European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2023
ReviewThe role of fibrinogen in traumatic brain injury: from molecular pathological mechanisms to clinical management.
Fibrinogen is the substrate of plasma coagulation. It plays an important role in the formation of reticular network, which is crucial to the strength and stability of blood clots. In addition to directly participating in coagulation, fibrinogen also participates in the destruction of blood-brain barrier and neuroinflammation. ⋯ Considerable efforts have been made to understand the mechanisms by which fibrinogen damages the central nervous system. Combined with the latest research hotspots, potentially promising treatment strategies at the molecular level were discussed. We believe that understanding the role of fibrinogen-mediated damage in nerve and blood-brain barrier function will enable timely intervention in patients with nerve damage, and guide the development of novel targeted therapeutics.
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Eur J Trauma Emerg Surg · Aug 2023
ReviewAdvancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage.
The European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects' objectives, the NIGHTINGALE consortium used a Translational Science (TS) process. The present work is the first TS stage (T1) aimed to extract data relevant for the subsequent modified Delphi study (T2) statements. ⋯ The three simultaneous scoping reviews allowed the extraction of relevant PH MCI subthemes and novel concepts that will enable the NIGHTINGALE consortium to create scientifically anchored statements in the T2 modified Delphi study.
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Eur J Trauma Emerg Surg · Aug 2023
Meta AnalysisNonoperative management with angioembolization for blunt abdominal solid organ trauma in hemodynamically unstable patients: a systematic review and meta-analysis.
The objective of the present study is to provide a comprehensive review of the literature on associated outcomes of angioembolization in blunt abdominal solid organ traumas. ⋯ For blunt abdominal solid organ trauma in hemodynamically unstable patients, this review shows that angioembolization exhibited a high clinical success rate, low mortality, and tolerable technique-related adverse events. Furthermore, the top possible indication for angioembolization in hemodynamically unstable patients is an individual who responds to rapid fluid resuscitation. However, high-quality and large-scale trials are needed to confirm these results and determine the selection criteria for appropriate patients in this setting.
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Eur J Trauma Emerg Surg · Aug 2023
ReviewThe New Zealand National Trauma Registry: an essential tool for trauma quality improvement.
Trauma registries are essential tools for trauma systems and underpin any quality improvement activities. This paper describes the history, function, challenges, and future goals of the New Zealand National Trauma Registry (NZTR). ⋯ The NZTR has proven to be a critical component of trauma quality improvement in New Zealand. A user-friendly portal and a simple minimum dataset have been keys to successes but maintenance of an effective structure in a constrained healthcare system is a challenge.
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Eur J Trauma Emerg Surg · Aug 2023
Multicenter StudyChanges in injury patterns, injury severity and hospital mortality in motorized vehicle accidents: a retrospective, cross-sectional, multicenter study with 19,225 cases derived from the TraumaRegister DGU®.
In the last 20 years, the number of fatalities due to road traffic accidents (RTA) in Germany has steadily decreased from 7503 to 2724 per year. Due to legal regulations, educational measures and the continuous development of safety technology the number of severe traumatic injuries and injury patterns are most likely to change. The aim of the study was to analyse severely injured motorcyclists (MC) and car occupants (CO) that were involved in RTAs in the last 15 years and investigate the development and changes of injury patterns, injury severity and hospital mortality. ⋯ The severity of injuries and their incidence, especially head injuries, have decreased over the years and seem to contribute to a decreasing hospital mortality of polytraumatized MCs and COs injured in traffic accidents. Young drivers and an increasing number of seniors are the age groups at risk and require special attention and treatment.