Pub Date : 2025-04-25DOI: 10.1186/s13017-025-00612-8
Hwei Jene Ng, Nicholas J. W. Rattray, Tara Quasim, Susan J. Moug
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.
{"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}
Pub Date : 2025-04-24DOI: 10.1186/s13017-025-00614-6
Annika Reintam Blaser, Merli Koitmäe, Kaspar F. Bachmann, Paola De Gaetano, Ele Kiisk, Kaja-Triin Laisaar, Simone Piva, Klaus Stahl, Kadri Tamme, Stefan Acosta
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
急性肠系膜缺血（AMI）的治疗指南主要基于专家意见和回顾性研究，汇集了不同的AMI亚型。在临床实践中，通常根据患者病情的严重程度选择管理策略，而比较不同策略的随机对照试验甚至调整分析很少。我们的目的是对不同治疗方案的效果进行系统回顾和荟萃分析，并根据疾病的基线严重程度进行调整。在PubMed、Cochrane图书馆、Web of Science和Scopus中进行了文献检索。研究招募2000年后的患者，评估至少10例可靠确诊AMI的成年患者，并比较不同的治疗方法。针对AMI不同亚型的不同管理策略，先验地制定了13个研究问题。我们纳入了报告调整分析结果的研究，或报告了反映两组比较中疾病严重程度的任何变量的研究。共鉴定出3324篇文献，其中321篇入选全文综述，31篇纳入综述分析。大多数比较AMI不同治疗策略的研究没有报道被比较组的疾病严重程度。26项研究报告了任何可以被认为反映疾病严重程度的变量。现有数据仅允许一项荟萃回归分析，比较动脉闭塞性AMI的初始血管内重建术与开放手术，包括四项报告白细胞计数和乳酸的研究。结果表明，当调整疾病的严重程度时，在粗分析中提出的血管内入路的显著优势可能会被取消。叙述摘要和原始数据提出了其他研究问题。疾病的严重程度在治疗策略的选择中起着重要作用，在很大程度上决定了任何治疗的结果，但在评估AMI治疗的现有研究中通常没有考虑到疾病的严重程度。文献中有一个主要的空白，妨碍了对治疗效果的适当分析。未来的研究应该报告AMI的亚型和每组的疾病严重程度。PROSPERO CRD42024568497，注册日期：2024年7月20日
{"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}
Pub Date : 2025-04-23DOI: 10.1186/s13017-025-00611-9
Deng Li, Wanting Zeng, Jichuan Chen
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.
{"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}
Pub Date : 2025-04-19DOI: 10.1186/s13017-025-00609-3
Akira Kuriyama, Yumi Kato, Ryosuke Echigoya
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.
{"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}
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 < 38.5 °C with a downward trend, systolic blood pressure > 100 mmHg, stable traumatic brain injury status) and blood routine (white blood cell count < 22.0 × 10⁹/L with a neutrophil percentage < 90%, both trending downward; platelet count > 50 × 10⁹/L; hemoglobin > 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
{"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 < 38.5 °C with a downward trend, systolic blood pressure > 100 mmHg, stable traumatic brain injury status) and blood routine (white blood cell count < 22.0 × 10⁹/L with a neutrophil percentage < 90%, both trending downward; platelet count > 50 × 10⁹/L; hemoglobin > 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}
Pub Date : 2025-04-12DOI: 10.1186/s13017-025-00601-x
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
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.
急性胰腺炎（AP）是一种常见的临床胰腺疾病，以胰腺急性炎症为特征，常伴有胆道或酒精事件。如果在首次发作后不进行胆囊切除术，患者可能会经历AP复发，因此需要紧急手术，并增加死亡风险。分析可能导致胆汁性和酒精性胰腺炎（BAP和AAP）复发的危险因素，可以推动未来的研究为预防和治疗这种胰腺疾病提供新的解决方案。由两名独立审稿人对来自BiomedCentral、PubMed、Scopus和Web of Science的研究进行系统评价。仅考虑2000年1月至2024年6月期间以英文撰写的出版物，并调查BAP和AAP复发的危险因素。在选择结束时，使用PROBAST工具进行质量评估阶段。本系统综述从6.945篇文献中筛选出8篇，共涉及11.271例患者，其中38.77%的患者复发。37.5%的纳入研究集中于复发性急性胆源性胰腺炎（RBAP），而62.5%的研究集中于复发性急性酒精性胰腺炎（RAAP）。AP复发的危险因素显示酒精性和胆道性病因有明显的区别。大多数考虑的研究采用回顾性设计，其特点是对潜在的方法学偏差敏感。然而，这一趋势表明，最近前瞻性研究的增加，以及对识别和理解与急性胰腺炎（RAP）复发相关的可能危险因素的更多关注。这一结果突出了科学方法的进展，以更严格和系统地评估影响疾病复发的原因和动态。研究强调了生活方式因素、临床并发症和手术干预的重要性，这些因素可以影响胆道性或酒精性复发性急性胰腺炎的风险。更多和系统地采用基于人工智能的工具可能会显著影响与复发风险和相对预防可能性相关的未来知识。
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Pub Date : 2025-04-11DOI: 10.1186/s13017-025-00599-2
Paschalis Gavriilidis, Carlo Alberto Schena, Salomone Di Saverio, Larry Hromalik, Mehmet Eryilmaz, Fausto Catena, Nicola de’Angelis
Perforated peptic ulcers (PPU) represent a critical surgical emergency. Despite the historical predominance of open surgical repair, laparoscopic and endoscopic approaches have shown promise in reducing morbidity and hospital stay. This study aimed to conduct a network meta-analysis comparing open, laparoscopic, and endoscopic interventions for PPU repair. A systematic search of Medline (PubMed), Embase, Cochrane Library, Google Scholar, and the National Institute for Health and Clinical Excellence (NICE) databases identified randomized controlled trials (RCTs) comparing these approaches. The primary outcomes were 30-day mortality and morbidity. Eight RCTs including 657 patients were analyzed. Endoscopic interventions were associated with fewer respiratory complications and shorter hospital stays, while the laparoscopic approach demonstrated fewer surgical site infections and less postoperative pain compared to open repair. Other outcomes demonstrated non-significant differences across interventions. Prompt resuscitation and surgical repair, either laparoscopic or open, remains the gold standard for PPU. Endoscopic techniques are viable alternatives for small perforations and in selected cases where general anesthesia is contraindicated.
穿孔性消化性溃疡（PPU）是一种重要的外科急诊。尽管开放性手术在历史上占主导地位，但腹腔镜和内窥镜方法在减少发病率和住院时间方面显示出了希望。本研究旨在进行一项网络荟萃分析，比较开放、腹腔镜和内窥镜干预对PPU修复的影响。通过对Medline （PubMed）、Embase、Cochrane Library、b谷歌Scholar和National Institute for Health and Clinical Excellence （NICE）数据库的系统检索，确定了比较这些方法的随机对照试验（RCTs）。主要结局为30天死亡率和发病率。共分析8项rct，共657例患者。内窥镜干预与更少的呼吸并发症和更短的住院时间相关，而与开放式修复相比，腹腔镜方法显示更少的手术部位感染和术后疼痛。其他结果显示干预之间没有显著差异。迅速复苏和手术修复，无论是腹腔镜还是开放，仍然是PPU的金标准。内窥镜技术是可行的替代小穿孔和在某些情况下，全身麻醉是禁忌的。
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Pub Date : 2025-04-09DOI: 10.1186/s13017-025-00604-8
Arif Alper Cevik, Fikri M. Abu-Zidan
The COVID-19 pandemic disrupted medical education worldwide, prompting the need for innovative e-learning solutions. This study evaluated the effectiveness of an online extended Focused Assessment with Sonography in Trauma (EFAST) course, delivered via the International Emergency Medicine Education Project’s platform, to improve participants’ knowledge and perceived confidence in EFAST procedure. A prospective observational study was conducted between May 17, 2020, and December 20, 2023. Pre- and post-course quizzes and surveys were used to assess participants’ knowledge and confidence. Participant demographics, quiz scores, and survey responses were collected. Quantitative data were analysed using the Wilcoxon Signed-Rank test and Cohen’s d to evaluate knowledge improvement and confidence changes. Thematic analysis of qualitative feedback was performed with the assistance of large language model AI tools for emerging themes. 1758 participants enrolled in the course. From 111 countries, 1515 started the course, and 1190 (78.6%) reached the final exam stage, with 96.1% achieving a passing score. 66.4% indicated they had never attended a prior ultrasound course. Most (81.1%) were medical students, interns, or residents. 36.5% of participants were from low- or lower-middle-income countries. 1175 (77.6%) participants completed both the pre- and post-course formative knowledge quizzes. The median (IQR) scores were 53.3 (40.0–66.7) pre-course and 86.7 (73.3–93.3) post-course (p < 0.001, effect size: -0.958). 771 participants completed both pre- and post-course surveys. Participants’ median (IQR) confidence in EFAST increased from 5 (3–7) to 8 (7–10) (p < 0.001, effect size: -0.844). Qualitative feedback showed that participants found the course practical, well-structured, and effective. They suggested improving video quality and simplifying content for clarity and engagement. The online EFAST course enhanced participants’ knowledge and perceived confidence, demonstrating the potential of online clinical education during global crises.
{"title":"Online extended focused assessment with sonography for trauma (EFAST) course enhanced knowledge and perceived confidence among medical trainees during the COVID-19 pandemic disaster","authors":"Arif Alper Cevik, Fikri M. Abu-Zidan","doi":"10.1186/s13017-025-00604-8","DOIUrl":"https://doi.org/10.1186/s13017-025-00604-8","url":null,"abstract":"The COVID-19 pandemic disrupted medical education worldwide, prompting the need for innovative e-learning solutions. This study evaluated the effectiveness of an online extended Focused Assessment with Sonography in Trauma (EFAST) course, delivered via the International Emergency Medicine Education Project’s platform, to improve participants’ knowledge and perceived confidence in EFAST procedure. A prospective observational study was conducted between May 17, 2020, and December 20, 2023. Pre- and post-course quizzes and surveys were used to assess participants’ knowledge and confidence. Participant demographics, quiz scores, and survey responses were collected. Quantitative data were analysed using the Wilcoxon Signed-Rank test and Cohen’s d to evaluate knowledge improvement and confidence changes. Thematic analysis of qualitative feedback was performed with the assistance of large language model AI tools for emerging themes. 1758 participants enrolled in the course. From 111 countries, 1515 started the course, and 1190 (78.6%) reached the final exam stage, with 96.1% achieving a passing score. 66.4% indicated they had never attended a prior ultrasound course. Most (81.1%) were medical students, interns, or residents. 36.5% of participants were from low- or lower-middle-income countries. 1175 (77.6%) participants completed both the pre- and post-course formative knowledge quizzes. The median (IQR) scores were 53.3 (40.0–66.7) pre-course and 86.7 (73.3–93.3) post-course (p < 0.001, effect size: -0.958). 771 participants completed both pre- and post-course surveys. Participants’ median (IQR) confidence in EFAST increased from 5 (3–7) to 8 (7–10) (p < 0.001, effect size: -0.844). Qualitative feedback showed that participants found the course practical, well-structured, and effective. They suggested improving video quality and simplifying content for clarity and engagement. The online EFAST course enhanced participants’ knowledge and perceived confidence, demonstrating the potential of online clinical education during global crises.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"4306 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805773","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}
Pub Date : 2025-04-07DOI: 10.1186/s13017-025-00577-8
Federico Coccolini, Yoram Kluger, Ernest E. Moore, Ronald V. Maier, Raul Coimbra, Carlos Ordoñez, Rao Ivatury, Andrew W. Kirkpatrick, Walter Biffl, Massimo Sartelli, Andreas Hecker, Luca Ansaloni, Ari Leppaniemi, Viktor Reva, Ian Civil, Felipe Vega, Massimo Chiarugi, Alain Chichom-Mefire, Boris Sakakushev, Andrew Peitzman, Osvaldo Chiara, Fikri Abu-Zidan, Marc Maegele, Mario Miccoli, Mircea Chirica, Vladimir Khokha, Michael Sugrue, Gustavo P. Fraga, Yasuhiro Otomo, Gian Luca Baiocchi, Fausto Catena
Correction: World Journal of Emergency Surgery (2021) 16:6 https://doi.org/10.1186/s13017-021-00350-7
Following publication of the original article [1], one of the collaborator names was incorrectly written as “Hossein Samadi Kaf” instead of “Hossein Samadi Kafil” in The WSES Trauma Quality Indicators Expert Panel. The incorrect and correct names are listed in this correction article.
Incorrect author name: Hossein Samadi Kaf
Correct author name: Hossein Samadi Kafil
The original article has been updated.
Coccolini F, Kluger Y, Moore EE, et al. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation. World J Emerg Surg. 2021;16:6. https://doi.org/10.1186/s13017-021-00350-7.
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Authors and Affiliations
General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124, Pisa, Italy
Federico Coccolini & Massimo Chiarugi
Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
Yoram Kluger
Ernest E Moore Shock Trauma Center, Denver Health, Denver, CO, USA
Ernest E. Moore
Department of Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA
Ronald V. Maier
Riverside University Health System, Riverside, CA, USA
Raul Coimbra
Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia
Carlos Ordoñez
VCU Medical Center, Richmond, VA, USA
Rao Ivatury
General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Canada
Andrew W. Kirkpatrick
Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA
Walter Biffl
General and Emergency Surgery, Macerata Hospital, Macerata, Italy
Massimo Sartelli
Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
Andreas Hecker
General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy
Luca Ansaloni
Abdominal Center, Helsinki University Hospital, Helsinki, Finland
Ari Leppaniemi
Department of War Surgery, Kirov Military Medical Academy, Saint-Petersburg, Russia
Viktor Reva
General and Emergency Surgery Dept., Auckland City Hospital, Auckland, New Zealand
Ian Civil
Department of Surgery,
更正：World Journal of Emergency Surgery (2021) 16:6 https://doi.org/10.1186/s13017-021-00350-7Following发表原始文章b[1]时，其中一个合作者的名字被错误地写成“Hossein Samadi Kaf”，而不是“Hossein Samadi Kafil”在WSES创伤质量指标专家组。错误和正确的名字都列在这篇更正文章中。错误的作者名称：Hossein Samadi kaf正确的作者名称：Hossein Samadi kafil原文章已更新。柯科利尼F， Kluger Y, Moore EE，等。创伤质量指标：国际上认可的创伤管理质量评价的核心因素。世界生物医学杂志，2021;16:6。https://doi.org/10.1186/s13017-021-00350-7.Article PubMed PubMed Central谷歌学者下载参考文献作者和单位比萨大学医院普通急诊和创伤外科，Via Paradisa, 256124，意大利比萨federico Coccolini &；Massimo chiarugi普通外科，以色列海法Rambam医疗保健校区，约拉姆·克鲁格，欧内斯特·E·摩尔休克创伤中心，丹佛健康中心，丹佛，科罗拉多州，美国，欧内斯特·E·摩尔外科，华盛顿大学，西雅图，华盛顿州，美国，罗纳德·v·迈尔，里弗赛德大学卫生系统，加州，里弗赛德，美国，阿劳尔·科英布拉创伤和急性护理外科，Fundación哥伦比亚，加利，瓦利德尔·利利，卡洛斯OrdoñezVCU医疗中心，里士满，弗吉尼亚州，USARao ivaturi General，急症护理、腹壁重建和创伤外科，Foothills Medical Centre, Calgary，加拿大andrew W. kirkpatrick创伤和急症护理外科，Scripps Memorial Hospital, La Jolla, San Diego， CA, USAWalter biffl， General and急诊外科，Macerata医院，Macerata，意大利massimo sarteli， General and Thoracic Surgery, University Hospital of Giessen, Giessen，德国意大利切塞纳布法利尼医院急诊与创伤外科；芬兰赫尔辛基赫尔辛基大学医院卢卡·安萨洛尼腹部中心；俄罗斯圣彼得堡基洛夫军事医学院战争外科；新西兰奥克兰奥克兰市医院普通与急诊外科；墨西哥墨西哥城安吉利斯洛马斯医院外科；喀麦隆喀麦隆杜阿拉alain chichomm - mefiredouala妇产科和儿科医院保加利亚普罗夫迪夫圣乔治大学医院alain chichomm - mefire普通外科美国匹兹堡大学医学院外科安德鲁·佩茨曼创伤小组和普通外科意大利米兰尼瓜尔达助理医师约瓦尔多·恰阿拉阿联酋大学阿尔艾因医学与健康科学学院外科阿拉伯联合酋长国fikri abu - zidand德国科隆Witten/Herdecke大学（UW/H）科隆- merheim医学中心（CMMC）创伤和骨科意大利比萨大学比萨大学marc maegele统计系法国格勒诺布尔阿尔卑斯大学格勒诺布尔医院中心白俄罗斯莫日尔市医院急诊外科vladimir khokhav Letterkenny医院普通外科爱尔兰michael sugrue巴西坎皮纳斯大学医学院创伤外科科日本东京东京医科和牙科大学医院gustavo P. fragatatrauma和急性重症监护中心意大利布雷西亚大学医院普通外科gian Luca baiocchia帕尔马大学医院急诊和创伤外科ItalyFausto CatenaAuthorsFederico CoccoliniView作者出版物您也可以在pubmed谷歌ScholarYoram KlugerView作者出版物中搜索此作者您也可以在pubmed谷歌ScholarErnest E. MooreView作者出版物中搜索此作者您也可以在pubmed谷歌ScholarRonald V. MaierView作者出版物中搜索此作者您也可以在pubmed谷歌ScholarRaul CoimbraView作者出版物中搜索此作者您还可以搜索此作者inPubMed谷歌ScholarCarlos OrdoñezView作者出版物您也可以在pubmed谷歌ScholarRao IvaturyView作者出版物您也可以在pubmed谷歌ScholarAndrew W。 KirkpatrickView作者出版物您也可以在pubmed谷歌ScholarWalter BifflView作者出版物中搜索此作者您也可以在pubmed谷歌ScholarMassimo SartelliView作者出版物中搜索此作者您也可以在pubmed谷歌ScholarAndreas HeckerView作者出版物中搜索此作者您也可以在pubmed谷歌ScholarLuca AnsaloniView作者出版物中搜索此作者您也可以在pubmed谷歌ScholarAri LeppaniemiView中搜索此作者作者出版物你也可以搜索这个作者在pubmed谷歌ScholarViktor RevaView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarIan CivilView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarFelipe VegaView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarMassimo ChiarugiView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarAlain chichomm - mefireview作者你也可以搜索这个作者在pubmed谷歌ScholarBoris SakakushevView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarAndrew PeitzmanView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarOsvaldo ChiaraView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarFikri Abu-ZidanView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarMarc MaegeleView作者publations你也可以搜索这个作者在pubmed谷歌ScholarMario MiccoliView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarMircea ChiricaView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarVladimir KhokhaView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarMichael SugrueView作者出版物你也可以搜索这个作者在pubmed谷歌ScholarGustavo P. FragaView作者出版物您也可以在pubmed谷歌ScholarYasuhiro OtomoView作者出版物您也可
{"title":"Correction: Trauma quality indicators: internationally approved core factors for trauma management quality evaluation","authors":"Federico Coccolini, Yoram Kluger, Ernest E. Moore, Ronald V. Maier, Raul Coimbra, Carlos Ordoñez, Rao Ivatury, Andrew W. Kirkpatrick, Walter Biffl, Massimo Sartelli, Andreas Hecker, Luca Ansaloni, Ari Leppaniemi, Viktor Reva, Ian Civil, Felipe Vega, Massimo Chiarugi, Alain Chichom-Mefire, Boris Sakakushev, Andrew Peitzman, Osvaldo Chiara, Fikri Abu-Zidan, Marc Maegele, Mario Miccoli, Mircea Chirica, Vladimir Khokha, Michael Sugrue, Gustavo P. Fraga, Yasuhiro Otomo, Gian Luca Baiocchi, Fausto Catena","doi":"10.1186/s13017-025-00577-8","DOIUrl":"https://doi.org/10.1186/s13017-025-00577-8","url":null,"abstract":"<p><b>Correction: World Journal of Emergency Surgery (2021) 16:6 </b><b>https://doi.org/10.1186/s13017-021-00350-7</b></p><p>Following publication of the original article [1], one of the collaborator names was incorrectly written as “Hossein Samadi Kaf” instead of “Hossein Samadi Kafil” in The WSES Trauma Quality Indicators Expert Panel. The incorrect and correct names are listed in this correction article.</p><p>Incorrect author name: Hossein Samadi Kaf</p><p>Correct author name: Hossein Samadi Kafil</p><p>The original article has been updated.</p><ol data-track-component=\"outbound reference\" data-track-context=\"references section\"><li data-counter=\"1.\"><p>Coccolini F, Kluger Y, Moore EE, et al. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation. World J Emerg Surg. 2021;16:6. https://doi.org/10.1186/s13017-021-00350-7.</p><p>Article PubMed PubMed Central Google Scholar </p></li></ol><p>Download references<svg aria-hidden=\"true\" focusable=\"false\" height=\"16\" role=\"img\" width=\"16\"><use xlink:href=\"#icon-eds-i-download-medium\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"></use></svg></p><h3>Authors and Affiliations</h3><ol><li><p>General Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisa, 2, 56124, Pisa, Italy</p><p>Federico Coccolini & Massimo Chiarugi</p></li><li><p>Division of General Surgery, Rambam Health Care Campus, Haifa, Israel</p><p>Yoram Kluger</p></li><li><p>Ernest E Moore Shock Trauma Center, Denver Health, Denver, CO, USA</p><p>Ernest E. Moore</p></li><li><p>Department of Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA</p><p>Ronald V. Maier</p></li><li><p>Riverside University Health System, Riverside, CA, USA</p><p>Raul Coimbra</p></li><li><p>Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia</p><p>Carlos Ordoñez</p></li><li><p>VCU Medical Center, Richmond, VA, USA</p><p>Rao Ivatury</p></li><li><p>General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Canada</p><p>Andrew W. Kirkpatrick</p></li><li><p>Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA</p><p>Walter Biffl</p></li><li><p>General and Emergency Surgery, Macerata Hospital, Macerata, Italy</p><p>Massimo Sartelli</p></li><li><p>Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany</p><p>Andreas Hecker</p></li><li><p>General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy</p><p>Luca Ansaloni</p></li><li><p>Abdominal Center, Helsinki University Hospital, Helsinki, Finland</p><p>Ari Leppaniemi</p></li><li><p>Department of War Surgery, Kirov Military Medical Academy, Saint-Petersburg, Russia</p><p>Viktor Reva</p></li><li><p>General and Emergency Surgery Dept., Auckland City Hospital, Auckland, New Zealand</p><p>Ian Civil</p></li><li><p>Department of Surgery, ","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"37 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790128","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}
Pub Date : 2025-04-04DOI: 10.1186/s13017-025-00595-6
Ryo Yamamoto, Brian J. Eastridge, Ramon F. Cestero, Keitaro Yajima, Akira Endo, Kazuma Yamakawa, Junichi Sasaki
Advances in healthcare and the development of various technologies have improved disease-free longevity. Although the number of healthy centenarians is gradually increasing, studies on postinjury functions among centenarians are lacking. Therefore, we aimed to determine the clinical predictors of mortality and unfavorable functions after injury among centenarians. A retrospective study was conducted using a nationwide trauma database, and data from patients aged ≥ 100 years across ≥ 250 institutions during 2019–2022 were analyzed. Patient demographics, comorbidities, mechanism of injury, injury severity, vital signs on arrival, and pre- and in-hospital treatments were compared between survivors and non-survivors as well as between survivors who had and did not have the ability to live independently at discharge, which was defined as Glasgow Outcome Scale (GCS) score of ≤ 3. Independent predictors of in-hospital mortality and unfavorable functions after injury were examined using a generalized estimating equation model to account for institutional and regional differences in the management and characteristics of centenarians. Of the 409 centenarians, 384 (93.9%) survived to discharge. Although 208 (50.9%) patients had lived independently before the injury, only 91 (22.2%) could live independently at discharge. All patients had blunt injury, and fall from standing was the most frequent (86.6%) mechanism. The injury severity score was 10 ± 5, and surgery/angiography was performed in < 2% of the centenarians, except for fracture fixation in the extremity/pelvis, which was conducted in 225 (55.0%) patients. The adjusted model revealed three independent predictors of in-hospital mortality: male gender, mechanism of injury other than fall from standing, and GCS score on arrival. In contrast, only injury severity in the extremity/pelvis was an independent predictor of unfavorable functions after injury. Male gender, mechanisms of injury other than fall from standing, and GCS on arrival were associated with higher in-hospital mortality. Injury severity in the extremity/pelvis was related to dependent living after injury among centenarians.
{"title":"Functional outcomes following injury in centenarians: a nationwide retrospective observational study","authors":"Ryo Yamamoto, Brian J. Eastridge, Ramon F. Cestero, Keitaro Yajima, Akira Endo, Kazuma Yamakawa, Junichi Sasaki","doi":"10.1186/s13017-025-00595-6","DOIUrl":"https://doi.org/10.1186/s13017-025-00595-6","url":null,"abstract":"Advances in healthcare and the development of various technologies have improved disease-free longevity. Although the number of healthy centenarians is gradually increasing, studies on postinjury functions among centenarians are lacking. Therefore, we aimed to determine the clinical predictors of mortality and unfavorable functions after injury among centenarians. A retrospective study was conducted using a nationwide trauma database, and data from patients aged ≥ 100 years across ≥ 250 institutions during 2019–2022 were analyzed. Patient demographics, comorbidities, mechanism of injury, injury severity, vital signs on arrival, and pre- and in-hospital treatments were compared between survivors and non-survivors as well as between survivors who had and did not have the ability to live independently at discharge, which was defined as Glasgow Outcome Scale (GCS) score of ≤ 3. Independent predictors of in-hospital mortality and unfavorable functions after injury were examined using a generalized estimating equation model to account for institutional and regional differences in the management and characteristics of centenarians. Of the 409 centenarians, 384 (93.9%) survived to discharge. Although 208 (50.9%) patients had lived independently before the injury, only 91 (22.2%) could live independently at discharge. All patients had blunt injury, and fall from standing was the most frequent (86.6%) mechanism. The injury severity score was 10 ± 5, and surgery/angiography was performed in < 2% of the centenarians, except for fracture fixation in the extremity/pelvis, which was conducted in 225 (55.0%) patients. The adjusted model revealed three independent predictors of in-hospital mortality: male gender, mechanism of injury other than fall from standing, and GCS score on arrival. In contrast, only injury severity in the extremity/pelvis was an independent predictor of unfavorable functions after injury. Male gender, mechanisms of injury other than fall from standing, and GCS on arrival were associated with higher in-hospital mortality. Injury severity in the extremity/pelvis was related to dependent living after injury among centenarians.","PeriodicalId":48867,"journal":{"name":"World Journal of Emergency Surgery","volume":"23 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775588","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}
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