World Journal of Emergency Surgery最新文献

{"title":"Acute paraesophageal hernia with gastric volvulus. Results of surgical treatment: a systematic review and meta-analysis","authors":"Carlos Manterola, Enrique Biel, Josue Rivadeneira, Manuel Pera, Luis Grande","doi":"10.1186/s13017-025-00617-3","DOIUrl":"https://doi.org/10.1186/s13017-025-00617-3","url":null,"abstract":"Acute gastric volvulus (AGV), is an uncommon complication of large paraesophageal hernias (PEH), resulting in closed-loop obstruction that may lead to incarceration and strangulation. The aim of this study was to summarize the evidence on clinical characteristics, surgical treatment, postoperative complications (POC), recurrence, and 30-day mortality (30DM), in patients undergoing surgery for AGV secondary to PEH. A systematic review including studies on AGV secondary to PEH was conducted. Searches were performed in WoS, Embase, Medline, Scopus, BIREME-BV and SciELO. Primary outcomes included POC, 30DM and recurrence. Secondary outcomes comprised publication date, study origin and design, number of patients, volvulus type, hospital stay length, treatments; and methodological quality (MQ) of studies assessed using MInCir-T and MInCir-Pr2 scales. Descriptive statistics, weighted averages (WA), least squares logistic regression for comparisons, and meta-analysis of POC prevalence and HM were applied. Of 1049 studies 171 met selection criteria, encompassing 15,178 patients. The WA age of patients was 75.3 ± 13.9 years, with 51.3% female. Most studies originated from USA (31.6%), with 52.6% published in the last decade. The WA of hospital stay was 7.9 ± 5.3 days. Among patients, 32.0% experienced POC, 7.6% required reinterventions and HM was 5.7%. MQ scores averaged 8.9 ± 2.3 (MInCir-T) and 13.4 ± 5.4 (MInCir-Pr2). When comparing 1990–2014 and 2015–2024 periods, there were significant differences in age, reinterventions, readmissions and recurrence rates. Despite surgical and resuscitative advancements, AGV prognosis remains poor, with high POC rates, prolonged hospitalization and significant 30DM. These findings emphasize the importance of early diagnosis and timely intervention for acute PEH to improve surgical outcomes.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"44 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of the optimal needle length and decompression site for tension pneumothorax and consensus recommendations on current ATLS and ETC guidelines.","authors":"Suhaib J S Ahmad,Jason R Degiannis,Marion Head,Ahmed R Ahmed,Edgar Gelber,Sherif Hakky,Armin Kieser,Martin Müller,John Darling,Dominik A Jakob,Ioannis Panagiotis Kyriazidis,Konstantinos Degiannis,Patrick Dorn,Anil Lala,Christopher Bowman,Danielle Wilkinson,Graham Whiteley,Umair Hassan,Younis Mohamed,Kai Hui Loo,Ynyr Dewi Davies,Richard Egan,Sjaak Pouwels,Amber Coulthard,Lowri Churchill,Kiran Bhavra,Christopher Bailey,Ian Johnson,Ifan Rees,Dafydd Williams,Shahab Hajibandeh,Wah Yang,Christian Peter Subbe,Amy Owen,David Rawaf,Ameer Khamise,Ali Waleed Khalid,Chetan Parmar,J Agustin Soler,Miriam Khalil,Ata Mohajer-Bastami,Sarah Moin,Rami Archid,Mohamed Abdulmajed,Rosalind Jones,Vignesh Balasubaramaniam,Rawa Al-Salihi,Arran Shoker,Mei-Ju Hwang,Olga Griffiths,Sushil Pandey,Lucy Lee-Smith,Aristomenis K Exadaktylos","doi":"10.1186/s13017-025-00613-7","DOIUrl":"https://doi.org/10.1186/s13017-025-00613-7","url":null,"abstract":"BACKGROUNDTension pneumothorax (TP) is a life-threatening condition. The immediate recommended management is needle decompression (ND), followed by the insertion of an intercostal chest drain. The European Trauma Course (ETC) and the Advanced Trauma Life Support (ATLS) guidelines differ on needle size and decompression site, creating clinical uncertainty. This meta-analysis aims to explore the optimal approach for emergency needle decompression in TP.METHODSThis meta-analysis followed the PRISMA 2020 guidelines. It included English-language RCTs, cohort, case-control, cross-sectional studies, and case series with more than six patients. Studies on adults undergoing needle decompression therapy for TP or with chest wall thickness measurements were included. Ovid MEDLINE, Embase, and Web of Science databases were searched until May 31, 2024. Data were extracted, assessed for quality using OCEBM and GRADE, and analyzed using SPSS and OpenMeta with random-effects models.PRIMARY OUTCOMEneedle decompression failure rate.SECONDARY OUTCOMESpatient demographics, cannula size, and chest wall thickness comparisons.RESULTSThis review analyzed 51 studies on needle decompression for TP, with a weighted mean patient age of 36.67 years. Radiological data from 24 studies (n = 8046) indicated a 32.84% failure rate for needle penetration into the pleural cavity (I2: 99.72%). Increased needle length reduced failure rates by 7.76% per cm. No significant differences in chest wall thickness between genders were observed (T-test, p = 0.77), but thickness at the 5th anterior axillary line (5AAL) and 5th midaxillary line (5MAL) was less than at the 2nd midclavicular line (2MCL). Injury rates were higher at 5AAL than 5MAL, with strong positive correlations between needle length and injury at these sites (0.88, 0.91).CONCLUSIONBased on our meta-analysis, a 7 cm needle may be appropriate for decompression of right-sided tension pneumothorax at either the 5th intercostal space along the midaxillary line or the 2nd intercostal space along the midclavicular line. For left-sided cases, given the potential risk of cardiac injury, the 2nd midclavicular line is a safer option. However, these recommendations should be interpreted with caution due to considerable heterogeneity among the included studies, potential risk of bias, and variability in measurement techniques. Clinical decisions should always be individualized, taking into account patient-specific factors.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"32 1","pages":"39"},"PeriodicalIF":8.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of rib fracture stabilization and conservative treatment in a high-volume Asian trauma center: a propensity score-matched retrospective study","authors":"Chia-Cheng Kao, Ke-Cheng Chen, Xu-Heng Chiang, Jen-Hao Chuang, Chao-Wen Lu, Wei-Ling Hsiao, Tzu-Hsin Lin, Hsien-Chi Liao","doi":"10.1186/s13017-025-00620-8","DOIUrl":"https://doi.org/10.1186/s13017-025-00620-8","url":null,"abstract":"Rib fractures are common chest wall injuries with conservative treatment and surgical stabilization of rib fractures (SSRF) as treatment options. We retrospectively compared the efficacy and long-term prognosis of conservative treatment and SSRF as treatment options for rib fractures. This retrospective study was conducted at a single trauma center in Taiwan. The study population comprised patients with rib fractures who underwent conservative treatment or SSRF at the National Taiwan University Hospital between 2017 and 2022. We analyzed the outcomes between the operative and non-operative groups, including the length of intensive care unit and hospital stays, pain scales at admission and follow-up, and post-operative complication rates. Of the 217 patients with rib fractures in this study, 103 received SSRF, and 114 received conservative treatment. Patients in the operative group had worse consciousness statuses and higher injury severity scores than those in the non-operative group. In addition, patients in the operative group had more preoperative chest complications than those in the non-operative group. Regarding outcomes and long-term prognoses, patients in the operative group had longer intensive care unit and hospital stays than those in the non-operative group; however, patients in the operative group had better recovery quality than those in the non-operative group. Our study showed that, in patients who meet the surgical indications, SSRF is an effective and safe way to relieve acute pain after thoracic injury and achieve better recovery and quality of life after surgical intervention.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"41 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence between frailty, sarcopenia and physical status on mortality in patients undergoing emergency laparotomy","authors":"May Myat Thu, Hwei Jene Ng, Susan Moug","doi":"10.1186/s13017-025-00588-5","DOIUrl":"https://doi.org/10.1186/s13017-025-00588-5","url":null,"abstract":"Frailty and sarcopenia have been independently shown to predict mortality in emergency laparotomy (EmLap), and both can be indicative of poor physical status. We aim to assess the prevalence of frailty, sarcopenia, and physical status in EmLap and explore the relationship between these factors and 30-day, 90-day and 1-year mortality. Retrospective analysis was performed on prospectively maintained Emergency Laparotomy and Laparoscopic Scottish Audit (ELLSA) database (2017–2019) which included patients ≥ 18 years who underwent EmLap. Clinical frailty scale (CFS) was used to classify frailty (score ≥ 4 as frail). Sarcopenia was assessed using total psoas index (TPI). Poor physical status (PPS) was defined by American Society of Anaesthesiologists physical status classification (ASA) ≥ 4. Binary logistic regression and fisher’s exact tests were used for statistical analysis. 215 patients were included in the study, with 57.2% female and median age of 64 years. Frailty was present in 17.2%, sarcopenia in 25.1% and 14.4% had PPS; 3.3% had all three factors. Frail patients had significantly higher risk for 30-day (p = 0.003), 90-day (p = 0.006) and 1-year mortality (p = 0.032). Patients with poor physical status also showed significantly higher mortality at 30-day (p < 0.001), 90-day (p < 0.001) and 1-year (p = 0.001). Sarcopenic patients did not show significant differences in mortality risks up to 1 year. Patients with all three factors had significantly higher 30-day (p = 0.003), 90-day (p = 0.046) and 1-year mortality (p = 0.108) compared to patients who had none of the factors. Frailty, sarcopenia, and PPS are prevalent in EmLap. Frailty and PPS were independently associated with short and long-term mortality, but not sarcopenia. While overlap exists between three factors, more research is required to understand the complex interplay.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"31 6 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in frailty status and discharge destination post emergency laparotomy","authors":"Hwei Jene Ng, Nicholas J. W. Rattray, Tara Quasim, Susan J. Moug","doi":"10.1186/s13017-025-00612-8","DOIUrl":"https://doi.org/10.1186/s13017-025-00612-8","url":null,"abstract":"Pre-operative frailty adversely affects morbidity and mortality after emergency laparotomy (EmLap), especially in older adults (65 years and above). Little is known about frailty after EmLap. We explored the change in frailty status from pre- to post-EmLap and any influence on discharge destination. EmLap patients aged ≥ 65years from an acute surgical site were recruited from May 2022 to April 2023. Prospective data collection included demographics, frailty, mortality and discharge destination. Frailty was assessed using the Rockwood Clinical Frailty Scale at pre-EmLap and day-90 post-EmLap (< 4 as non-frail, 4 as pre-frail and > 4 as frail). EmLap patients with no 90-day follow-up were excluded. A p-value of < 0.05 was considered significant. 63 EmLap patients were included in the study. The median age was 75 years (range 65–91 years) with 36 (57.1%) females. Eleven (17.5%) were living with frailty pre-EmLap, and 10 (15.9%) developed new frailty by day-90 post-EmLap. Pre-EmLap, all patients came from home with 20.6% of the frail and pre-frail group having a package of care service (POC) in place. On 90-day post-EmLap, 1 was still an inpatient but 25.8% had a change in discharge destination: care home (n = 1), home with new POC (n = 2) and home with increased POC (n = 13). Of the 16 patients with change of discharge destination, 9 (56.3%) were frail pre-EmLap. There was a significant association between pre-EmLap frailty and change in home circumstances on discharge (p < 0.00001). Emergency surgery can increase a patient’s frailty status and significantly increases care requirements and social support after hospital discharge. Frailty assessment needs to be performed before and after admission in all EmLap patients to improve post-EmLap care planning and patient expectations.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"53 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis","authors":"Annika Reintam Blaser, Merli Koitmäe, Kaspar F. Bachmann, Paola De Gaetano, Ele Kiisk, Kaja-Triin Laisaar, Simone Piva, Klaus Stahl, Kadri Tamme, Stefan Acosta","doi":"10.1186/s13017-025-00614-6","DOIUrl":"https://doi.org/10.1186/s13017-025-00614-6","url":null,"abstract":"Guidance on managing acute mesenteric ischaemia (AMI) is largely based on expert opinion and retrospective studies pooling different subtypes of AMI. In clinical practice, management strategy is often selected based on the patient’s severity of illness, whereas randomized controlled trials or even adjusted analyses comparing different strategies are rarely available. We aimed to perform a systematic review and meta-analysis on the effect of different management options when adjusted for the baseline severity of illness. A literature search was performed in PubMed, the Cochrane Library, Web of Science and Scopus. Studies recruiting patients after the year 2000, assessing at least 10 adult patients with reliably confirmed AMI, and comparing different management approaches were considered for inclusion. Thirteen study questions on different management strategies in different subtypes of AMI were formulated a priori. We included studies reporting results of adjusted analyses or reporting any variables reflecting the severity of illness in both study groups under comparison. A total of 3324 publications were identified, 321 were selected for full-text review and 31 included in the review and analysis. Most of the studies comparing different management strategies of AMI did not report the severity of illness in the groups under comparison. Any variable that could be considered to reflect the severity of illness was reported in 26 studies. The available data only allowed one meta-regression analysis comparing initial endovascular revascularization versus open surgery in arterial occlusive AMI, including four studies that reported white blood cell count and lactate. The results indicate that the significant advantage of the endovascular approach suggested in the crude analysis may be abolished when adjusting for the severity of the illness. Narrative summaries and raw data are presented for other research questions. The severity of illness plays an important role in the selection of management strategy and largely determines the outcome of any treatment, yet is generally not considered in available studies assessing the management of AMI. There is a major gap in the literature precluding appropriate analyses on treatment effects. Future studies should report subtypes of AMI and the severity of illness for each group. PROSPERO CRD42024568497, date of registration: July 20th, 2024","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"219 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fish bone migration: complications, diagnostic challenges, and treatment strategies","authors":"Deng Li, Wanting Zeng, Jichuan Chen","doi":"10.1186/s13017-025-00611-9","DOIUrl":"https://doi.org/10.1186/s13017-025-00611-9","url":null,"abstract":"Fish bone impaction in the pharynx is a common otolaryngological emergency. However, if the fish bone perforates the pharyngeal wall or the gastrointestinal wall and migrates to the neck tissues or organs, entering the lungs, mediastinum, heart, liver, biliary tract, spleen, pancreas, or other structures, or damages major blood vessels in the thoracic or abdominal cavities, it can lead to severe complications. This condition is rare and dangerous, potentially resulting in a series of serious complications, including neck abscess, thyroid abscess, thrombosis or air embolism of the cervical vessels, esophageal perforation, rupture of major mediastinal vessels, mediastinitis, aorto-esophageal fistula, lung abscess, spinal injury, sepsis, splenic abscess, hepatic abscess, anal fistula, and it may even be misdiagnosed as a tumor. This narrative review synthesizes evidence on fish bone translocation complications to (1) identify high-risk clinical presentations, (2) guide site-specific imaging selection, and (3) inform multidisciplinary management strategies. Use the keyword “fishbone” to systematically search articles from PubMed、CNKI and Embase databases from 1972 to 2024. Review all original articles and include them in this review where appropriate. This narrative review synthesizes evidence from case reports and observational studies to explore complications and management of fish bone translocation in uncommon sites. Given the predominance of heterogeneous case reports, a formal systematic review with meta-analysis was not feasible; however, we employed systematic search strategies to minimize selection bias. To avoid severe complications, it is crucial to provide comprehensive information on the management of fish bone impaction. When fish bone removal cannot be achieved using laryngoscopy, prompt and decisive surgical intervention is required to extract the foreign body.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"13 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemothorax due to inferior phrenic artery injury from blunt trauma: a case series and systematic review","authors":"Akira Kuriyama, Yumi Kato, Ryosuke Echigoya","doi":"10.1186/s13017-025-00609-3","DOIUrl":"https://doi.org/10.1186/s13017-025-00609-3","url":null,"abstract":"Hemothorax is a common complication of thoracic trauma, often associated with morbidity and mortality. While intercostal and internal mammary arteries are commonly involved, the inferior phrenic artery (IPA) is rarely the source of hemothorax following blunt trauma. We aimed to investigate the prevalence of IPA-related hemothorax by describing a single-center case series and to outline the characteristics and management of hemothorax secondary to IPA injury with a systematic review. We conducted a chart review of patients with trauma to identify patients with hemothorax due to IPA injury at a Japanese tertiary care hospital between 2013 and 2019. We performed a systematic review of published studies about this condition by searching PubMed, EMBASE, and ICHUSHI from their inception to January 18, 2025, summarizing their clinical characteristics, treatment, and prognosis. Among 231 patients with hemothorax following blunt trauma, 3 (1.3%) were caused by IPA injury. The systematic review identified published articles for 16 additional reports, yielding 19 reports for analysis. IPA injury was typically diagnosed after 1 day to 3 weeks post-injury, with 94% of patients presenting with shock. Transcatheter arterial embolization (TAE) was the primary treatment, although many patients required additional interventions such as thoracotomy and hematoma evacuation. Complications included pneumonia, and the mortality rate was 11%. Hemothorax due to IPA injury following blunt trauma may be rare and potentially life-threatening. While endovascular techniques such as TAE were effective in many cases, repeated bleeding and substantial hematoma necessitated repeat interventions or surgical procedures. Despite an overall favorable prognosis, significant risks for complications and mortality remained. Thus, early recognition and increased awareness of IPA injury in patients with trauma are essential for improving outcomes.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"25 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A China-Based exploration of surgical timing for polytrauma with a focus on fracture reconstruction","authors":"Chenning Ding, Mingwang Jia, Xing Han, Jiahui Zhang, Xin Zhao, Xiguang Sang","doi":"10.1186/s13017-025-00607-5","DOIUrl":"https://doi.org/10.1186/s13017-025-00607-5","url":null,"abstract":"For patients with severe polytrauma and fractures, early fracture reconstruction surgery under stable conditions can significantly reduce pulmonary and other complications. However, premature surgical intervention may heighten infection risk, adversely affecting the patient’s prognosis. Consequently, determining the optimal timing of surgery is crucial for patients with multiple traumatic injuries. Given China’s healthcare context, this study will assess injury severity and perform definitive fracture reconstruction at specified post-trauma intervals. Postoperative infection rates, including wound infections, other complication incidences, hospital stay duration, treatment costs, and long-term outcomes will be observed and compared to identify the optimal timing for surgical intervention. This study also aims to develop effective polytrauma management models. By applying accessible criteria and choosing suitable timing for fracture reconstruction, we can better assess patient conditions, reduce complications, and minimize the surgery’s “second hit” effect, addressing an important research gap regarding optimal surgical timing for polytrauma in China. This study collected data on 200 patients treated at our hospital between March 2023 and March 2024, with an average age of 47.24 ± 16.56 years and an average Injury Severity Score (ISS) of 25.85 ± 13.35. A total of 250 fractures received definitive fixation in the initial surgery, including femoral fractures (n = 75), spinal fractures (n = 46), pelvic ring fractures (n = 49), tibial fractures (n = 25), acetabular fractures (n = 12), humeral fractures (n = 12), and other fractures (n = 5) (including clavicle, radius and ulna, calcaneus, and patella). Among these patients, 151 underwent single-fracture reconstruction, 42 had two fractures reconstructed, and 5 had three fractures treated during the first surgery. The study protocol excluded patients with absolute contraindications, including bacteremia and infections near the surgical site. Additional inclusion criteria required stable vital signs (temperature &lt; 38.5 °C with a downward trend, systolic blood pressure &gt; 100 mmHg, stable traumatic brain injury status) and blood routine (white blood cell count &lt; 22.0 × 10⁹/L with a neutrophil percentage &lt; 90%, both trending downward; platelet count &gt; 50 × 10⁹/L; hemoglobin &gt; 90 g/L). Based on these criteria, historical cohorts were identified and assigned to either an experimental group or a control group. Observed outcomes included postoperative complications, wound healing grades, inflammatory markers, changes in vital signs, length of hospital stay, costs, and long-term follow-up results. Among the patients, 97 underwent surgery after meeting the specified criteria for fracture reconstruction, while 103 received surgery without meeting these criteria. Patients who met the surgical criteria demonstrated superior outcomes, with lower complication rates (including pneumonia and respiratory distress syndrom","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"74 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the predictive factors for the recurrence of acute pancreatitis","authors":"Daniela Pacella, Adriano De Simone, Adolfo Pisanu, Gianluca Pellino, Lucio Selvaggi, Valentina Murzi, Eleonora Locci, Giulia Ciabatti, Laura Mastrangelo, Elio Jovine, Matteo Rottoli, Giacomo Calini, Stefano Cardelli, Fausto Catena, Carlo Vallicelli, Raffaele Bova, Gabriele Vigutto, Fabrizio D’Acapito, Giorgio Ercolani, Leonardo Solaini, Alan Biloslavo, Paola Germani, Camilla Colutta, Pasquale Lepiane, Rosa Scaramuzzo, Savino Occhionorelli, Domenico Lacavalla, Maria Grazia Sibilla, Stefano Olmi, Matteo Uccelli, Alberto Oldani, Alessio Giordano, Tommaso Guagni, Davina Perini, Francesco Pata, Bruno Nardo, Daniele Paglione, Giusi Franco, Matteo Donadon, Marcello Di Martino, Salomone Di Saverio, Luca Cardinali, Grazia Travaglini, Dario Bruzzese, Mauro Podda","doi":"10.1186/s13017-025-00601-x","DOIUrl":"https://doi.org/10.1186/s13017-025-00601-x","url":null,"abstract":"Acute Pancreatitis (AP) is a prevalent clinical pancreatic disorder characterized by acute inflammation of the pancreas, frequently associated with biliary or alcoholic events. If not treated with cholecystectomy after the first episode, patients may experience a recurrence of AP, with consequent need for emergency surgery and increased risk of death. Analyzing the risk factors that may contribute to the recurrence of Biliary and Alcoholic Pancreatitis (BAP and AAP), future research can be driven toward new solutions for preventing and treating this pancreatic disease. A systematic review was conducted selecting studies from BiomedCentral, PubMed, Scopus and Web of Science by two independent reviewers. Publications were considered only if written in English in the time interval between January 2000 and June 2024 and investigated the risk factors for the recurrence of BAP and AAP. At the end of the selection, a quality assessment phase was conducted using the PROBAST tool. In this systematic review, 8 articles were selected out of 6.945, involving a total sample of 11.271 patients of which 38.77% developed recurrence episodes. 37.5% of the included studies focus on recurrent acute biliary pancreatitis (RBAP), while 62.5% are dedicated to recurrent acute alcoholic pancreatitis (RAAP). The risk factors for the recurrence of AP showed a clear differentiation between the alcoholic and biliary etiology. Most of the considered studies adopted a retrospective design, characterized by a susceptibility to potential methodological biases. However, the trend indicated a more recent increase in prospective studies, together with a greater focus on identifying and understanding the possible risk factors associated with the recurrence of acute pancreatitis (RAP). This result highlighted the progress in the scientific approach toward a more rigorous and systematic assessment of the causes and dynamics that influence the recurrence of the disease. Studies highlighted the importance of lifestyle factors, clinical complications, and surgical interventions that can impact the risk of biliary or alcoholic recurrent acute pancreatitis. Increased and systematic adoption of artificial intelligence-based tools could significantly impact future knowledge relating to the risks of recurrence and relative possibilities of prevention.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"38 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}