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Updates in Emergency Trauma Management
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Updates in Emergency Trauma Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (15 July 2024) | Viewed by 5859

Special Issue Editors

Prof. Dr. Cristof Burger

E-Mail Website
Guest Editor
Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany
Interests: biodegradable materials; spine and pelvic trauma; polytrauma care; septic surgery
Prof. Dr. Frank Schildberg

E-Mail Website
Guest Editor
Department for Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
Interests: orthopedics and trauma surgery; musculoskeletal immunology; peri-implant infections; aseptic loosening; osteolysis; bone homeostasis; regeneration
Special Issues, Collections and Topics in MDPI journals
Dr. Sebastian Scheidt

E-Mail Website
Guest Editor
Department of Orthopedics and Trauma Surgery, University Hospital Bonn, 53127 Bonn, Germany
Interests: knee surgery; arthroplasty; periprosthetic infection; trauma surgery; cartilage repair; hip; knee
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Even though we are living in times of ever-increasing safety efforts, with individual traffic demonstrably causing fewer serious accidents due to continuously improved safety precautions, it is obvious that a functioning and constantly self-checking and improving trauma management in rescue services and hospitals is of great importance. Recent disasters, such as the floods in Germany, the earthquakes in Turkey and Syria, or the war in Ukraine, show us that we must not slacken our efforts to improve the management of casualties and critical patients.

We expect this Special Issue to provide interesting contributions and updates from our esteemed colleagues on clinical topics, such as algorithms for managing a mass casualty incident, treatment of polytraumatized children, coagulation management, and the impact of inflammatory acute reactions. Predictors of patient outcome are also an area of interest for discussion. Another focus lies in novel techniques that are currently being tested or have been proven successful in early and follow-up assessment of perfusion of injured tissues or extremities. We would also like to discuss the socio-economic impact of multiple injury or polytrauma patients on the health-care system, as well as their management and the provision of appropriate resources in the event of an emergency. In addition, fundamental research topics on coagulation management, biomarkers predicting infection, sepsis, or wound healing issues, as well as studies on the cellular and molecular mechanisms of trauma, improving our understanding of the underlying pathophysiology and therapeutic avenues, complete the overview that this Special Issue aims to provide.

We welcome all submissions and ask that the above topics be considered as suggestions only. In addition, all valuable studies on the topic of “Emergency Trauma Management” are welcome and will be considered in the review process.

Prof. Dr. Cristof Burger
Dr. Frank Schildberg
Dr. Sebastian Scheidt
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • trauma
  • algorithms
  • predictors
  • coagulation
  • novel techniques
  • patient outcome
  • biomarkers
  • infection
  • pathophysiology
 

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Published Papers (3 papers)

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Research

12 pages, 2406 KiB  
Article
Impact of Patient-Specific Hip Joint Geometry on the Morphology of Acetabular Fractures
by Amadeo Touet, Yannick Schmiedt, Jessica Köller, Christian Prangenberg, Davide Cucchi, Kristian Welle, Christoph Endler and Sebastian Scheidt
J. Clin. Med. 2024, 13(23), 7332; https://doi.org/10.3390/jcm13237332 - 2 Dec 2024
Viewed by 651
Abstract
Background: Acetabular fractures continue to pose a major challenge in clinical practice, not least because of the growing geriatric population. While the influence of the force vectors on fracture formation is well established, the impact of anatomical factors on fracture morphology remains [...] Read more.
Background: Acetabular fractures continue to pose a major challenge in clinical practice, not least because of the growing geriatric population. While the influence of the force vectors on fracture formation is well established, the impact of anatomical factors on fracture morphology remains poorly understood. The aim of this study was to investigate patient-specific hip joint geometry, identify structural risk factors and correlate these with the resulting fracture patterns. Methods: This retrospective cohort analysis included 226 patients (Mdn age = 58 yrs.) with acetabular fracture categorized by Judet/Letournel and the AO/OTA classification. Computed tomography (CT) datasets of the injured and contralateral sides were analyzed using multiplanar reconstruction. Parameters included modified center-edge (CE) angle (Wiberg), rotation angles (Ullmann and Anda), acetabular sector angle (Anda), true caput-collum-diaphyseal (CCD) angle, femoral head diameter and volume, as well as femoral neck length, circumference, and diameter. In addition, intrarater reliability within a subcohort was assessed for the metric measurements and inter-rater analysis for the classification of the entire sample. Results: The primary analysis showed direct effects of femoral head diameter, femoral neck length and femoral head size on the fracture type according to AO/OTA (type A/B/C), whereby this effect was particularly seen between type A and type C fractures (p = 0.001). Ordinal regression identified femoral head diameter as the only significant predictor (p = 0.02), with a 25% increased likelihood of complex fractures per unit of change. Low-energy trauma doubled the risk of severe fractures. Specific findings include a higher acetabular anteversion in anterior column fractures. Age correlated positively with the cause of injury and fracture type. The inter-rater reliability for fracture classification was excellent, as was the intrarater reliability of the measurements. Conclusions: This study suggests that anatomical factors, particularly proximal femoral geometry, have an impact on acetabular fracture morphology—in addition to factors such as trauma type and patient demographics. Full article
(This article belongs to the Special Issue Updates in Emergency Trauma Management)
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11 pages, 1406 KiB  
Article
Hyperbilirubinemia as a Risk Factor for Mortality and Morbidity in Trauma Patients
by Mina Lee, Myungjin Jang, Jayun Jo, Byungchul Yu, Giljae Lee, Jungnam Lee, Seunghwan Lee, Yangbin Jeon and Kangkook Choi
J. Clin. Med. 2023, 12(13), 4203; https://doi.org/10.3390/jcm12134203 - 21 Jun 2023
Cited by 4 | Viewed by 3171
Abstract
Hyperbilirubinemia is frequently reported in trauma patients. However, few studies have investigated the effects of hyperbilirubinemia on patients’ clinical trajectories. This study aimed to evaluate the relationship between hyperbilirubinemia and patient outcomes following trauma. Our study included 387 patients who were admitted to [...] Read more.
Hyperbilirubinemia is frequently reported in trauma patients. However, few studies have investigated the effects of hyperbilirubinemia on patients’ clinical trajectories. This study aimed to evaluate the relationship between hyperbilirubinemia and patient outcomes following trauma. Our study included 387 patients who were admitted to the trauma bay with severe trauma between January 2017 and December 2021. We categorized patients into two groups based on their peak bilirubin levels: the low-bilirubin (LB) group, with levels below 3 mg/dL, and the high-bilirubin (HB) group, with levels above 3 mg/dL. We then compared the rates of complications and mortality between these two groups. The incidence of pneumonia (10.8% vs. 32.3%, p < 0.001), acute kidney injury (AKI) (2.8% vs. 19.2%, p < 0.001), sepsis (2.8% vs. 10.1%, p = 0.003), and wound infections (8.3% vs. 30.3%, p < 0.001) was significantly higher in the HB group. Additionally, the mortality rate was significantly higher (4.2% vs. 10.1%, p = 0.028) in the HB group. Multivariate analysis revealed that the higher the bilirubin level, the greater the risk of complications (pneumonia: odds ratio [OR] = 3.238; 95% confidence interval [CI] = 1.68–6.22; p < 0.001, AKI: OR = 4.718; 95% CI = 1.65–13.44; p = 0.004, sepsis: OR = 3.087; 95% CI = 1.00–9.52; p = 0.04, wound infection: OR = 3.995; 95% CI = 2.073–7.700; p < 0.001). In conclusion, hyperbilirubinemia was associated with poorer outcomes in trauma patients. Full article
(This article belongs to the Special Issue Updates in Emergency Trauma Management)
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10 pages, 230 KiB  
Article
Do Patients with Diabetes Mellitus and Polytrauma Continue to Have Worse Outcomes?
by James Tebby, Vasileios P. Giannoudis, Sophia M. Wakefield, Fiona Lecky, Omar Bouamra and Peter V. Giannoudis
J. Clin. Med. 2023, 12(10), 3423; https://doi.org/10.3390/jcm12103423 - 12 May 2023
Viewed by 1398
Abstract
The management of patients with multiple injuries remains challenging. Patients presenting with comorbidities, such as diabetes mellitus, may have additional unpredictable outcomes with increased mortality. Therefore, we aim to investigate the impact of major trauma centres in the UK on the outcomes of [...] Read more.
The management of patients with multiple injuries remains challenging. Patients presenting with comorbidities, such as diabetes mellitus, may have additional unpredictable outcomes with increased mortality. Therefore, we aim to investigate the impact of major trauma centres in the UK on the outcomes of polytrauma patients with diabetes. The Trauma Audit and Research Network was used to identify polytrauma patients presenting to centres in England and Wales between 2012 and 2019. In total, 32,345 patients were thereby included and divided into three groups: 2271 with diabetes, 16,319 with comorbidities other than diabetes and 13,755 who had no comorbidities. Despite an overall increase in diabetic prevalence compared to previously published data, mortality was reduced in all groups, but diabetic patient mortality remained higher than in the other groups. Interestingly, increasing Injury Severity Score (ISS) and age were associated with increasing mortality, whereas the presence of diabetes, even when taking into consideration age, ISS and Glasgow Coma Score, led to an increase in the prediction of mortality with an odds ratio of 1.36 (p < 0.0001). The prevalence of diabetes mellitus in polytrauma patients has increased, and diabetes remains an independent risk factor for mortality following polytrauma. Full article
(This article belongs to the Special Issue Updates in Emergency Trauma Management)
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