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.
Objective
To explore the distinctions between different types of traumatic facial fractures in predicting intracranial lesions using data from the National Trauma Registry of Iran (NTRI).
Methods
This retrospective registry-based study analyzed six years of data from four NTRI trauma centers, focusing on patients with facial fractures. Patients with at least one facial fracture were included, with data on demographics, injury mechanisms, fracture patterns, and intracranial lesions. The multiple logistic regression model explored the association between clinical variables and intracranial lesions.
Results
Among 32,525 patients, 1,166 (3.6%) had facial fractures. Motorcycle riders had a higher probability of malar-maxillary fractures than mandibular fractures (p < 0.001). Non-RTA injuries were significantly associated with mandibular fractures compared to malar-maxillary fractures (p < 0.001). Intracranial lesions were identified in 14.8% of patients, with subarachnoid hemorrhage (SAH) (38.4%), subdural hemorrhage (SDH) (19.8%), and epidural hemorrhage (EDH) (18.6%) being the most common. Most intracranial lesions developed in patients with malar-maxillary fractures (N = 82 (47.7%)). Also, patients with malar-maxillary fractures had the highest chance of developing intracranial lesions among different types of facial fractures (OR = 15.33, 95% CI: 6.57 to 35.79, p < 0.001), remained significant after adjustment (adjusted OR (aOR) = 7.20, 95% CI: 2.97 to 17.42, p < 0.001).
Conclusion
Traumatic facial fractures, particularly malar-maxillary fractures, significantly increase the risk of intracranial lesions. Road traffic accidents (RTA) are major contributors to such injuries. Prompt management, especially for malar-maxillary fractures, is critical for reducing risks and improving outcomes, necessitating further research on treatment strategies.
Objective To identify relationships between skull fracture (SF) and hyperfibrinolysis (HF) among patients with isolated traumatic brain injury (TBI). Methods This was a retrospective cohort study based on a nationwide neurotrauma database in Japan. Adult patients with isolated TBI (head Abbreviated Injury Scale [AIS] >2, any other AIS <3) and who were registered in the multicenter neurotrauma registry from 2015 to 2017 were included. To examine the relationship between SF and HF, we conducted multivariable logistic regression analyses to calculate the adjusted odds ratios (aORs) with their 95% confidence intervals (CIs) for HF. HF was defined as a D-dimer level ≥38 mg/L on arrival based on a previous study. Results A total of 335 patients were enrolled and the median age of the cohort was 64 years (interquartile range, 44–76 years). HF was observed in 161 patients (48.1%). The association of SF with HF yielded an aOR of 4.78 (95% CI, 2.71–8.42) compared to non-SF in multivariable logistic regression analysis. In addition, the associations of skull base fracture, skull vault fracture, and combination of skull base and vault fracture with HF yielded the corresponding aORs of 3.60 (95% CI, 1.20–10.81), 4.99 (95% CI, 2.63–9.44), and 4.84 (95% CI, 2.41–9.72), respectively, relative to non-SF. Conclusion This multicenter observational study demonstrated the association of SF with HF in patients with isolated TBI.
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
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
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
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.
Objective To explore and analyze pediatric trauma care practices across designated pediatric trauma centers (PTCs) in Switzerland. The focus was on reception, trauma team activation (TTA), trauma team composition, patient volumes, and infrastructure.
Methods A national online survey was conducted among all eight PTCs in Switzerland using an 18-item questionnaire. The survey investigated organizational aspects, criteria for TTA, patient volume, and communication modalities in pediatric emergency departments (PEDs).
Results All PTCs responded, revealing varying methods of TTA, with reception of major trauma patients occurring at either PEDs or adjacent adult trauma facilities. Trauma team composition and activation criteria also differ among centers, with nonsurgeons often leading the teams and anesthesiologists being the default facilitators of airway management. TTA criteria vary widely, with the most common being the request of prehospitalization staff (62.5%) and physician discretion (50%). Trauma resuscitation is predominantly led by PED attendants (75%).
Conclusion This survey provides insights into the state of pediatric trauma care in Switzerland. The findings underscore the importance of multidisciplinary teams and variability in trauma management practices, which are often tailored to local circumstances. Despite the study limitations of using self-reported data and the small sample size owing to the country's size, the results suggest that a national trauma registry would be helpful to the evaluation and optimization of pediatric trauma care protocols.
Chaemoon Lim, Jung-Hwan Oh, Jeong Rae Yoo, Seo Young Ko, Jeong Ho Kang, Sung Kgun Lee, Wooseong Jeong, Gil Myeong Seong, Hyun Jung Lee, Chul-Hoo Kang, Ji Hyun Moon, In-seok Son, Hyun Ju Yang, Min-su Oh, Sung Wook Song
Clin Exp Emerg Med 2025;12(1):56-65. Published online May 23, 2024
Objective This study aimed to investigate the characteristics and epidemiological trends of pediatric injuries among patients visiting emergency departments on Jeju Island, Korea. Methods Using a community-level serial cross-sectional analysis, we targeted pediatric patients 18 years or younger who visited emergency departments for injuries over a 10-year period. A comprehensive examination of injury characteristics and epidemiological trends was performed using the data sourced from the Jeju Injury Surveillance System. This included an evaluation of the annual incidence and overall trends in pediatric injury cases. Results The study found toddlers (42.5% of cases) to be the most frequently injured age group. Male patients were more prone to injuries, with a male to female ratio of 1.7:1. Injuries among visitors accounted for 17.3% of cases, with a seasonal spike in summer, evenings, and weekends. Most incidents occurred at home, were predominantly accidental in nature, with adolescents more likely to require emergency medical system services. The common mechanisms of injuries were blunt force (49.2%), slips/falls (22.0%), and motor vehicle collisions (13.2%), leading to bruises, cuts, and sprains. Over the decade, a general increase in pediatric injuries was observed. Accidental injuries initially surged but later stabilized; however, self-harm/suicide and assault/ violence injuries showed a concerning upward trend. Age-specific analysis revealed increasing trends in infants and adolescents. Conclusion The results of the present study underscore the crucial need for targeted injury prevention and resource allocation strategies, particularly for high-risk groups and time of injury, to effectively mitigate pediatric trauma on Jeju Island.
Citations
Citations to this article as recorded by
Traumatic brain injury from diaper change-related falls in children younger than 3 years: an evaluation of South Korean national emergency department registry data Minha Kim, Sejin Heo, Seung Jin Maeng, Taerim Kim, Hansol Chang, Se Uk Lee, Sung Yeon Hwang, Won Chul Cha, Hee Yoon BMC Pediatrics.2026;[Epub] CrossRef
Challenges in Pediatric Facial Laceration Management Amid the Health Care Crisis in South Korea Daihun Kang Journal of Craniofacial Surgery.2025; 36(8): 2701. CrossRef
Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) are the two predominant causes of preventable death after trauma. Early control of bleeding sources and rapid detection, characterization and management of TIC have been associated with improved outcomes. However, recent surveys confirm vast heterogeneity in the clinical diagnosis and management of hemorrhage and TIC from acute trauma, even in advanced trauma centers. In addition, conventional coagulation assays, although still used frequently during the early assessment of bleeding trauma patients, have their limitations. This narrative review highlights the clinical value of rapid point-of-care viscoelastic testing for the early diagnosis and individualized goal-directed therapy in bleeding trauma patients with TIC.
Citations
Citations to this article as recorded by
Initial TEG 6s parameters for risk stratification of hemorrhage-related outcomes in massively transfused trauma patients Dongmin Seo, Junsik Kwon, Inhae Heo, Kyoungwon Jung European Journal of Trauma and Emergency Surgery.2026;[Epub] CrossRef
Four new markers of early thrombotic molecules and thromboelastography in prognostic evaluation of AMI patients undergoing PCI Weisha Sun, Yi Gao, Weiran Sun, Qinhan Zhang, Xi Zhao, Xuan Jing, Chonghua Hao The Egyptian Heart Journal.2026;[Epub] CrossRef
The metabolic and endocrine response to trauma Christina Dunn, Andrew McGuire Anaesthesia & Intensive Care Medicine.2026; 27(4): 222. CrossRef
Thrombocytopenia in Critically Ill Children: A Review for Practicing Clinicians Balagangadhar R. Totapally, Abhinav Totapally, Paul A. Martinez Children.2025; 12(1): 83. CrossRef
TOMADA DE DECISÃO CIRÚRGICA NO TRAUMA TORACOABDOMINAL EM PACIENTES COM COAGULOPATIAS PRÉ-EXISTENTES: UMA REVISÃO INTEGRATIVA DE LITERATURA Sofia Maiolli Marques, Khalil Jorge Nabhan, Maria Lunara de S. A. Pessoa, Mariana de Paula Farias, Isadora Cortez Diana, Luís Alberto do Valle, Lincoln Luis Silva REVISTA FOCO.2025; 18(10): e9997. CrossRef
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
Citations to this article as recorded by
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;[Epub] 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
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
Citations to this article as recorded by
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
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
Objective This study investigated the characteristics and survival rates of patients with unintentional severe trauma who visited a regional trauma center (TC) or a non-TC.
Methods This retrospective, national, population-based, observational, case-control study included patients with abnormal Revised Trauma Score from January 2018 to December 2018. We divided hospitals into two types, TC and non-TC, and compared several variables, including in-hospital mortality. Propensity score matching was used to reduce the effect of confounding variables that influence survival outcome variables.
Results Of the 25,743 patients, 5,796 visited a TC and 19,947 visited a non-TC. Compared to patients treated at non-TCs, patients treated at TCs were more likely to have a higher Injury Severity Score (TC, 11.5; non-TC, 7.4; P<0.001), higher rate of surgery or transcatheter arterial embolization (TC, 39.2%; non-TC, 17.6%; P<0.001), and higher admission rate (TC, 64.7%; non-TC, 36.9%; P<0.001) through the emergency department. After propensity score matching, 2,800 patients from both groups were analyzed. Patients in the TC had a higher survival rate than patients that were not treated in the TC (TC, 83.0%; non-TC, 78.6%; P=0.003).
Conclusion This study using Korean emergency medical services data showed that initial transport to trauma centers was associated with mortality reduction. Further research is required because of limitations with use of single-year data and retrospective design.
Citations
Citations to this article as recorded by
Intentionally self-injured patients have lower mortality when treated at trauma centers versus non-trauma centers in South Korea Jin Woo, Han Zo Choi, Jongkyeong Kang Trauma Surgery & Acute Care Open.2024; 9(1): e001258. CrossRef
The Association Between Inter-Hospital Transfers and the Prognosis of Pediatric Injury in the Emergency Department Darjin Jung, Jin Hee Jung, Jin Hee Kim, Jie Hee Jue, Joong Wan Park, Do Kyun Kim, Jae Yun Jung, Eui Jun Lee, Jin Hee Lee, Dongbum Suh, Hyuksool Kwon Journal of Korean Medical Science.2023;[Epub] CrossRef
Objective This study aimed to investigate the relationship between abnormal intracranial findings on brain computed tomography and antiplatelet or anticoagulant use in patients with nontraumatic headache in the emergency department (ED).
Methods This was a single-center prospective observational study of patients admitted to the tertiary ED with complaints of nontraumatic headache between May 1, 2016 and September 1, 2016. Anticoagulant or antiplatelet drug use by the patient was recorded. Brain computed tomography (CT) results were categorized into two groups, abnormal results (CT positive) and no pathologic results (CT negative), and compared. The CT positive group included any pathological signs in the brain and the negative group was considered a normal read. A logistic regression analysis was used for evaluating the association of antiplatelets and anticoagulants with abnormal CT findings.
Results Of the 837 patients with nontraumatic headaches, 157 (18.8%) patients who underwent brain CT scanning were included. The mean age of the patients was 44.4±16.7 years. Eighty-eight (56.1%) of the patients were women. Of the 29 (18.4%) patients using antiplatelets or anticoagulants, 16 (55.2%) were in the CT positive group. There was a statistically significant difference between both groups in terms of drug use compared to the CT negative group (P<0.001). Factors affecting CT results were examined in logistic regression analysis and a statistically significant difference was found in the detection of positive results in antiplatelet or anticoagulant drug users (adjusted odds ratio, 2.478; 95% confidence interval, 1.006–6.102; P=0.048).
Conclusion The use of antiplatelets or anticoagulants in patients admitted to the ED with nontraumatic headache is associated with an increased risk of abnormal intracranial results in brain CT.
Citations
Citations to this article as recorded by
Warfarin Therapy Improved Migraine Headaches with Aura: A Case Report Saleh Alqifari Archives of Pharmacy Practice.2023; 14(1): 66. CrossRef
Resolution of Migraine with Aura Associated with Warfarin Use: A Case Report Angelo Russo, Fabiana Zani, Maria De Paola, Sara Santi Annals of Pharmacy Practice and Pharmacotherapy.2023; 3(1): 36. CrossRef
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
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
Objective As the use of electric scooters increased in Italy in the last years, we aimed to estimate the burden of accidents caused by this micro-mobility vehicle and identify characteristics, severity, and type of injuries.
Methods We conducted a case series analysis of news reports about electric scooter crashes occurring in Italy from January 1, 2019 to September 30, 2020. Events were included when a road traffic accident involved an electric scooter and caused damages or injuries to the driver or others.
Results We identified 96 road accidents involving electric scooters in Italy. The mean age of patients was 30 ± 16 years, and 79% (n = 71/90) were male. Of the 96 patients, only two (2%) were driving an electric scooter with a helmet, and three (3%) were driving while intoxicated. In 68% (n = 62/94) of cases, the incident was caused by a collision with another vehicle or a pedestrian, and 30% (n = 18/96) were transported with life-threatening injuries to the emergency department. In 15% (n = 14/96), the emergency medical service physician was dispatched to the scene. Head trauma was the most common injury (60%, n = 32/53). Patients who had life-threatening conditions were more likely to have head trauma than those who did not (82% [n = 9/11] vs. 55% [n = 23/42], P = 0.10). Polytrauma was significantly more common in patients with life-threatening conditions than in patients with no life-threatening conditions (36% [n = 4/11] vs. 5% [n = 2/42], P < 0.01). Fifteen percent of patients (n = 12/81) were admitted to the intensive care unit; only one death was reported.
Conclusion Road traffic accidents involving electric scooters often result in serious injuries, including head trauma and polytrauma, necessitating the involvement of an emergency medical service physician and intensive care unit admission in a non-negligible percentage of instances.
Citations
Citations to this article as recorded by
Work-related road traffic accidents: emergence of new modes of personal journey – analysis based on data from a register of road traffic accidents in France Emmanuel Fort, Nicolas Connesson, Julien Brière, Amina Ndiaye, Blandine Gadegbeku, Barbara Charbotel Injury Prevention.2025; 31(3): 242. CrossRef
Electronic Scooter Versus Non-electronic Scooter Injuries: A Study Comparing Distal Radius Fracture Open Reduction and Internal Fixations in an Urban Trauma Centre Liang Zhi Wong, Anthony Kinnair, Chirag Rao, Ademola Adejuwon, Alistair R Hunter Cureus.2025;[Epub] CrossRef
Analysis of dental traumatic patterns in standing electric scooter-related accidents Youngmin Kwon, Jihye Lim, Chunui Lee Injury.2024; 55(2): 111148. CrossRef
Impact of COVID-19 pandemic on interhospital transfer of patients with major trauma in Korea: a retrospective cohort study Sung Hoon Cho, Woo Young Nho, Dong Eun Lee, Jae Yun Ahn, Joon-Woo Kim, Kyoung Hoon Lim, Hyun Wook Ryoo, Jong Kun Kim BMC Emergency Medicine.2024;[Epub] CrossRef
The characteristics of e-scooter accidents reported by police in Türkiye Ebru Arikan Öztürk, Fatih Karaçor, Hikmet Bayirtepe Traffic Injury Prevention.2024; 25(8): 1089. CrossRef
The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study Giovanni Salzano, Francesco Maffia, Luigi Angelo Vaira, Roberta Fusco, Massimo Albanese, Salvatore Crimi, Marco Cucurullo, Fabio Maglitto, Claudia Maugeri, Marzia Petrocelli, Francesca Pitino, Paolo Priore, Fabio Roccia, Alessandro Tel, Anna Maria Baietti Journal of Clinical Medicine.2024; 13(17): 5195. CrossRef
The Investigation of Electric Scooter Accident Cases Admitted to the Emergency Department: A Multicenter Study Serbülent Kılıç, Melih Yüksel, Musa Şahin, Arzu Oto, Suna Eraybar, Vahide Aslıhan Durak, Sümeyye Tuğba Sarkı Cander Medical Science and Discovery.2023; 10(8): 640. CrossRef
Objective Ultrasound-guided infraclavicular nerve block (IB) has become a well-established method in several outpatient procedures; however, its use in emergency departments (EDs) remains limited. The aim of this study was to compare procedural sedation and anlagesia (PSA) and IB in the pain management for patients who underwent forearm fracture reduction in the ED.
Methods This prospective randomized study included 60 patients aged 18 to 65 years, who visited the ED with forearm fractures. They were randomly divided into two groups: Group PSA (n=30) and Group IB (n=30). The pain scores of patients were evaluated before and during the procedure with the visual analog scale. Complications and patient and operator satisfaction levels were recorded.
Results There was no difference between the two groups in terms of demographic characteristics. The median (interquartile range) pain scores observed during the procedures were significantly higher in Group PSA than in Group IB (4 [4–6] vs. 2 [0–2], respectively; P<0.001). Patient and operator satisfaction levels were significantly higher in Group IB (P<0.001). Oxygen desaturation was statistically higher in Group PSA than in Group IB (40.00% vs. 3.33%, respectively; P=0.002).
Conclusion IB was an effective alternative for reducing pain and increasing patient satisfaction in ED patients undergoing forearm fracture reduction.
Citations
Citations to this article as recorded by
Procedural sedation and analgesia in the emergency department: a review of current practices and clinical implications Burcu Özen Karabulut, Metin Akgün Anesthesiology and Perioperative Science.2026;[Epub] CrossRef
Complications of Ultrasound-Guided Peripheral Nerve Blocks in the Emergency Department: A Systematic Review and Meta-Analysis Joyce Hanyue Gu, Adrian Cotarelo, Mark Samarneh The Journal of Emergency Medicine.2025; 75: 256. CrossRef
Ultrasound‐Guided Nerve Blocks Improve Success Rate of Closed Reduction of Colles' Fractures: A Randomised Controlled Trial Anette B. Christensen, Christine IIkjær, Torben K. Laustrup, Esben Sejer, Camilla Rønnøw, Kaj V. Døssing, Troels B. Jensen, Jacob K. Andersen, Christoffer G. Sølling Acta Anaesthesiologica Scandinavica.2025;[Epub] CrossRef
Pain management with ketamine procedural sedation and infraclavicular block for forearm fracture in the emergency department Emine Sarcan, Ahmet Burak Erdem, Şerife Büşra Uysal, Evrim Duman, Zübeyir Cebeci, Emine Arık The American Journal of Emergency Medicine.2025; 96: 256. CrossRef
Ultrasound-guided nerve blocks in emergency medicine practice: 2022 updates Andrew J. Goldsmith, Joseph Brown, Nicole M. Duggan, Tomer Finkelberg, Nick Jowkar, Joseph Stegeman, Matthew Riscinti, Arun Nagdev, Richard Amini The American Journal of Emergency Medicine.2024; 78: 112. CrossRef
Peripheral nerve blocks for closed reduction of distal radius fractures—A systematic review with meta‐analysis and trial sequential analysis Sanja Pisljagic, Jens L. Temberg, Mathias T. Steensbæk, Sina Yousef, Mathias Maagaard, Lana Chafranska, Kai H. W. Lange, Christian Rothe, Lars H. Lundstrøm, Anders K. Nørskov Acta Anaesthesiologica Scandinavica.2024; 68(9): 1149. CrossRef
Regional anesthesia for acute pain management in pre-hospital and in-hospital emergency medicine Andreas Fichtner, Benedikt Schrofner-Brunner, Tina Magath, Peik Mutze, Thea Koch Deutsches Ärzteblatt international.2023;[Epub] CrossRef
Impact of Insurance Benefits and Education on Point-of-Care Ultrasound Use in a Single Emergency Department: An Interrupted Time Series Analysis Soo-Yeon Kang, Sookyung Park, Ik-Joon Jo, Kyeongman Jeon, Seonwoo Kim, Guntak Lee, Jong-Eun Park, Taerim Kim, Se-Uk Lee, Sung-Yeon Hwang, Won-Chul Cha, Tae-Gun Shin, Hee Yoon Medicina.2022; 58(2): 217. CrossRef
Regional Anesthesia for Trauma in the Emergency Department Nadia Hernandez, Johanna B. de Haan Current Anesthesiology Reports.2022; 12(2): 240. CrossRef
Ultrasound-Guided Peripheral Nerve Blocks: A Practical Review for Acute Cancer-Related Pain David Hao, Michael Fiore, Christopher Di Capua, Amitabh Gulati Current Pain and Headache Reports.2022; 26(11): 813. CrossRef
First
Prev
