Injury-International Journal of the Care of the Injured最新文献

{"title":"Infectious complications of K-wire fixation in pediatric fractures: Risk factors and management at a tertiary care center","authors":"Matteo Palmetti ,&nbsp;Elisabetta Venturini ,&nbsp;Agnese Tamborino ,&nbsp;Alberto Galeotti ,&nbsp;Giuseppe Cucca ,&nbsp;Salvatore Di Giacinto ,&nbsp;Elena Chiappini ,&nbsp;Giovanni Beltrami ,&nbsp;Luisa Galli","doi":"10.1016/j.injury.2025.112944","DOIUrl":"10.1016/j.injury.2025.112944","url":null,"abstract":"<div><h3>Introduction</h3><div>Kirschner wires (K-wires) are frequently used for pediatric fracture fixation. Infectious complications range from 1 % to 20 %, but the few available studies mostly focus on the adult population. The severity of infection varies from minor pin tract infections (PTIs) to severe osteomyelitis. Current literature on this topic is limited, especially regarding the pediatric population.</div></div><div><h3>Methods</h3><div>In this retrospective observational study, we enrolled children (0–18 years old) with traumatic bone fractures treated with smooth (unthreaded) K-wires at the Orthopedics Unit of Meyer Children's Hospital in Florence between January 1, 2020, and December 31, 2024. The aim was to evaluate infection rates at our institution, describe clinical presentations and risk factors, identify the most frequent pathogens, and assess the treatment strategies adopted.</div></div><div><h3>Results</h3><div>A total of 1386 patients were included, of whom 1349 (97.3 %) had fractures of the upper extremities (including the hand) and 37 (2.7 %) had fractures of the lower extremities (including the foot). We recorded 33 infections, with an infection rate of 2.4 %. PTIs were the most common infectious complication (16/33, 48.5 %), followed by osteomyelitis (11/33, 33.3 %) and deep soft tissue infections (3/33, 9.1 %). Fever of unknown origin (FUO), associated with elevated inflammatory markers, was observed in 3/33 (9.1 %) patients. The most common pathogen was <em>Staphylococcus aureus</em>, with no cases of methicillin-resistant strains. Children younger than 9 years were 2.8 times more likely to develop an infectious complication, as confirmed by both univariate (<em>p</em> = 0.012) and multivariate analysis (<em>p</em> = 0.036). Surgery during the summer season was significantly associated with a twofold increased risk of infection in univariate (<em>p</em> = 0.014) and multivariate analysis (<em>p</em> = 0.033). The timing of surgery, number of wires, fracture site, and type of reduction were not associated with a higher risk of infection.</div></div><div><h3>Conclusion</h3><div>This study describes the infection rate following K-wire fixation in a large pediatric cohort at a tertiary care facility. Based on our findings, these complications are rare, and patient education on wound and cast care may play a role in reducing their occurrence.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112944"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of the ICOUGH protocol results in a decreased incidence of postoperative hospital-acquired pneumonia in geriatric hip fracture patients","authors":"A.M. van Rossum du Chattel ,&nbsp;H. Frencken ,&nbsp;J. Raats ,&nbsp;N. Ponds ,&nbsp;D. van der Velde ,&nbsp;H.J. Schuijt","doi":"10.1016/j.injury.2025.112897","DOIUrl":"10.1016/j.injury.2025.112897","url":null,"abstract":"<div><h3>Introduction</h3><div>As the number of older adults with hip fractures rises, improving strategies to prevent postoperative pneumonia is crucial in this vulnerable population. This study aims to evaluate the effect of implementing the ICOUGH protocol for the prevention of pneumonia on the incidence of postoperative hospital-acquired pneumonia in geriatric hip fracture patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 1342 patients aged ≥ 70 years with operative treatment of a hip fracture between 2021 and 2024. In January 2023, the ICOUGH protocol was implemented, consisting of incentive spirometry, coughing and deep breathing, oral care, early mobilization, patient education, and head-of-bed elevation. A historical control cohort of 646 patients was compared to a post-implementation cohort of 696 patients. The primary outcome was the incidence of hospital-acquired pneumonia. Secondary outcomes included delirium, urinary tract infection, intensive care unit admission, length of stay, and 30-day mortality. Multivariable logistic regression analysis was performed with predetermined covariates.</div></div><div><h3>Results</h3><div>The incidence of postoperative pneumonia was 8.0 % in the historical cohort, and 4.7 % in the intervention cohort (<em>p</em> = 0.013). Implementation of the ICOUGH protocol was independently associated with a lower risk of developing postoperative hospital-acquired pneumonia (aOR=0.551, 95 % CI=0.347–0.875, <em>p</em> = 0.012). Secondary outcomes showed that delirium was reduced with 7.9 % (<em>p</em> = 0.012) and 30-day mortality was reduced with 1.4 % (<em>p</em> = 0.022) in the intervention group.</div></div><div><h3>Conclusion</h3><div>Implementation of the ICOUGH protocol effectively reduces the incidence of postoperative hospital-acquired pneumonia among geriatric hip fracture patients. This protocol is a practical and minimally invasive strategy, and shows that multidisciplinary, proactive care is effective in preventing postoperative pneumonia.</div></div><div><h3>Level of Evidence</h3><div>IIIb</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112897"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The road injury chain of survival: A framework for improving trauma outcomes","authors":"Tim Nutbeam ,&nbsp;Willem Stassen","doi":"10.1016/j.injury.2025.112285","DOIUrl":"10.1016/j.injury.2025.112285","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112285"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic spinal injuries: A retrospective epidemiological analysis following the 2018 driving policy reform in Saudi Arabia","authors":"Nizar A. Algarni ,&nbsp;Rushaid N. Aljurayyan ,&nbsp;Khalid F. Alrasheed ,&nbsp;Nawaf M. Alrefaei ,&nbsp;Omar Y. Alkadhi ,&nbsp;Abdulkareem M. Alotaibi ,&nbsp;Huthayfah T. Alkhliwi","doi":"10.1016/j.injury.2025.112968","DOIUrl":"10.1016/j.injury.2025.112968","url":null,"abstract":"<div><h3>Background</h3><div>The epidemiology of traumatic spinal injuries (TSI) differs across various regions and is influenced by national income, infrastructure, and culture. TSIs are a source of high morbidity and mortality, requiring considerable resource allocation. Saudi Arabia’s 2018 decision allowing women to drive introduced a new demographic element, potentially shifting TSI epidemiology. In this paper, we aimed to study patterns and outcomes of TSIs, including sex-based analyses, and to identify demographic, injury-related, and in-hospital factors associated with length of hospital stay, neurological severity, and spinal surgery requirement.</div></div><div><h3>Methods</h3><div>This is a retrospective observational study conducted in a tertiary center between 2018 and May 2025. A total of 5380 computed tomography scans were screened. All patients with a diagnosis of spinal injury caused by a traumatic mechanism were included. Patients' demographics, mechanism of injury, injury level, associated injuries, AIS grade, hospital course, and disposition were collected and analyzed.</div></div><div><h3>Results</h3><div>623 TSI patients were included. Most of them were males (78.5 %) and Saudi nationals (74.2 %), with a male-to-female ratio of 3.7. The average age was 32.5 (±15.9) years. Substance use was documented in 7.4 % of cases. Four-wheel motorized-vehicle accidents (Four W-MVA) predominated (57.6 %) and were more common among Saudis (68.4 %), whereas falls from height (36.0 %), pedestrian injuries (21.1 %) were more common among non-Saudis. The most common injury was at the lumbar region (53.9 %), and most patients were neurologically intact (AIS E 93.7 %). Female sex and older age were associated with longer length of stay (LOS). Longer LOS was independently associated with prior psychiatric illness (RR=3.77), higher AIS severity (RR=1.22), pulmonary infection (RR=3.11), and ICU admission (RR=2.01). Higher AIS severity was linked to cervical involvement (per injured level RR=1.10) and vertebral subluxation/dislocation (RR=1.24).</div></div><div><h3>Conclusion</h3><div>The epidemiology of TSIs has demonstrated notable shifts in demographics, patterns of injury, and outcomes. This study highlights the need for targeted interventions, including intensified efforts to enforce traffic regulations, addressing health disparities experienced by non-Saudi residents, and an expansion of mental health services.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112968"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of trauma team activation criteria in Germany. A retrospective analysis of 94.000 cases from the TraumaRegister DGU®","authors":"Paul Hagebusch ,&nbsp;Rolf Lefering ,&nbsp;Daniel Anthony Koch ,&nbsp;Philipp Faul ,&nbsp;Philipp Störmann ,&nbsp;Dan Bieler ,&nbsp;Matthias Münzberg ,&nbsp;Uwe Schweigkofler","doi":"10.1016/j.injury.2025.113010","DOIUrl":"10.1016/j.injury.2025.113010","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective trauma triage relies on accurate trauma team activation (TTA) criteria to balance resource allocation and patient outcomes. Current guidelines prioritize high-risk of severe injury (HRSI) criteria, while moderate-risk of severe injury (MRSI) criteria are associated with high over-triage rates. Using data from the TraumaRegister DGU® (TR-DGU), this study evaluates the impact of different TTA criteria on patient outcomes and trauma system efficiency.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using TR-DGU data from 2018 to 2023, including patients aged ≥16 years with trauma team activation, emergency room treatment, and intensive or intermediate care admission. Patients were categorized based on TTA criteria: HRSI, MRSI, or provider decision (“None”). Injury severity, mortality, emergency interventions, intensive care unit (ICU) stay, and hospital length of stay were analyzed. Statistical comparisons utilized chi-square and Mann-Whitney-U tests, with significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>The final cohort included 97,295 patients: 42 % met HRSI criteria, 38 % MRSI, and 20 % were assigned due to provider decision. Patients in the HRSI group had the highest injury severity (ISS=23.5), mortality (19.3 %), and need for emergency interventions (31 %). In contrast, the MRSI group had significantly lower severity (ISS=12.5), mortality (1.6 %), and intervention rates (13 %). The \"None\" group, comprising mostly elderly patients with ground-level falls, had a higher mortality rate (8.5 %) despite a comparable ISS (13.5).</div></div><div><h3>Conclusion</h3><div>Findings highlight the limitations of MRSI-based TTA criteria, which contribute to resource overutilization without improving patient outcomes. A tiered activation strategy prioritizing HRSI while refining MRSI criteria may enhance triage efficiency. The high mortality rate in the \"None\" group suggests the need for additional triage parameters, particularly for geriatric patients. These insights support recent guideline revisions and are the basis for further evaluations.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 113010"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal femur shaft stress fracture in South Korean military","authors":"Yoo-Sun Won,&nbsp;Woo Kyoung Kwak,&nbsp;Sang Min Lee,&nbsp;Tae Hong Min,&nbsp;Jong Seop Kim,&nbsp;Byung Hyun Ahn,&nbsp;Cheungsoo Ha","doi":"10.1016/j.injury.2025.112911","DOIUrl":"10.1016/j.injury.2025.112911","url":null,"abstract":"<div><h3>Objective</h3><div>Distal femur shaft fractures are typically associated with high-energy trauma. Stress fractures involving the distal femur shaft are extremely limited. Therefore, epidemiological characteristics, diagnostic protocol, optimal management strategies, and prognosis of distal femoral shaft stress fractures (DFSSF) remain poorly understood. This study aims to report clinical experience with 10 cases of DFSSF in South Korean military.</div></div><div><h3>Methods</h3><div>This retrospective case series included patients diagnosed with DFSSF at the single South Korean military hospital between January 2022 and December 2023. Demographic and epidemiologic data, including military rank and training context, were collected. Radiographic evaluation including AO classification and femoral bowing angles were assessed. Clinical outcomes assessed included time to union, treatment modality, return to military duty, and complications.</div></div><div><h3>Results</h3><div>Nine patients were male, one female noncommissioned officer candidate with a mean age of 21.2 ± 1.8 years (range, 19–24). As military rank, six patients were recruits, two were privates, and one patient was a private first class. The mean anterior and lateral femoral bowing angle measured by the Sasaki method was 3.7 ± 1.8° and 12.7 ± 2.3° respectively. All fractures achieved successful union within an average of 16.3 ± 2.4 weeks. All patients successfully returned to full military duty at an average of 16.7 ± 2.8 weeks post-injury. No complications were observed.</div></div><div><h3>Conclusion</h3><div>This study provides valuable insight into the rare entity of DFSSF, emphasizing clinical awareness, and optimal management strategies.</div></div><div><h3>Level of Evidence</h3><div>Case Series, IV.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112911"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The «gull sign» in acetabular fractures revisited: is it predictive for failure after osteosynthesis in older adults?","authors":"Silviya Ivanova ,&nbsp;Andromachi Chantzara ,&nbsp;Rainer J Egli ,&nbsp;Marius JB Keel ,&nbsp;Johannes D Bastian","doi":"10.1016/j.injury.2025.112971","DOIUrl":"10.1016/j.injury.2025.112971","url":null,"abstract":"<div><h3>Background</h3><div>The gull sign was described as a radiographic marker of superomedial dome impaction in acetabular fractures and was considered predictive of failure after osteosynthesis in older patients (≥ 60 years).</div></div><div><h3>Aim</h3><div>To determine whether the radiographic gull sign is associated with higher conversion rates to total hip arthroplasty (THA) within 24 months after open reduction and internal fixation (ORIF) for displaced acetabular fractures in patients aged ≥ 60 years.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, 126 patients aged ≥ 60 years (mean 76 years, range 60.1–93.6) underwent ORIF for displaced acetabular fractures via the Pararectus approach between 2009 and 2020. Preoperative pelvic radiographs were assessed for the presence of the gull sign, and CT scans were evaluated for dome impaction. Failure was defined as conversion to total hip arthroplasty (THA) within 24 months after ORIF. Kaplan–Meier analyses with log-rank tests were performed on the entire cohort, and diagnostic performance was analysed in the subset with complete two-year follow-up (<em>n</em> = 93).</div></div><div><h3>Results</h3><div>At two years, 20 of 93 patients (22 %) had undergone THA, occurring on average 12.1 months after the index surgery (range 2–45 months). A radiographic gull sign was identified in 21 patients (23 %). The subsequent THA conversion rate was similar between those with and without the sign (5/21 [24 %] vs 15/72 [21 %]; <em>p</em> = 0.99). Concordance between radiographs and CT was limited: only 12 of 21 gull-positive patients (57 %) showed a true dome impaction on CT, while CT nevertheless revealed impaction in 21 of 72 gull-negative patients (29 %). Among patients with CT-confirmed impaction, 8 of 33 (24 %) underwent THA within 24 months, compared with 12 of 60 (20 %) without impaction (<em>p</em> = 0.79). Kaplan–Meier analysis of the entire cohort (<em>n</em> = 126) likewise showed no difference in THA-free survival between groups.</div></div><div><h3>Conclusion</h3><div>Neither a radiographic gull sign nor CT-confirmed dome impaction predicted early conversion in our series of acetabular fractures managed via Pararectus approach; overall conversion rates were acceptable. Accordingly, the gull sign is not a harbinger per se for failure of osteosynthesis in older adults.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112971"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified calcar ratio for predicting varus collapse in proximal humerus fractures","authors":"Kemal Şibar ,&nbsp;Abdülsamet Emet ,&nbsp;Yasin Erdoğan ,&nbsp;Hatice Ezgi Rifaioğlu ,&nbsp;Erkan Akgün ,&nbsp;Ahmet Fırat","doi":"10.1016/j.injury.2025.112961","DOIUrl":"10.1016/j.injury.2025.112961","url":null,"abstract":"<div><h3>Introduction</h3><div>Proximal humerus fractures are common, especially in older adults, and often result in complications such as varus collapse after open reduction and internal fixation (ORIF). Despite successful surgical methods, complication rates remain significant, with varus collapse being a primary cause of failure. Ensuring proper screw placement, particularly the calcar screw, is vital to prevent this issue. This study introduces a modified calcar ratio (MCR) that combines two key measurements - tip distance and calcar distance - to predict varus collapse and improve surgical outcomes.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed patients treated for proximal humerus fractures from September 2022 to June 2024. Inclusion criteria were adults with 3- or 4-part fractures who underwent ORIF with a proximal humerus plate within two weeks of injury. Preoperative and postoperative radiographs were evaluated to determine fracture classification, reduction quality, and radiological parameters, including MCR. MCR was calculated as the sum of the tip distance and calcar distance divided by the humeral head radius. Statistical analysis, including ROC curve analysis, assessed MCR’s ability to predict varus collapse.</div></div><div><h3>Results</h3><div>A total of 108 patients were included. MCR was significantly higher in patients who experienced varus collapse (median MCR: 0.7) compared to those who healed (median MCR: 0.5). Varus collapse occurred in 17.6 % of patients, with a median onset time of 8 weeks post-surgery. Statistical analysis showed a strong correlation between higher MCR and varus collapse, with a sensitivity of 100 % and a specificity of 47 %, at a cut-off point of 0.46 for predicting failure. The ROC curve demonstrated 78 % discriminatory ability for MCR.</div></div><div><h3>Conclusion</h3><div>The MCR is a reliable, practical tool for predicting varus collapse following ORIF in proximal humerus fractures. By considering both the tip and calcar distances, MCR provides a single, effective measure to optimize surgical outcomes. An intraoperative MCR value below 0.46 demonstrated high sensitivity for predicting lower risk of varus collapse, and may serve as a useful intraoperative reference.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112961"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concern on “Ultrasound-guided percutaneous cryoneurolysis of intercostal nerves in traumatic rib fractures”","authors":"Amiya Kumar Barik ,&nbsp;Anju Gupta ,&nbsp;Chitta Ranjan Mohanty ,&nbsp;Rakesh Vadakkethil Radhakrishnan ,&nbsp;Aditya Vikram Prusty","doi":"10.1016/j.injury.2025.112564","DOIUrl":"10.1016/j.injury.2025.112564","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112564"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated metabolomics and proteomics to screen early diagnostic biomarkers of venous thromboembolism following severe trauma: A retrospective study","authors":"Yi Gou ,&nbsp;Dan-dan Li ,&nbsp;Xin Li ,&nbsp;Xin Yuan ,&nbsp;Yi-han Wang ,&nbsp;Jian-zhong Yang ,&nbsp;Ke Feng","doi":"10.1016/j.injury.2025.112934","DOIUrl":"10.1016/j.injury.2025.112934","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of trauma-related mortality within 30 days in severe trauma patients. Current diagnostic methods have limitations, leading to an urgent need to identify early diagnostic biomarkers of VTE.</div></div><div><h3>Objective</h3><div>To screen early diagnostic biomarkers of VTE following severe trauma by integrating metabolomics and proteomics.</div></div><div><h3>Method</h3><div>The existing plasma metabolomics and proteomics data from 72 severe trauma patients with (22 cases) and without (49 cases) VTE were retrospectively analyzed. By comparing two groups, early diagnostic biomarkers of VTE in severe trauma patients were identified.</div></div><div><h3>Results</h3><div>210 differentially expressed metabolites (DEMs) and 11 DEPs (DEPs) were identified. We screened the top 10 DEMs and 11 DEPs as early diagnostic biomarkers for VTE after severe trauma, then developed two panels using top 10 DEMs (AUC=0.952) and 11 DEPs (AUC=0.955), respectively. By integrating metabolomics and proteomics, we developed a diagnostic panel consisting of LPC16:0 and FA7, which demonstrated superior diagnostic efficacy (AUC = 0.937).</div></div><div><h3>Conclusion</h3><div>This study identified potential biomarkers of VTE after severe trauma, providing a novel strategy for early precision diagnosis, providing new insights into the pathogenesis of VTE after severe trauma, and establishing a translational framework for developing early diagnostic biomarker panels.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"57 2","pages":"Article 112934"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}