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Original Article

Experimental study | Trauma

Study of ubiquitin C-terminal hydrolase-L1, glial fibrillary acidic protein, and interleukin-6 levels in an experimental head trauma model in rabbits
İlknur Şahin, Hasan Kara, Ali Ünlü, Ceyhan Uğurluoğlu, Beyza Saraçlıgil
Clin Exp Emerg Med 2025;12(4):380-390.   Published online December 23, 2025
DOI: https://doi.org/10.15441/ceem.24.383

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Study of ubiquitin C-terminal hydrolase-L1, glial fibrillary acidic protein, and interleukin-6 levels in an experimental head trauma model in rabbits
Clin Exp Emerg Med. 2025;12(4):380-390.   Published online December 23, 2025
DOI: https://doi.org/10.15441/ceem.24.383
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Study of ubiquitin C-terminal hydrolase-L1, glial fibrillary acidic protein, and interleukin-6 levels in an experimental head trauma model in rabbits
Clin Exp Emerg Med. 2025;12(4):380-390.   Published online December 23, 2025
DOI: https://doi.org/10.15441/ceem.24.383
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Objective
The study investigates experimental brain trauma in rabbits, assessing levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1), glial fibrillary acidic protein (GFAP), and interleukin 6 (IL-6) in serum and cerebrospinal fluid (CSF) and compares these biomarkers among trauma groups.
Methods
Thirty rabbits were randomized to a control group (n=6) or to mild-, moderate-, and severe-trauma groups (n=8 each) created by dropping 200, 350, or 500 g weights, respectively, onto their skulls using a modified Marmarou impact acceleration model. CSF and venous blood samples were collected at 0, 12, and 24 hours after injury; UCH-1 L, GFAP, and IL-6 concentrations in CSF and serum were quantified by enzyme-linked immunosorbent assays, and group differences were analyzed with a Friedman test followed by Dunn-Bonferroni correction.
Results
Neither CSF nor serum concentration of GFAP, IL-6, or UCH-L1 differed from those of controls after mild trauma. Severe head trauma produced markedly higher GFAP and IL-6 concentrations in CSF compared with the control group (P<0.05), with both biomarkers peaking at 12 hours after injury. Serum UCH-L1 increased significantly in both moderate-trauma (peak at 12 hours) and severe-trauma groups (peak at 24 hours) compared with the control group (P<0.05), whereas no intergroup difference in CSF UCH-L1 levels was evident.
Conclusion
Serum UCH-L1 differentiated moderate and severe trauma from controls in a rabbit model, whereas CSF GFAP and IL-6 levels reflected severe injury. Validation in larger preclinical and clinical studies is warranted.
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Review Article

Imaging | Emergency Medical Services

Ultrasound as a tool in prehospital settings: a scoping review
Jose Luis Piñeros-Alvarez, Jose Daniel Yusty Prada, Esteban Portuguez
Clin Exp Emerg Med 2025;12(4):320-330.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.374

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Ultrasound as a tool in prehospital settings: a scoping review
Clin Exp Emerg Med. 2025;12(4):320-330.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.374
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Ultrasound as a tool in prehospital settings: a scoping review
Clin Exp Emerg Med. 2025;12(4):320-330.   Published online April 30, 2025
DOI: https://doi.org/10.15441/ceem.24.374
Close
Point-of-care ultrasound (POCUS) is a valuable tool in the prehospital management of critically ill patients, particularly patients with trauma, dyspnea, or shock. This review aims to evaluate the diagnostic and therapeutic applications, limitations, and implementation challenges of POCUS in prehospital care. Key findings are that ultrasound, particularly the extended Focused Assessment with Sonography in Trauma (eFAST) protocol, offers high specificity in identifying severe hemorrhage in trauma cases, although its sensitivity varies depending on the clinical context and operator experience. In dyspnea, pulmonary ultrasound significantly enhances diagnostic accuracy, aiding early detection of heart failure and other respiratory conditions. For shock, focused echocardiography facilitates rapid diagnosis and timely therapeutic decisions, improving patient outcomes. However, the effectiveness of POCUS is highly dependent on the operator’s expertise, and challenges such as time, space, and resource limitations in prehospital settings may impact its use. Furthermore, local studies in Latin America assessing the impact of prehospital ultrasound on morbidity and mortality reduction are lacking. Based on our review, we recommend standardized training programs, increased availability of portable ultrasound devices, and prospective studies on cost-benefit analysis to optimize POCUS implementation in prehospital systems, particularly in resource-limited regions. Prehospital ultrasound has the potential to revolutionize patient care by improving diagnostic precision and reducing time to definitive treatment, but its successful implementation requires strategic integration of technology, education, and research.

Citations

Citations to this article as recorded by  Crossref logo
  • Meta-analysis of the effectiveness of portable imaging diagnostics for multiple fractures and chest injuries in combat zones: mobile X-ray systems and ultrasound devices (literature review)
    V. V. Chorna, L. D. Kotsur, N. I. Gumeniuk, M. O. Cherniak, I. V. Kachur
    Reports of Vinnytsia National Medical University.2026; 30(1): 156.     CrossRef
  • 5,722 View
  • 187 Download
  • 1 Crossref

Original Article

Trauma

Impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated traumatic brain injury
Kyung Won Park, Sung Wook Song, Woo Jeong Kim, Jeong Ho Kang, Ji Hwan Bu, Sung Kgun Lee, Seo Young Ko, Soo Hoon Lee, Chang Bae Park, Jin Gu Lee, Jong Yeon Kang, Jaeyoon Ha, Jiwon Kim
Clin Exp Emerg Med 2025;12(4):358-368.   Published online January 15, 2025
DOI: https://doi.org/10.15441/ceem.24.331

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Impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated traumatic brain injury
Clin Exp Emerg Med. 2025;12(4):358-368.   Published online January 15, 2025
DOI: https://doi.org/10.15441/ceem.24.331
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Impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated traumatic brain injury
Clin Exp Emerg Med. 2025;12(4):358-368.   Published online January 15, 2025
DOI: https://doi.org/10.15441/ceem.24.331
Close
Objective
Traumatic brain injury (TBI) often occurs alongside injuries to other body regions, worsening patient outcomes. This study evaluates the impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated TBI.
Methods
This retrospective cross-sectional analysis was conducted using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) for 180,058 TBI patients admitted to 23 tertiary hospitals from January 1, 2020, to December 31, 2022. Patients were categorized into isolated TBI group (iTBI; n=127,673) and non-isolated TBI group (niTBI; n=52,385) based on injury diagnostic codes. Clinical outcomes—24-hour and 30-day mortality, hospital admission, and interhospital transfer—were compared. Multivariate logistic regression analyses adjusted for potential confounders were performed.
Results
The niTBI patients exhibited significantly higher 24-hour mortality (1.5% vs. 0.4%), 30-day mortality (2.6% vs. 1.0%), hospital admissions (24.5% vs. 8.4%), and interhospital transfers (3.6% vs. 1.1%) than iTBI patients (all P<0.001). Concomitant injuries increased the adjusted odds of 24-hour mortality (adjusted odds ratio [aOR], 1.456; 95% confidence interval [CI], 1.286–1.648) and 30-day mortality (aOR, 1.111; 95% CI, 1.022–1.208). Thoracic injuries were the most significant predictor of adverse outcomes in niTBI patients, increasing the odds of 24-hour mortality by nearly sixfold (aOR, 5.958; 95% CI 5.057–7.019).
Conclusions
Concomitant injuries significantly worsen clinical outcomes in TBI patients, with thoracic injuries being the most critical predictor of mortality. These findings highlight the importance of comprehensive trauma assessments and targeted prevention strategies to improve survival rates and optimize resource allocation for patients with multiple injuries.
  • 3,287 View
  • 116 Download

Review Article

Blood failure: traumatic hemorrhage and the interconnections between oxygen debt, endotheliopathy, and coagulopathy
Jae Hyuk Lee, Kevin R. Ward
Clin Exp Emerg Med 2024;11(1):9-21.   Published online March 21, 2024
DOI: https://doi.org/10.15441/ceem.23.127

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Blood failure: traumatic hemorrhage and the interconnections between oxygen debt, endotheliopathy, and coagulopathy
Clin Exp Emerg Med. 2024;11(1):9-21.   Published online March 21, 2024
DOI: https://doi.org/10.15441/ceem.23.127
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Blood failure: traumatic hemorrhage and the interconnections between oxygen debt, endotheliopathy, and coagulopathy
Clin Exp Emerg Med. 2024;11(1):9-21.   Published online March 21, 2024
DOI: https://doi.org/10.15441/ceem.23.127
Close
This review explores the concept of “blood failure” in traumatic injury, which arises from the interplay of oxygen debt, the endotheliopathy of trauma (EoT), and acute traumatic coagulopathy (ATC). Traumatic hemorrhage leads to the accumulation of oxygen debt, which can further exacerbate hemorrhage by triggering a cascade of events when severe. Such events include EoT, characterized by endothelial glycocalyx damage, and ATC, involving platelet dysfunction, fibrinogen depletion, and dysregulated fibrinolysis. To manage blood failure effectively, a multifaceted approach is crucial. Damage control resuscitation strategies such as use of permissive hypotension, early hemorrhage control, and aggressive transfusion of blood products including whole blood aim to minimize oxygen debt and promote its repayment while addressing endothelial damage and coagulation. Transfusions of red blood cells, plasma, and platelets, as well as the use of tranexamic acid, play key roles in hemostasis and countering ATC. Whole blood, whether fresh or cold-stored, is emerging as a promising option to address multiple needs in traumatic hemorrhage. This review underscores the intricate relationships between oxygen debt, EoT, and ATC and highlights the importance of comprehensive, integrated strategies in the management of traumatic hemorrhage to prevent blood failure. A multidisciplinary approach is essential to address these interconnected factors effectively and to improve patient outcomes.

Citations

Citations to this article as recorded by  Crossref logo
  • What Would Mother Say? Whole Blood and RhD Alloimmunization in Trauma Resuscitation
    John Ramos
    Journal of Emergency Nursing.2026; 52(1): 28.     CrossRef
  • Association of endotheliopathy and coagulopathy biomarkers with survival in a swine model of isolated uncontrolled hemorrhage
    Alan Weaver, Kim Hildreth, Charnae Williams, Natalie Nguyen, Lorie Leyva, Irasema Terrazas, Cheresa Calhoun, Thomas Edwards
    Transfusion.2026;[Epub]     CrossRef
  • Erythrocytes as immunomodulators in trauma: orchestrating clearance pathways, inflammation, and organ injury
    Xuru Qian, Linglong Chen, Renxian Gao, Yue Lin, Kaihuai Wu, Xiaojie Wang, Yingying Jiang
    Frontiers in Immunology.2026;[Epub]     CrossRef
  • Experimental Modeling of Blood Loss and Hemorrhagic Shock: Past Achievements, Current Recommendations, and Future Challenges (Review)
    I. A. Ryzhkov, A. Yu. Dubensky, R. A. Cherpakov, V. A. Reva, V. V. Moroz, V. T. Dolgikh
    General Reanimatology.2026;[Epub]     CrossRef
  • Initial arterial pH predicts survival of out-of-hospital cardiac arrest in South Korea
    Daun Jeong, Sang Do Shin, Tae Gun Shin, Gun Tak Lee, Jong Eun Park, Sung Yeon Hwang, Jin-Ho Choi
    Acute and Critical Care.2025; 40(3): 444.     CrossRef
  • 18,326 View
  • 560 Download
  • 5 Web of Science
  • 5 Crossref

Original Articles

Imaging

The predictive value of point-of-care ultrasonography versus magnetic resonance imaging in assessing medial meniscal tears in patients with acute knee injury
Omid Ahmadi, Mehdi Motififard, Farhad Heydari, Saeed Hatami, Azita Azimi Meibody
Clin Exp Emerg Med 2024;11(2):188-194.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.111

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The predictive value of point-of-care ultrasonography versus magnetic resonance imaging in assessing medial meniscal tears in patients with acute knee injury
Clin Exp Emerg Med. 2024;11(2):188-194.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.111
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The predictive value of point-of-care ultrasonography versus magnetic resonance imaging in assessing medial meniscal tears in patients with acute knee injury
Clin Exp Emerg Med. 2024;11(2):188-194.   Published online January 29, 2024
DOI: https://doi.org/10.15441/ceem.23.111
Close
Objective
Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the accuracy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus tears in knee. Methods The prospective study was conducted on patients with suspected medial meniscus tears in knee. in the emergency department. In the absence of a knee fracture on x-ray, POCUS on the knee was performed. All patients underwent POCUS and MRI of the knee followed by arthroscopy. POCUS findings were then compared to MRI findings to diagnose medial meniscus tears. Results A final total of 157 patients with a mean age of 25.04±7.41 years was included. Out of 157 patients, 94 (59.9%) were male. Medial meniscus tears were detected in 89 patients (56.7%) using arthroscopy as the gold standard. The sensitivity, specificity, positive and negative predictive values, and accuracy of POCUS to detect medial meniscus tears were 88.8% (95% confidence interval [CI], 80.3%–94.5%), 89.7% (95% CI, 79.9%–95.8%), 91.9% (95% CI, 84.8%–95.8%), 85.9% (95% CI, 77.2%–91.7%), and 89.2% (95% CI, 83.3%–93.6%), respectively. The diagnostic accuracy of MRI to detect medial meniscus injury was 93.0% (95% CI, 87.8%– 96.4%). Conclusion The present study demonstrated that POCUS is an accurate and reliable diagnostic tool alternative to MRI in detecting medial meniscal tears. POCUS had acceptable sensitivity, specificity, and accuracy in detecting meniscal injuries and could be performed as an effective immediate investigation to guide further modalities in patients with acute knee trauma

Citations

Citations to this article as recorded by  Crossref logo
  • Diagnostic accuracy of ultrasonography for meniscal tears: a systematic review and meta-analysis
    Rifat Hassan, Daryl Poku, Otto Chan, Nicola Maffulli
    Skeletal Radiology.2026; 55(8): 1777.     CrossRef
  • Diagnostic accuracy of ultrasound in assessing medial collateral ligament and medial meniscus injuries? A systematic review and meta-analysis.
    Melanie Potter, Anthony Smith
    The Ultrasound Journal.2026; 18(1): 18171.     CrossRef
  • Point-of-care ultrasound in trauma: a systematic review of recent literature
    Azizul Fadzli Jusoh, Rosliza Yahaya, Mohd Hashairi Fauzi, Shaik Farid Abdull Wahab
    Journal of Ultrasonography.2026;[Epub]     CrossRef
  • Ultrasonographic Assessment of Meniscus Damage in the Context of Clinical Manifestations
    Tomasz Poboży, Wojciech Konarski, Kacper Janowski, Klaudia Michalak, Kamil Poboży, Julia Domańska-Poboża
    Medicina.2025; 61(8): 1339.     CrossRef
  • A Retrospective Audit of the Timescales Involved in the Diagnosis and Management of Soft Tissue Knee Injuries at a Single National Health Service Trust: A Quality Service Improvement and Redesign Project
    Ashmitha Vindya, Siddesh Bhushan Gangadharaswamy Nagabhushan
    Cureus.2025;[Epub]     CrossRef
  • The Utility of a Community-Based Knee Ultrasound in Detecting Meniscal Tears: A Retrospective Analysis in Comparison with MRI
    Fatima Awan, Prosanta Mondal, Johannes M. van der Merwe, Nicholas Vassos, Haron Obaid
    Healthcare.2024; 12(20): 2051.     CrossRef
  • 9,504 View
  • 152 Download
  • 5 Web of Science
  • 6 Crossref

Trauma | Public Health & Policy

Characteristics of fall-from-height patients: a retrospective comparison of jumpers and fallers using a multi-institutional registry
Jinhae Jun, Ji Hwan Lee, Juhee Han, Sun Hyu Kim, Sunpyo Kim, Gyu Chong Cho, Eun Jung Park, Duk Hee Lee, Ju Young Hong, Min Joung Kim
Clin Exp Emerg Med 2024;11(1):79-87.   Published online November 29, 2023
DOI: https://doi.org/10.15441/ceem.23.074

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Characteristics of fall-from-height patients: a retrospective comparison of jumpers and fallers using a multi-institutional registry
Clin Exp Emerg Med. 2024;11(1):79-87.   Published online November 29, 2023
DOI: https://doi.org/10.15441/ceem.23.074
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Characteristics of fall-from-height patients: a retrospective comparison of jumpers and fallers using a multi-institutional registry
Clin Exp Emerg Med. 2024;11(1):79-87.   Published online November 29, 2023
DOI: https://doi.org/10.15441/ceem.23.074
Close
Objective
Fall from height (FFH) is a major public health problem that can result in severe injury, disability, and death. This study investigated how the characteristics of jumpers and fallers differ.
Methods
This was a retrospective study of FFH patients enrolled in an Emergency Department-based Injury In-depth Surveillance (EDIIS) registry between 2011 and 2018. Depending on whether the injury was intentional, FFH patients who had fallen from a height of at least 1 m were divided into two groups: jumpers and fallers. Patient characteristics, organ damage, and death were compared between the two groups, and factors that significantly affected death were identified using multivariable logistic analysis.
Results
Among 39,419 patients, 1,982 (5.0%) were jumpers. Of the jumpers, 977 (49.3%) were male, while 30,643 (81.9%) of fallers were male. The jumper group had the highest number of individuals in their 20s, with the number decreasing as age increased. In contrast, the number of individuals in the faller group rose until reaching their 50s, after which it declined. More thoracoabdominal, spinal, and brain injuries were found in jumpers. The in-hospital mortality of jumpers and fallers was 832 (42.0%) and 1,268 (3.4%), respectively. Intentionality was a predictor of in-hospital mortality, along with sex, age, and fall height, with an odds ratio of 7.895 (95% confidence interval, 6.746–9.240).
Conclusion
Jumpers and fallers have different epidemiological characteristics, and jumpers experienced a higher degree of injury and mortality than fallers. Differentiated prevention and treatment strategies are needed for jumpers and fallers to reduce mortality in FFH patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Criteria for Methods of Radio Frequency Scanning at Telecommunication Towers in Malaysia Based on Delphi-AHP Analysis
    Rosdin Abdul Kahar, Mohd Nizam Ab Rahman, Nizaroyani Saibani, Mohd Fais Mansor, Mirza Basyir Rodhuan
    Eng.2026; 7(1): 35.     CrossRef
  • Age-dependent injury mechanisms and injury patterns in pediatric window falls
    Alina Badina, Aymeric Deygas, Ibrahim Saliba, Andrei Corbu, Emma Pereira Da Costa, Samuel Georges, Philippe Wicart
    European Journal of Trauma and Emergency Surgery.2026;[Epub]     CrossRef
  • 13,816 View
  • 119 Download
  • 2 Web of Science
  • 2 Crossref

Systematic Review

Relationships between trauma death, disability, and geographic factors: a systematic review
Bona Hwang, Taewook Jeong, Jiyeon Jo
Clin Exp Emerg Med 2023;10(4):426-437.   Published online August 1, 2023
DOI: https://doi.org/10.15441/ceem.23.009

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Relationships between trauma death, disability, and geographic factors: a systematic review
Clin Exp Emerg Med. 2023;10(4):426-437.   Published online August 1, 2023
DOI: https://doi.org/10.15441/ceem.23.009
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Relationships between trauma death, disability, and geographic factors: a systematic review
Clin Exp Emerg Med. 2023;10(4):426-437.   Published online August 1, 2023
DOI: https://doi.org/10.15441/ceem.23.009
Close
Objective
Trauma is a global health problem. The causes of trauma-related deaths are diverse and may depend in part on socioeconomic and geographical factors; however, there have been few studies addressing such relationships. The aim of this study was to investigate the relationships between trauma and geographical factors in order to support policy recommendations to reduce trauma-related deaths and disability.
Methods
In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched international and Korean databases to retrieve relevant literature published between 2000 and 2020.
Results
Thirty-two studies showed a positive relationship between the outcomes of major trauma and geographical factors. The study investigated regional factors including economic factors such as size of urban areas, gross domestic product, and poverty rate, as well as hospital parameters, such as presence of trauma centers and number of hospital beds. There was a tendency toward higher mortality rates in rural and low-income areas, and most of the studies reported that the presence of trauma centers reduced trauma-related mortality rates.
Conclusion
Our study showed that geographic factors influence trauma outcomes. The findings suggest geographical considerations be included in care plans to reduce death and disability caused by trauma.

Citations

Citations to this article as recorded by  Crossref logo
  • AI-driven surgical decision making in oral and maxillofacial surgery: from diagnostic ambiguity to personalized therapy via data structuring, predictive modeling, and XR-enhanced execution
    Philipp Thoenissen, Jannik Schaaf, Sophie Zorn, Robert Sader, Keisuke Sugahara, Thomas Maal
    Innovative Surgical Sciences.2026;[Epub]     CrossRef
  • Construction of an emergency nursing-sensitive quality indicator system for patients with severe trauma: a modified Delphi study in the Chinese context
    La Xie, Meng He, Nianlu Xing, Mei Feng, Xiangping Liu
    BMJ Open.2026; 16(2): e110217.     CrossRef
  • A comparative analysis of trauma-related mortality in South Korea using classification models
    Yookyung Boo, Youngjin Choi
    International Journal of Medical Informatics.2025; 196: 105805.     CrossRef
  • Clinical Significance of Rotational Thromboelastometry (ROTEM) for Detection of Early Coagulopathy in Trauma Patients: A Retrospective Study
    Mohammad Asim, Ayman El-Menyar, Ruben Peralta, Suresh Arumugam, Bianca Wahlen, Khalid Ahmed, Naushad Ahmad Khan, Amani N. Alansari, Monira Mollazehi, Muhamed Ibnas, Ammar Al-Hassani, Ashok Parchani, Talat Chughtai, Sagar Galwankar, Hassan Al-Thani, Sandro
    Diagnostics.2025; 15(9): 1148.     CrossRef
  • Recent advances, mechanisms, and applications of natural medicines incorporated hydrogel-based drug delivery systems for enhancing wound-healing efficacy
    Awn Abbas, Muhammad Asim Raza, Xiaoyang Ai, Sadia, Hua Liao, Nanxin Li, Sameera Naseer, Dongbo Li, Yifan Zhang, Lian Chen, Wei Zhang, Gang Shu, Hualin Fu
    Journal of Biomaterials Science, Polymer Edition.2025; 36(16): 2490.     CrossRef
  • Perioperative Analgesia Management for a Chinese Patient with Multiple Traumatic Injuries: A Case Report
    Yang Chen, Yang Jing
    International Journal of Medical Case Reports.2025; 4(3): 47.     CrossRef
  • Split-bolus single-pass CT in splenic injury: does it miss relevant vascular injury?
    Sadia R. Qamar, Ferco H. Berger, Tjarda N. Tromp, Digna R. Kool, Ludo F.M. Beenen, Bernd P. Teunissen, Maeke J. Scheerder, Michael J.R. Edwards, Monique Brink
    Emergency Radiology.2025; 32(6): 829.     CrossRef
  • C-reactive Protein/Albumin Ratio as a Predictive Inflammatory Marker for Postoperative Systemic Inflammatory Response Syndrome and/or Sepsis in Polytraumatized Patients in ICU
    Ahmed S Salem, Mohamed A Zaghloul, Alfred M Boctor, Mohamed Maher Abd Elfattah, Oliver M Shehata
    Indian Journal of Critical Care Medicine.2025; 29(12): 1002.     CrossRef
  • Associations between traumatic dental injuries due to violence and various drinking behaviors in Korea: A cross‐sectional study
    Ji‐Young Son, Jaehyung Lim, Dong‐Hun Han
    Dental Traumatology.2024; 40(5): 537.     CrossRef
  • Return to Work One Year after Moderate to Severe Traumatic Injury in a Working Age Population
    Christoph Schäfer, Håkon Øgreid Moksnes, Mari Storli Rasmussen, Torgeir Hellstrøm, Cathrine Brunborg, Helene Lundgaard Soberg, Olav Røise, Cecilie Røe, Nada Andelic, Audny Anke
    Journal of Clinical Medicine.2024; 13(17): 5308.     CrossRef
  • Regional deprivation and cause-specific mortality in Russian adults in 2006–2022
    Anastasia Zelenina
    Global Health Journal.2024; 8(4): 190.     CrossRef
  • Portraying disability with trauma: A case study of documentary screenwriting in presenting visually impaired subject
    Ruohan Tang
    Journal of Screenwriting .2024; 15(3): 303.     CrossRef
  • 12,694 View
  • 188 Download
  • 10 Web of Science
  • 12 Crossref

Original Articles

Injury & Prevention

Clinical characteristics and outcomes of injuries in agricultural and nonagricultural workers visiting the emergency department: a propensity-matched analysis
Jong Yeon Kang, Sung Wook Song, Hansol Hong, Woo Jeong Kim, YoungJoon Kang, Jeong Ho Kang, Sung Kgun Lee, Ji Hwan Bu, Seo Young Ko, Soo Hoon Lee
Clin Exp Emerg Med 2024;11(1):68-78.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.022

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Clinical characteristics and outcomes of injuries in agricultural and nonagricultural workers visiting the emergency department: a propensity-matched analysis
Clin Exp Emerg Med. 2024;11(1):68-78.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.022
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Clinical characteristics and outcomes of injuries in agricultural and nonagricultural workers visiting the emergency department: a propensity-matched analysis
Clin Exp Emerg Med. 2024;11(1):68-78.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.022
Close
Objective
Agriculture is a hazardous industry. However, previous studies have focused on injuries to agricultural workers without comparison with injuries to nonagricultural workers. Therefore, we compared the clinical characteristics and outcomes of injuries reported at an emergency department (ED) between agricultural workers and nonagricultural workers.
Methods
We established a prospective ED-based agricultural injury surveillance system at a tertiary university hospital. Adult patients visiting the ED for an injury were divided into farmer and non-farmer groups depending on their engagement with agriculture. Using an adjusted multivariate analysis and propensity score matching (age, sex, inhabitant, and insurance type), we compared the clinical characteristics and outcomes of injuries between the farmer and non-farmer groups.
Results
In total, 38,556 injured adult patients (37,746 in the non-farmer group and 810 in the farmer group) were available for the unmatched sample analysis. The 1,620 matched subjects were equally classified after one-to-one nearest-neighbor propensity score matching. A multivariate logistic regression analysis of the unmatched sample revealed higher adjusted odds ratios (ORs) for intensive care unit admission (adjusted OR, 1.752; P=0.003) and overall surgery (adjusted OR, 1.870; P<0.001) in the farmer group. In contrast, univariate logistic regression analyses of the propensity score–matched sample found a higher OR in the farmer group only for overall surgery (OR, 1.786; P<0.001).
Conclusion
Injuries of agricultural workers had higher odds only of requiring surgery; differences in injury-related mortality between groups were not statistically significant in either the matched or unmatched sample analyses.

Citations

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  • Stress, Health, and Injury Among Illinois Farmers
    Josie M. Rudolphi, Salah Issa, Courtney Cuthbertson, Kaleigh Barnett
    American Journal of Industrial Medicine.2025; 68(9): 761.     CrossRef
  • 7,128 View
  • 120 Download
  • 1 Web of Science
  • 1 Crossref

Trauma

Frequency of posttrauma complications during hospital admission and their association with Injury Severity Score
Shayan Dasdar, Mahmoud Yousefifard, Mehri Farhang Ranjbar, Mehdi Forouzanfar, Hamid Mazloom, Saeed Safari
Clin Exp Emerg Med 2023;10(4):410-417.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.053

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Frequency of posttrauma complications during hospital admission and their association with Injury Severity Score
Clin Exp Emerg Med. 2023;10(4):410-417.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.053
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Frequency of posttrauma complications during hospital admission and their association with Injury Severity Score
Clin Exp Emerg Med. 2023;10(4):410-417.   Published online July 13, 2023
DOI: https://doi.org/10.15441/ceem.23.053
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Objective
Multiple trauma is associated with a remarkable risk of in-hospital complications, which harm healthcare services and patients. This study aimed to assess the incidence of posttrauma complications, their relationship with poor outcomes, and the effect of the Injury Severity Score (ISS) on their occurrence.
Methods
This retrospective cohort study was conducted at a pair of trauma centers, between January 2020 and December 2022. All hospitalized adult patients with multiple trauma were included in this study. Multivariable logistic regression was used to identify factors related to posttrauma complications.
Results
Among 727 multiple trauma patients, 90 (12.4%) developed in-hospital complications. The most frequent complications were pneumonia (4.8%), atelectasis (3.7%), and superficial surgical site infection (2.5%). According to multivariable logistic regression, ISS, the length of stay in the intensive care unit (ICU), the length of stay in the hospital, and mortality were significantly associated with complications. The complication rate increased by 17% with every single-unit increase in ISS (adjusted odds ratio [OR], 1.17; 95% confidence interval [CI], 1.00–1.38). Per every 1-day increase in the ICU or hospital stay, the complication rate increased by 65% (adjusted OR, 1.65; 95% CI, 1.00–2.73) and 20% (adjusted OR, 1.20; 95% CI, 1.03–1.41), respectively. Posttrauma complications were also significantly more common in patients with mortality (adjusted OR, 163.30; 95% CI, 3.04–8,779.32). In multiple trauma patients with a higher ISS, the frequency, severity, and number of complications were significantly increased.
Conclusion
In-hospital complications in multiple trauma patients are frequent and associated with poor outcomes and mortality. ISS is an important factor associated with posttrauma complications.

Citations

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  • The prevalence and risk factors of posttraumatic stress disorder following road traffic accidents in China: A meta-analysis
    Yanna Zhou, Juanita A Haagsma, Jan Busschbach, Rong Zeng, Zhihao Yang, Jindong Ding Petersen, Xiuquan Shi
    Traffic Injury Prevention.2026; 27(5): 526.     CrossRef
  • Ventilator-Associated Pneumonia in Trauma Patients with Splenic Injuries: Does Splenectomy Increase the Risk?
    Michael Alchaer, Ricardo Fonseca, Leonardo Diaz, Marco Henriquez, Amin Deghdan, Fabiana Sanchez, Melissa Canas, Jennifer L. McCarthy, Grant Bochicchio, Jason Snyder
    Surgical Infections.2026; 27(1): 73.     CrossRef
  • Hospital-based psychological consultation relates to post-discharge treatment engagement following violent injury
    Sydney C. Timmer-Murillo, Claire M. Bird, Andrew T. Schramm, Sacha McBain, Devi Jayan, Nicholas R. Schumann, Madeline R. Marks, Timothy J. Geier
    Journal of Trauma and Acute Care Surgery.2026; 101(3): 503.     CrossRef
  • The Impact of Non-trauma Factors on Trauma Patient Mortality and Hospital Resource Utilization: Population-Based Retrospective Review
    Mariel Javier, Ilko Luque, Jaclyn Kliewer, Nicole Yordan Lopez, David Ritchie, Beatriz Cobo Dominguez, Orlando Morejon
    The American Surgeon™.2025; 91(3): 365.     CrossRef
  • Risk Factors and Preventive Measures of Venous Thromboembolism in Trauma Patients using Trauma Embolic Scoring System: A retrospective chart review
    Eun-Ji Choi, Hyunjin Oh
    International Emergency Nursing.2025; 79: 101585.     CrossRef
  • Analysis of Trauma Severity Scores (NISS, RTS, and MGAP) in Patients Undergoing Emergency Surgery for Abdominal Trauma: An Observational Study
    Carolyny M de Oliveira, Daniel M Mauro, Ana SVB Simões, Giulia A Sakashita, Bruna M Galetti, Thais Shimokava
    Panamerican Journal of Trauma, Critical Care & Emergency Surgery.2025; 14(1): 18.     CrossRef
  • Epidemiology, risk factors, and antimicrobial resistance of nosocomial infections in the intensive care unit trauma patients: A cross-sectional study
    Bahar Darouei, Shiva Jafari, Soodabeh Rostami, Parto Nasri, Hossein Mahjoobipour, Saeed Abbasi
    Journal of Research in Medical Sciences.2025;[Epub]     CrossRef
  • Morbidity and Mortality of Trauma Patients 55 and Older: A Study of Nontrauma Risk Factors
    Mariel A. Javier, Ilko Luque, Hector Mendez, Nicole Yordán López, Marcela Ramirez, Orlando Morejón, Mark McKenney
    The American Surgeon™.2024; 90(11): 2862.     CrossRef
  • 8,941 View
  • 174 Download
  • 10 Web of Science
  • 8 Crossref
The impact of patient sex on survival after unintentional trauma in Korea: a retrospective, observational, case-control study
Seung Jin Maeng, Jongkyeong Kang, Myung Chun Kim, Han Zo Choi
Clin Exp Emerg Med 2023;10(3):296-305.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.002

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The impact of patient sex on survival after unintentional trauma in Korea: a retrospective, observational, case-control study
Clin Exp Emerg Med. 2023;10(3):296-305.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.002
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The impact of patient sex on survival after unintentional trauma in Korea: a retrospective, observational, case-control study
Clin Exp Emerg Med. 2023;10(3):296-305.   Published online June 2, 2023
DOI: https://doi.org/10.15441/ceem.23.002
Close
Objective
This study aimed to describe the relationship between sex and survival in patients experiencing unintentional trauma.
Methods
This retrospective, national population–based observational, case-control study involved a cohort of Korean trauma patients who were transferred to an emergency department by a Korean emergency medical service from January 1 to December 31, 2018. Propensity score matching was used. The primary outcome was survival until hospital discharge.
Results
Of 25,743 patients with severe unintentional trauma, 17,771 were male and 7,972 were female. Prior to propensity score matching, there was no significant difference in survival among male and female patients (92.6% vs. 93.1%, P=0.105). After using propensity score matching to adjust for confounders, there was still no sex difference in survival (male, 93.6% vs. female, 93.1%; P=0.270).
Conclusion
Survival after severe trauma was not influenced by the sex of the patient. Further studies with patients of reproductive age and a larger study population are needed to analyze the effects of sex on survival in patients with trauma.

Citations

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  • Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
    Mohamad Iqhbal Bin Kunji Mohamad, Sabariah Faizah Jamaluddin, Norhaiza Ahmad, Arifah Bahar, Zarina Mohd Khalid, Nuraina Aqilah Binti Mohd Zaki, Nurul Azlean Norzan, Sang Do Shin, Goh E. Shaun, Wen-Chu Chiang, Kentaro Kajino, Kyoung Jun Song, Do Ngoc Son
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2025;[Epub]     CrossRef
  • 7,778 View
  • 131 Download
  • 1 Web of Science
  • 1 Crossref

Systematic Review

The impact of COVID-19 on mortality in trauma patients undergoing orthopedic surgery: a systematic review and meta-analysis
Husna Dharma Putera, Valentina Halim, Roselina Panghiyangani
Clin Exp Emerg Med 2023;10(3):315-326.   Published online May 15, 2023
DOI: https://doi.org/10.15441/ceem.22.403

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The impact of COVID-19 on mortality in trauma patients undergoing orthopedic surgery: a systematic review and meta-analysis
Clin Exp Emerg Med. 2023;10(3):315-326.   Published online May 15, 2023
DOI: https://doi.org/10.15441/ceem.22.403
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The impact of COVID-19 on mortality in trauma patients undergoing orthopedic surgery: a systematic review and meta-analysis
Clin Exp Emerg Med. 2023;10(3):315-326.   Published online May 15, 2023
DOI: https://doi.org/10.15441/ceem.22.403
Close
Objective
The global spread of the COVID-19 pandemic has affected all aspects of medicine, including orthopedic trauma surgery. This study aims to investigate whether COVID-19 patients who underwent orthopedic surgery trauma had a higher risk of postoperative mortality.
Methods
ScienceDirect, the Cochrane COVID-19 Study Register, and MEDLINE were searched for original publications. This study adhered to the PPRISMA 2020 statement. The validity of the studies was evaluated using a checklist developed by the Joanna Briggs Institute. Study and participant characteristics, as well as the odds ratio, were extracted from selected publications. Data were analyzed using RevMan ver. 5.4.1.
Results
After applying the inclusion and exclusion criteria, 16 articles among 717 total were deemed eligible for analysis. Lower-extremity injuries were the most common condition, and pelvic surgery was the most frequently performed intervention. There were 456 COVID-19 patients (6.12%) and 134 deaths among COVID-19 patients, revealing an increase in mortality (29.38% vs. 5.30%; odds ratio, 7.72; 95% confidence interval, 6.01–9.93; P<0.001).
Conclusion
Among COVID-19 patients who received orthopedic surgery due to trauma, the postoperative death rate increased by 7.72 times.

Citations

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  • 2025 ICM: Risk Factors for Surgical Site Infection (SSI)/Periprosthetic Joint Infection (PJI)
    Nathanael Heckmann, Amir Human Hoveidaei, Seyed Mohammad Javad Mortazavi, Sayid Omar Ahmed, Mohammadali Enayatollahi, Arash Aali Rezaie, Mauro J. Salles, Azlina Amir Abbas, Vinay K. Aggarwal, Derek F. Amanatullah, Bülent Atilla, Wael Barsoum, Natividad Be
    The Journal of Arthroplasty.2025; 41(1): S6.     CrossRef
  • The impact of pulmonary tuberculosis on SARS-CoV-2 infection: a nationwide cohort study
    Sang Hwan Lee, Yun Jin Kim, Jaehoon Oh, Hyunggoo Kang, Kyung Hun Yoo, Byuk Sung Ko, Tae Ho Lim, Bo-Guen Kim, Hyun Lee, Sang-Heon Kim, Jang Won Sohn, Ho Joo Yoon, Hayoung Choi, Yongil Cho, Dong Won Park
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • 6,798 View
  • 145 Download
  • 2 Web of Science
  • 2 Crossref

Original Articles

Imaging | Trauma

The role of repeated brain computed tomography based on ultrasound monitoring of optic nerve sheath diameter after moderate traumatic brain injury
Mehdi Torabi, Amirsasan Mirhosseini, Moghaddameh Mirzaee
Clin Exp Emerg Med 2023;10(1):68-73.   Published online January 11, 2023
DOI: https://doi.org/10.15441/ceem.22.340

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The role of repeated brain computed tomography based on ultrasound monitoring of optic nerve sheath diameter after moderate traumatic brain injury
Clin Exp Emerg Med. 2023;10(1):68-73.   Published online January 11, 2023
DOI: https://doi.org/10.15441/ceem.22.340
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The role of repeated brain computed tomography based on ultrasound monitoring of optic nerve sheath diameter after moderate traumatic brain injury
Clin Exp Emerg Med. 2023;10(1):68-73.   Published online January 11, 2023
DOI: https://doi.org/10.15441/ceem.22.340
Close
Objective
This study was conducted to evaluate the association between changes in repeated brain computed tomography (CT) findings and the optic nerve sheath diameter (ONSD) determined by ocular ultrasonography in patients with moderate blunt traumatic brain injury (TBI).
Methods
This cross-sectional study was performed on patients with moderate blunt TBI (Glasgow Coma Scale, 9–12) who were referred to the emergency department during a 1-year period. Initially, all patients underwent a brain CT scan and primary ocular ultrasonography. Patients who were candidates for a second brain CT scan under observation in the emergency department also underwent a second ocular ultrasound. The primary outcome was the progression of brain lesions on repeated brain CT scans. Logistic regression and the area under receiver operating characteristic curve (AUC) were used.
Results
Overall, 204 patients with a mean age of 43±13.4 years were enrolled in the study. The study detected expanding changes in brain CT scans from 29 patients (14.2%). The progression of lesion on CT scan were significantly associated with changes in the Glasgow Coma Scale. In the second brain CT scan, there were significant associations between the progression of lesion on CT scan and the increased size of the ONSD measured on both axial and coronal sections (odds ratio, 17.3–47.5; AUC, 0.88–0.93).
Conclusion
Among patients with moderate TBI, an increase in ONSD on ocular ultrasound seems to be an appropriate criterion for repeating a brain CT scan to select a suitable therapeutic intervention.

Citations

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  • Utilizing transorbital ultrasound for assessment of intracranial pressure in traumatic brain injury patients
    Mohamed Elnokaly, Mohamed Gamal, Saied Issa, Ahmed Hamed
    Egyptian Journal of Neurosurgery.2026;[Epub]     CrossRef
  • Predictive Factors for Surgical Decision Making in Nonconcussive Traumatic Brain Injury Patients without Immediate Surgery: A Propensity Score Matching Study of Optic Nerve Sheath Diameter, Glasgow Coma Scale, and Rotterdam Computed Tomography Score
    Chayanin Wanachiwanawin, Jitti Chatpuwaphat, Siri-on Tritrakarn, Anchisa Chatkaewpaisal, Sasima Tongsai, Ekawut Chankaew, Rathachai Kaewlai
    World Neurosurgery.2025; 193: 936.     CrossRef
  • Related studies on measuring the normal values of optic nerve sheath diameter in healthy Chinese adults based on CT scans
    Lei Han, Ning Su, Chao Wu, Jiamin Yang, Xiaolin Liu
    Scientific Reports.2025;[Epub]     CrossRef
  • Diagnostic evaluation of optic nerve sheath diameter in predicting elevated intracranial pressure among neurocritically ill patients: A prospective observational study
    Sindhuja Kasinathan, Shankar Duraisamy, Rishiraj N. Verma
    International Journal of Critical Illness and Injury Science.2024; 14(3): 120.     CrossRef
  • Optic nerve sheath diameter measurement by ultrasound after moderate traumatic brain injury
    Mario Graziano, Danilo Biondino, Isabella Fioretto, Andrea Valerio Marino
    Clinical and Experimental Emergency Medicine.2023; 10(2): 249.     CrossRef
  • 6,315 View
  • 183 Download
  • 4 Web of Science
  • 5 Crossref

Airway

Machine learning for the prediction of preclinical airway management in injured patients: a registry-based trial
André Luckscheiter, Wolfgang Zink, Torsten Lohs, Johanna Eisenberger, Manfred Thiel, Tim Viergutz
Clin Exp Emerg Med 2022;9(4):304-313.   Published online November 23, 2022
DOI: https://doi.org/10.15441/ceem.22.335

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Machine learning for the prediction of preclinical airway management in injured patients: a registry-based trial
Clin Exp Emerg Med. 2022;9(4):304-313.   Published online November 23, 2022
DOI: https://doi.org/10.15441/ceem.22.335
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Machine learning for the prediction of preclinical airway management in injured patients: a registry-based trial
Clin Exp Emerg Med. 2022;9(4):304-313.   Published online November 23, 2022
DOI: https://doi.org/10.15441/ceem.22.335
Close
Objective
The aim of this study was to determine the feasibility of using machine learning to establish the need for preclinical airway management for injured patients based on a standardized emergency dataset.
Methods
A registry-based, retrospective analysis was conducted of adult trauma patients who were treated by physician-staffed emergency medical services in southwestern Germany between 2018 and 2020. The primary outcome was to assess the feasibility of using the random forest (RF) and Naive Bayes (NB) machine learning algorithms to predict the need for preclinical airway management. The secondary outcome was to use a principal component analysis to determine the attributes that can be used and advanced for future model development.
Results
In total, 25,556 adults with multiple injuries were identified, including 1,451 patients (5.7%) who required airway management. Key attributes were auscultation, injury pattern, oxygen therapy, thoracic drainage, noninvasive ventilation, catecholamines, pelvic sling, colloid infusion, initial vital signs, preemergency status, and shock index. The area under the receiver operating characteristics curve was between 0.96 (RF; 95% confidence interval [CI], 0.96–0.97) and 0.93 (NB; 95% CI, 0.92–0.93; P<0.01). For the prediction of airway management, RF yielded a higher precision-recall area than NB (0.83 [95% CI, 0.8–0.85] vs. 0.66 [95% CI, 0.61–0.72], respectively; P<0.01).
Conclusion
To predict the need for preclinical airway management in injured patients, attributes that are commonly recorded in standardized datasets can be used with machine learning. In future models, the RF algorithm could be used because it has robust prediction accuracy.

Citations

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  • Artificial intelligence-driven predictive analytics for postoperative management and recovery in trauma patients
    Olivier Duranteau, David Leon
    Current Opinion in Anaesthesiology.2026; 39(2): 154.     CrossRef
  • Artificial Intelligence in Trauma Care: A Systematic Review of Resuscitation, Diagnosis, Risk Prediction, and Management
    Sukriti Prashar, Youssef Nasef, Alexander Brown, Cameron Nishida, Logan Samuel Rogers, Ian Bundschu, Ruth Zagales, Alexandra Kata, Adel Elkbuli
    Journal of Trauma Nursing.2026; 33(3): 160.     CrossRef
  • From decision support to clinical integration: A scoping review of artificial intelligence in prehospital airway management
    Bai Fangfang, Qiu Wenjuan, Zhu Xiaoting, Feng Yanghui
    International Journal of Medical Informatics.2026; 216: 106480.     CrossRef
  • Automatic Detection of Physiological Attributes from Verbal Communication During Time-Critical Medical Events
    Chenyang Gao, Wenjin Zhang, Aaron H. Mun, Aleksandra Sarcevic, Mary S. Kim, Randall S. Burd, Ivan Marsic
    ACM Transactions on Computing for Healthcare.2026;[Epub]     CrossRef
  • Development and Validation of a Bayesian Network Predicting Intubation Following Hospital Arrival Among Injured Children
    Travis M. Sullivan, Mary S. Kim, Genevieve J. Sippel, Waverly V. Gestrich-Thompson, Caroline G. Melhado, Kristine L. Griffin, Suzanne M. Moody, Rajan K. Thakkar, Meera Kotagal, Aaron R. Jensen, Randall S. Burd
    Journal of Pediatric Surgery.2025; 60(2): 161888.     CrossRef
  • Human intention recognition for trauma resuscitation: An interpretable deep learning approach for medical process data
    Keyi Li, Mary S. Kim, Wenjin Zhang, Sen Yang, Genevieve J. Sippel, Aleksandra Sarcevic, Randall S. Burd, Ivan Marsic
    Journal of Biomedical Informatics.2025; 161: 104767.     CrossRef
  • Utilization of non-invasive ventilation before prehospital emergency anesthesia in trauma – a cohort analysis with machine learning
    André Luckscheiter, Manfred Thiel, Wolfgang Zink, Johanna Eisenberger, Tim Viergutz, Verena Schneider-Lindner
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2025;[Epub]     CrossRef
  • From algorithms to airways: Applying artificial intelligence to enhance airway assessment, management, and training
    Mingzhu Guo, Yongheng Hou, Yan Liu, Bo Yang, Chuhan Qiao, Jian Li
    Trends in Anaesthesia and Critical Care.2025; 61: 101548.     CrossRef
  • Deep Learning during burn prehospital care: An evolving perspective
    Mohammad Vakili Ojarood, Ramyar Farzan, Seyed Mostafa Mohsenizadeh, Hossein Torabi, Tahereh Yaghoubi
    Burns.2024; 50(5): 1349.     CrossRef
  • Use of artificial intelligence to support prehospital traumatic injury care: A scoping review
    Jake Toy, Jonathan Warren, Kelsey Wilhelm, Brant Putnam, Denise Whitfield, Marianne Gausche‐Hill, Nichole Bosson, Ross Donaldson, Shira Schlesinger, Tabitha Cheng, Craig Goolsby
    JACEP Open.2024; 5(5): e13251.     CrossRef
  • Unravelling intubation challenges: a machine learning approach incorporating multiple predictive parameters
    Parisa Sezari, Zeinab Kohzadi, Ali Dabbagh, Alireza Jafari, Saba Khoshtinatan, Kamran Mottaghi, Zahra Kohzadi, Shahabedin Rahmatizadeh
    BMC Anesthesiology.2024;[Epub]     CrossRef
  • 7,945 View
  • 210 Download
  • 12 Web of Science
  • 11 Crossref

Review Article

Imaging

Current updates in acute traumatic aortic injury: radiologic diagnosis and management
Shivani Gupta, Atin Kumar, Tejinder Kaur, Shivanand Gamanagatti, Abhinav Kumar, Amit Gupta, Subodh Kumar
Clin Exp Emerg Med 2022;9(2):73-83.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.22.233

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Current updates in acute traumatic aortic injury: radiologic diagnosis and management
Clin Exp Emerg Med. 2022;9(2):73-83.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.22.233
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Current updates in acute traumatic aortic injury: radiologic diagnosis and management
Clin Exp Emerg Med. 2022;9(2):73-83.   Published online June 30, 2022
DOI: https://doi.org/10.15441/ceem.22.233
Close
Acute traumatic aortic injuries, which have substantial lethal outcomes at the time of admission, are fatal in 80% to 90% of cases. These injuries are relatively rare and have nonspecific clinical presentations. Radiologists and emergency physicians need to identify the radiological signs of acute traumatic aortic injury and differentiate them from common imaging errors to ensure accurate diagnosis and determine appropriate management protocols. In combination with image-guided interventions, advances in cross-sectional imaging have enabled nonsurgical management of acute traumatic aortic injuries. Timely and precise diagnoses of these injuries following prompt treatment are essential as up to 90% of patients presenting at the hospital can undergo early repair.

Citations

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  • Imaging of Cardiac and Nonaortic Thoracic Vascular Trauma
    Kyle Costenbader, Elham Beheshtian, Thorsten R. Fleiter, Jean Jeudy, Rishi Kundi, Elana B. Smith, Clint W. Sliker
    RadioGraphics.2026;[Epub]     CrossRef
  • Acute Traumatic Aortic Injury: What the Radiologist Needs to Know
    Kristina Ramirez-Garcia, Catalina Jaramillo, Emma Ferguson, Jason Au, Erika Odisio, Gustavo S. Oderich, Daniel Ocazionez, Cihan Duran, Thanila Macedo
    Tomography.2026; 12(4): 57.     CrossRef
  • CT angiography in blunt thoracic aortic injury: An evidence-mapped review and structured reporting framework
    Farbod Khosravi, Ali Nabipoor, Sanaz Asadian, Nastaran Sadat Hosseini, Arash Bedayat, Majid Chalian, Bahar Mansoori, Hamid Chalian
    Current Problems in Diagnostic Radiology.2026;[Epub]     CrossRef
  • Preoperative Imaging of the Thoracic Aorta
    Zehavit E. Kirshenboim, Omer Onder, Emrah Duman, Azza Elgendy, Gabin Yun, Sina Tavakoli
    Radiologic Clinics of North America.2025; 63(4): 633.     CrossRef
  • Thoracic trauma WSES-AAST guidelines
    Federico Coccolini, Camilla Cremonini, Ernest E. Moore, Ian Civil, Zsolt Balogh, Ari Leppaniemi, Tal Horer, Viktor Reva, Chad Ball, Andrew W. Kirkpatrick, Andrea Colli, Laura Besola, Fank Plani, Bruno Viaggi, Giacomo Bellani, Marco Ceresoli, Enrico Cicutt
    World Journal of Emergency Surgery.2025;[Epub]     CrossRef
  • A retrospective analysis of thoracic trauma: outcomes from a tertiary care hospital in war time
    Abdulameer M. Hussein, Laith Fathi Sharba
    TRAUMA.2025; 26(6): 449.     CrossRef
  • Successful management of a delayed presentation of traumatic descending thoracic aorta pseudoaneurysm: a literature review based on a case report
    Mohammad Sadeghian, Pouya Ebrahimi, Parnian Soltani, Massoud Ghasemi, Homa Taheri, Maryam Mehrpooya
    International Journal of Emergency Medicine.2024;[Epub]     CrossRef
  • Intraoperative TEE during TEVAR following blunt thoracic trauma: A case review
    Daniel C. Stonko, Rebecca N. Treffalls, Jonathan J. Morrison, Justin Richards, David P. Stonko
    Annals of Vascular Surgery - Brief Reports and Innovations.2023; 3(2): 100188.     CrossRef
  • Urgent endovascular aorta repair for a rupture of a traumatic infrarenal aortic dissection: Case report and review of literature
    D. Dorpmans, W.A. Van Dijk, R.H.D. Vaes
    Trauma Case Reports.2023; 46: 100859.     CrossRef
  • 16,924 View
  • 402 Download
  • 5 Web of Science
  • 9 Crossref

Case Report

Airway

Emergent use of a King laryngeal tube for traumatic intraoral bleeding: two case reports
Han Bit Kim, Sungwoo Choi, Seung June Min, Sangsoo Han, Bora Kang, Giwoon Kim
Clin Exp Emerg Med 2022;9(3):257-261.   Published online June 10, 2022
DOI: https://doi.org/10.15441/ceem.21.159

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Emergent use of a King laryngeal tube for traumatic intraoral bleeding: two case reports
Clin Exp Emerg Med. 2022;9(3):257-261.   Published online June 10, 2022
DOI: https://doi.org/10.15441/ceem.21.159
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Emergent use of a King laryngeal tube for traumatic intraoral bleeding: two case reports
Clin Exp Emerg Med. 2022;9(3):257-261.   Published online June 10, 2022
DOI: https://doi.org/10.15441/ceem.21.159
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Maxillofacial trauma occasionally presents a serious challenge for physicians, and an orofacial injury can be considered life-threatening. It is difficult to control the bleeding and prevent airway obstruction simultaneously with conventional treatment. Herein, we share two cases in which we managed massive orofacial bleeding using a King laryngeal tube, a supraglottic airway device equipped with an inflatable balloon. Both patients had uncontrolled orofacial bleeding. In one of the patients, endotracheal intubation was possible; however, bleeding continued, and vital signs became unstable. The second patient had failed endotracheal intubation due to uncontrolled bleeding. We deployed the King laryngeal tube in both patients and achieved bleeding control and airway maintenance. Both patients were discharged without complications after 3 to 4 weeks. The King laryngeal tube method can be considered a useful management option for addressing massive orofacial bleeding that is uncontrollable with conventional treatment.
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Original Article

Trauma

Predictive values of the Pediatric Penetrating Ocular Trauma Score and the Toddler/Infant Ocular Trauma Score in Brazilian children with open globe injury
Gilvan Vilarinho Silva-Filho, Adriana Moreno Morgan-Kanada, Niro Kasahara
Clin Exp Emerg Med 2022;9(1):41-46.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.092

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Predictive values of the Pediatric Penetrating Ocular Trauma Score and the Toddler/Infant Ocular Trauma Score in Brazilian children with open globe injury
Clin Exp Emerg Med. 2022;9(1):41-46.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.092
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Predictive values of the Pediatric Penetrating Ocular Trauma Score and the Toddler/Infant Ocular Trauma Score in Brazilian children with open globe injury
Clin Exp Emerg Med. 2022;9(1):41-46.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.092
Close
Objective
This study compared the prognostic value of the Pediatric Penetrating Ocular Trauma Score (POTS) with the Toddler/Infant Ocular Trauma Score (TOTS) in a cohort of Brazilian children with open-globe injuries.
Methods
This retrospective, observational case series included consecutive children with open-globe injuries seen at the Santa Casa de Sao Paulo Eye Emergency Service. The medical records of all patients were reviewed for data analysis, including the circumstance and time of injury, type of penetrating injury, initial and final visual acuity (VA), time of surgery, and associated eye diseases. The test characteristics of POTS and TOTS for VA were calculated and compared by the McNemar test.
Results
Thirty patients were included. The mean age was 3.9 ± 1.6 years; 20 were male patients and 10 were female patients. Most wounds were limited to the anterior segment (93.3%). The sensitivity for the POTS was higher than that of the TOTS (100%; 95% confidence interval [CI], 75.3–100 vs. 61.5%; 95% CI, 31.6–86.1; P = 0.014). The specificity was not significantly different (14.3%; 95% CI, 0.4–57.8 vs. 0%; 95% CI, 0–41.0; P = 0.563). The accuracy for the POTS was higher than the TOTS (70.0%; 95% CI, 45.7–88.1 vs. 40.0%; 95% CI, 19.1–63.9; P = 0.001).
Conclusion
In this cohort of Brazilian children with open-globe injuries, the POTS had better accuracy than did the TOTS in predicting VA after treatment.

Citations

Citations to this article as recorded by  Crossref logo
  • How Well Do Ocular Trauma Scores Predict Vision after Open-Globe Injury?
    Kimia Rezaei, Germán Mejía-Salgado, Ibrahim Abboud, Marina Gad El Sayed, Jennifer Bahn, Kurt Parker, Richard J. Blanch, Alejandra de-la-Torre, Donny W. Suh, Rupesh Agrawal
    Ophthalmology.2026; 133(6): 780.     CrossRef
  • Wound size and location affect the prognosis of penetrating ocular injury
    Xue Gao, Qiuqiu Zhang, Fang Wang, Xuewei Li, Chunli Ma, Yixiao Li, Xiaofei Zhao, Han Zhang
    BMC Ophthalmology.2023;[Epub]     CrossRef
  • 8,824 View
  • 190 Download
  • 2 Web of Science
  • 2 Crossref

Case Report

Imaging

Cat got your artery? Point of care ultrasound in the evaluation of penetrating trauma by a feline: a case report
Campbell Belisle Haley, David Mackenzie
Clin Exp Emerg Med 2022;9(1):63-66.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.20.065

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Cat got your artery? Point of care ultrasound in the evaluation of penetrating trauma by a feline: a case report
Clin Exp Emerg Med. 2022;9(1):63-66.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.20.065
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Cat got your artery? Point of care ultrasound in the evaluation of penetrating trauma by a feline: a case report
Clin Exp Emerg Med. 2022;9(1):63-66.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.20.065
Close
Point of care ultrasound is an important tool for diagnosis of musculoskeletal and vascular pathology in patients presenting to the emergency department. Superficial vascular and soft tissue structures are well-visualized at the bedside using modern ultrasound systems and have image characteristics that can be rapidly identified. This report describes the use of point of care ultrasound to distinguish between rapidly progressive soft tissue infection and vascular injury following penetrating trauma from a cat scratch. Ultrasound allowed the physician to rapidly make accurate decisions about the next necessary steps in the patient’s care. Point of care ultrasound provides immediate diagnostic information to supplement indeterminate physical examination findings. In this case, it allowed the treating physician to make the diagnosis of arterial injury using ultrasound image characteristics. An integrative approach to ultrasonography of superficial musculoskeletal and vascular structures could enhance clinical decision making and improve care of patients with similar complaints.

Citations

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  • Diagnostic technologies for neuroblastoma
    Leena Khelifa, Yubing Hu, Jennifer Tall, Rasha Khelifa, Amina Ali, Evon Poon, Mohamed Zaki Khelifa, Guowei Yang, Catarina Jones, Rosalia Moreddu, Nan Jiang, Savas Tasoglu, Louis Chesler, Ali K. Yetisen
    Lab on a Chip.2025; 25(15): 3630.     CrossRef
  • 6,780 View
  • 175 Download
  • 1 Web of Science
  • 1 Crossref

Original Articles

Experimental study | Trauma

Secondary hypoxic ischemia alters neurobehavioral outcomes, neuroinflammation, and oxidative stress in mice exposed to controlled cortical impact
Se-Kwang Oh, Hyun-Jeong Park, Gyeong-Gyu Yu, Seong-Hae Jeong, Suk-Woo Lee, Hoon Kim
Clin Exp Emerg Med 2021;8(3):216-228.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.124

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Secondary hypoxic ischemia alters neurobehavioral outcomes, neuroinflammation, and oxidative stress in mice exposed to controlled cortical impact
Clin Exp Emerg Med. 2021;8(3):216-228.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.124
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Secondary hypoxic ischemia alters neurobehavioral outcomes, neuroinflammation, and oxidative stress in mice exposed to controlled cortical impact
Clin Exp Emerg Med. 2021;8(3):216-228.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.124
Close
Objective
Hypoxic ischemia (HI) is a secondary insult that can cause fatal neurologic outcomes after traumatic brain injury (TBI), ranging from mild cognitive deficits to persistent vegetative states. We here aimed to unravel the underlying pathological mechanisms of HI injury in a TBI mouse model.
Methods
Neurobehavior, neuroinflammation, and oxidative stress were assessed in a mouse model of controlled cortical impact (CCI) injury followed by HI. Mice underwent CCI alone, CCI followed by HI, HI alone, or sham operation. HI was induced by one-vessel carotid ligation with 1 hour of 8% oxygen in nitrogen. Learning and memory were assessed using the novel object recognition test, contextual and cued fear conditioning, and Barnes maze test. Brain cytokine production and oxidative stress-related components were measured.
Results
Compared to TBI-only animals, TBI followed by HI mice exhibited significantly poorer survival and health scores, spatial learning and memory in the Barnes maze test, discrimination memory in the novel object recognition test, and fear memory following contextual and cued fear conditioning. Malondialdehyde levels were significantly lower, whereas glutathione peroxidase activity was significantly higher in TBI followed by HI mice compared to TBI-only and sham counterparts, respectively. Interleukin-6 levels were significantly higher in TBI followed by HI mice compared to both TBI-only and sham animals.
Conclusion
Post-traumatic HI aggravated deficits in spatial, fear, and discrimination memory in an experimental TBI mouse model. Our results suggest that increased neuroinflammation and oxidative stress contribute to HI-induced neurobehavioral impairments after TBI.

Citations

Citations to this article as recorded by  Crossref logo
  • The immunological landscape of traumatic brain injury: insights from pathophysiology to experimental models
    Matthew Abikenari, Joseph H. Ha, Justin Liu, Alexander Ren, Kwang Bog Cho, Jaejoon Lim, Lily H. Kim, Ravi Medikonda, John Choi, Michael Lim
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • The long-term influences of age at injury on neuroinflammation and neuronal apoptosis following traumatic brain injury in pediatric and adult mice
    Jin-Soo Park, Hyun-Jeong Park, Young-Min Kim, Hyun-Seok Chai, Gwan Jin Park, Sang-Chul Kim, Gyeong-Gyu Yu, Suk-Woo Lee, Hoon Kim
    Clinical and Experimental Emergency Medicine.2025; 12(3): 267.     CrossRef
  • Chronic juvenile stress exacerbates neurobehavioral dysfunction and neuroinflammation following traumatic brain injury in adult mice
    Sung-Jin Park, Hyun-Jeong Park, Backyoun Kim, Young-Min Kim, Suk-Woo Lee, Hoon Kim
    Clinical and Experimental Emergency Medicine.2023; 10(2): 200.     CrossRef
  • 9,463 View
  • 80 Download
  • 4 Web of Science
  • 3 Crossref

Pediatrics | Trauma

External validation and comparison of the Pediatric Emergency Care Applied Research Network and Canadian Assessment of Tomography for Childhood Head Injury 2 clinical decision rules in children with minor blunt head trauma
Bo Sung Kwon, Hyung Jun Song, Jun Hee Lee
Clin Exp Emerg Med 2021;8(3):182-191.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.123

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External validation and comparison of the Pediatric Emergency Care Applied Research Network and Canadian Assessment of Tomography for Childhood Head Injury 2 clinical decision rules in children with minor blunt head trauma
Clin Exp Emerg Med. 2021;8(3):182-191.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.123
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External validation and comparison of the Pediatric Emergency Care Applied Research Network and Canadian Assessment of Tomography for Childhood Head Injury 2 clinical decision rules in children with minor blunt head trauma
Clin Exp Emerg Med. 2021;8(3):182-191.   Published online September 30, 2021
DOI: https://doi.org/10.15441/ceem.20.123
Close
Objective
Among the pediatric population with minor head trauma, it is difficult to determine an indication for the usage of brain computerized tomography (CT). Our study aims to compare the efficiency of the most commonly used clinical decision rules: the Pediatric Emergency Care Applied Research Network (PECARN) and Canadian Assessment of Tomography for Childhood Head Injury 2 (CATCH2).
Methods
This retrospective study investigated whether the PECARN and CATCH2 rules were applicable to Korean children with minor head trauma for reducing the use of brain CT imaging, while detecting intracranial pathology.
Results
Overall, 251 patients (0–5 years old) admitted to emergency rooms within 24 hours of injury were included between August 2015 to August 2018. The performance results are as follows: the PECARN and CATCH2 rules had a sensitivity of 80.00% (51.91%–95.67%) and 100% (78.20%–100.00%) with a specificity of 28.39% (22.73%–34.60%) and 15.25% (10.92%–20.49%), respectively; the negative predictive values were 98.58% and 100%, respectively. Overall, the CATCH2 rule was more successful than the PECARN rule in detecting intracranial pathology; however, there was no significant difference between them. Furthermore, the PECARN and CATCH2 rules lowered the rate of head CT imaging in our study group.
Conclusion
Both the rules significantly lowered the rate of indicated brain CT. However, since the CATCH2 rule had higher sensitivity and negative predictive value than the PECARN rule, it is more appropriate to be used in emergency rooms for detecting intracranial pathology in children with minor head trauma.

Citations

Citations to this article as recorded by  Crossref logo
  • Validation of Quality Indicators for Pediatric Trauma Care
    Lynne Moore, Natalie L. Yanchar, Suzanne Beno, Marianne Beaudin, Mélanie Bérubé, Pier-Alexandre Tardif, Xavier Neveu, Amina Belcaid, Matthew Weiss, Emilie Beaulieu, Antonia Stang, Isabelle Gagnon, Belinda Gabbe, Henry Thomas Stelfox, Simon Berthelot, Terr
    Annals of Surgery.2026; 283(1): 24.     CrossRef
  • Evaluation of Computed Tomography Decision-Making in Pediatric Minor Head Trauma: PECARN, CATCH, AND CHALICE
    Bekir Tunç, Halil İbrahim Açıkgöz
    Medical Research Reports.2026; 9(2): 108.     CrossRef
  • Efficacy and safety of ketamine alone and ketamine‐dexmedetomidine combination for sedation for brain computed tomography in paediatric patients with head injuries: A retrospective study
    Jaeyeon Yoon, Ju Ok Park, Hyeonyoung Song, Choung A Lee, Soon‐Joo Wang, Hang A Park
    Emergency Medicine Australasia.2024; 36(3): 443.     CrossRef
  • Predicting Complicated Mild Traumatic Brain Injury in Adolescent Trauma to Enhance Clinical Decisions in Imaging
    Heather X. Rhodes, Gina Berg, Anthony L. Shadiack, Kevin D. Thomas, Jennifer L. Horawski, Geoff Boyer, Sara M. Kleist, Aaron I. Worthley, David I. Rosenberg, Scott B. Gutovitz, George A. Helmrich, Saptarshi Biswas, Antonio P. Pepe
    Journal of Trauma Nursing.2023; 30(3): 150.     CrossRef
  • “Feed and Swaddle” method of Infants Undergoing Head CT for minor head injury in the pediatric emergency department – A comparative case review
    Eyal Heiman, Evelyn Hessing, Elihay Berliner, Ruth Cytter-Kuint, Yuval Barak-Corren, Giora Weiser
    European Journal of Radiology.2022; 154: 110399.     CrossRef
  • Consequences of inequity in the neurosurgical workforce: Lessons from traumatic brain injury
    Shivani Venkatesh, Marcela Bravo, Tory Schaaf, Michael Koller, Kiera Sundeen, Uzma Samadani
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • Reducing Inequity in Outcomes After Traumatic Brain Injury: A Call for Validation of Objective Measures
    Shivani Venkatesh, Marcela Bravo, Tory Schaaf, Kiera Sundeen, Uzma Samadani
    SSRN Electronic Journal.2022;[Epub]     CrossRef
  • 11,294 View
  • 132 Download
  • 5 Web of Science
  • 7 Crossref

Injury & Prevention

Factors associated with injury severity among users of powered mobility devices
Suk Won Choi, Jae-Hyug Woo, Sung Youl Hyun, Jae Ho Jang, Woo Sung Choi
Clin Exp Emerg Med 2021;8(2):103-110.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.20.078

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Factors associated with injury severity among users of powered mobility devices
Clin Exp Emerg Med. 2021;8(2):103-110.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.20.078
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Factors associated with injury severity among users of powered mobility devices
Clin Exp Emerg Med. 2021;8(2):103-110.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.20.078
Close
Objective
To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings.
Methods
Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio–adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared.
Results
Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239–3.642), head injury (OR, 10.441; 95% CI, 5.465–19.950), and torso injury (OR, 4.858; 95% CI, 2.495–9.458).
Conclusion
The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.

Citations

Citations to this article as recorded by  Crossref logo
  • Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008–2015
    Hang A Park, Federico E. Vaca, Kyunghee Jung-Choi, Hyesook Park, Ju Ok Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Factors associated with the injury severity of falls from a similar height and features of the injury site: a retrospective study
    Dae Hyun Kim, Jae-Hyug Woo, Yang Bin Jeon, Jin-Seong Cho, Jae Ho Jang, Jea Yeon Choi, Woo Sung Choi
    Journal of Trauma and Injury.2023; 36(3): 187.     CrossRef
  • Study on Elevator Recognition Techniques for Upper-Limb-Disabled Wheelchair Users
    Daewe Kim, Su-Hong Eom, Eung-Hyuk Lee
    Applied Sciences.2023; 13(22): 12182.     CrossRef
  • 8,570 View
  • 96 Download
  • 4 Web of Science
  • 3 Crossref
Traumatic brain injury in patients aged ≥65 years versus patients aged ≥80 years: a multicenter prospective study of mortality and medical resource utilization
SooJin Bae, Sung Wook Song, Woo Jeong Kim, YoungJoon Kang, Kyeong Won Kang, Chang Bae Park, Jeong Ho Kang, Ji Hwan Bu, Sung Kgun Lee, Seo Young Ko
Clin Exp Emerg Med 2021;8(2):94-102.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.20.045

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Traumatic brain injury in patients aged ≥65 years versus patients aged ≥80 years: a multicenter prospective study of mortality and medical resource utilization
Clin Exp Emerg Med. 2021;8(2):94-102.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.20.045
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Traumatic brain injury in patients aged ≥65 years versus patients aged ≥80 years: a multicenter prospective study of mortality and medical resource utilization
Clin Exp Emerg Med. 2021;8(2):94-102.   Published online June 30, 2021
DOI: https://doi.org/10.15441/ceem.20.045
Close
Objective
This study aimed to determine whether there is a difference in mortality and medical resource utilization between geriatric (aged ≥65 years) and super-geriatric patients (aged ≥80 years) with traumatic brain injury (TBI).
Methods
We obtained comprehensive data (demographics, injury characteristics, injury severities, and outcomes) of geriatric and super-geriatric TBI patients from an emergency department-based injury surveillance system database from 2011 to 2016. Multivariate logistic regression analysis was performed to compare the mortality and nonroutine discharge (NRDC) status between both groups.
Results
Among 442,533 TBI patients, 48,624 were older than 65 years. A total of 48,446 patients (37,140 geriatric and 11,306 super-geriatric) without exclusion criteria were included in the final analysis. Both overall in-hospital mortality (adjusted odds ratio, 1.88; 95% confidence interval [CI], 1.28 to 2.74; P=0.001) and NRDC (adjusted odds ratio, 1.35; 95% CI, 1.07 to 1.71; P=0.011) were significantly higher in the super-geriatric group. In the stratified analysis, there were no significant differences in NRDC rate for all stratifications of treatment timing (emergency department vs. ward admission), but mortality remained to be significant for all stratifications.
Conclusion
Super-geriatric TBI patients showed a significantly higher risk-adjusted overall mortality and more inadequate medical resource utilization than did geriatric TBI patients. However, super-geriatric patients were more likely to undergo NRDC after admission; thus, further research about age-related health inequalities is needed in the treatment of super-geriatric patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated traumatic brain injury
    Kyung Won Park, Sung Wook Song, Woo Jeong Kim, Jeong Ho Kang, Ji Hwan Bu, Sung Kgun Lee, Seo Young Ko, Soo Hoon Lee, Chang Bae Park, Jin Gu Lee, Jong Yeon Kang, Jaeyoon Ha, Jiwon Kim
    Clinical and Experimental Emergency Medicine.2025; 12(4): 358.     CrossRef
  • Trauma in the Geriatric and the Super-Geriatric: Should They Be Treated the Same?
    Khaled El-Qawaqzeh, Tanya Anand, Qaidar Alizai, Christina Colosimo, Hamidreza Hosseinpour, Audrey Spencer, Michael Ditillo, Louis J. Magnotti, Collin Stewart, Bellal Joseph
    Journal of Surgical Research.2024; 293: 316.     CrossRef
  • Effect of low fibrinogen level on in-hospital mortality and 6-month functional outcome of TBI patients, a single center experience
    Omid Yousefi, Amirmohammad Farrokhi, Reza Taheri, Hadis Ghasemi, Sina Zoghi, Asma Eslami, Amin Niakan, Hosseinali Khalili
    Neurosurgical Review.2024;[Epub]     CrossRef
  • Traumatic brain injury in elderly population: A global systematic review and meta-analysis of in-hospital mortality and risk factors among 2.22 million individuals
    Zixuan Ma, Zhenghui He, Zhifan Li, Ru Gong, Jiyuan Hui, Weiji Weng, Xiang Wu, Chun Yang, Jiyao Jiang, Li Xie, Junfeng Feng
    Ageing Research Reviews.2024; 99: 102376.     CrossRef
  • Outcome after decompressive craniectomy in older adults after traumatic brain injury
    Thomas Kapapa, Stefanie Jesuthasan, Franziska Schiller, Frederike Schiller, Dieter Woischneck, Stefanie Gräve, Eberhard Barth, Benjamin Mayer, Marcel Oehmichen, Andrej Pala
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Novel application of the Rotterdam CT score in the prediction of intracranial hypertension following severe traumatic brain injury
    Ahmed Ismail Kashkoush, Tamia Potter, Jordan C. Petitt, Song Hu, Kyle Hunter, Michael L. Kelly
    Journal of Neurosurgery.2023; 138(4): 1050.     CrossRef
  • In-hospital mortality and risk factors among elderly patients with traumatic brain injury: protocol for a systematic review and meta-analysis
    Zixuan Ma, Jiyuan Hui, Chun Yang, Jiyao Jiang, LI Xie, Junfeng Feng
    BMJ Open.2023; 13(3): e065371.     CrossRef
  • Trends in traumatic brain injury–related emergency department visits in Korea: a report from the National Emergency Department Information System (NEDIS) 2018–2022
    Hang A Park, Borami Lim, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S63.     CrossRef
  • Predictors of Mortality, Withdrawal of Life-Sustaining Measures, and Discharge Disposition in Octogenarians with Subdural Hematomas
    Ahmed Kashkoush, Jordan C. Petitt, Husayn Ladhani, Vanessa P. Ho, Michael L. Kelly, Mira Ghneim, Jennifer S. Albrecht, Karen Brasel, Anna Livaris, Jill B. Watras, Christopher P. Michetti, James M. Haan, Kelly Lightwine, Robert D. Winfield, Sasha D. Adams,
    World Neurosurgery.2022; 157: e179.     CrossRef
  • 8,602 View
  • 129 Download
  • 10 Web of Science
  • 9 Crossref

Case Report

Gastrointestinal

Management of intractable oronasal bleeding using Sengstaken-Blakemore tubes in patients with facial trauma: a case series and technical notes
Gi Woon Kim, Sangchun Choi, Sangsoo Han, Younghwan Lee, Bora Kang, Yoon Seok Jung
Clin Exp Emerg Med 2021;8(1):65-70.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.079

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Management of intractable oronasal bleeding using Sengstaken-Blakemore tubes in patients with facial trauma: a case series and technical notes
Clin Exp Emerg Med. 2021;8(1):65-70.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.079
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Management of intractable oronasal bleeding using Sengstaken-Blakemore tubes in patients with facial trauma: a case series and technical notes
Clin Exp Emerg Med. 2021;8(1):65-70.   Published online March 31, 2021
DOI: https://doi.org/10.15441/ceem.20.079
Close
Objective
Intractable massive oronasal bleeding can become a life-threatening condition. The success rate of conventional bleeding control methods other than transarterial embolization (TAE) is not expected to be high. We investigated the efficacy of Sengstaken-Blakemore tube (SBT) balloon tamponade in patients with sustained and intractable oronasal bleeding secondary to facial injury.
Methods
This study is a retrospective chart review from traumatic patients with sustained and intractable oronasal bleeding who were admitted to the emergency center of Ajou University Hospital and Soonchunhyang University Bucheon Hospital from January 2014 to December 2016.
Results
Twelve patients were included in the study, of whom nine (75%) were male. The median age was 31 years (range, 20–73 years). Bleeding was controlled in 11 of the 12 patients (91.7%) either temporarily or definitively. One patient without hemostasis underwent TAE. TAE was performed in an additional three patients out of the 11 patients with hemostasis who experienced continued nasal bleeding after the removal of SBTs. There were no complications from performing the procedure.
Conclusion
Using SBTs as a hemostatic tool will aid patients with life-threatening intractable oronasal bleeding. Furthermore, this method may be used in patients with continual and intractable oronasal bleeding after facial trauma as a bridging procedure from the emergency department or the intensive care unit to the interventional radiology.
  • 9,130 View
  • 109 Download

Original Articles

Neurology

Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study
Hayoung Kim, Sihyoung Lee, Joonghee Kim
Clin Exp Emerg Med 2020;7(3):176-182.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.064

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Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study
Clin Exp Emerg Med. 2020;7(3):176-182.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.064
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Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study
Clin Exp Emerg Med. 2020;7(3):176-182.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.064
Close
Objective
Peripheral vertigo is one of the most common causes of the emergency department (ED) visits. It can impair balance and might predispose patients to injuries after discharge. The purpose of this study was to determine whether peripheral vertigo is associated with an increased risk of trauma.
Methods
This matched-cohort study used the nationally representative dataset of de-identified claim information of 1 million randomly sampled individuals from a real Korean population, from 2002 to 2013. The exposure cohort included patients who visited EDs for new-onset peripheral vertigo without prior or concurrent injury. Each patient was randomly matched to five unexposed individuals (also without previous injury) by incidence density sampling. The primary outcome was a new injury within 1 year. The secondary outcomes were various injury subtypes. The time-dependent effect of the exposure was modeled using the extended Cox model. Age, sex, comorbidities, and household income level were included as covariates.
Results
A total of 776 and 3,880 individuals were included as the exposure and comparison cohorts, respectively. The risks of trunk injury and upper extremity injury were significantly higher in the exposure cohort. Extended Cox models with multivariable adjustment showed significantly increased risk for up to 1 year, with the first 1-month; 1 month to 3 months; and 3 months to 1 year hazard ratios of 5.23 (95% confidence interval [CI], 2.83–9.64); 1.50 (95% CI, 1.02–2.20); and 1.37 (95% CI, 1.11–1.68), respectively.
Conclusion
Patients visiting EDs for acute peripheral vertigo are at a higher risk of a new injury for up to a year.

Citations

Citations to this article as recorded by  Crossref logo
  • Association Between Sleep and Vertigo Severity in Benign Paroxysmal Positional Vertigo: Mediating Role of Psychological Factors
    Juanli Xing, Xinyu Xu, Hongying Shan, Jiaqian Wu, Peiyu Liu, Wenyan Shi, Peihua Ren, JinLing Liu, Yuge Huang, Baibing Mi
    Nature and Science of Sleep.2025; Volume 17: 1477.     CrossRef
  • Incidence of Subsequent Injuries Associated with a New Diagnosis of Benign Paroxysmal Positional Vertigo and Effects of Treatment: A Nationwide Cohort Study
    Jhen-Jie Mao, Hung-Che Lin, Shih-Tsang Lin, Po-Cheng Lin, Ching-Hsiang Chang, Wu-Chien Chien, Chi-Hsiang Chung, Ying-Jiin Chen, Jeng-Wen Chen
    Journal of Clinical Medicine.2024; 13(15): 4561.     CrossRef
  • Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study
    Po‐Ling Wu, Hung‐Che Lin, Wu‐Chien Chien, Chi‐Hsiang Chung, Jeng‐Wen Chen
    Otolaryngology–Head and Neck Surgery.2023; 168(3): 443.     CrossRef
  • Use of Physical Therapy and Subsequent Falls Among Patients With Dizziness in the US
    Schelomo Marmor, Pinar Karaca-Mandic, Meredith E. Adams
    JAMA Otolaryngology–Head & Neck Surgery.2023; 149(12): 1083.     CrossRef
  • Effects of customized vestibular rehabilitation plus canalith repositioning maneuver on gait and balance in adults with Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial
    Phui Lin Se To, Devinder Kaur Ajit Singh, Susan L. Whitney
    Journal of Vestibular Research.2022; 32(1): 79.     CrossRef
  • Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association
    Courtney D. Hall, Susan J. Herdman, Susan L. Whitney, Eric R. Anson, Wendy J. Carender, Carrie W. Hoppes, Stephen P. Cass, Jennifer B. Christy, Helen S. Cohen, Terry D. Fife, Joseph M. Furman, Neil T. Shepard, Richard A. Clendaniel, J. Donald Dishman, Joe
    Journal of Neurologic Physical Therapy.2022; 46(2): 118.     CrossRef
  • Occlusion of two semicircular canals does not disrupt normal hearing in adult mice
    Tianying Wang, Huizhan Liu, David Z. He, Yi Li
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • Immersive Technologies for Vestibular Rehabilitation
    Emanuel Pereira, Bruno Ferreira, Ana Margarida Amorim, Paulo Menezes
    International Journal of Creative Interfaces and Computer Graphics.2022; 13(1): 1.     CrossRef
  • 8,663 View
  • 140 Download
  • 7 Web of Science
  • 8 Crossref

Injury & Prevention | Epidemiology

Trampoline-related injuries in children: a nationwide cross-sectional study in South Korea
Geonmoo Lee, Do Kyun Kim, Joong Wan Park, Young Ho Kwak, Jae Yun Jung
Clin Exp Emerg Med 2020;7(3):190-196.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.060

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Trampoline-related injuries in children: a nationwide cross-sectional study in South Korea
Clin Exp Emerg Med. 2020;7(3):190-196.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.060
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Trampoline-related injuries in children: a nationwide cross-sectional study in South Korea
Clin Exp Emerg Med. 2020;7(3):190-196.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.060
Close
Objective
Trampoline-related injuries have increased in South Korea. However, little research has been conducted on this topic. This study aimed to show the characteristics of pediatric trampoline-related injuries in South Korea and to investigate the factors associated with admission.
Methods
A retrospective, cross-sectional study was conducted using data from South Korea’s Emergency Department-based Injury In-depth Surveillance registry for dates between January 2011 and December 2016. All patients under 18 years of age with trampoline-related injuries were included. We divided the patients into two groups based on whether they were admitted or discharged. Odds ratios with 95% confidence intervals were calculated to evaluate the factors associated with hospital admission for pediatric trampoline-related injuries.
Results
A total of 2,745 patients were enrolled and the incidence increased over time (P for trend<0.01). The most common injury site was the lower extremity (45%). Fracture was the most frequent diagnosis (34.3%). Compared to the discharge group, the adjusted odds ratios (95% confidence intervals) for hospital admission were 3.53 (1.73–7.17) for the teenage group, 2.62 (1.82–3.77) for upper extremity injuries, 18.48 (7.95–42.95) for fractures, 2.28 (1.35–3.86) for falls, and 2.04 (1.15–3.60) for collisions.
Conclusion
Trampoline-related injuries in children have increased over time in South Korea. Most occur in children under the age of 12 years, but children between the ages of 13 and 18 years are at a higher risk for hospitalization. Also, injuries of the upper extremity, fracture, falling, and collision are risk factors for admission. Preventive strategies are needed to reduce trampoline-related injuries in children.

Citations

Citations to this article as recorded by  Crossref logo
  • Outdoor play and risk in kids: a cross-sectional study
    Fiona Armstrong, Michael Barrett, Lorraine D’Arcy, David Gaul
    Archives of Disease in Childhood.2026; 111(3): 205.     CrossRef
  • Trampoline Fractures in Children
    Roope Parviainen, Topi Laaksonen, Petra Grahn, Juha-Jaakko Sinikumpu, Ilkka Helenius, Matti Ahonen
    Journal of Pediatric Orthopaedics.2026; 46(10): 619.     CrossRef
  • Children’s outdoor play injuries: how real are parental concerns of danger in outdoor play?
    Fiona Armstrong, David Gaul
    International Journal of Play.2025; 14(2): 152.     CrossRef
  • Pediatric Trampoline Injuries From Head to Toe
    Neetika Gupta, Hirva Manek, Gali Shapira-Zaltsberg, Kerri Highmore, Elka Miller, Herman Kan
    Roentgen Ray Review.2025;[Epub]     CrossRef
  • A Review of 13,470 Head and Neck Injuries from Trampoline Jumping
    Dani Stanbouly, Rami Stanbouly, Michael Baron, Firat Selvi, Raymond Wong Chung Wen, Sung-Kiang Chuang
    Craniomaxillofacial Trauma & Reconstruction.2024; 17(2): 124.     CrossRef
  • Pediatric Hospitalization Due to Trampoline-Related Injuries in the United States During 2019
    Balagangadhar R Totapally, Ritika Appanagari, Fuad Alkhoury, Keith Meyer
    Cureus.2024;[Epub]     CrossRef
  • Differences in Trampoline-Related Knee Injuries Between Children and Adults: A Cross-Sectional Study
    Martin Husen, Samantha K. Engrav, Dominik Saul, Michael J. Stuart, Todd A. Milbrandt, Bruce A. Levy, Aaron J. Krych, Daniël B.F. Saris
    Orthopaedic Journal of Sports Medicine.2023;[Epub]     CrossRef
  • Trampolining Accidents in an Adult Emergency Department: Analysis of Trampolining Evolution Regarding Severity and Occurrence of Injuries
    Nora Sasse, Mairi Ziaka, Lara Brockhus, Martin Müller, Artistomenis K. Exadaktylos, Jolanta Klukowska-Rötzler
    International Journal of Environmental Research and Public Health.2022; 19(3): 1212.     CrossRef
  • Trampoline Injuries in Children and Adolescents
    Mohammad H. Hussein, Ahmad A. Toreih, Abdallah S. Attia, Majed Alrowaili, Manal S. Fawzy, Danielle Tatum, Eman A. Toraih, Emad Kandil, Juan Duchesne, Sharven Taghavi
    Pediatric Emergency Care.2022; 38(2): e894.     CrossRef
  • Trampoline centre injuries in children and adolescents: a systematic review and meta-analysis
    Carlos Nunez, Guy D Eslick, Elizabeth J Elliott
    Injury Prevention.2022; 28(5): 440.     CrossRef
  • 8,750 View
  • 105 Download
  • 7 Web of Science
  • 10 Crossref

Trauma

Comparison of traumatic brain injury patients with brain computed tomography in the emergency department by age group
Kwang Real Huh, Jung-Youn Kim, Sung-Hyuk Choi, Young-Hoon Yoon, Sung Jun Park, Eu Sun Lee
Clin Exp Emerg Med 2020;7(2):81-86.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.076

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Comparison of traumatic brain injury patients with brain computed tomography in the emergency department by age group
Clin Exp Emerg Med. 2020;7(2):81-86.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.076
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Comparison of traumatic brain injury patients with brain computed tomography in the emergency department by age group
Clin Exp Emerg Med. 2020;7(2):81-86.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.076
Close
Objective
Traumatic brain injury (TBI) is an important public health concern due to its high prevalence and mortality rate among young people. We investigated the clinical and social characteristics of patients who visited the emergency department due to TBI in whom brain computed tomography, was performed by age.
Methods
We retrospectively analyzed 15,567 TBI patients who received a brain computed tomography evaluation at the emergency department of Korea University Hospital from March 2013 to February 2016. We divided patients into age groups by decade and analyzed factors such as sex, trauma mechanism, need for operation, hospitalization, and results of treatment.
Results
The mean age was 42.0±22.8 years; the most common age group was the 50s (16.5%). Except for the age group over 70 years, males predominated. Under 9 years of age, public ambulance usage rate was lower than in other age groups. Regarding severity based on the Glasgow Coma Scale score, the proportion of mild cases was higher in those under 9 years of age (99.3%) and the proportion of severe cases was higher in those in their 20s (4.6%). The most common injury mechanism was blunt trauma, followed by car accidents. For those under 9 years of age, falls were more common than in other age groups. Only 20.5% of TBI patients were hospitalized and 11.9% were treated surgically, while 70.6% of patients were discharged home after treatment.
Conclusion
TBI may present with different characteristics depending on the age of the patients, thus prevention policies and clinical practice should be tailored to age.

Citations

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  • Simultaneous High-Frame-Rate Acoustic Plane-Wave and Optical Imaging of Intracranial Cavitation in Polyacrylamide Brain Phantoms during Blunt Force Impact
    Eric J. Galindo, Riley R. Flores, Ricardo Mejia-Alvarez, Adam M. Willis, Michaelann S. Tartis
    Bioengineering.2024; 11(2): 132.     CrossRef
  • Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008–2015
    Hang A Park, Federico E. Vaca, Kyunghee Jung-Choi, Hyesook Park, Ju Ok Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Mortality and incidence rate of acute severe trauma patients in the emergency department: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Jung-Youn Kim, Young-Hoon Yoon, Sung Joon Park, Won Pyo Hong, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S55.     CrossRef
  • Trends in traumatic brain injury–related emergency department visits in Korea: a report from the National Emergency Department Information System (NEDIS) 2018–2022
    Hang A Park, Borami Lim, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S63.     CrossRef
  • The circadian clock regulator Bmal1 affects traumatic brain injury in rats through the p38 MAPK signalling pathway
    Bing Li, Di Li, Haibo Ni, Chenglin Liu, Jian Xiong, Huixiang Liu, Rong Gao, Li Zhang, Gang Chen
    Brain Research Bulletin.2022; 178: 17.     CrossRef
  • Analysis of the Adequacy of Prehospital Emergency Medical Services Use of Patients Who Visited Emergency Departments in Korea from 2016 to 2018: Data from the National Emergency Department Information System
    Sung Joon Park, Jung-Youn Kim, Young-Hoon Yoon, Eu Sun Lee, Hyun-Jin Kim, Seoung Bum Kim, Hyun Gu Kahng, Yan-Ren Lin
    Emergency Medicine International.2021; 2021: 1.     CrossRef
  • 8,919 View
  • 130 Download
  • 6 Web of Science
  • 6 Crossref
Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model
Eric Weiss, Teena Dhir, Abigail Collett, Michal Reola, Mark Kaplan, Corrado Minimo, Laurel Omert, Pak Leung
Clin Exp Emerg Med 2020;7(2):87-94.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.050

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Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model
Clin Exp Emerg Med. 2020;7(2):87-94.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.050
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Effect of complement C1-esterase inhibitor on brain edema and inflammation after mild traumatic brain injury in an animal model
Clin Exp Emerg Med. 2020;7(2):87-94.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.050
Close
Objective
Traumatic brain injury (TBI) is characterized by damage to the blood-brain barrier, inflammation, and edema formation. In this pilot study, we aimed to investigate the effects of a complement inhibitor, C1-esterase inhibitor (C1 INH), on brain edema and inflammation in a rat model of mild TBI.
Methods
Thirty-six male Sprague Dawley rats were randomly assigned to control, TBI, or TBI plus C1 INH groups. TBI and TBI plus C1 INH rats received an injection of saline or 25 IU/kg C1 INH, respectively, with TBI using a weight drop model. Control rats received saline only. Rats were subsequently euthanized and their brain tissue harvested for analysis. The primary outcome was the extent of edema as assessed by the brain’s water content. Secondary outcomes included enzyme-linked immunosorbent assays to determine levels of pro-inflammatory mediators.
Results
Tumor necrosis factor-α levels were significantly greater in TBI rats than control rats, indicating that inflammation was generated by the weight drop impact. Brain water content following TBI was significantly different between TBI rats treated with C1-INH (78.7%±0.12), untreated TBI rats (79.3%±0.12), and control rats (78.6%±0.15, P=0.001). There was a significant decrease in C3a and interleukin 2 levels among C1 INH–treated rats compared with untreated TBI rats, but no change in levels of tumor necrosis factor-α and S100β.
Conclusion
C1-INH inhibited the complement pathway, suggesting that C1-INH may have a therapeutic benefit in TBI. Further studies are needed to investigate the effect of C1-INH on clinical outcomes.

Citations

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  • The immune regulation of complement system in intracerebral hemorrhage(ICH): the double-edged effects of mechanisms and therapeutic strategies
    Zixuan Wang, Diyang lyu, YuanYuan Xiang, YuTao Lu, Tianrui Yu, Weixin Zhou, Moxin Wu, Xiaoping Yin, Zhiying Chen
    International Immunopharmacology.2026; 175: 116381.     CrossRef
  • The Interaction of Neutrophil Extracellular Traps and Complement in Intracerebral Hemorrhage
    Yaxin Shang, Binglin Kuang, Jia Zheng, Yunpeng Du, Tong Shang, Baochun Luo, Yue Sun, Lei Zheng, Baiwen Zhang, Li Liu, Wei Zou
    Cellular and Molecular Neurobiology.2026;[Epub]     CrossRef
  • Complement in Traumatic Brain Injury: Linking Acute Injury to Chronic Neurodegeneration
    Ariana Chacon, Roy Raheb Khelo, Layth J.M. Saada, Jonathan A. Grossberg, Andrew Reisner, Ali M. Alawieh, Stephen Tomlinson
    European Journal of Immunology.2026;[Epub]     CrossRef
  • Tackling Neuroinflammation After Traumatic Brain Injury: Complement Inhibition as a Therapy for Secondary Injury
    Inge A.M. van Erp, Iliana Michailidou, Thomas A. van Essen, Mathieu van der Jagt, Wouter Moojen, Wilco C. Peul, Frank Baas, Kees Fluiter
    Neurotherapeutics.2023; 20(1): 284.     CrossRef
  • Combined anti-C1-INH and radiotherapy against glioblastoma
    Emma Liljedahl, Elise Konradsson, Emma Gustafsson, Karolina Förnvik Jonsson, Jill K. Olofsson, Kurt Osther, Crister Ceberg, Henrietta Nittby Redebrandt
    BMC Cancer.2023;[Epub]     CrossRef
  • Effects of C1-INH Treatment on Neurobehavioral Sequelae and Late Seizures After Traumatic Brain Injury in a Mouse Model of Controlled Cortical Impact
    Min Chen, Quang M. Tieng, Jiaxin Du, Stephen R. Edwards, Dhiraj Maskey, Emil Peshtenski, David Reutens
    Neurotrauma Reports.2023;[Epub]     CrossRef
  • Role of gC1qR as a modulator of endothelial cell permeability and contributor to post-stroke inflammation and edema formation
    Mychael Delgardo, Anthony J. Tang, Thilan Tudor, Andrés Pascual-Leone, E. Sander Connolly
    Frontiers in Cellular Neuroscience.2023;[Epub]     CrossRef
  • Complement Component 5 (C5) Deficiency Improves Cognitive Outcome After Traumatic Brain Injury and Enhances Treatment Effects of Complement Inhibitors C1-Inh and CR2-Crry in a Mouse Model
    Min Chen, Stephen R. Edwards, Dhiraj Maskey, Trent M. Woodruff, Stephen Tomlinson, David Reutens
    Neurotrauma Reports.2023;[Epub]     CrossRef
  • Stem Cell Therapy for Sequestration of Traumatic Brain Injury-Induced Inflammation
    Mia C. Borlongan, Susanna Rosi
    International Journal of Molecular Sciences.2022; 23(18): 10286.     CrossRef
  • Challenging Hurdles of Current Targeting in Glioblastoma: A Focus on Immunotherapeutic Strategies
    Vassilis Genoud, Denis Migliorini
    International Journal of Molecular Sciences.2021; 22(7): 3493.     CrossRef
  • 8,972 View
  • 130 Download
  • 10 Web of Science
  • 10 Crossref

Imaging

Comparative and retrospective evaluation of the predictive performance of optic nerve sheath thickness and optic nerve sheath diameter for traumatic brain injury using facial computed tomography
Woo Sung Sim, Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho
Clin Exp Emerg Med 2020;7(2):122-130.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.033

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Comparative and retrospective evaluation of the predictive performance of optic nerve sheath thickness and optic nerve sheath diameter for traumatic brain injury using facial computed tomography
Clin Exp Emerg Med. 2020;7(2):122-130.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.033
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Comparative and retrospective evaluation of the predictive performance of optic nerve sheath thickness and optic nerve sheath diameter for traumatic brain injury using facial computed tomography
Clin Exp Emerg Med. 2020;7(2):122-130.   Published online June 30, 2020
DOI: https://doi.org/10.15441/ceem.19.033
Close
Objective
To evaluate the predictive performance of optic nerve sheath thickness (ONST) on the outcomes of traumatic brain injury (TBI) and to compare the inter-observer agreement To evaluate the predictive performance of optic nerve sheath thickness (ONST) for traumatic brain injury (TBI) and to compare the predictive performance and inter-observer agreement between ONST and optic nerve sheath diameter (ONSD) on facial computed tomography (CT).
Methods
We retrospectively enrolled patients with a history of facial trauma and who underwent both facial CT and brain CT. Two reviewers independently measured ONST and ONSD of each patient using facial CT images. Final brain CT with clinical outcome was used as the reference standard for TBI. Multivariate logistic regression analyses, receiver operating characteristic (ROC) curves, and intraclass correlation coefficients were used for statistical analyses.
Results
Both ONST (P=0.002) and ONSD (P=0.001) on facial CT were significantly independent factors to distinguish between TBI and healthy brains; an increase in ONST and ONSD values corresponded with an increase in the risk of TBI by 8.9- and 7.6-fold, respectively. The predictive performances of the ONST (sensitivity, 96.2%; specificity, 94.3%; area under the ROC curve, 0.968) and ONSD (sensitivity, 92.6%; specificity, 90.2%; area under the ROC curve, 0.955) were excellent and exhibited similar sensitivity, specificity, and area under the curve (P=0.18–0.99). Interobserver and intraobserver intraclass correlation coefficients for ONST were significantly higher than those for ONSD (all P<0.001).
Conclusion
ONST on facial CT is a feasible predictor of TBI and demonstrates similar performance and superior observer agreement than ONSD. We recommend using ONST measurements to assess the need for additional brain CT scans in TBI-suspected cases.

Citations

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  • Online Learning versus Hands-On Learning of Basic Ocular Ultrasound Skills: A Randomized Controlled Non-Inferiority Trial
    Soo-Yeon Kang, Jonghoon Yoo, Sookyung Park, Ik-Joon Jo, Seonwoo Kim, Hyun Cho, Guntak Lee, Jong-Eun Park, Taerim Kim, Se-Uk Lee, Sung-Yeon Hwang, Won-Chul Cha, Tae-Gun Shin, Hee Yoon
    Medicina.2022; 58(7): 960.     CrossRef
  • 7,436 View
  • 93 Download
  • 1 Web of Science
  • 1 Crossref

Review Article

Trauma

Damage control resuscitation
Evan Leibner, Mark Andreae, Samuel M. Galvagno, Thomas Scalea
Clin Exp Emerg Med 2020;7(1):5-13.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.089

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Damage control resuscitation
Clin Exp Emerg Med. 2020;7(1):5-13.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.089
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Damage control resuscitation
Clin Exp Emerg Med. 2020;7(1):5-13.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.089
Close
The United States Navy originally utilized the concept of damage control to describe the process of prioritizing the critical repairs needed to return a ship safely to shore during a maritime emergency. To pursue a completed repair would detract from the goal of saving the ship. This concept of damage control management in crisis is well suited to the care of the critically ill trauma patient, and has evolved into the standard of care. Damage control resuscitation is not one technique, but, rather, a group of strategies which address the lethal triad of coagulopathy, acidosis, and hypothermia. In this article, we describe this approach to trauma resuscitation and the supporting evidence base.

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  • Incidence of and factors associated with damage control laparotomy in adult patients undergoing emergency laparotomy following abdominal trauma: A retrospective cohort study from a UK Major trauma centre
    Charlotte A Needham-Bennett, Zubair Ahmed, Justine J Lee, David N Naumann
    Trauma.2026; 28(1): 6.     CrossRef
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    Elisha Purcell, Samara Rosenblum, Biswadev Mitra, Marc Schnekenburger
    Burns.2026; 52(1): 107827.     CrossRef
  • The Concept of “Damage Control Resuscitation”: Scoping-Review
    I. V. Sbitnev, A. R. Rasskazov, M. A. Petrushin, V. A. Reva
    Russian Sklifosovsky Journal "Emergency Medical Care".2026; 14(4): 763.     CrossRef
  • Management of Acute Hemorrhage and Damage-Control Resuscitation: Critical Care Concepts for Vascular Interventional Radiologists
    Sameer Singhal, Ke Zhang, Khanant Desai
    Techniques in Vascular and Interventional Radiology.2026; 29(2): 101114.     CrossRef
  • Current issues of clinical and organizational problems of polytrauma
    E. A. Olenev, D. V. Zhukov, N. V. Vygovsky, V. G. Cherepanov
    Clinical Medicine (Russian Journal).2026; 103(10-11): 720.     CrossRef
  • Mechanical Ventilation in Trauma-Induced Respiratory Failure: A Clinical Review
    Carolina Ruiz, Andrés Aquevedo, Consuelo Marambio-Coloma, Lorena Arqueros, Guillermo Bugedo, L. Felipe Damiani
    Respiratory Care.2026; 71(4): 405.     CrossRef
  • Prevalence and predictors of hypotension on hospital arrival in traumatic brain injury: a prehospital HEMS cohort study
    Agnė Macaitė, L. S. Scholl, J. Schwietring, S. Rehberg, A. Hoyer, K.-C. Thies
    Scientific Reports.2026;[Epub]     CrossRef
  • Perioperative Patient Blood Management: Evidence-Based Strategies for Surgeons and Anesthesiologists: A Narrative Review
    Taxiarchis Konstantinos Nikolouzakis, Epameinondas Evangelos Kantidakis, Richard Crawford, Riaan Pretorius, Orfeas Nikolaos Zaimakis, Emmanuel Chrysos
    Journal of Clinical Medicine.2026; 15(8): 3017.     CrossRef
  • Failure-to-Rescue From Intraoperative Massive Hemorrhage and Preventable Deaths: A Retrospective Observational Study From Nationwide Incident Reporting System
    Daisuke Koike, Hiroyuki Kato, Yoshitomo Kajino, Yuka Kondo, Masahiro Ito, Akihiko Horiguchi, Yoshimasa Nagao
    Journal of Surgical Research.2026; 325: 486.     CrossRef
  • Damage control resuscitation in resource-diverse settings: a survey-based comparison of trauma care practices worldwide
    Leticia Stefani Pacheco, Rafael Dib Possiedi, Thomas Michael Scalea, Marcelo Augusto Fontenelle Ribeiro Junior
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Original Articles

Resuscitation | Trauma

Prognostic factors related with outcomes in traumatic out-of-hospital cardiac arrest patients without prehospital return of spontaneous circulation: a nationwide observational study
Gwang Soo Jun, Jae Guk Kim, Hyun Young Choi, Gu Hyun Kang, Wonhee Kim, Yong Soo Jang, Hyun Tae Kim
Clin Exp Emerg Med 2020;7(1):14-20.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.057

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Prognostic factors related with outcomes in traumatic out-of-hospital cardiac arrest patients without prehospital return of spontaneous circulation: a nationwide observational study
Clin Exp Emerg Med. 2020;7(1):14-20.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.057
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Prognostic factors related with outcomes in traumatic out-of-hospital cardiac arrest patients without prehospital return of spontaneous circulation: a nationwide observational study
Clin Exp Emerg Med. 2020;7(1):14-20.   Published online March 31, 2020
DOI: https://doi.org/10.15441/ceem.19.057
Close
Objective
To evaluate the prognostic factors associated with the sustained return of spontaneous circulation (ROSC) and survival to hospital discharge in traumatic out-of-hospital cardiac arrest (TOHCA) patients without prehospital ROSC.

Methods
We analyzed Korean nationwide data from the Out-of-Hospital Cardiac Arrest Surveillance, and included adult TOHCA patients without prehospital ROSC from January 2012 to December 2016. The primary outcome was sustained ROSC (>20 minutes). The secondary outcome was survival to discharge. Multivariate analysis was performed to investigate factors associated with the outcomes of TOHCA patients.

Results
Among 142,905 cases of OHCA, 8,326 TOHCA patients were investigated. In multivariate analysis, male sex (odds ratio [OR], 1.326; 95% confidence interval [CI], 1.103–1.594; P=0.003), and an initial shockable rhythm (OR, 1.956; 95% CI, 1.113–3.439; P=0.020) were significantly associated with sustained ROSC. Compared with traffic crash, collision (OR, 1.448; 95% CI, 1.086–1.930; P=0.012) was associated with sustained ROSC. Fall (OR, 0.723; 95% CI, 0.589– 0.888; P=0.002) was inversely associated with sustained ROSC. Male sex (OR, 1.457; 95% CI, 1.026–2.069; P=0.035) and an initial shockable rhythm (OR, 4.724; 95% CI, 2.451–9.106; P<0.001) were significantly associated with survival to discharge. Metropolitan city (OR, 0.728; 95% CI, 0.541–0.980; P=0.037) was inversely associated with survival to discharge. Compared with traffic crash, collision (OR, 1.745; 95% CI, 1.125–2.708; P=0.013) was associated with survival to discharge.

Conclusion
Male sex, an initial shockable rhythm, and collision could be favorable factors for sustained ROSC, whereas fall could be an unfavorable factor. Male sex, non-metropolitan city, an initial shockable rhythm, and collision could be favorable factors in survival to discharge.

Citations

Citations to this article as recorded by  Crossref logo
  • Re-evaluating the traumatic cardiac arrest paradigm: the case for early rhythm assessment and targeted compressions
    A. A. Garner, R. Lynham
    Canadian Journal of Emergency Medicine.2026;[Epub]     CrossRef
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    Saeed Khayat Kakhki, Majid Daneshfar, Alireza Namaei Qasemnia, Mehrdad Yousefnezhad, Matina Rajaee
    BMC Emergency Medicine.2026;[Epub]     CrossRef
  • Signs of life and clinical outcomes in patients with traumatic out-of-hospital cardiac arrest: a nationwide multicenter observational study
    Ikutaro Yamashita, Ryo Yamamoto, Masaru Suzuki, Nobuya Kitamura, Takashi Tagami, Hideo Yasunaga, Shotaro Aso, Munekazu Takeda, Tomoyoshi Tamura, Junichi Sasaki
    The Journal of Emergency Medicine.2026;[Epub]     CrossRef
  • Prehospital Management of Adults With Traumatic Out-of-Hospital Circulatory Arrest—A Joint Position Statement
    Amelia M. Breyre, Nicholas George, Alexander R. Nelson, Charles J. Ingram, Thomas Lardaro, Wayne Vanderkolk, John W. Lyng
    Annals of Emergency Medicine.2025; 85(3): e25.     CrossRef
  • Prehospital Trauma Compendium: Prehospital Management of Adults with Traumatic Out-of-Hospital Circulatory Arrest – A Joint Position Statement and Resource Document of NAEMSP, ACS-COT, and ACEP
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    Ramiz Yazıcı
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    Niek Johannes Vianen, Esther Maria Maartje Van Lieshout, Iscander Michael Maissan, Wichor Matthijs Bramer, Dennis Den Hartog, Michael Herman Jacob Verhofstad, Mark Gerrit Van Vledder
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    I-Ming Kuo, Yi-Fu Chen, Chih-Ying Chien, Yi-Wen Hong, Shih-Ching Kang, Chih-Yuan Fu, Chih-Po Hsu, Chien-Hung Liao, Chi-Hsun Hsieh
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    Daniel Ohlén, Magnus Hedberg, Paula Martinsson, Erik von Oelreich, Therese Djärv, Malin Jonsson Fagerlund
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2022;[Epub]     CrossRef
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    Hiromichi Naito, Tetsuya Yumoto, Takashi Yorifuji, Tsuyoshi Nojima, Hirotsugu Yamamoto, Taihei Yamada, Kohei Tsukahara, Mototaka Inaba, Takeshi Nishimura, Takenori Uehara, Atsunori Nakao
    BMC Emergency Medicine.2021;[Epub]     CrossRef
  • 8,975 View
  • 148 Download
  • 14 Web of Science
  • 13 Crossref

Trauma | Imaging

Higher enhanced computed tomography attenuation value of the aorta is a predictor of massive transfusion in blunt trauma patients
Tetsuya Yumoto, Hiromi Ihoriya, Ryo Tanabe, Hiromichi Naito, Atsunori Nakao
Clin Exp Emerg Med 2019;6(4):330-339.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.090

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Higher enhanced computed tomography attenuation value of the aorta is a predictor of massive transfusion in blunt trauma patients
Clin Exp Emerg Med. 2019;6(4):330-339.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.090
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Higher enhanced computed tomography attenuation value of the aorta is a predictor of massive transfusion in blunt trauma patients
Clin Exp Emerg Med. 2019;6(4):330-339.   Published online December 31, 2019
DOI: https://doi.org/10.15441/ceem.18.090
Close
Objective
Several scoring systems have been developed to identify patients who require massive transfusion (MT) after major trauma to improve survival. The primary goal of this study was to investigate the usefulness of enhanced computed tomography attenuation values (CTAVs) of major vessels to determine the need for MT in patients with major blunt trauma.
Methods
This single-center retrospective cohort study evaluated patients aged 16 years or older who underwent contrast-enhanced computed tomography scan of the torso after major blunt trauma. The CTAVs of six major vessel points in both the arterial and portal venous phases at initial computed tomography examination were assessed and compared between the MT and the no MT group. The capability of enhanced CTAVs to predict the necessity for MT was estimated based on the area under the receiver operating characteristic curve.
Results
Of the 254 eligible patients, 36 (14%) were in the MT group. Patients in the MT group had significantly higher CTAVs at all sites except the inferior vena cava in both the arterial and portal venous phases than that in the no MT group. The descending aorta in the arterial phase had the highest accuracy for predicting MT, with an AUROC of 0.901 (95% confidence interval, 0.855 to 0.947; P<0.001).
Conclusion
Initial elevation of enhanced CTAV of the aorta is a predictor for the need for MT. A higher CTAV of the aorta should alert the trauma surgeon or emergency physician to activate their MT protocol.

Citations

Citations to this article as recorded by  Crossref logo
  • Hemolysis Control in the Emergency Department by Interventional Blood Sampling
    Hyeseung Lee, Heekyung Lee, Changsun Kim, Hyungoo Shin, Inhye Lee, Yihyun Kim
    Journal of Personalized Medicine.2023; 13(4): 651.     CrossRef
  • 8,740 View
  • 73 Download
  • 1 Web of Science
  • 1 Crossref
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