European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Feb 2025
Meta AnalysisEffectiveness of antibiotic prophylaxis in polytrauma patients: a systematic review and meta-analysis.
The use of antibiotic prophylaxis in trauma patients, particularly to prevent ventilator-associated pneumonia (VAP), is debated due to rising antibiotic resistance. Therefore, this systematic review evaluated the safety and effectiveness of antibiotic prophylaxis compared to placebo or standard care on clinical outcomes in adult polytrauma patients. ⋯ The results indicate that antibiotic prophylaxis has no significant effect on mortality and clinical status compared with placebo or standard care in adult polytrauma patients but may reduce the risk of VAP. However, the evidence is outdated and of very low certainty, with insufficient data to draw definitive conclusions regarding efficacy. Therefore, high-quality, up-to-date research is urgently needed to support clinical decision-making, and current interpretations should be treated with caution.
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Eur J Trauma Emerg Surg · Jan 2025
Review Meta AnalysisAccuracy of GFAP and UCH-L1 in predicting brain abnormalities on CT scans after mild traumatic brain injury: a systematic review and meta-analysis.
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In recent years, blood biomarkers including glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have shown a promising ability to detect head CT abnormalities following TBI. This review aims to combine the existing research on GFAP and UCH-L1 biomarkers and examine how well they can predict abnormal CT results after mild TBI. ⋯ Present results suggest that GFAP and UCH-L1 have the clinical potential for screening mild TBI patients for intracranial abnormalities on head CT scans.
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Eur J Trauma Emerg Surg · Jan 2025
Meta AnalysisLactate-enhanced-qSOFA (LqSOFA) score as a predictor of in-hospital mortality in patients with sepsis: systematic review and meta-analysis.
Sepsis is a systemic process that refers to a deregulated immune response of the host against an infectious agent, involving multiple organ dysfunction. It is rapidly progressive and has a dismal prognosis, with high mortality rates. For this reason, it is necessary to have a tool for early recognition of these patients, with the aim of treating them appropriately in a timely manner. ⋯ The LqSOFA score demonstrates a good predictive capacity for in-hospital mortality in septic patients, showing clinically significant levels of sensitivity (69%) and specificity (79%).
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Eur J Trauma Emerg Surg · Jan 2025
Review Meta AnalysisSurgical intervention in traumatic brain injury: a systematic review and meta-analysis of decompressive craniotomy.
Traumatic brain injury (TBI) is considered a major cause of death globally, resulting from trauma. Decompressive craniectomy (DC) may improve functional outcomes in patients with TBI and its associated complications. This study was designed to determine safety and efficacy of DC in improving clinical outcomes in TBI patients compared to standard therapy. ⋯ This study presents evidence suggesting that DC is linked to a lower mortality rate, decreased ICP, and shorter hospital stays among patients with moderate to severe TBI. However, it did not show a significant impact on improving favorable clinical outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Meta AnalysisOptimal timing of stabilization and operative technique for extremity fractures in polytrauma patients: a systematic review and meta-analysis.
In polytrauma patients, injuries involving the extremities are frequently seen. Treatment concepts vary from early definitive care to temporary fixation and delayed definite stabilization. This analysis therefor aims to illuminate the impact of timing for operative stabilization of extremity fractures on outcome factors in adult polytrauma patients. ⋯ The results indicate that immediate surgical treatment by nailing is superior to delayed treatment or a staged surgical approach in stable polytrauma patients with long-bone fractures. As there is a lack of clear evidence regarding the optimal timing for definitive operative stabilization of extremity fractures in polytrauma patients, further high-quality studies are essential to enhance the certainty of evidence and provide more conclusive treatment algorithms.