contemporary Long-Term Patient Reported Outcomes of Pilon Fractures.

Background: Pilon fractures are historically associated with suboptimal outcomes. No long-term Australian data is available on patient-reported outcomes. We hypothesised that pilon fracture long-term outcomes are inferior to Australian population norms.

Trauma systems: a global comparison.

Traumatic injuries are a leading cause of global morbidity and mortality, with 40 million people permanently injured and nearly 6 million deaths every year. Approximately 90% of trauma-related deaths occur in low- and middle-income countries, and 50% of trauma-related deaths are believed to be preventable. Although effective trauma systems encompassing prehospital, hospital, and rehabilitative care are critical for improving outcomes, global documentation remains limited.

Timely enteral nutrition of ventilated polytrauma patients: current standards and room for improvements.

Purpose: Polytrauma patients in intensive care units (ICUs) face significant risks of morbidity and mortality, with nutrition playing a crucial role in mitigating energy deficits and complications such as multi-organ failure (MOF). This study aimed to evaluate adherence to enteral nutrition (EN) guidelines in ventilated polytrauma patients and explored correlations between EN timing and clinical outcomes.

Methods: A four-year retrospective (2019-2022) analysis of ventilated polytrauma patients (abbreviated injury scale > 2 in ≥ 2 body regions) admitted to a level 1 trauma centre.

Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia.

Background: Fragility hip fractures are a common and often devastating event, and a shared care approach between orthopaedics and geriatrics can improve patient, health service and quality of care outcomes. The aim of this cross-sectional survey, administered to all hospitals caring for patients with acute hip fracture, in New South Wales (NSW), Australia, was to establish current models of care (e.g.

Epidemiology of myocardial injury in trauma patients: proposed phenotypes for future research.

Purpose: To describe the epidemiology of myocardial injury in trauma patients, in doing so informing design for future multicentre prospective studies.

Method: A one-year retrospective study ending on 31/08/2023 was conducted at a Level-1 Trauma Centre. All adult trauma resuscitation patients with elevated Troponin serum concentration were included.

COVID-19 infection is a significant risk factor for death in patients presenting with acute cholecystitis: a secondary analysis of the ChoCO-W cohort study.

Background: During the coronavirus disease (COVID-19) pandemic, there has been a surge in cases of acute cholecystitis. The ChoCO-W global prospective study reported a higher incidence of gangrenous cholecystitis and adverse outcomes in COVID-19 patients. Through this secondary analysis of the ChoCO-W study data, we aim to identify significant risk factors for mortality in patients with acute cholecystitis during the COVID-19 pandemic, emphasizing the role of COVID-19 infection in patient outcomes and treatment efficacy.

Indocyanine green fluorescence-guided surgery in the emergency setting: the WSES international consensus position paper.

Background: Decision-making in emergency settings is inherently complex, requiring surgeons to rapidly evaluate various clinical, diagnostic, and environmental factors. The primary objective is to assess a patient's risk for adverse outcomes while balancing diagnoses, management strategies, and available resources. Recently, indocyanine green (ICG) fluorescence imaging has emerged as a valuable tool to enhance surgical vision, demonstrating proven benefits in elective surgeries.

Are we ready for the next pandemic? Public preferences and trade-offs between vaccine characteristics and societal restrictions across 21 countries.

In vaccination decisions, individuals must weigh the benefits against the risks of remaining unvaccinated and potentially facing social restrictions. Previous studies have focused on individual preferences for vaccine characteristics and societal restrictions separately. This study aims to quantify public preferences and the potential trade-offs between vaccine characteristics and societal restrictions, including lockdowns and vaccine mandates, in the context of a future pandemic.

Increasing prehospital tourniquet use attributed to non-indicated use: an 11-year retrospective study.

Purpose: 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.

Methods: An 11-year retrospective study was performed at a Level-1 Trauma Centre on all trauma patients admitted with a PHTQ.

Willingness to participate in placebo-controlled surgical trials of the knee.

Aims: Surgeon and patient reluctance to participate are potential significant barriers to conducting placebo-controlled trials of orthopaedic surgery. Understanding the preferences of orthopaedic surgeons and patients regarding the design of randomized placebo-controlled trials (RCT-Ps) of knee procedures can help to identify what RCT-P features will lead to the greatest participation. This information could inform future trial designs and feasibility assessments.