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: 15 July 2024 | Viewed by 3104

Special Issue Editors


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Guest Editor
Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany
Interests: biodegradable materials; spine and pelvic trauma; polytrauma care; septic surgery

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
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Guest Editor
Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany
Interests: periprosthetic and implant infections; knee and ancle joint traumatology and reconstruction; gait analysis; spine trauma; pelvic trauma

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

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Keywords

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

Published Papers (2 papers)

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Research

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 1 | Viewed by 1907
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
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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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