Trauma Surgery

Delays, transfers, and rural residence increase early orthopaedic trauma mortality in Tanzania

Prospective cohort of 7,121 orthopaedic trauma patients in five Tanzanian hospitals found 14‑day mortality 10.8%, higher for open fractures (16.4%). Interfacility transfer (aOR 1.99), rural residence (aOR 1.80) and longer prehospital delay independently predicted higher mortality. Timely surgery was associated with lower mortality (aOR 0.87). Among surgical patients, 22.2% had complications; functional recovery at discharge occurred in 72.8% of survivors. 1

State designation concordance with ACS‑COT varies and links to for‑profit trauma center expansion

Cross‑sectional analysis of 464 newly designated US trauma centers (2013–2022) found state concordance with ACS‑COT standards ranged 31.1%–100%. Lower concordance correlated with greater expansion of for‑profit trauma centers (rs = -0.39; P = .004) but not nonprofit expansion. Most new centers (81.9%) were Level III–IV, where concordance tended to be lower. 2

PROTECT: large multicenter geriatric perioperative cohort for risk modeling

Ambispective perioperative cohort enrolled 61,289 inpatients aged ≥65 across three tertiary centers with high follow‑up (96.5% at 48h). Median age was 71; 52.2% ASA III or higher; 30‑day mortality was 0.7%. PROTECT includes standardized preop, intraop, and postoperative assessments and has produced prediction models for major postoperative complications. 3